Sheryl

Little point to the "infection" test as you will also get the culture. The w hour "infection" test is just a dipstck for nitrates. No point in your Gf bring tested for UTI unless she has symptoms as no reason to think she has a UTI and unrelated to your problem. UTIs are not transmitted from person to person. Chlamydia antigen test for her might make some sense though as it is possible for chlamydia to be asymptomatic, it could be present for years and unlike UTI it is sdxuslly trsnsmisssble to other people. As for chlamydia testing for you: you are presumptively treating yourself for prostatitis caused by chlamydia. We do not in fact know that you even have prostatitis let alone that it is caused by chlamydia and indeed your history makes that less likely than the many other non-STD bacterial causes of prostatitis. Many of which do not respond to doxycycline. Indeed given the low suspicion for STD it is a bit odd that you have chosen to take this. SInce the doxycycline may be unnecessary, and there is chance you need a totally different antibiotic (or none at all) any information that would confirm chlamydial infection could be useful. Note that chlamydia does not always respond to doxy. Since treatment of chlamydial prostatitis can take a prolonged course of medication it would be good to have at least some indication that this is the problem. Just a suggestioni since you seem determined to self-test and self-treat. ...which is not the approach I recommend at all. If cost is the issue you could wait for the result of the urine culture first as if it is positive then the other tests can be skipped st least for now.

http://www.maximumclinic.com/

Monovision can also be achieved with Lasik. This is what I did and at almost 70 I still do not need reading glasses. If/when I get cataract surgery I will make sure to keep one eye nearsighted so as to maintain the monovision. To get monovision with Lasik it needs to be pre-planned and one eye done at a time and the vision stabilized in one eye first before doing the other. Note that not everyone adjusts well to monovision so good idea to have a trial run via glasses or contacts first. Good that you mentioned about cataracts later in life: it is important to know the vision parameters (including corneal power) before the Lasik surgery and provide that info to the doctor who removes the cataract. Also be sure to use a doctor experienced in cataract surgery on Lasik patients. So get the pre-Lasik vision info and save it for future reference.

Obviously what occurred with 2 people is not a valid sample. should also note that both Bidens were asymptomatic during these "rebounds". Would not have been known had they not been tested. Most people of course do not undergo daily COVID testing when asymptomatic. It is quite possible that brief, asymptomatic resurgence of COVID antigen after apparent recovery from COVID (regardless of how or if treated) is more common than realized since the only way to know would be to routinely rest everyone after recovery every day for at least a month and that is hardly worth the cost and effort. COVID rebound is not limited to people who took Paxlovid nor in any way "caused" by Paxlovid. And none of this had anything to do with Paxlovid's effectiveness in preventing serious illness, hospitalizations and death. Very unfortunate that Fox News feels the need to polticize this treatment.

In order of importance: 1. Culture and Sensitivity (urine) -- you only 2. Chlamydia antigen test - both of you but note it requires a vaginal swab from her, for you can be done either on urine sample or urethral swab, but urethral swab is more accurate. Note that this tests only for current infection and, in your case, the doxycline could cause false negative. But worth trying. 3. Chlamydia IgM (blood test) for both of you. Positive result indicates current or very recent infection but negative does not rule it out as sensitivity is low. An antibody panel that includes IgA, IgG as well as IgM would be better but is not on the list; you might ask though. This would give more info as it would also capture antibodies from old infection. With all these tests negative results do not rule out infection, especially since you are already taking antibiotic. But a positive result would be meaningful

Unlike prostatitis, which can be (but is not always) due to an STD, bladder infections usually are not. There is no point in bringing your Gf for a test. UTIs are different from STDs, usual causative organism is simple GI flora. You can try getting a urine culture yourself, but as mentioned having already started an antibiotic may make it hard to detect infection. Nothing lost by trying though. You can try getting on e

Nothing in that address the frequency of rebound. Rather it discussed the significance of rebound (little to none) and indications for its management (no need to to retreat). Incidence of rebound after Paxlovid is low. 1-2% in some studies, 3-5% in others. Nowhere has the CDC or anyone else said it is common or usual, far from it.

It does have benefit for people under age 65 who have other risk factors. The clinical trials were unable to show a benefit in people under 65 with no special risk factors because the outcome being measured (need for hospitalization) was already so infrequent even in the control group. This has all been known from the start. Relapse is rare.

https://www.pathlab.co.th/ Has a branch on Phattanakorn

As above. Different antibiotics are effective against different organisms. The preferred approach is to get a wound culture which will show exactly what organism is responsible and which antibiotics it's sensitive to. With mild superficial infections of the skin (as opposed to bone or deep tissue) doctors (especially Thai doctors!) will often initially guess at the organism based on appearance and location of the wound and history of how it occurred. You have not provided any of that info. Are you sure it is in fact an infection?

