Sheryl

Thanks. I do indeed use this, but I'm still well stocked and have a trip to US coming up in July where I can restock.

The difference, and it is a big one, is that the tax thing is NOT an Immigration Dept rule. The bank letters, proof of income, are. And are required per Immigration Police Order. No such requirement for tax clearance for people on retirement extension. Why should the Immigration Dept take on the Revenue Dept's job on a matter that does not concern Imm and is not covered in any IMM police order?

They could, but there is not the slightest indication that they will. Why on earth would they? Nothing in the immigration law or regs asks for this. Tax revenue is not Immigration Dept's concern. And inter-departmental coordination is not a strong point in Thai government. Also, pensioners are not the prime target of this from RD standpoint. As they have repeatedly explained, it is primarily aimed at wealthy persons investing abroad and previously using the loophole to avoid taxation. Hard to imagine they would have any reason to ask a different government dept to help them collect the piddling amounts that would be owed by pensioners.

One of these doctors (do nto be put off by fact they are on the cancer service, they handle any type of pain) https://www.bangkokhospital.com/en/doctor/asst-prof-dr-pornpan-chalermkitpanit https://www.bangkokhospital.com/en/doctor/dr-laksamee-chanvej https://www.bangkokhospital.com/en/doctor/dr-pramote-euasobhon They work with other specialties like neuro etc. If they cannot address headache prevention, suggest you also see https://www.bangkokinternationalhospital.com/doctors/dr-chakorn-chansakul and ask specifically if you are a candidate for Botox or triptans Re NSAIDs, concurrnet use of PPI likeo meprazole can help prevent stomach issues and you might alternate between the tramadol and an NSAId i.e. each just 2-3 times a week

The headline is inaccurate. He did not win an appeal. He was granted the right to file an appeal. Huge difference.

Probably true for retirees as a whole. But not so true for other groups.

Thailand has already decided to tax the UK State Pendion. Long ago in fact and clearly spelled out in its tax treaty with the UK. In the past one could get around this by remitting pension in a differrnt year than initially received. No longer. But your math is correct and most Brits remitting only the OAP will owe little or no tax. People remitting private pensions or other income (rentsl investment etc,,) have more cause for concern.

To say that they won't tax foreigner's income of any sort is crazy. They already tax the invome of foreigners working in Thailand and will surely tax foreigners bringing in income from work done rrmotely or abroad or from investments abroad. And take action against tax evaders. Now retirees are another matter, since many bring in money that is is not tax assessable in Thailand and the terms of tax treaties vary greatly by country. Chasng down taxes owed by retirees will be a daunting task with low yields. Possible many RDs won't bother, but remains to be seen.

Remotely working. But who knows if they owned a place in UK may also now have rental income. Like income from working remotely, rental income if remitted to Thailand is taxable here. Of course due to DTA any tax paid in Thailand can be credited against tax owed to UK and vice versa. But Thailand's threshold for taxing is lower than UK. So one could owe no tax in UK but still owe tax in Thailand.

Obesity rates are rapidly escalating. Collection, analysis and reporting of data takes time. Quite likely the reported figure is based on data collected a couple of years back.

IHerb has not removed melatonin. Just limitting quantities per shipment to avoid customs hassles. (How well this will work given new customs tax on small value shipnents remains to be seen....) The "alternative medicine"/ nutritional supplement industry is also a multi billion dollar lobby. And with far lower overheads and less regulatory oversight than "big pharma". A mistake to think the former is more trustworthy than the latter

I still think you should see a headache specialist and consider botox or preventive med. Where in Thailand are you? why would you prefer to kerp taking these meds ehen the headaches csn be prevented or reduced in frequency? as to other treatments for the back pain it depends on cause. If due to inflammation, NSAIDs will do more than tramadol. Be sure to take with food and lowest dose needed as heavy usage can be rough on the kidneys. A single dose a few times a week shoulx be fine if you have no kidney or stomach problems. If the pain is due to muscle spasm then heating pad, massage, maybe accupuncture (in addition to PT) are helpful. If the pain is voming ftom a doecific nerve, nerve blick migjf help. You should see a pain specialist. Again, where in Thailand are you?

As she is working (remotely) it is quite relevant. All the income she brings into Thailand will be taxable, and the tax threshold here is a lot lower than in the UK. and then there are the health care costs.... Most long term expats are either retired or working here. The tax situation for retirees is complicated depending on pension source and country, and whether or not they are living on savings. Many retirees will legitimately owe no taxes in Thailand and others will owe only very small amounts. There is a special deduction available for pension income (if assessable) over and above the other deductions. The situation of a young working person bringing in invome from abroad is quite different.

One wonders if they are aware of the new tax regulations.

Some are scams e.g. people who call themselves chiropractors but have not had any formal training in it and are not licensed. Others of course are genuine. Whether or not their treatment will benefit you, depends on the nature of your problem and their skill. But as places go, I would say odds of encountering a fake chiro are greater in Thailand than in most.

Any good chiropracter will. Any who do not, should be avoided.

It will depend on whether public or private hospital. In both cases, has to be ordered/requested by a cardiologist.

