Sheryl

There are one or two. And more to the point there are a number of good orthos specializing in foot and ankle.

Nothing will really correct the bunion but surgery.

I entered province but ampur still did not show. Finally I had to find it in Thai script for Muang, entering that got the menu to show.

I think it is capsulitis, usually caused by abnormal foot mechanics which could be secondary to the bunion. See https://www.foothealthfacts.org/conditions/capsulitis-of-the-second-toe

I am stumped trying to do this. Found the fields in profile but can't get the search options to show for ampur and typing in first few letters doesn't yield anything....(I'm in the Ampur muang)

Glad to hear it and yes, Siriraj is excellent.

Bone spurs can if necessary be removed through arthroscopic surgery. However with significant osteoarthritis just removing bone spurs will seldom make a lasting difference (among other things new spurs will form as a redult of the underlying erosion of cartilege) and more definitive treatment such as knee replacement may make more sense. Every case is different so this is something to discuss in detail with your orthopedic surgeon.

"Routine cleanse just in case" is not recommended for liver fluke unless one both lives in a highly endemic area and consumes raw fish....which not many expats do. Praziquantal is the preferred treatment for liver fluke. Albendazole is a possible alternative but requires a prolonged course of treatment.

Nothing t all wrong with mRNA vaccines, it;'s an excellent technology. Which contrary to what some believe does not alter one's genetics/ DNA in any way. However the Qdenga vaccine is not mRNA. It is live attenuated vaccine.

Note that this is not pharmaceutical grade.

Also: Japanese B encephalitis. For which there is an effective vaccine.

I think most major hospitals would be able to do this.

Dengue is a virus and completely unrelated to malaria, which is not a viral disease but rather caused by a parasite. While both are spread by (different species) mosquitos these 2 diseases are totally unrelated.

Pocitrin taklets here contain 231.5 mg potassium citrate. Available at pharmacies These are compressed tablets not a powder Lazada has what appear to be caspules 99 mg https://www.lazada.co.th/tag/potassium-citrate-now/?exlaz=d_1:mm_150050845_51350204_2010350204::13:12361258253!116250847885!!!dsa-19959388920!c!!!!593083946049!&gclid=CjwKCAjw3oqoBhAjEiwA_UaLtlCyVsH0qVpTwSoNG8SH8z-YWtslQ91vir_W4fpyNo_9S6Boo87AaRoCOgkQAvD_BwE I see some powders on Shoppee but from China and I am not sure can be considered pharmaceutical grade. But if what you already have is liquid, can you not just further dilute it?

Then you will need to avoid a number of foods, including bamboo shoots, spinach, almonds, lima beans, soy etc Small amounts of cyanide naturally occur in quite a number of foods and are harmless. As are the trace amounts of cyanide released from metabolism of synthetic B12.

What new booster / new strain do you mean? The Omicron one that came out about a year ago is available here. The one just approved by the US FDA this month is not yet available anywhere much less in Thailand.

Bear in mind that peptides are, in effect, just protein (more specifically, protein fragments ) There are a number of high priced clinics in Thailand offering untested/unproven "peptide" treatments and no real quality control or regulation of it. Personally I would just suggest s diet high in protein, or a protein supplement along with of course continued exercise.

Actually with GERD the problem is not excessive stomach acid. It is weakness of the lower esophagal sphincter. This in turn can be due to aging, obesity, eating too much at once (even if not obese), caffeine intake, smoking, alcohol, hiatal hernia . Anything that increases pressure against the valve will worsen it - such as overeating and also lying down after eating. PPIs like omeprazole reduce acid production. This does not stop the reflux at all, it just renders the contents less acidic so the reflux is less painful . Short-term PPI use is unavoidable in conditions like gastric ulcer and gastritis, where it is necessary to lower gastric pH to allow the mucosa to heal. For GERD it does nothing to correct the problem (though it will usually decrease the burning sensation) and long term use does carry some costs health-wise. Thus it is preferrable to try to address the causes of the reflux as the primary approach, with occasional antacid use if necessary (gaviscon, sodium bicarb etc). The following measures are recommended and will usually suffice if followed: lose weight if at all overweight (this alone will cure it in many cases) smaller amounts at a time- avoid overfilling stomach. take nothing more than sips of water for at least 2 hours before lying down avoid or minimize caffeine (coffeee, tea, chocolate) stop smoking minimize alcohol elevate head of bed or use special GERD pillow Sometimes if there is a severe hiatal hernia underlying the reflux surgery is required but this is rare. Some people recommend d-limonene as a supplement, it acts by supporting peristalsis (movement of foods through the GI tract). Hard to find in Thailand but iHerb has it. I haven't tried it personally.

https://www.bangkokinternationalhospital.com/doctors/dr-kiratikorn-vongvaivanich Also Prof. Nijasri SUmanwela at Chulalongkorn Hospital, can try through their after hours clinic

Unfortunately I know cases where serious injuries needing highly specialized care were brought to Pattaya City Hospital despite it lacking the necessary capacities. By the way Pattaya City costs these days aren't much less than BPH.

