Sheryl

You can go back to Lamplaimat Hospital with all the records you now have including the recommendation to see a head & neck surgeon, and ask for a referral letter to Buriram Hospital but you will have to wait to see a doctor to do this. I would give that about 60 - 70% chance of working. If you can get a letter from Buriram (government) Hospital asking them to provide referral letter, that is a surer approach; I have not known that to fail. You may need to first go to Buriram Hospital and be seen by a surgeon there to get this. No, don't show the doctors this thread.

Go to Khon Kaen Univeristy Hoispital (Srinagarind) Special MedicalClinic https://www.smckku.com/smc-doctors/ scroll down to "otolaryngology" for list of doctors and their hours, select one that is a Prof or Assoc. Prof.

As has been established this is a mixture of 5 different herbs. If it is making her feel weird or unwell, she should stop taking it. Try to find out exactly what issues she is taking it for, how severe, and whether she has first tried other medications for it.

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While consultation costs at private hospitals are not much, actual impatient admission and surgery is another matter and inclusive of all tests, the surgery, and follow up you would likely be at 100,000 baht or more. You can get a more exact quote fro mthe hospital after seeing the surgeon. Unless the amount is affordable for you, I would suggest that you try to get the surgery done at Buriram (government) hospital. It can be fully covered under the "30 baht" scheme if your wife gets a referral letter from Lamplaimat. A doctor's note from Buriram Hospital asking them to supply this will almost certainly work. Dr. Preeyapat should be able to help, and the head & neck surgeon, if he also works there (probably will) also could do this. This advice assumes she can be scheduled for surgery in a timely manner at the government hospital. If she cannot, then that would be a reason to spend the extra money to have it done privately, if you can afford to, In fact, the doctor she saw at Lamplaimat should IMO have given her a referral at the first visit but I think you were dealing with a brand new medical graduate who was unsure of him/herself and may have just recently been posted there after graduation. They are told to avoid "unnecessary" referrals but deciding when a referral is necessary/unnecessary is up to their medical judgement....which in this doctor's case was weak. Hence the stalling, come back after a few weeks for more blood tests etc etc.

The main side effects of cialis are headache, dyspepsia, nasal congestion, flushing and back pain. It also can lower blood pressure which can sometimes cause dizziness or fainting. This is most likley to happen in people combining cialis with alsohol or people on other blood pressure-lowering medications. Cialis must never be combined with certain heart medications (specifically, nitrates, and that includes both therapeutic medications and certain "recreataional" drugs e.g. poppers). Deaths have been reported from such combinations. It is strongly recommended that anyone with cardiac problems, or on heart medications, consult their doctor before taking cialis (or other ED medications)

You need to see an ENT. Might be sinusitis (and at this point, chronic). Where in Thailand are you?

Doesn't make too much sense to me to get Southrrn strain vaccine in October, flu season here is almost over at that point.

Off topic, baiting post removed

Thsiland has excellent preventive care servuces/programs for infectious diseases. It is taking them time to catch up to the changes in epidemologic profile towards chronic non-infectious diseases. Prevention/early detection & treatment of these ard more complex and costly. Reverting to OP, at age 40 what she most needs is a mammogram and pap smear (thin prep). May have to push to get a doctor to order these, and not all govetnment hospitals have mammogram capacity.

It is intended to be a permanent solution. Follow up data at this point is for only 5 years as the device is new. 5 year results are favorable. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205643/ Should note that this, like Rezum, is suitable only for relatively small prostate size. Laser treatments can be used with larger prostates

Large number of off topic and/or trolling posts removed. Please stay on topic and respect Community Standards and Health Forum rules. This is a serious -- and specific -- health issue.

Anyone know what it contains?

Biopsy is only way to know if cancer is present, and what type. UItrasound gives only odds/probilities. However as I mentioned above, even benign thyroid masses need surgical removal if large enough, so a surgeon might recommend proceeding with thyroid removal first and biopsy after. Depends on the specifics of each patient's case Be guided by/follow what surgeon recommends.

