Sheryl

By far the best spine specialost in Thailand is https://www.bnhhospital.com/search-doctor/entry/4093/ https://www.bnhhospital.com/doctorsstory-th/dr-wicharn-yingsakmongkol

Indeed I am not sure you can get a new, local, accident policy at your age...but AA Brokers would know best.

I assume you refer to Chula aftet hours clinic since thete is a vast diffrtence in cist between the publuc vhannek and any private hospital. While it is true that consultation costs aren't much less at Chula after hours clinic than at nonprofit hospitals like Bangkok Christian, St Louis etc, diagnostic procedures and treatments cost many times more. BNH is a high end for-profit private hodpital costing more than Bangkok Christian and the like.

The difference between fear and anxiety is fear has a clear object/cause while anxiety does not.

Better confirm this includes lens as sounds like govt hosp price

Would not make much sense. a better -- and cheaper -- approach would be to fit the standard lenses such that one eye is 20/20 and the other eye a bit nearsighted. ("Monovision"). Most people adjust well to this, I did same thing with Lasik surgery 25 years ago and worked well for me. But a small number of people just can't adjust so good idea to first do a trial first via contact lens in one eye.

A cataract operation involves complete removal of the lens and replacement with an artificial lens. There isn't any "scrap" that can be removed. The lens itself has hardened and become opaque. So must be removed.

The main consideration is the type of lens implanted. For standard lens, at govt hospital usually around 20k baht, give or take. For progressive lenses, maybe 40k the difference being entirely the lens cost. Main advantage to progressive lenses is that one may be able to avoid need gor reading glasses. On the other hand not everyone adjusts to them. Most people opt for standard lenses and use reading glasses as needed.

Mild bilateral perinephric fluid in kidney is a common finding and often benign.

Chula is once of the 2 top university hospitals in Thailand. Very safe, well equipped.

At any hospital, you have to consult doctors when they have office hours. As mentioned, should call to confirm those hours as sometimes website is out of date or a doctor will not be in for one reason or another. For both Thonburi and St Louis, you can call and ask to make appointment but, even if given one, the time is just an approximate and it still seems to be first come. SIPH on the other hand requires appointment. SIPH: there is often a sizable delay in getting an appointment (though I have at times succeeded in pleas for one sooner than offered). The biggest delay comes in then scheduling admission or a procedure, that can take weeks or more. About a year ago I accompanied a Cambodian friend with prostate issues there, multiparametric MRI was recommended and would have been a month wait for it, then again as much or more for biopsy if (as proved the case) it was indicated. The doctor himself suggested that Thonburiwould be quicker, and it was immediately arranged there. Which would not have been an option had that doctor not also had privileges at Thonburi. When you arrange admission, you can do it for whenever is convenient & doctor available, what I meant is you can make that arrangement right on the spot after the consultation and it will usually be possible to schedule quite soon if that is what you want, often even the very next day. In other words, usually no wait list for procedures per se. Yes 1-2 trips at the private hospitals but Chula may be more, or might need a longer stay at the first trip to get everything set up. You would likely have to come back a second time, during government working hours, to schedule the procedure and, as at SIPH, there may be a wait list. You might also have to make separate visits for preliminary blood work and (if they will use general anesthetoc) EKG etc. At a minimum they will likely want a blood count, blood sugar, coagulation profile and EKG unless you have these results available from within say past month). Whereas at a private hospital this will all be done at admission on the spot. Just in general things go more slowly and there is more red tape when using a government hospital, and that does include SIPH even though it is technically private. However I would expect total costs at Chula to be less than half that of the private hospitals...maybe even a third. SIPH, being technically private wing, will be only about 10% less than the mid-range (price wise) private hospitals mentioned. You can try to get cost estimates by phone but have a Thai speaker do it and make sure they can clearly name & spell the procedure. Emails may or may not be answered by Thonburi and St Louis, won't be by Chula for sure. SIPH actually does answer emails and even though you might opt to go elsewhere, their price would be useful to know as Thonburi is not likely to be a whole lot more. Note that cost estimates will be for the procedure and normal anesthetic (Usually IV sedation eg propofol), if it isd determined that due to your other conditions general anesthesia is required that would up the cost. You would be in safe hands with any of the doctors and facilities discussed. What is not safe would to delay if the MRCP confirms stones in the CBD and any are larger than 5 mm. As for donations, just pay it forward for someone else. :)

Title has been edited.