Tourist visa will give you 60 days on arrival and you can extend it for another 30 incountry.

This is a somewhat different issue than the use of "network" hospitals (which as explained applies only to USA. Many insurers have such arrangements in US.) April and pretty much every other insurer requires pre-authorization for hospitalization except in emergency when authorization should be sought as soon as possible after admission. Private hospital third party payment offices take care of arranging this. It is a process wherein the hospital submits anticipated treatment costs, sometimes there is back-and-forth negotiation on it, and it ends with the insurer giving the hospital something called a "Guarantee of Payment" (GOP) which promises to reimburse the hospital directly up to the approved amount. Hospital can go back to them at any time for additional GOP if additional unforseen treatments/costs become necessary. Again not unique to April, most insurers do this. What is perhaps less common is that April will potentially reimburse 80% of costs after the fact if pre-authorization was not otained either prior to admission or (if emergency) as soon afterwards as feasible. Some insurers will refuse to pay anything in that case. One exception worth noting in April policies is if total costs do not exceed US $2,000. In that case pre-authorization is not mandatory and you can pay up front and be reimbursed. You aren't likely to have an inpatient hospitalization costing that little (except at a government hospital for something fairly routine). But things categorized as day surgeries often do. I twice opted to go this route for epidural spine injections as I was in a lot of pain and wanted quick relief and was willing to pay first to get it. (In a non -emergency situation pre-authorization usually takes 5-10 working days). I was reimbursed in full but it did take a long time. A few other things to know about the pre-authorization process: - Although it is not required (or, obviously, possible) to get the authorization in advance in case of emergency admission many Thai private hospitals will not agree to expensive treatments (e.g. surgery) on direct billing basis without a GOP in hand and may therefore ask for a credit card deposit, refunding it once they get the insurer's GOP. The processing time for a GOP in an emergency admission is not limited to working days and is much faster than normal pre-authorization but may still take several hours to a full day. This happened to me after an accident in 2019. Hospital provided immediate emergency care and scans but then gave me a choice of either postponing surgery until the GOP came through or making an advance payment myself refundable upon receipt of the insurer GOP. I opted for the latter (my leg was torn wide open and while bleeding was by then controlled there was real risk of infection) and signed for something like US 10-15k on a credit card. By the time I was out of a 3 hour surgery and 1 hour recovery room stay the hospital had gotten the GOP from April so I never had to pay this (I forget if hospital just tore up the charge or credited the amount back but either way it worked). This was on a Sunday and I arrived at hospital 11 AM our time so around 5 AM in France. -- Thai hospital 3rd party payment staff vary in their competence and work ethic. Not unusual for them to try to make their work easier by asking you to pay something that the insurer had issues with or even just asked for a more detailed breakdown of. It is usually best to refuse and tell them you aren't paying, they need to work it out with the insurer. They almost always can, just by showing the cost breakdowns in more detail or differently broken out/described. Common situations where this arises is when there is a "package price" or regarding room rates. Some April policies limit reimbursement for private rooms but that refers solely to room charge not room + meals + nursing charge so simply breaking things out better and making sure the room charge is within their limit will usually solve it. And hospital can easily do this but as mentioned sometimes staff are lazy and will first try to hit you up for the cost. Happened to me on a back surgery in 2021. Hospital had a "package price" for it and whatever the hospital originally submitted put the room rate above the insurer maxium. They called me asking if I would pay it myself, I basically said no, you need to work this out with the insurer. Within a few days the problem had magically disappeared and hospital got a GOP for the full package price. Obviously just needed to resubmit the paperwork with more detailed breakown that was consistent with insurer limits on rate for room alone. I have even heard of some hospital staff trying to get out of doing their jobs altogether by persuading the patient to just pay and get reimbursed later (shifting all problems to the patient....and good luck getting the kind of paperwork details needed after the fact once the hospital has already been paid). Hasn't happened to me but I've had reports from others especially where smaller private hospitals were involved. If you encounter this stand firm. Tell them you will not pay, insurer will pay directly and they need to get GOP from the insurer or else you'll go elsewhere.

Glad it worked out and thanks for the feedback on this doctor. Spontaneous flare ups and remissions are common with lupus. Anyway wait to see what the tests show.

Amlodopine would not account for the belly. In a minority of people it causes some water retention (edema) in the ankles and legs. Not true weight gain. Majority of people do not experience this side effect but some do. BP medications have to be taken daily. Taking every other or 3rd day will not work. There are plenty of alternative BP drugs if amlodopine does not suit you. Consult your doctor.

Absolutely correct. Actually so could (comparatively) younger men. TRT should not be started without first ruling out prostate cancer. One of several reasons why it shuld not be self-initiated