Sheryl

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)

Please respect the OP's statement: "said friend is not seeking a cure or treatment - just a dignified death"

As I have previously posted, there are palliative care specialists in Thailand -- good ones -- who will provide adequate pain relief, either as outpatient or inpatient. And in Chiang Mai there is an excellent facility (McKean) which offers hospice type care very well. The problem is that such services are pretty much limited to Bangkok and Chiang Mai (though Khon Kaen University hospital has opened a palliative care center; I have not yet gotten feedback on it). Hospitals elsewhere will often prescribe pain killers (including opiates) for people with terminal cancer but are not as skilled at palliation as the palliative care specialists, and some will do so only as inpatient, a problem for those who want to die at home. Certainly palliative care is still a weak spot in the Thai medical system but it is not as bad as you describe.

Euthanasia/assisted suicide is not legal in Thailand. But this is not what OP is asking about. Nor is he asking for far-fetched cancer treatments. He is asking about palliative care, to reduce pain and suffering. Please keep posts on topic accordingly.

2 separate anti-diarrheals (not usually recommended in rotavirus) plus an antispasmaodic. Overmedication to say the least. And these could have been bought at a pharmacy at less cost. It is always best to not but medications at a hospital, unless one of the few drugs nto sold over the counter are required. Can declibne medications at the cashier and have them removed from the bill, then buy at an outside pharmacy.

if you are on anticoagulants make sure to mention this to the surgeon. Your prostate issue is not really a barrier but anticoagulation and history of DVT present some challenges. Now that the gallstones are symptomatic, the situation is a bit different. Unless the symptoms are quite mild and the stones are small in size , surgery is probably indicated Stone size is important and should be in the ultrasound report. The big danger is that larger stones can block the common bile duct creating a life-threatening situation.

What drugs were given? Any IVs?

"The primary mode of transmission is the fecal-oral route, usually through direct contact between people. Because the virus is stable in the environment, transmission also can occur through ingestion of contaminated water or food and contact with contaminated surfaces or objects." https://www.cdc.gov/rotavirus/clinical.html Unless they did a nucleic acid detection PCR assay or antigen-detection immunoassay (not imposisble but unlikely), the diagnosis is a guess based on exclusion of other causes and thus not certain. If it is rotavirus, it should not last much more than a week. So if it persists another opinion may be in order. Meanwhile, since I gather you are not hospitalized, stock up on oral rehydration packets, coconut water etc and be sure to stay hydrated