Sheryl

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.

The new rule applies only to funds brought into Thailand.

1. If you are asking should you have submitted a Thai tax return, the answer is no unless you were transferring in passive or active income in the same year it was earned or had income from Thai sources. 2. If you will be newly bringing in passive or earned income that is not exempt under the terms of a DTA between Thailand and your home country then to my reading yes, you'll be legally required to file. If you will bring in funds exempt under the terms of a DTA then I would say no, unless it becomes a requirement to show a tax return for visa extension purpoes (not currently the case). If bringing in savings it is less clear cut at this time.

2003 not 2023. And as the latest ruling makes no statement about overseas savings of foreign residents I can't see how it would be rescinded.

You cannot be subject to double taxation on pension or anything else if there is a tax treaty between your country and Thailand. The big problem is for people who ard non resident for tax purposes in their home countey and have income which is assessable under thd Thai Revenue code. We have actually heard from some who prefer to be subject to taxes in Thailand because rates are lower than in their home country. For others the opposite might apply in which case they might want to consider whether they can legally claim tax residency in their home country (assuming there is a DTA).

I believe you are correct. If you are a non-resident for tax purposes in the UK then terms of DTA will not apply and what you describe is clearly assessable income. Things you might do are: 1. Make a large enough transfer in before the end of the year to tide you over for a while you sort out next move. 2. If you have other funds that can either be classified as savings (on already taxed income) OR as already taxed in UK, bring those in and cease transferring in royalty income.

Yes. Any Omron band of hte type that wraps around the arm (as opposed to wrist device) is good.

Thank you for this. Absolutely correct. It all depends upon: 1) what is considered Assessable Income and 2) The terms of any applicable DTA. I have no idea if accurate but this site states that there was a Revenue Department ruling in 2003 stating that savings brought into the country by foreign residents are not assessable income https://sherrings.com/assessable-income-foreign-sources-thailand.html I have been unsuccessful in locating source if this statement. If anyone can, would be very helpful as the savings issue is a key one for many expats. Same site states that the RD 2003 tax ruling declared pension income brought in by foreigners to be Assessable. However in at least some cases that will be superseded by terms of DTA. For example the US DTA clearly exempts Social Security and Government pensions (but nto private pensions) from taxation in Thailand. For that matter the terms of the US DTA would class many, perhaps most, expats as residents of US only for tax purposes but that is an anomaly in that the US taxes its nationals based on nationality, not residence, with the result that 100% of US citizens re US residents for tax purposes while also, if in Thailand for more than 180 days, Thai residents for tax purposes, leading to provisions on determining residence under the Tx treaty to come into play. These are complex but largely hinge on where you have a "permanent resident available to you" which I would think means own a home, and also in which country your "personal and economic relations are closer". In countries where taxation is based on residence, leading an expat to be non-resident of their country for tax purposes, matters would be different.

Did the cardiologist do BP and pulse readings lying down then standing up? What was your BP when there? And what brand of home BP machine did you buy?

The heart rate <60 is undoubtedly due to the atenolol and a normal effect of it. As long as the rate is completely regular and above 40 (preferrably above 50) and no dizziness associated with it, this might not be cause for concenr. However in some cases, especially older patients, it can indicate an abnormality of electrical conduction in the heart ("hart block"). The EKG will have shown whether you have a normal but slow hear rhythm ("sinus bradycardia" -- a normal effect of atenolol and similar drugs) as opposed to heart block or other arrythmia. It sounds like you may have had an EKG ("loads of wires attached and a printout") but I have no way of knowing what it showed. The doctor however does, and he advised you to stop the atenolol, so do so and return for follow up as advised. If you want to understand more of what was going on ask the doctor at your next visit if the atenolol and caused heart block or other arryhtmia, and get a copy of the EKG or rhythm strip that was done on this last visit. Regarding the fluctuations in blood pressure, if in fact you had heart block this could cause episodes of low BP which will improve once the underlying arrythmia (abnormal electrical conduction in the heart) is corrected. Also, the doxazosin and losartan have a synergistic effect and you are taking them together sop there may be an initial drop in BP as a result. I am more concerned by the elevated readings you report which might indicate a need for adjustment to your BP meds (dose and/or timing). Losartan in doses under 100 mg has a shorter duration of action (well under 24 hours) than in doses of 100 so it might just be that the higher readings represent the losartan having worn off. It would be useful to know the correllation between different BP readings and timing of your meds. But of course IF you have heart block getting that sorted out is the first priority.

The solution is to call the main SS office in Nonrhaburi or hotline (1506). Preferrably while at local SS iffuce and have them talk to the staff there after you explain the isdmsue. What you are being told is incorrect but many local SS offices have no experience processing this for foreigners. You might also try showing the landlord's Tabian Ban plus your rental contract.

Suit yourself. But there is a risk of hyponatremia due to the dilutional effect of all that plain water. Urine color does not tell you anythting about electrolyte balance. And if this sort of volume is taken over a short time, water intoxication can even result, though that is fairly rare. Aside from electrolyte solutions there are many other drinks that contain electrolytes. Green coconut water is an excellent choice. Also lemon and orange juice (the fresh kind at markets to which they add a bit of sugar an salt -- you can further dilute as desired). Including at least a little of such things into the daily mix instead of all plain water would be wise.

You can also directly communicate with them through Messenger on their website. Immediate response.