IF you have BPH you should not consider invasive tresatments until/unless conservative treatment (medications) are no longer sufficient. Finasteride in urinary dose should not be started without confirmation of benign prostate enlargement. AFAIK Urolift is not available in Thailand . Even Rezum is quite new and available in only a few places. But you are getting way, way ahead of yourself. Aside from prostatitis another possible cause of your symptoms is urinary tract (bladder/urethra) secondary to urine retention secondary to enlarged prostate. In fact given stated sexual history it may be more likely. Doxycycline will not be effective for that. And if UTI is the cause, failure to treat may lead to serious kidney infection, even sepsis. As mentioned before you really should get a urine culture.

Do you also have jaw pain? As if not it is unlikely your tinnitus is due to TMJ. The following dental clinic has been recommended by others (tho not specifically for TMJ) and lists a doctor who supposedly specializes in TMJ https://www.thantakit.com/temporoma ndibular-joint-disorders-tmd/

Problems reading a book is usually due to age related lack of accommodation and certainly not to near-sightedness which is what lasik is for.

A private hospital will usually not treat you without some assurance you can pay. They might transfer you to a government hospital but that whole process will mean significant delay. Government hospital will provide initial emergency care but often not anything costly (surgery etc) until sure the patient can pay. Further problems at time of discharge if unable to pay balance in full. Quite common for hospitals to withhold patient's clothing and passport until paid in full and to prevent them from leaving the hospital until the bill is sorted (while charges for the stay continue to increase with each passing day). Legal action is also not unknown especially by private hospitals.

I was in my early 40s.

The best place in Thailand for this -- and the first to do it -- is the Thai Refractive Surgery Center (TSRC). I had both eyes done there more than 20 years ago with still excellent results. I did one eye at a time and left one undercorrected which has worked out well in avoiding need for reading glasses as I aged -- something to consider/ discuss with them https://www.trsclasik.com/en/lasik

There are some travel policies which will cover people with pre-existing conditions. Including sometimes "acute exacerbations" of same. Which is a more likely scenario than the fractured skull etc. You do have to pay if you need medical care. It will cost much less at a government hospital than a private one but it will still cost. And, if unconscious or too ill to talk, you may not be able to influence what hospital you are brought to. If you have neither insursnce nor enough credit to cover costs, donot come here. Especially given chronic heart failure. Even with insurance you obviously need to have the card with you. You need to work out a way to have essentials on your person ( passport or at least photocopy of it; credit cards, insurance card). Money belt worn under clothing etc.

.50 is the upper limit of normal so 0.52 isn't much of an elevation. I assume that what was recommended was a pulmonary CT with contrast. That is a standard recommendation when D-Dimer is elevated and is meant mainly to see if you have thromboembolic complucations. It will also give a clear picture of the condition of your lung tissue. If your oxygenation levels were at all reduced then I would say this is essential. If not and given the low level of increase it is a harder call. You really need to discuss this (and the other findings) with a good pulmonoligist. The quality of review of findings with check up packages are often poor/cursory at best. In addition the tests included may not be what you need. These things are often put together by hospital marketing departments and, especially the disease specific packages, do not always make the best medical sense. In addition the implicit self-diagnosis which determined what package to get can be wrong. As I have mentioned before your shortness of breath is as likely to be due to a cardiac issue as to a pulmonary one. Where in Thailand are you located?

You do not mention what type of inhaler. Inhakers contwing salbutamol have a mild stimulant effect. Steroid inhaler is unlikely to have this effect.

You do not want to have a biopsy or a TURP in Phuket. I am not even sure Vachira does either as it is only a provincial hospital not a regional facility. They might well refer to Surat Thani or elsewhere. THere is at this point no reason to think you need either but if that changes you should best come to Bangkok.

No reason to think at tis point that you need a prostate biopsy. Prostatitis is indeed a possibility. PSA is nto reliable in the presence of prostatitis. However a urine culture is desirable and it is unfortunate you already started abx as this may make it harder to identify the organism. in terms of urologists in Phuket, if you go through the public channel at Vachira you will have no choice of doctor and likely be treated by an intern or resident in training. If you go through their new "Special" clinic (after hours, semi-private channel, from 4pm on ward) it will cost about the same as a private hospital. Personally I would suggest https://www.phukethospital.com/doctor/manoowet-thirawirot/ at Bangkok Hospital. Might also be able to see him at the Vachira SMC but will cost almost the same and waits will be longer.

Absolutely. Had you kept up with regular lab tests? Might you have been given medications (e.g. antibiotics) that interact with warfarin?

I don't have any in formation on the urologists at Vachira but if you are even remotely near requiring a prostate biopsy (indications for which include at minimum findings on ultrasound suggestive of malignancy, and more preferrably on MP MRI) you should not do it in Phuket, you should come to Bangkok. who has recommended a prostate biopsy and for what reason?

It is owned by the hospital but is a semi-private arrangement where the hospital's senior doctors can work after hours. Not much cheaper than the private hispitals.

Is she on birth control pills? And if so what brand? Some will help acne, dome will worsen or even cause it. Where in Thailand does she live?