At which hospital? And which new blood tests came back normal? We knew already her thyroid hormones were normal (actually a bad sign when there is a mass). Did they do blood test for liver function? Is she still jaundiced? With Ti-Rads 5 the decision tree is whether to biopsy first or remove thyroid and biopsy after. If the mass is large they would likely advise the latter since even if benign it is going to need removal eventually (even benign thyroid lesions keep growing). She needs to follow through quickly. But you can reassure her that (1) She can live a fully normal life with her thyroid removed, just have to take daily thyroid hormone replacement (pill) (2) Prognosis for most thyroid cancers is good (there are differnt types) https://my.clevelandclinic.org/health/diseases/12210-thyroid-cancer#outlook-prognosis

There is no restriction for treatment (except probably not gover implsnts such ss used in Utolift) but you are restricted to your registered hodpital snd highly unlikrly this offers othrr thsn conventional TURP.

Whatever is offered at your nominated hospital. In most cases that will be only TURP.

It's frog central here and that seems to control the mosquitoes well

If yiy have a prescriptio for it and are bringing it in with, will be fine.

The Thai colorectal screening program is aimed at people aged 50 and above and consists of stook test for occult blood with colonoscopy only if positive. https://he01.tci-thaijo.org/index.php/TCJ/article/view/260882 It is a new program and being slowly rolled out geographically, still not in most of the country. Anyway, since the woman you ask about is 40, she would not be covered. A 40 year old would nto be recommended for a routine screening colonoscopy even in the West. US used to recommend starting age 50, just recently dropped to age 45.

The price estimates I gave were for less expensive places thatn BPH so be prepared for even greater price shock. Also be prepared to be steered towards Rezum because, other than TURP (traditional surgery), I think that is all BPH can do. There is a much wider range of options in Bangkok. To get full advice on all option, including laser and Urolift, and which are best for you, you need to see a doctor in a hospital that offers them all.

Xatral XL is alfuzosin . Same class of drug and action as the tamsulosin you are already taking. Doubtful IMO that a change from tamsulosin to alfuzosin will make much if any difference. Whatever you do, do not take the Xataral in addition to your current meds as you'd be double dosing on the alpha blockers (tamsulosin and alfuzosin )

Atorvastatin is nto for prostate, it is for lipids (cholesterol). But otherwise yes you are in usual medications. The various non-surgical options I mentioned (rezum, laser) are likely what you read about. They are indeed day procedures though in Thailand they may like ot keep you as otherwise you have to go home in with a catheter -- there is initial urinary retention due to swelling. Or you may have read about "Urolift" which is a surgical procedure but without any cutting of the prostate, they insert implants to push the prostate away from the opening of the bladder. This is i deed available in the UK . In Thailand it has only just become available and so far just at Bumrungard. A technique that has only just (as in, last month) become available is sometimes better avoided until the surgeon(s) doing it have acquired a fair amount of experience, unless they already did a good number of procedures abroad. Be sure to ask about this. As you can see, many choices - the traditional surgery (greatest risk of long term incontinince), laser treatments (several types), Rezumn, Urolift. Discuss with urologist in detail the pros and cons of each in your specific case, ask how many such procedures he personally has performed to date. .

Then if it is also not an oisect bite, and it persists, best to see a dermatologist.

Yes, there have been innumerable threads on this. There are many options, but before considering them, make sure you are already maxed out on medication, which would mean taking 2 drugs, one in the finasteride/dutasteride family and one an alpha blocker like tamsulosin/doxazosin. As to alternatives when medications alone don't work, surgery is not the only one nor usually the best option. There are non-surgical approaches that have less risk of long term incontinence eg: Rezum (a steam treatment) - only if prostate volume is below a certain size. It is available in Thailand, please do a search for the many recent threads there have been on this. Laser treatment is another - HoLEP and newer lasers as well, less widely available but can get it at Siriraj. You may be shocked at costs which are around 200 -250k baht, give or take depending on type of treatment selected. If you want to pursue this here, I suggest going to Siriaj private wing as they have the widest range of options/newest lasers etc. See Assoc. Prof. Sunai Leewansangtong there. https://www.siphhospital.com/en/medical-services/find-doctor?doctor_id=247&medical_id=0&day=&startTime=&endTime=