Sheryl

A systolic that is usually at 150 or so, is too high. As for the low diastolic, several possibilities for that, the simplest being an issue with the machine used, but could also be indicative of an underlying cardiac problem. Yu should consult a good cardiologist.

Yes, 4mg twice a day would be the equivalent to 8mg once a day. I am nto sure if Urorec is extended release, but its dose is once a day whereas the 4mg preparations dosage is one twice a day. I can't think of any reason why the switch would cause the itchy skin you mention, unless you are allergic to one of the inactive ingredients. More likely the itchy skin has another cause altogether.

bickering posts have been removed

Urorec is silodosin. Brands here are: Urief Sidory 4

I would suggest a second opinion with a different uroligist. In particular, wonder about the possibility of infection (prostatitis) as your symptoms are worse than would normally be seen from benign enlargement at your age. Where in Thailand are you located?

Thailand does not manufacture it. It is an import.

Plenty of people lose weight with 3 or 7 mg dose of rybelsus. . Includng me.

Could be either what is called senile purpura, or mild venous insufficiency. Senile purpura is common in older people, due to increased fragility of blood vessels under the skin. No treatment. https://dermnetnz.org/topics/senile-purpura In venous insufficiency, blood return to the heart is impaired due to weak valves in the veins (sometimes worsened by obesity) and in addition to the discoloration there would usually be symptoms such as swelling of the legs especially after standing for some time, and leg discomfort - full or heavy feeling, maybe aching, maybe burning, tingling etc. https://my.clevelandclinic.org/health/diseases/16872-chronic-venous-insufficiency-cvi In more advanced stages there will be obvious distension of the veins in the leg and leg ulcers may develop. Venous insufficiency warrants treatment, senile purpura does not. Suggest you consult a doctor to be sure especially if you find your legs swell towards the end of the day or after standing for some time.

Yes. Also used for blood sugar control in diabetes.

There is. Made in Laos. I have no idea how reliable in terms of quality control. Seems to be available only in quite high dosage (14mg). Normal starting dose is only 3 mg and many people find that dose is as much as they every need, though experiences do vary. Should certainly not start at 14 mg. And I am not sure it is safe to cut the tablets.

Those packages are useful as an indication of what Holter monitor screening might cost (much of the packages, she would probably not need). Looks like under 10K. My advice is not to waste time with such packages, see doctor first to see exactly what sort of testing is recommended. You can't contact Chula in advance, have to go in person, it is a government hospital (hence the "less convenient" aspect). But it will certainly cost less, though multiple trips may be required what could be done in one at a private hospital

you need a cardiologist specializing in arrythmia management/electrophysiology. Prof. Koonlawee Nademanee is (and tops in the filed), Dr. Visuit is not (though otherwise excellent). If you see Prof. Koonlawee at Bumrungrad the consultation will be a few thousand baht, but any tests will be additonal. The full EKG done at Sukhumvit hospital will be OK as far as that goes, but they will likely also want at least a rhythm strip (like an EKG but longer in duration) or possible a 24 hour+ monitoring which can be done as outpatient using a portable device, this is to get a full picture of the heart's electrical activity and rhythms. I don't know the cost of this. In addition, they might or might not advise other tests to try to identify cause of the PVCs. If any tests have already been done, be sure to bring the results them along. In terms of cost, the most affordable option (but not the most convenient) would be to go to the specialty center at Chulalongkorn Hospital Cardiac Center http://www.chulacardiaccenter.org/en/about-us Cardiology, Physiology and Cardiac Laboratory Monday – Friday, 08.00 – 16.00 hrs. Bhumisirimangalanusorn Building, 4th Floor, Zone D Try if possible to see Dr. Nithi Tokavanich there. She should avoid tobacco, caffeine and alcohol (or at least minimize the last two). Also, absolutely no diet drinks/teas/pills. In fact if she has been taking such, might try stopping them first before doing anything else as they alone can cause this (and even more seriosu arryhtmias).

Having been treated for a month and a half already in Thailand, unlikely he needed any of that to fly home. Had he, that alone would have run to 20-30K,

Suggest https://www.medparkhospital.com/en-US/doctors/dr-sudumpai-jarukitsopa

Moved to the Health Forum. There are rheumatologists at all large hosiptals though of course skill vares. Are you willing/able to come ot Banglok?

She does not work anywhere else. She is semi-retired. And definitely the best option in Pattaya if the issue is skin cancer. If it is something else, then there are other options.

No. No forms of generic semaglutide here. The drug is still under patent. Can get rybelus for a bit under 10k here, ditto Wegovy/Ozempic: https://www.medconsultasia.com/contact/ The cost of 1mg Wegovy/OZempic is same as lower doses. Some people save money by buying higher dose and using "click method" to prorate it so that pen lasts longer. Important of course to calculate correctly. Dosage charts can be found online. In addition to cost, this drug is not without side effects including some potentially serious adverse reactions. Rare, but deaths have resulted. Research this carefully. Also, once desired weight is reached, can be difficult to maintain it after stopping the drug. Very slow tapering may help but will also need to make permanent dietary and lifestyle changes.

Have you been tested for sleep apnea?

Colonoscopies and PSA tests are not "limited to age 75". Different countries have different public health recommendations but in no place that I know of, are these tested prohibited past age 75. in the US, Medicare will pay for colonoscopy at any age. That said, the risks of colonoscopy rise after age 75 and that needs to be factored into the decision making process (talking now about colonoscopy purely for screening purposes in asymptomatic people) as does whether or not the patient would be a candidate for surgery if say cancer was detected.

This powder is for reconstituting with sterile water for injection. In Thailand, only pre-formulated injection is available (Ozempic or Wegovy). An oral preparation, Rybelsus, is also available.

Yes

Yes of course it is available, also CT. Important to be under thr care of a good colorectsl specialist for all tests. Where in Thailand are you located? And who performed the colonoscopy?

As above. MRIs in asymptomatic people/on body parts not suspected of pathology causes more harm than good. Benign incidental findings lead to unnecessary further procedures, and these are not risk free.

Any insurer will exclude pre-existing conditions. Why would you switch from your current German insurance?

I think he meant to say renal system (kidney). These drugs are indeed contraindicated in kidney disease and can cause kidney damage if taken regularly especially in high dosage. They are however completely over the counter in Thailand, and readily and legally bought without prescription contrary to what another poster wrote.