Any hospital able to do ERCP will have ICU facilities etc. and not need to trabnsfer you if there are complications. Yes, referring to Thonburi 1 hospital. Owing to its close proximity to Siriraj (almost walking distance) many of the Siriraj senior faculty have hours there. I haven't really found the other Thonburi branches to differ that much in price but they definitely differ in the seniority/experience of their doctors as the others are farther away from main teaching hospitals. Usually at Thonburi it is first come, first serve and if you show up at least an hour or two ahead of time you'll be seen. Whereas at SIPH it is harder. As long as Prof. Leelakusolvong is there, I think you'll be able to see him at Thonburi and then arrange admission etc all in one visit. Much harder at SIPH. Prof. Nonthalee is indeed very well qualified but as far as I know, only at SIPH. Thonburi Hospital is about as inexpensive as you are going to find short of going to a private hospital. As for "luxury", there is definitely none there but this is not as related to cost as one might think it to be. It is a common myth among expats that private hospitals are expensive because of fancy rooms and other frills. These are actually not major cost drivers. Costs at private hospitals have more to do with who is their clientele, and the fancier accommodations are just something added on as part of what the higher paying clientele expect...not the reason for the higher costs. Another alternative would be Saint Louis Hospital, this doctor https://saintlouis.or.th/doctor/assoc.prof.dr.pradermchai-kongkam/506ab8d3-1698-4c3b-aa2f-13974b161a7d This doctor is the head of Chulalonhkorn's Center of Excelelnce for Endoscopy Center. St Louis is nonprofit and also "no frills", nonetheless in my experience it often costs a bit more than Thonburi, probably due to location and drawing in better off foreigners. It may however be more convenient in terms of location for someone coming from Pattaya and that needs to be factored in. AI tools are not very accurate with regard to health care costs in Thailand. And in any event, cost differences among private hospitals are relatively small, much less than one would perhaps expect. The only big exceptions come into play when some offer special packages but ERCP is not common enough that there are likely to be any. To really save money you could have this done at Chula. While this is possible, it would entail more trips to Bangkok and longer waits...and coming from Pattaya these extra trips will entail costs that may offset the savings in hospital fees. If you want to try this, though, use the Chula "specialclinic". https://spcweb.kcmh.or.th/users/users/searchDoctor Open in Chrome for translation, select "Gastrointestinal/Kiver Disease parttime" from the menu and then one of these doctors Prof. Rungsun Rerknimitr Assoc. Prof. Wiriyaporn Ridtitid Asst. Prof. Parit Mekaroonkamol Spellings may vary a bit in Chrome trabslation. You have to call to make the appointment, and be ready for a long wait at consultation and need for additional visits just to get things scheduled

For the benefit of others, can you link where you buy these from? The lubricant is essential to avoid trauma/irritation which, aside from discomfort, is a risk factor for infection.

ERCP requires specialized equipment and a doctor experienced in its use. Any large private hospital will usually have this but only higher tier government hospitals. Actually every hospital you list is private though in the case of SIPH, it is a private branch of a government hospital. And for this reason, there is often a wait to get procedures scheduled. With CBD stones, a wait is unadvisable. You want to get this done ASAP, as if complete blockage occurs it becomes a medical emergency. As long as the hospital has the necessary equipment, choice of hospital is not so important, it is the choice of doctor that matters most. I suggest for this Prof.Somchai Leelakusolvong who is at both Thonburi and SIPH. Costs at Thonburi are usually almost same as SIPH, maybe just a tad more, and scheduling is faster. It is a solid, no-frills hospital popular with the Thai middle class. https://www.thonburihospital.com/en/doctorprofile/?page=1&department=288 https://www.siphhospital.com/en/medical-services/doctor-biography?id=100 Call ahead to Thonburi to make sure he will be there, schedule says Thursday & Saturday but their website is not always up to date.

Worth noting that AOC had a recent lawsuit against April -- not related to insurance benefits; AOC accused April of having poached one of their staff. They won their suit but something like htis can leave some residual resentment. Regarding NOW, my understanding is that they are headquartered in Hong Kong. If the policy is issued out of Hong Kong then I would have some concerns in terms of regulation environment and recourse, so ask specifically about that. You want a policy issued out of a Western country. I have had good experience with April paying my (unfortunately many) claims. Was also able to get prompt assist through AOC when there was a small hitch in one claim. But yes, AOC these days is a bit sour on April. If you have any health conditions now that you did nto have when you got your current policy, or have had recent claims, these can be a problem in changing insurers.

At that price, will have been open approach not laparoscopic. About 10-15k more for laparoscopic in govt hospitals where it is available.

Afraid not. I have only these directions to offer. It is the Huay Khwang BTS stop (which is indeed on Phahonyothin Rd). that it is near. Opposite the Big C. I don't think it will be much (if any) less expensive than the other 2 listed, thety are all about the same and all 3 stock inexpensive generics.

Sounds like she may be seeing a GP or dermatologist rather than attending an allergy center. Latter would be better choice. Most hospitals have one.

