Sheryl

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Most common cause of prostatitis is E. Coli, which an STD panel would nto detect. Also, depending on the type of test done, there can be false negatives esp for chlamydia. So you still need to rule out prostatitis IMO. It is just not usual for mild BPH to cause the degree of urinary frequency you describe. Add to that the lack of relief from tamsulosin, and suspicion of an infection rises. This doctor is not too far from Samut Prakan and has been recommended by other board members https://www.sukumvithospital.com/doctorprofile.php?id=188&lang=en Ideally you want toi get a prostate massage to express prostatic fluid then a culture and sensitivity As for your BPH: iti s a progressive condition and it worsens with age, but how fast varies greatly. One of the 2 classes of medication used for it can help reduce prostate size/slow growth. These are the 5-alpha reductase inhibitors, such as finasteride and dutasteride. It takes 6-12 months to see the therapeutic effect of these drugs, and they do unfortunately sometimes worsen ED. When they do, sometimes this effect eases up with continued use and sometimes not. The other class of drugs used for BPH are alpha antagonists, such as tamsulosin and doxazosin. These do nto affect oprostate size but rather give symptomatic relief from blockage by relaxing the smooth muscles in the prostate and bladder neck. Unlike the first class of drugs, action is almost immediate. You already tried this class of drug without relief. Cialis is also sometimes used to relax the muscles around the bladder neck and prostate, likewise only symptomatic relief. And of course, for ED. Since the 5-alpha reducatse inhibitors do, over time, reduce the size of the prostate and slow progression of BPH, you could ask doctor about a daily regimen of Cialis plus finasteride or dutasteride as a way of potentially off-setting the negative effect of the latter on erectile function. May or may not work, and may or may nto be suitable i nthe context iof your overall medical history. Urolift is nto widely available here, just a few places and doubt any doctor would do it for mild case of BPH. Like all treatments, it has potential side effects. Some people feel that saw palmetto and/or milk thistle supplements help with BPH, others don't, and there is a lack of clear evidence either way. No harm in trying. But above all, I suggest you rule out potential infection as your urinary frequency is unusual from mild BPH.

Before going into the BPH issue, I have to wonder if you might have an undiasgnosed prostate infecton or urethitis. Needing to per every1-2 hours seems inconsistent with your degree of BPH. Might be worth getting a second opinion during which you specifically ask about cultures. Where are you located?

https://sriphat.med.cmu.ac.th/en/doctor/detail/43

Perfectly normal to get up once or twiceto pee. Some people are lighter sleepers than others so more easily awoken by bladder pressure. And of course fluid intske is a factor. Getting up to pee per se should not be a concern. What is important is 1. Whether you can easily initiate the flow and fully empty your bladder when you do. 2. Whether urge to pee occurs only when bladder is actually full/nearly full. 2. Whether there are other symotoms like leg/feet swelling swelling during the dsy or shortness of breath.

https://www.bumrungrad.com/en/doctors/Krairerk-Athirakul

There is no way to claim a tax exemption as you describe. The process is to not declare income that is tax exempt under DTA to begin with. A pension is normally assessable yes but (assuming you mean a UK military or other government pension and not the State OAP) the terms of the DTA override this. And whole point will be irrelevant by next year anyhow if planned chsnge goes through.

His plan, however, like most only covers emrrgency care abroad. Perhaps the new adminidtrator id more alert to this than prior one was.

Thai tax law does not require you to file a retrun if you have less than 60k assessable income. Thai tax law and forms do not provide any means for declaring and then exempting non-assessable income.

This (and most other US policies) only covers emergency care when overseas. Did your claims fit that description?

Nowadays there are minimally invasive approaches and, in the right hands, it can be done much more quickly. My lumbar fusion took 60 minutes (1 level). Choice of surgeon is vital and one really needs to come to Bangkok for this.

They do provide a report. For spine, not worth much and specialistt will disregard in favor of reading the scan themselves. I'm not sure re hand scans. Before self referring for an MRI I'd see a hand specialist and get a simple Xray. Even if you had one before, hairline fractures sometimes are not visible at first. Quite likely a physical exam and xray will suffice.

His specialty is sports medecine, hip/knee etc (and very good for that) not spine.

Often, but not always. There are a few top doctors who are nowhere else.

