Sheryl

P.S. while using s PPI will help reduce gastric irritation ftom NSAIDs, other risks and side effects remain especially if use is prolonged and daily. These include liver and kidney toxicity, risk of bleeding (especilly if also on a blood thinner) etc. And regular/prolonged use of PPIs also carries usadvantages/risks.

Yes I know the actions. As I explained, naproxen n is an NSAID and esomeprazole is a PPI (proton pump inhibitor). Since NSAIDs can irritate the gastric lining it is common to take a PPI when on them. 2 different drugs and no need to pay extra/import to have both in 1 tablet. Just take the 2 types of drug separately. If you want to save money, can use omeprazole instead of esomeprazole. As for the NSAID, many choices: ibuprofen, diclofenac, naproxen etc.

Local guys, I would prefer an experienced contractor but none available out here. Will have to buy the washer. I'll try to get as long a hose as is affordable to minimize need to walk on tiles.

If you must use an enema make it a pre-made small one (Fleets or dimilar). High up enemas, soap suds etc not a good idea on a regular basis. Have you tried glycerine suppositories? Are you taking on opoid (would explain it).

Thanks. Unfortunately there is no secondary roof or membrane.

As long as not more yhsn 40 day supply no. And they aten't strict on that. But why on earth have it brought in when you can easily buy equivalent here? Just have to take 2 pills instead of one.

Thank you. Can you suggest settings for: 1- pressure setting 2- jet width And a brand of washer? My hope was that using pressure spray washer machine would remove need to walk on the tiles, is that not the case? Can't find any workers where I live with any exprrience doing this. I have a resident handyman who will do it with 1-2 helpers So need to instruct them pretty clearly. Thanks!

Vomovo brand is off market in Thailand. It is just a combination of two drugs: Naproxen (an NSAID) and esomeprazole (a PPI, same class as omeprazole). You can easily get those 2 things separately here without prescription. Sither those exact things, or any otger NSAID and PPI. All of these things -- and voltaren, paracetemol, even vitamins - are considered drugs here. But being considered a drug (pharmaceutical) does not exclude being sold over the counter. Most drugs are sold over the counter in Thailand. Voltaren (diclofenac) and Naproxen are similar in safety, no significant difference.

thanks. I am aware of the benefit of using chlorine. What I don't know is how to instruct the workers in use of the pressure washer so as to avoid cracking the tiles. (Distance? Are there settings? Etc)

IMG has a travel policy that covers US citizens visiting the US -- but they must be resident elsewhere. I believe it is called Patriot. Prior to becoming eligible for Medicare I got this each year. (Never had a claim tho).

Hi, I put a new roof on 10 years ago, white tiles (concrete I think). Now quite dirty with soot and blackish mold. Can people advise best way to clean these without damaging the tiles? It's a a very large 2 story house so pressure cleaning is probably the easiest approach but how to ensure not too much pressure? Thanks in advance

I doubt you will consider price reasonable anywhere in Thailand, but you can get it for less than this hospital quoted. Around 75k seems the current norm. See this thread https://aseannow.com/topic/1327841-dentist-for-an-implant/

The manufacturer states this cannot safely be done in the case of Ultraset. They do not say why. I think it prudent to adhere to manufacturer warning.

The OP is taking more than 100 mg a day. And he is addicted. He also has no known reason for needing a pain killer as such, and what he is experiencing now is not return of chronic pain but withdrawal symptoms. No one is "demonizing" tramadol. The OP however posted about an addiction problem. Which he definitely has. His situation and yours are different.

No reason at all to think about costly inpatient programs. Sounds like you have now decided to remain addicted. If in the future you ever decide to come out of the addiction I can refer to doctor specializing in this who can help with medications to control/lessen withdrawal symptoms. But you need to make that decision, and to summon up the determination to follow through.

Tramadol is a capsule. Ultracet is s tablet but cannot be split. So 1/2, 1/4 etc are not options. He has to work wuth dosages of 37.5 or 50 and number of doses per day.

The cause of his pain is withdrawal. He is addicted to tramadol.

You CANNOT safely do this. It is very dangerous and not at all the same as spliutting plain paracetemol. "Cutting, breaking, crushing, chewing or dissolving ULTRACET can lead to dangerous adverse events including death" https://www.mims.com/hongkong/drug/info/ultracet?type=full

Presumably if it is not serious, it could wait until after your trip anyway. The point of travel insurance is to assure immediate availability of emergency care.

How much are you assuming a simple doctor consultation is going to cost?

It opens fine for me.

The issue is not so much length of stay (assuming less than a year) as it is: do you have ready access to free or affordable health care in your home country, and would you be willing & able to fly back unexpectedly for care? If so then travel policy is fine. If not -- it isn't.

Indeed no liquid form available here, and indeed cannot cut or split ultracet tablets. Which does make it harder. He can go from 50mg doses to 37.5 easily enough butiotherwise can only alter dose schedule. The mood issues are why doctors who mange addiction sometimes prescribe SSRIs temporarily to people coming off tramadol. Among other things.

Exactly. In fact, it is always at the discretion of the company whether to pay for treatment in Thailand or just facilitate a return home. Obviously the urgency of the situation and fitness to fly play a part in that decision. But definitely, one must be prepared to have to return home for treatment/follow up treatment if using a travel policy. And nothing non-urgent will be covered. In addition, a travel policy may be invalidated if the company learns the person was in fact permanently resident in Thailand. And many require that the insured person have health cover in their home country.