Sheryl

Not available in Thailand period. No registered brand of it here. If/when it becomes available here it will certainly be controlled, drugs of this type all are here. Which in Thailand means getting it from a hospital pharmacy.

You are not allowed to import medicines without an FDA permit (which can usually not be obtained). Doesn't matter whether from online seller or your own doctor back home or whetever. The issue is the importation aspect not who/where you purchased from. Exception being when you bring meds with you when yourself entering the country. In that cas3 a permit beeded only if it is controlled substance.

@rumak Is the tingling/numbness in the leg on ssme side as your hip surgery?

Are you sure you can safely get an MRI? Presence of internal metal fragments could make that dangerous and would normally be a contraindication. CT would udually be preferred in such a case. ??

Obviously this is incorrect. Speak to the head office

Swimmer's ear plugs. I think you can get from Lazada or Shoppee but if not then Amazon

My lumbar injection was not edpecially painful. They numb the skin with lidicaine first and then the dolution they inject is a mixture of strroud and lidicaine. The one in the neck area was extremely painful as needle first went in, so much tgat fictor had to stop and inject ludicaine jnto fhe underlying tissue just to be able to oass fhe needle jnto fhe epudural soace. . After that it was bearabke. Momentary pain wgwn he dud one facet joint none on the other side. You are still a ling wqy from both epudural and hodpitalization/syrgerg as your last MRI wasn't bad abd has nor yet been repeated. Yoy can get MRI and an initial exam up in CM but if these suggest the pain is from the found I stringly advice coming to Bangkok for next steps.

My point was that you should see a cardioligist now, regarding the erratic/poorly controlled BP and heart rate issues you currently have.

Consult spinal specialist as above. If he feels not due to spine then next stop would be assessment by a vascular specialist to rule out peripheral vascular disease.

When the top number (systolic) is do high like this but bottom number (duastoluc) normal it is often an indication of some sort of trmporary stress...pain, anxiety etc. Be sure to tske readings while you are comfortable and at rest Also make sure the BP cuff is not too small for your arm as that will falsely elevate readings. Most machines sold in Thailand come with cuffams too small for average farang arm and it is often necessary to separately order n extr large (by Asian standarda) cuff. If you have only been seen by "diabetes speialist" I sugfest a consult with a cardiologist.

I do have advice but it means going to Bangkok. Get your xray and scans (actual films in disc not just radiology report) and consult Pof. Wicharn in Bangkok at BNH hospital spine center. When you say you have to rest after walking 50 meters -- is that due to back pain or other issue like shortness of breath?

Unhelpful posts have been removed. It is the Health Forum, not the Pub forum. Serious replies only please.

No idea at this time. With the last round of updated vaccines, they became available when other countries donated them to Thailand, Thai government did nto purchase. I expect it will be the same now. Likely at least a few months before anyplace donates since first priority will be supplying their own citizens at home.

Some info here https://aseannow.com/topic/995803-us-veteran-health-care-cover-info/ While one usually has to pay first and get reimbursed I believe there are one or two places in CM that will do direct billing to Tricare. It is not Tricare that disallows this but rather than most hospitals are not prepared to go through the paperwork. Price will not be affected by fact that you plan to submit to an insurer for subsequent reimbursement, hospitals/clinics could not care less. In direct billiing arrangements there may be some negotiation between provider and insurer but when you pay up front there is none. Big issue is to be sure you get the documentation you need to submit your claim.

If the MRI does not show an explanation then you'll need to look for other possible causes of the numbness/tingling. But start with the spine.

As I understand it, these were readings from home. He already takes his BP at home. He attends a government hospital, "bill padding" does not enter into it. Doctor has already advised him on dose reduction of the beta blocker.

You had not mentioned weakness/numbness. In that case it may be that the space where the nerve roor exits has further narrowed so a repeat MRI would be prudent.

She's in Bangkok. A Boots or Watsons won't have this. In Thailand these sell mainly cosmetics plus a very, very limited number of medications. Not where to look for health needs. You need a medical supply store or a large Thai pharmacy that also sells medical equipment. There are several on Ratchawethi Road opposite the hospitals near the Victory Monument BTS. You can also buy online from Lazada or Shoppee, both carry them. https://www.lazada.co.th/tag/compressor-nebulizer https://shopee.co.th/search?keyword=nebulizer&trackingId=searchhint-1695563149-abb39a32-5ae0-11ee-8e23-2ef6d661a5a5

Tight hamstrings will in themselves cause back ache. So will tightness in other muscles and tendons, and your lack of flexibilty suggests this is your problem. The way you describe your back issues sound much more like a problem due to issues with muscles than spine per se. I suggest you see a good physiotherapust to develop a personalized program of stretches and exercises.

There is a widespread problem of foreigners not knowing/not being told their options with regard to SS.

Sounds like you have reached the point where surgery may be indicated, provided you are a good surgical risk (i.e. not elevated risk from other underlying conditions). Surgical approaches have advanced a lot in recent years and now include less invasive approaches e.g. minimally invasive decompression without fusion. Every case is different and some people may still be better off with a fusion but for a lot of people a minimally invasive decompression surgery will work wonders. Recovery is fast as muscles etc are not cut tin the process.

