Sheryl

As your question is to do with TM30 I am moving this to the visa forum

https://www.yanhee.net/cosmetic-services/varicose-vein-treatment/

Moved to business/finance forum

Aftet completion of the h. Pylori treatment was she re-tested to ensure it was eradicated? As ot can be difficult to cure this. What fid the endoscopy show? Be dure yo bting CD of the endoscopy with you when she consults Dr. Parit. Has she tried an elimination diet? If not first thing to try would be eliminating all dairy. Lactose intolerance is common in Asians and can set in later in life in people who tolerated milk products previously.

A very high dose indeed (more on that later). As you are taking Gabapentin GPO which comes in no more than 300 mg strength, you are taking 12 tablets a day. So a little more than 3 1/2 boxes (box of 100) per month. I got boxes of 100 tabs of Gapentin GPO 300 mg last April for 450 baht per box at a large pharmacy in Bangkok. If coming to Bangkok is possible for you I will share location details. The online pharmacy site Medtide has it for 640 baht a box and will deliver to you. While much more than discount pharmacy in Bangkok this would still be a lot less than you currently pay. https://medtide.com/product/gabapentin-gpo-300-mg-100-capsules-box/ Note that you will need to register for an account (which is free) before you can get it to show specific medication prices. I suggest you also ask the online pharmacy Medisafe. You have to do so through Facebook messenger, search function on their website does not work. https://www.facebook.com/Medisafe.Pharmacy.Rama4/ Both Medtide and Medisafe are completely reliable services. Ask Medisafe for quotes for both Gabapentin 300mg and Gabapentin 600 mg as there are several locally made brands that come in 600 mg strength, which would be more convenient for you and possibly also cheaper. Aside from this I think you need a second opinion on management of your neuropathy. Addition of a second drug, such as venlafaxine or a tricylcic antidepressent, might help. See https://www.researchgate.net/publication/23659514_Gabapentin_and_Venlafaxine_for_the_Treatment_of_Painful_Diabetic_Neuropathy Other things that might help are: acupuncture use of TENS machine local application of capsacin ointment From Pechabun, the best place to go is Khn Kaen University Hospital (Srinagarind). They have a pain clinic.

It would nto be, what is amazing is that it worked at all. Clearly not your average Thai masseuse.

in a case like that call the government medical emergency number 1669. There is no financial liability for the person who calls. There are also numbers for ambulances linked to specific private hospitals but call those only if patient or family member is able to state they want/can afford this And yes, from your description, calling an ambulance would have been appropriate. If after ambulance arrived patient came to and refused hospitalization, and/or response team decided not necessary, that is not on you. If really nervous about it do not give your (real)name when you call Bystanders call ambulances all the time BTW sounds like he had grand mal seizures. Might have been an known, ongoing seizure disorder or something new. Immediately after such seizures people are in what is called a "post-ictal" state and cannot think clearly. They may also not remember what it was that happened to them.

Acupuncture is certainly not going to correct a varicosity. There are many ways to treat a varicose vein (sclerotherapy etc) other than surgery. And doctors will recommend and perform these where appropriate.

Government hospital fees are fixed and do nto vary regardless. In the kind of situation you describe, i.e. a quasi-private arrangement with a senior doctor on staff at a government hospital, the variation is that the doctor gets a private fee from the patient. What the hospital is paid for use of the OR, supplies, medications , room charge etc does not vary. (Of course there rae different room rates depending in ward bed vs private etc). And these costs are usually vastly less than at private hospitals. So the government hospital does not benefit by this arrangement and that would not be the motivation. Whether the surgeon gets the same fee, less fee or more fee than if he had operated at a private hospital, I cannot say. Also cannot say whether the surgeon might have to make some payments out of his fee to "grease the wheels" at the public hospital to get the patient scheduled in a timely manner, but it is possible since waiting lists at public hospitals can be long. Some public hospitals have formal arrangements that let their senior doctors operate privately after hours, some do not.

Could you share name and location of the masseuse? As this is far beyond the ability of most of them.

They work on a full range of legal issues.

"The hospital is basically holding him hostage, refusing to provide certain documents required by the insurance company to transfer him to a more capable hospital. " Very much an issue with the hospital. Any insurance company, Thai or international, will require medical documentation before paying a hospital or authorizing a transfer to another hospital. The hospital OP's friend is in (actually a first tier government hospital, not second tier) has refused to provide this documentation and refused (or failed) to respond to questions from the insurance company doctor. If nothing else a local lawyer might be able to get them to release the patient's records to the family and/or insurer.

Where in Thailand are you located?

What dosage are you on?

It is far from unusual for a patient to be unconscious and insurance co policy will have provision for that. To my understanding under US law when a patient cannot make their own decisions and there is no Health Care Power of Attorney the authority for medical decisions reverts to the next of kin. The problem here may be in obtaining documentation of the patient's condition i.e. that he is comatose. I gather the hospital has so far failed to respond to requests for information from the insurer. Please keep responses limited to the requested suggestions for legal help in Thailand. Pattaya based lawyer bring preferrable.

What brand did you get at pharmacy? And what pharmacy fid you ho yo? There are locally made generic equolivalents (e.g. Gabapentin GPO) which cost much less. You need a real Thai pharmacy that carries generics (i.e. not a Boots or Watsons etc). Where in Thailand are you?

Please suggest Pattaya based law firms if possible.

Yes same doctor. Will ccst about the same at either place. Consultation about 2000 baht. Biopsy if done under IV sedation is about 30-40k plus there are labs EKG etc beforehand. It would be less if done in office without IV sedation but pretty unpleasant.

My question also. The normal treatment is a combination of 2 anti-infectives plus a PPI for 10-14 days followed by a repeat test and re-treatment with different drugs if needed. Was this done? The various treatments you mention (turmeric, manuka honey etc) will not eradicate h. Pylori. In Bangkok thus GI doctor is excellent: https://www.bangkokhospital.com/en/doctor/asst-prof-dr-parit-mekaroonkamol

She should see Dr. PANON as above regarding the endometrial thickening. He will recommend a biopsy snd she should get it to rule out enfometrial cancer, which she is at risk of. She csn also discuss her PCOS nanagement with him but he might suggest a different Gyn for thst. If do, I would trust his recommenation.

An incisional hernia is possible after any open abdominal surgery but would be very, very unlikley with laparoscopic surgery. Apple cider vinegar does not dissolve gallstones. Diet changes can reduce painful attacks (i.e. low fat intake will reduce need for gallbladder to express bile) but not eliminate the stones he already has either.

Physicians at private hospitals set their own fees and there are many specialists at BPH who charge 1,500 - 2,000. An internist would be 700 - 1000 but not a specialist.

Good plan.

Laparoscopic procedures involve very, very small incision (band-aid sized) and much less pain, this is the advantage of them. Pain will be more with an open approach.

The Oral rehydration salts are critical. Keep taking and buy more - you can get at every 7-11. If you prefer, green coconut water is equally good. Unless the diarrhea is really, really profuse and intractable I would not take the Irribow or the Hidrasec . If it is really, really profuse then the Hidrasec. (and seek another opinion, because rotavirus should run its course within 8 days or less). Irribow is actually indicated only for diarrhea associated with irritable bowel syndrome, which there is no reason to suspect in your case. As for Metospasm, it is mainly used for abdominal distension due to gas and secondarily for abdominal cramps related to irritable bowel disease. You probably don't need it, unl;ess cramping is severe (in which case again - need another opinion)