Sheryl

I had not thought of that but indeed a possibility. @still kicking had you taken Viagra/Cialis in the 24 hours before this episode? Or any other meds?

Yes, dehydration can lower your BP and is especially dangerous for people in antihypertensive meds. If you have further episodes you should see your doctor as your meds may need adjustment.

The point is that he would like to know the cause and what, if any, treatment(s) might help. He would also like to know if massage etc is safe for him. And, for planning purposes, he might like to know where this is going, i.e. is it likely to worsen? How quickly? Might he in the future need surgery? Could it resolve with conservative measures? If so, what? Spine issues likely to resolve on their own do not usually last this long. Pain lasting beyond 3 months -- and certainly beyond 6 months -- is more likely to prove chronic. There are in fact a range of treatments that can help with pain stemming from age-related spinal degeneration. These may include physical therapy, anti-inflammatories and other oral medications. improved ergonlmics, use of cervical traction, epidural injections and, in severe cases, surgery.

I have seen people with permanent brain damage from this. Years ago, working in refugee camps on the Thai border, one of the western relief workers got this and was in coma for many weeks in a Neuro ICU. Not to be risked IMO. Exception being those who live in cities and spend no time in rural areas. Urban risk is very, very low since resevoir is pigs. The advise to "never mind" is based on Thai populations -since most adults will already have been infected in childhood and thus immune. Same is not true of farangs.

AccuChek brand is recommended and has good support from the company if any problems with the machine. A good pharmacy will not only sell one but teach her to use it.

Various Youtibe and other social media links have been removed in keeping with forum rules: "18. Social media content is acceptable in most forums. However, in factual areas such as, but not limited to news, current affairs and health topics, social media cannot be used unless it is from a credible news media source or a government agency and must include a link to the original source." https://aseannow.com/forum_rules/

There is no question but that the first line of approach should be diet and lifestyle. And this will be enough for some people, maybe even most people. For others, it will be enough initially but as they age, it may not be. However there are people for whom no amount of dietary control and exercise etc will work -- especially those with familial dyslipidemias, which are genetic. There are also people who are unable or unwilling to sufficiently alter their lifestyles/diets, and they should not be shamed or criticized if they opt for medication instead. The topic of this thread is medications, specifically medication alternatives to statins. Please stay on topic.

You need to see not just an ortho but one specializing in spine. The best are in Bangkok. https://www.bnhhospital.com/search-doctor/entry/4093/ Is the best spinal specialist in Thailand. And worth going to Bangkok for. You will need an MRI and an Xray. Yu can save money by getting the MRI first at https://mrithailand.com/en/

the resevoir for Japanese B is pigs. Anywhere with pigs being kept is a risk and I would think that would be much of the villages along the Mekong. I would (and did) personally get the vaccine.

Googling what you want to believe is not "research". And Google is not designed for, or appropriate for. medical research. When you google something, what comes up on the screen is whatever most other people using similar search terms clicked on. Making it an excellent source for spreading misinformation. Use scientific search tools like https://www.ncbi.nlm.nih.gov/pmc/ And enter neutral terms. Medscape.com is also good but you have to register a subscription. Steer clear of youtube videos. Even when taken from a credible source the clips may have been edited to suit someone's ideology.

The best medical care in the Southern Provinces is at Prince of Songkhla Univeristy Hospital in Hat Yai --- but that is so far from Phuket, thta one might just as well fly to Bangkok (where there are some world class endocrinologists). In Phuket itself there are a handful of endocrinologists. Of the 3 at Bangkok Phuket Hospital this one seems the most experienced https://www.phukethospital.com/doctor/chukiat-somjit/ I believe (not 100% sure) there is one at Mission Hospital but I have no specifics on him/her. And there should be at least one at Vachira.

Actually he cannot get vaccinated against M-pox -- not easily, anyhow. Vaccine availability is limited and it is only being provided to high risk groups. But Shingles, should indeed get vaccinated for if not already. It is not known how long and how much a prior smallpox vaccination will help but even after longer time some cellular immunity may remain. In any event risk of getting this in Thailand at present is extremely small. Infection requires close contact with an infected person - e.g. sexual contact of living together in a household etc.

Every article I have read on Mpox stressed that it is not spread by casual contact. I Completely fail to see how/where there is any attempt to "create a panic".

Disk replacements (artificial disk) are costly. Likely almost half of the estimated cost is the hardware (artificial disk, screws and spacer). In which case different hospital for exact same procedure -- even a public one -- can only reduce cost somewhat. It should be possible to forgo disk replacement altogether and do a 2 level fusion. Would likely reduce cost by 150k give or take. Disadvantage is more loss of neck flexibility. But possible and indeed for a long time was only option. If you go the public hospital route artificial disk might not be availble anyhow.

I have not heard of any document being given to a Thai citizen to confirm coverage under the Universal Scheme. It is usually just shown in the hospital database. Perhaps a special arrangement made to allod her to register in Bangkok despite having permanent residence elsewhere?

