Sheryl

Definitely warrants further investigation, but a multiparametric MRI would be the preferred next step, before proceeding to biopsy. Also if not done already, a fractional PSA (fPSA) is helpful (but not definitive) in differentiating elevations due to BPH (benign enlargement) and cancer. I have also sent you a PM

yes

An enlarged prostate is quite common in men starting from age 50 and usually benign. In a younger man, more of a danger sign but even then can be due to inflammation (prostatitis) rather than cancer. OP how old are you? Although there will be at least 1 urologist at Chonburi hospital, you may get a more senior one if you go through Burapha after hours clinic.

Might I ask what exactly you need a cardiologist for? If it is only for medication refills, most cardiovascular meds can be bought over the counter at a pharmacy here. If it is to evaluate a problem that you think is heart related, might do better with an internist in case the cause is something else.

Moved to Wellness subforum

Posts discussing illegal substances removed.

Cough with fever, you need to see a doctor. More than allergic post-nasal drip is involved. Brown Mixture is an effective cough suppressant, but it is not always a good idea to suppress a cough, and in any case, with fever, there is likely an infection of some sort that needs to be diagnosed and treated.

Eating anything with a lot of sugar will result in first a spike and then a precipitous drop in blood sugar leading to hunger. Do not eat such things close to bedtime. Best to eat something high in protein and with some fat, but not sugar, before sleep. That will maintain your blood sugar during the night.

Biopsy is NOT usually indicated based on PSA alone. I don't think you were well advised. What exactly was your PSA? And did doctor perform a digital rectal exam? A parametric MRI might preclude the need for biopsy. But Banglamung is nto the place for this. Nor the place to have any sort of biopsy, even if they offer to do it. It is a fine hospital for many things but not something this specialized, you need an experienced senior doctor. Strongly urge you to consult senior urologist at Burapha.

Please edit this to show source. Or - if it is AI, so indicate and I will delete it. AI is worse than useless when it comes to medical information for Thailand (not much use anywhere else, either). AFAIK there is no registered brand of this drug in Thailand, so only if a hospital went to the trouble of importing it themselves, might it be available.

Tramadol does not even require a script, it is sold over the counter in Thailand. Buprenorphine however is controlled, hospital only and as I explained, nto at all sure hospitals will have it since no registered brand available in Thailand as far as I can tell. So you risk not being able to get buprenorphine here.

You won't find a stand alone clinic for sleep disorders. Are you really looking for a sleep disorder specialist or just someone to write a script? There is a big difference. Any doctor (if willing) can do the latter. An internal medicine doctor would be who'd you see for that. As others have pointed put, there are medications that can be bought over the counter that do aid sleep. The medications that need to come from a hospital are the benzos etc, and in any event not wise to take regularly - tolerance will develop and there is addiction potential. In terms of (private) hospitals, Pattaya Memorial is the least expensive, followed by PIH. Government hospitals are less than either of those but doctors there may be less accommodating when it comes to this. https://www.pattayamemorial.com/ https://www.pattayainterhospital.net/medical.php?Page=2 If you want an actual sleep medicine specialist, best alternative to Bangkok Pattaya Hospital would probably be either https://www.phyathai-sriracha.com/?lang=en or https://shop.samitivejsriracha.com

"Random" prostate biopsies are now pretty much a thing of the past, you may have trouble finding anyone willing to do it, involves more excision sites so more bleeding risk, and less accurate. And there is still chance of missing a cancer even if one is present. The standard these days is what is called an "MRI fusion" biopsy where both MRI and rectal ultrasound are used to pinpoint where to biopsy. This is done under general anesthesia and involves at least 1 night stay in hospital (may be more if you have trouble urinating immediately afterwards). Currently some private hospitals in Bangkok are offering package of 120,000 baht, does not include the pre-op checks and consultation, and assumes just 1 night in hospital. I would guess cost at government hospital to be about 1/2 to 1/3 that. At a bare minimum (and less desirable/accurate) a biopsy needs to be done with ultrasound guidance. Performing a multi-parametric MRI beforehand, if you have nto already had one, can often eliminate the need for biopsy. Of course, if it indicates biopsy is necessary, then cost will have been more, so a bit of a gamble but can be worth it if it prevents unnecessary biopsy, as it often does. I do not think any government hospitals in Pattaya itself have the capacity to do this. There is some chance - but no guarantee- that this could be done at the Burapha University Hospital in Bang Saen . They do have urologists, as shown in this schedule (open in chrome for English translation) https://buh.buu.ac.th/doctors/schedule.php?dm_id=26 In addition, the larger university affiliated government hospitals in Bangkok (Siriraj, Chulalongkorn, Ramathibodhi) can do this. You would start by consulting a urologist at one of these places. Siriraj levies a 20% surcharge on foreign patients, and is less conveniently located, so you might prefer one of the latter two. You can consult a senior urologist through the "after hours" clinic at Chula https://spcweb.kcmh.or.th/users/users/searchDoctor Also possible to go through the public channel for the initial consultation but will take much longer (as in, multiple visits) , involve queuing at the break of dawn, and your interactions will be with doctors in training. May also be long wait lists. Consulting via the "Special clinic" does not preclude performing a procedure through the public channel. Ramthibodhi (which excels in urology) also as an after hours clinic called the Premium Clinic but it seems not to have a urology section. Could call and ask, though. https://www.rama.mahidol.ac.th/qsmc/th/service/premium_clinic-th