There are many types of EIA test for many different purposes/ In the case of suspected allergy, it can detect the presence of certain antibodies which can help confirm that the patient has an allergy, but not to what. (Total IGE testing) It can also be done involves exposing the blood sample to suspected allergens in the lab and then checking for formation of antibodies. It will help only if the person is allergic to the specific allergens applied and it is less sensitive for food intolerances than other types of allergy. This would normally be done only if skin prick testing was not possible, for example if the patient's skin condition precluded skin testing. It is more expensive and time consuming than skin prick tests. Bangkok Hospital Hua Hin can do it https://www.bangkokhospital.com/en/bangkok/center-clinic/internal-medicines/bangkok-allergy-and-asthma-center/allergy-test (RAST test is a brioad term that usually encompasses EIA tests) So can MedEx and may be less expensive https://medex.co.th/service/checkup-packages/ Though I think they'll send the specimen elsewhere for analysis. Cost will be around 5 - 9 k depending on what allergens are tested for Has the patient already had skin prick tests? As that would be more usual fiorst step. In the case of suspected food intolerance , an elimination diet can also often help and can be done at home by the patient, for free.

Thread title has been edited. Any hospital can do this but not all can go it laparoscopically which, especially given your age, would be better if possible. Least expensive options would be government hospitals such as Queen Sirikit Naval Hospital in Sattahip or the Red Cross hospital in Sri Racha. However I am not completely sure these can do laparoscopic surgery and finding out would require a visit (arrive very early morning) and there may be a wait list. The Burapha University Hospital in Ban Saeng is also a possibility and might be more likely to offer laparaoscopic surgery. Using a government facility will involve long waits, arriving early morning, several appointments to do what could be done in one at a private hospitl, and possibly a wait list for the surgery itself, but costs will be about 1/3 - 1/4 that of private hospitals. Otherwise, among private options, I would suggest either Pattaya Memorial Hospital https://www.pattayamemorial.com/ Phyathai Sri Racha https://www.phyathai-sriracha.com/?lang=en In both cases, make an advance appointment with a general surgeon. In the case of Phyathai there is a Westerner in their marketing office you can contact who can help select a doctor and make appointment etc - email or call Gavin Waddell <[email protected]> tel Tel: 0 3831 7333 At these private hospitals, I would estimate laparoscopic repair would be around 200 - 250k. Much less than BPH but still much more than public hospital. In terms of your travel plans, assuming no complications, the usual guidance is to wait 2-4 weeks before lengthy air travel.

Reverting to the issue of GB removal for gallstone disease (which is not the situation for the patient in question): One needs to distinguish between asymptomatic and asymptomatic stones. The latter are a common incidental finding from ultrasounds and other scans (and one of many reasons why routine abdominal ultrasounds are NOT recommended as part of routine physical checkups...but quite popular with private hospitals as they find all manner of things that then lead to further tests and treatments, many of them unnecessary). For people with symptomatic stones, generally surgery is advised but if the patient is a poor surgical risk, or symptoms are mild (i.e. pain is manageable, no high fever, no blockage of the common bile duct etc) , conservative measures can be tried if patient agrees. Note that CBD blockage is a serious condition that can lead to life threatening, complications and requires prompt treatment. Conservative measures would include diet, medications to help dissolve stones etc. For asymptomatic stones, the thinking has evolved in recent years. It needs to be understood that there are risks both ways i.e. failing to remove a stone, especially a large one, will lead to CBD blockage, pancreatitis, even death, in a small minority of people; and GB removal, while generally a safe and common surgery, will nonethless cause serious complications in a small minority of people. Looking at populations as a whole, the data overall supports not treating asymptomatic stones ("watchful waiting"). https://www.nice.org.uk/guidance/cg188/chapter/Recommendations#managing-gallbladder-stones https://www.worldgastroenterology.org/guidelines/asymptomatic-gallstone-disease/asymptomatic-gallstone-disease-english Nonethless, in certain specific individual cases, a surgeon might advise treatment for asymptomatic stones, for example if the patient lives or will be travelling somewhere far from medical facilities. Some surgeons may also advise this if the stone is large and the patient elderly or frail, on the rationale that there is more than average risk of CHD blockage and the patient is at elevated risk of death if such occurs. But in most cases, asymptomatic stones should be left as is.

As described above , prompt surgery is very definitely indicated. Cancer of the GB is quite serious and often carries poor prognosis. This situation is entirely different from that of patients with gallstones (see post to follow)

In this case it appears the patient has a mass (not a stone or sludge) within the GB. So the concern is cancer of the GB, which is more common in Thais than in Westerners. In this instance trying to avoid or delay surgery could be a serious, even life-threatening, mistake.

It is and that is what he needs. The bunion will keep getting worse without it. For the hammer toe , once bunion is corrected it can usually be managed with curling exercises, taping/splinting, sometimes a cortisone shot.