As I previously indicated, the purpose of going to BNH was to get Prof. Wicharn's recommendation, not to necessarily have surgery there. Now that i is confirmed she needs surgery (and from the cost, apparently a 2 level fusion), you can explore other options that cost less. Bangkok Hospital will not be cheaper. A single level cervical spine is about 400K. https://www.bangkokinternationalhospital.com/packages-promotions/spine-surgery-packages-2 However if you insist in this hospital (should actually never choose the hospital, rather the surgeon -- and make absolutely sure it is a spinal specialist with experience operating on cervical spine) then the doctor you would want is https://www.bangkokhospital.com/en/doctor/assoc-prof-dr-worawat-limthongkul?srsltid=AfmBOoqzr6BkgVuRt0kCBjK_LnsB5bs4lqn0iFjuVgEinqlwK5JdPWBK My suggested options: (A) See the same doctor as above at Chulalongkorn Hospital, seeing him through their after hours clinic: https://spcweb.kcmh.or.th/users/users/getDoctorClinic/8d51362723f31bd29648a7cd8f317b47-010514- Above website is in Thai, open in Chrome for English translation. He is there Wednesday and Friday evenings. Have your GF call 02-256-5193 for an appointment (not much English spoken) and make note of the appointment confirmation number given. Then arrive at the Por Por Ror Building by 3 PM (on Rama IV road, accessible by walkway from BTS), register for a patient number on the ground floor, showing them the confirmation number, proceed to the floor they tell you and wait. They start issuing queue numbers at 4 PM. Expect crowds and long wait. I don't know what cost would be at Chula on private basis but certainly less than either BNH or Bangkok Hospital. (B) Another option is this surgeon at Bangkok Christian Hospital (BCH): https://www.bch.in.th/find-doctor/doctor-profile/?smid=4548 He specifically specializes in cervical spine surgery It will cost less at BCH than at BNH or BH but I can't say how much less or how it will compare to Chula private channel. Waits will be less and overall dealings easier at BCH. (C) Lastly, but not least - she can probably get this done through the government "30 baht" system (though would have to pay out of pocket for all the titanium screws etc, so probably at least still 100K) if you do the following: (1) with all records, scans, Xrays in hand , including Prof. Wicharn's note recommending surgery, go to the Chulalongkorn orthopedic clinic public channel during normal working hours. She may have to first get a referral from a general doctor. Need to arrive at crack of dawn, and expect very long waits and crowds. May take more than a day to be seen in the ortho clinic. (2) Once she is, tell them she saw Prof. Wicharn privately and he recommended surgery on cervical spine, then show all records. (He is in a senior position at Chula, they all know who he is). (3) Once surgery there is being actively discussed, explain that she is covered under the "30 baht" scheme at Hospital X in the provinces and ask for a letter to show that hospital to get a referral letter from them which will get her surgery at Chula covered under that scheme. (4) Take that letter back to the hospital where she is registered in her home province and ask for a referral. This approach usually works though may need to be assertive and persistant. There will still be some private costs e.g. for the hardware (maybe 100 - 150k) and private room assuming you opt for one. As you can see option (c) is by far the cheapest but also the most time consuming to pursue. Options A & B will be less than BCH or BH but still pretty costly (i.e. somewhere between 300 - 550K or so) Wherever you go, be sure to bring: * Medical summary or certificate from BNH stating diagnosis and recommended treatment * MRI on DVD *Xrays on DVD

yes, seems to have just been approved this February. May still be hard to locate.

There are many medications that need to be taken indefinitely. The "root cause" of dyslipidemia is sometimes genetic.

This needs a head & neck or maxillofacila surgeon and they are often ENTs rather than dentists. Experience with this is limited in Thailand. Best choice would be in Bangkok https://www.vichaiyut.com/en/doctor/dr-prasit-mahakit https://www.bnhhospital.com/search-doctor/entry/4009/ (same doctor, different hospitals. BNH will likely cost more but be easier to deal with for appointment etc).

I suggest you redo that quote being sure it is for Silver Plan and with a USD deductible of 750 and perhaps a small copay. Should also look into "Close Care" I can't recommend anything less expensive than Cigna but you can certainly get it for less than you cite.

Prof. Wichien Sirithanaphol

My recent experience with April (international not April Thailand) when I needed spine surgery: - received pre-approval/Guarantee of Payment within 48 hours of the hospital submitting the forms - 580k baht directly paid to the hospital. I paid only my chosen $500 deductible and the difference between room charge (room only, excluding meals and nursing) and the $75/night allowance for a single room. - over another 80k reimbursed for outatient care before & after the surgery (including MRIs, Xrays, preop labs etc) In addition I was reimbursed about 45k for an epidural injection considered a day surgery. (I could have had it directly paid to the hospital but opted not to as I was in a lot of pain so didn't want to bother with the pre-approval process; pre approval is not required for hospitiizations costing less than $2,000). Reimbursements were pretty fast. Maybe 10- 14 days on average. -

Xray that hold is of no meaning. You'll need a current Xray.

A number of trolling/conspiracy posts have been removed. As has a flaming post. Mpox is real. It is however not spread by casual contact and vaccination of the general population is not recommended.

Any location should be fine. I have in the past done MRIs at both the Chatuchak branch and the smaller Silom branch. Other board members gave used Bang Na. Either way you'll get what you need and save about 10k over hospitsl MRI price. The Xray will have to be done at the hospital. Prof. Wicharn has his own protocol for this in any case. Consultation plus Xray will run about 5k baht.