No, I think he means the opposite, based on the idea propagated on some "alternate health" websites that reduced stomach acid weakens the LES. This is not exactly true as I will shortly explain, but also not at all true is the popular misconception that GERD is due to excessive acid in the stomach. GERD is due to backflow through the valve between the esophagus and stomach, the Lower Esophageal Sphincter (LES). This in turn can have several causes and often more than one of them is in play in the same individual. It is important to understand that this valve, while designed to prevent backflow of stomach contents under normal conditions (i.e. to stay closed except when swallowing), is also designed to open under certain conditions such as when you need to vomit or burp. Aside from that, the valve can weaken or open in response to any of the following: 1. Weakening of the valve itself - aging does this, so does caffeine (coffee, tea, chocolate), nicotine, alcohol, some medications and some hormones (especially progesterone in women) 2. Increased pressure in the stomach against the valve. When you vomit a series of things occur leading to opening of the valve (plus, the stomach contracts). When you burp, the valve also opens though without the contraction of stomach muscles. There are other scenarios though where pressure in the stomach increases enough to at least partially open the LES. These include: obesity pregnancy overfilling of the stomach with food or fluids (eating or drinking too much at one time) lying down soon after eating or drinking hiatal hernia build up of gas in the stomach and duodenum - which can in turn be related to specific foods The burning felt in GERD is from the acidic stomach contents coming into contact with the esophagus or even the larynx/pharynx, but the underlying problem is not that the stomach contents are acidic - they are supposed to be! The underlying problem is that they aren't staying confined to the stomach as they should. Antacids and drugs like PPIs etc simply reduce the burning sensation by lowering the acidity of the stomach juices. They do not stop the reflux itself. And they can have significant adverse effects especially if taken regularly long term. When one has gastritis (inflammation of the stomach lining) or gastric or duodenal ulcer, there is no choice about it, the acidity must be lowered to allow the mucosa to heal, but that can usually be accomplished in a month or two after which these drugs should be tapered off. (It is also very important to treat h. pylori infection if present). In the absence of ulcers and inflammation, for simple GERD, it is preferrable to avoid the use of PPIs if at all possible by instead focusing n the underlying cause(s). Now as to this idea that increasing stomach content acidity will help GERD, it is based on the idea that reduced stomach acidity will slow digestion and thus lead to a fuller stomach for longer after eating / increased pressure on the LES. In people taking PPIs gastric emptying is indeed significantly slowed (though not solely because of changes in pH). However in someone not on those medications, and not over-using antacids, idea that their GERD is due to "insufficient acid" is almost as faulty as the idea that it is due "too much acid". It is due to neither. This does not mean that diet has no effect on GERD. Foods that lead to increased gas formation in the digestive tract can increase pressure on the LES and indeed, episodes of reflux are often the result of expelling small amounts of gas which may otherwise be below the threshold of awareness. Some (but not all) carbohydrates can do this, so can some other foods, and it is highly individual. In addition, fat delays stomach emptying so ingestion of fatty foods, especially in the evening, can lead to the stomach still being full when you lie down. In terms of diet, people with GERD should avoid excessive fat intake, avoid or minimize chocolate/coffee/tea, avoid/minimize alcohol, and try to identify and then avoid what foods for them seem to be triggers.

Excellent video! Thanks for sharing.

For spine no, I cannot recommend anyone outside of Bangkok. And this is something that very much warrants having the best . Besides myself and various friends and board members, my sister also had 2 spinal surgeries (1 lumbar, 1 cervical) both successful here. Many years later she had an epIdural for pain that developed at a level of the lumbar spine above that of the prior surgery. It worked and so far -- it's been at least 5 years -- she hasn't needed further treatment. Not all back pain is due to the spine per se. In fact most probably is not. Muscle strain and spasm are common causes and can be cased by both overuse (sports, work outs etc) and excessive sitting....and by poor posture. The muscles responsible may not even be in the back; Issues with hip flexors and piriformis (a muscle deep in the buttocks) can both cause lower back pain. If I were you I would try stretches and exercises (maybe consult a physiotherapist initially to identify clearly which muscles need work) and massage. Also heating pad. If these work no need to look further. If they don't then you need to see not just an ortho but specifically one specializing in spine. The very best is Prof. Wicharn at the BNH hospital spine center. You'll need an Xray and MRI, can do these at an imaging center first to save money. Prof. Wicharn will know quickly whether or not the pain is due to the spine and likely to respond to an epidural or need surgery. Contrary to what some people expect, he does not recommend surgery to everyone and indeed will refuse people who want it if he thinks it is not indicated. Ditto other spine specialists I have dealt with here and in the West. It is not at all the case that surgeons always want to operate and surgery is not the only tool in their repertoire.

Have you had an MRI and has a spine specialist recommended this? It is not a simple "one size fits all" treatment for back pain. It will help only with pain from certain causes and the injection has to be targeted to the specific part of the spine responsible. Which in turn means an experienced spine specialist has reviewed an MRI and identified the likly source of the problem. I had it done. Twice actually -- once in lower spine once in cervical spine. The one in the lower spine worked for only a few weeks so I went on to have surgery (successful). Though I know people who have gotten relief for 6 months or more and do this regularly as an alternative to surgery. The one I had in the cervical spine on the other hand gave complete relief, over a year already (knock on wood!). That was not only an epidural but also a facet joint injection. I insisted on both to cover all bases as cause of the pain was a bit uncertain.