Actually, although the drug as a generic is approved for use in Thailand, there does not seem to be any registered brand of it here as far as I can tyell. If it is available, would have to come from a hospital pharmacy based on prescription by a doctor at that hospital. Best to see a pain specialist for that. Doubt you will get much from emailing Bumrungrad, emails are usually not read or answered by medically trained people. It is a schedule 2 narcotic, so if bringing it in with you, you need first a permit from the MOPH FDA (not as hard to get as it sounds, but need to do in advance) https://permitfortraveler.fda.moph.go.th/nct_permit_main/Upload/Guidance for Travelers who travel into Thailand_21092024.pdf The good news is that, as per the attached which was issued September 2024, you can bring 90 day supply with you once you have the permit.

If you got it at a pharmacy or street vendor (which is illegal), may have been fake. Can't see why it would have been prescribed after a biopsy, or for an infection????

It is. Illegal for a pharmacy to sell it. It is also addictive.

No, I was saying -- contrary to several posts ptior to mine -- that it cannot be adequately learned by just watching a video. A CPR course will include hands on (mannewuin) practice.

In an 82 year old it would be rare to need an MRI or arthroscopy. In that age group osteoarthritis is the usual culprit and physical exam plus Xray usually suffice to show the extent.

Very best knee specialist is https://www.bumrungrad.com/en/doctors/panya-wongpatimachai

HA injections work differently than steroids and usually last at least 6 months, longer in some people. Not everyone is a good candidate, important to consult a good orthopedic specialist. There is a recent thread in this forum on this. https://aseannow.com/topic/1346428-hyaluronic-acid-knee-injection-where-in-bangkok-please/

There are many cough syrups sold in Thailand which contain dextromethorphan. No restrictions that I know if. Diphenhydramine does not need prescription in Thailand nor for that matter most countries. What I have no idea about is the status of these 2 drugs in Dubai.

Ban Lamung is a fairly low level hospital so not surprising it does not not have a cardiologist. Quern Sirikit is small. lt might hsve one but maybe not every day. Best option for cardioligy in terms of government hospitals would be the Red Cross Hospital in Sri Racha https://maps.app.goo.gl/KUHMG3VhjUou1jZc8 There are also several private options. Pattaya MEmorial probably the least expensive.

@giddyup You need to see an orthopedic doctor. Pain such that you can't walk 30 minutes at a normal pace needs intervention. If it is due to arthtitis there are alternatives to surgery that can help. eg HA injections. Targeted physical therapy to strengthen specific muscles that support the knee may also be beneficial. In the meantime should stop at the point of pain as continuing will lead to inflammation and worsen matters. Maybe try 15 minutes twice a day instead of 30 minutes once?

Speaking as one who has been certified and (innumerable times) recertified in CPR, and actually performed it scores of times over the years: It is s physical skill and cannot be adequatly learned ftom a video. Hands on practice is needed. There are mannikins specifically designed for this purpose . Even among people properly trained and certified, if they never actually do it, skill level is often poor and confidence lacking. Note that CPR and first aid are not the same thing. As for the utility of CPR in a situation where defibrillation etc not available, it really depends on the cause of the arrest. And how quickly medical aid arrives. CPR by a lay person in a community or home setting does the most good when the victim is comparatively young and healthy, and arrest was due to a sudden event rather than underlying medical condition. e.g. cases of drowning etc. For that matter, even CPR by medical personnel accompanied by defibrillation if indicated (it is NOT alwsys necessary) often does not have a very good outcome if the arrest resulted ftom an underlying medical condition as opposed to sudden event. Especially in older people.

These tiers refer to government hospitals..and are not widely used as too complicated. Some government hospitals charge foreigners more than Thais, some do not. Mostly this occurs in locations which get a lot of foreign patients (Bangkok, CM etc). Private hospitals likewise may or may not have diffrtent pricing tiers, it is up to them. To date there is no effective government regulation of the private medical sector. Overcharging is a very well known issue at private hospitlas and also affects Thais.