Thai based insurers can and do raise premiums based on claim history but this is not allowed in most western countries. International insurance premiums may go up for other reasons but not due to claims. Insurers may however reject Bumrungrad cost estimates as sometimes higher than the norm compared to other hospitals. This generally shakes out during the hospitslization pre-approval process.

They don't, unless they do a time consuming, costly investigation, which would be rare. Hence under the pre-2024 rule there was little tax being paid on overseas remittances, and if the proposed new change happens things will revert to that. Under the current rule, makes no difference when earned. And of course everyone has responded by minimizing remittances.

It is actually pretty simple. Old (pre 2024) rule: otherwise assessable income remitted from abroad was not assessable unless remitted in the year it was earned. In practice, little tax was paid on remittances, since it would take some doing for the RD to establish when remittances had been earned. So no disincentive to remitting overseas funds into Thailand. Current rule: no matter when remitted, income is assessable unless otherwise exempted (eg under a DTA). This has had the predictable effect of discouraging remittances. So: New proposed rule: overseas income remitted into Thailand will not be assessable if remitted the year it was earned or the year thereafter. In practice I think this will just revert things to how it was under the old rule, for the same reason (difficult/time consuming to establish when remittances were earned). Most expats have been unaffected by these changes so far. For your average retiree having a foreign pension or equivalent remitted into Thailand as it is received: - if the pension is non-assessable in Thailand under the terms of a DTA, it is so under all 3 scenarios, no difference -if the pension is otherwise assessable, they were always technically required to declare it on a tax return, and are so now. But unless their was other income, most would owe no tax. In practice few filed tax returns and I haven't heard of anyone having a problem as a result. Under the proposed new change, this requirement (which few observed anyhow) will no longer exist. People for whom this will make a difference (if they are currently following the letter of the law) : (1) Global nomads who are tax residents in Thailand. Currently, income they remit is tax assessable; this will cease to be the case. (2) retirees with a lot of passive income of a type tax exempt in their home country but assessable in Thailand.

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I would add, some private hospitals here are not for profit. Including St Louis and Camellian, both of which have palliative care programs. You get the advantages of private care but without the (profit driven) frills and more of a normal hospital orientation/attitude towards patients.

Sciatica is a symptom, not a disease. It just means pain along the sciatic nerve and its branches. And is indeed what he seems to describe. The question is the cause. Nerve compression in the lumbar spine needs to be ruled out.

A well educated Thai wife makes a big difference. Especially if she is comfortable being assertive with doctors as may become necessary. With your wife to supervise things, hiring in nurses/nurses aides becomes feasible. You can certainly get strong pain killers here from private hospitals. You can get them from government hospitals as well but more constraints, harder to get dosage increases, changes in drug etc; may be hard to get refills when you can't come in yourself; may have to wait (in pain) if reliant on home visitors through the public sector etc etc. Sometimes being a customer is advantageous and palliative care is definitely such a time. in addition the palliative care services of private hospitals can offer other treatments, such as nerve ablations, if and when advantageous. You will not get the same level of care through the government system though they will do their best.

EST certainly does not need to be done yearly in people without heart disease, but in men over say 40 and post-menopausal women it is a good idea to do every 5 years or so, possibly more often if prior result was borderline or symptoms develop.

Should be able to, yes. The free to total ratio is no help in distinguishing elevations due to prostatitis vs cancer but is helpful in distinguishing between elevations due to BPH (benign enlargement) vs cancer. Could help inform the decision of whether or not to proceed to additional tests such as MP-MRI. Results of prior PSAs also useful for comparison.

The place I linked to has branch in CM. Click on "contact us"and scroll down for the location. Be sure to get the scan on DVD for spine specialist toi review personally. That and not the radiologist report they'll insist on giving you, is what matters. (Take the latter with a hefty grain of salt). But, for spine specialist, you really should come to Bangkok. No comparison to the expertise there vs CM when it comes to spine.

It does not mean that all remittances must be declared on a tax return. Neither under current rules nor the proposed change. There is no section on tax forms for declaring remittances as such. One simply declares all assessable income on the line for income. Some remittances are assessable, some are not. What would change under the proposed new regulation would be the tax assessibility of some types of remitted incomes. Non-assessable income does not get declared on tax returns, period.