It depends completely on: 1. What is wrong with you. There are many conditions where chiropractic manipulation could be dangerous. If your issue is back pain, I would suggest you first see an orthopedic doctor specializing in spine to make sure there are no contraindications before allowing someone to manipulate yours. 2. How good the chiropractor is. Note that chiropracty (like many other things) is not very effectively regulated in Thailand, making this a less than ideal place for it. There are many Westerners here claiming to practice it, some have actual training and some do not. Very much caveat emptor. For what problem are you considering this, and why in Thailand specifically?

First of all, ergotamine has no effect whatsoever on back pain, it is not a pain killer as such. Its utility is only for throbbing (vascular) headaches i.e. migraine. Are you actually having severe throbbing headaches 5-6 times a week? If so, you need a preventive treatment and should see a specialist in migraines. There are medications suitable for long term use that can prevent, or at least decrease, these headaches. Also, botox injections work well for some people (repeated about every 3 months). Botox is especially helpful for people with 15 or more headaches a month. Such treatments should make it possible to greatly reduce the ergotamine usage to an occasional level. Note that Cefergot also contains caffeine, also an issue if taking regularly. The back pain is a different matter. Ideally, the cause should be addressed. Prior nerve damage will not cause pain now (though it could cause functional limitations -- but sounds not so for you if you can regularly work out), but current compression of nerves will cause pain (as I know all too well first hand myself! This can often be effectively treated with newer, minimally invasive surgical techniques. Have you seen a good spine specialist? (There are only a handful in Thailand, all in Bangkok). Long-term tramadol use is definitely unadvisable. Addiction aside, it is highly likely to cause GI problems (chronic constipation, IBS-like symptoms), and can also cause liver and kidney damage, cardiovascular problems, and weakened immune function. Nobody can tell you exactly how many doses/how often will have this effect but 5-6 times a week is pushing it IMO. If you can get it down to say not more than 3 doses a week and never 2 days consecutively, you'd be safer.

When I get home again, I'll check the receipt and tell you exactly. Possible it was a bit more, I just know that I considered it very reasonable and it was a huge savings compared to private hospital rates for the same thing. Also given how rare skin cancers are in Thais, this is probably the best place in Bangkok to have this done, in terms of having the biopsy read by someone with experience in examining skin cancer samples.

Do not delay on this, it is considered an ocular emergency as there is a risk of the dislocated lens damaging the eye. Both repair of a dislocated IOL and cataract surgery are usually done under local anesthesia in Thailand. It used to be the same in the US and still often is, but with the advent of very effective and comparatively safe short-acting IV sedation (e.g. propofol), that is often also provided in US. This is not actually general anesthesia, rather what is termed "conscious sedation", the patient is deeply sedated but rousable to strong stimuli. However there is no memory of the procedure afterwards. (propofol can also be used in combination with anesthetic gases for true general anesthesia but that would not have been done for a cataract surgery). If you feel strongly about it, you can request IV sedation for the repair, but it will add to the cost. The procedure without it won't hurt, but of course can be anxiety-provoking to go through. Up to you -- but as mentioned, do not delay.

A biopsy is curative only if the entire lesion was removed, with clear margins all round. There is never any guarantee of this, though it could have worked out that way for you in the past. Usual procedure is to do a "punch biopsy" which may or may not yield clear margins. If it does not, options then are a wider surgical excision OR Mohs surgery, the latter being preferred if there is any cosmetic concern or if the lesion is located in a spot where wide excision is difficult (e.g. side of the nose -- I am scheduled for Mohs surgery tomorrow for that reason, nodular BCC on side of nose). It sounds like the surgeon you spoke to at Bangkok Hospital was proposing to do a wide excision rather than a punch biopsy. Maybe because he felt the likelihood of it being cancerous was high based on your history and the appearance of the lesion, who knows. in any case you can get what you need done at a tiny fraction of that cost at the government skin hospital near Victory Monument: https://www.iod.go.th/en/ I suggest not trying the "after hours" channel as they often will not do procedures there, and just make you come back via the public channel; the "after hours" route is useful only for other (non-surgical) types of issues....and also costs much more. Also, while there will be some waiting, it is not as crowded here as at some government hospitals. It is helpful to have a Thai speaker with you but if you do not, can manage with Google Translate etc. With the lesion being on your arm, easy to just point to it, but be sure to add that you have had BCC in the past. (you will be seen first at a triage desk by a nurse, who likely won't speak English, and she will then decide which doctor to send you to). Prepare that phrase ("I have hsogtory of skin cancer, Basal Cell Carcinoma, in the past" on your phone in Thai. The staff are helpful and the hospital sees few enough foreigners that they are still a novelty and thus get extra help. The senior doctors will speak at least some English They will do a punch biopsy and then the results will determine whether or not further excision is needed. (Same as anywhere else, including US). You should expect to wait a few hours so bring some reading materials, and it is possible that you may have to attend on a subsequent day for the actual biopsy (odds of getting it all done same day are greater if you go there early morning). It will take a month or more to get the biopsy results, but they can be emailed to you on request if you want to save what might be an unnecessary follow up visit. Obviously this is all vastly slower than in a private hospital but with a BCC there is no great rush and the savings are well worth it. The hospital has a Line App account and there is an English speaker who responds on it, so once you have a hospital number you can use that for future communications. I forget exactly what my punch biopsy cost but I think it wasn't much more than 1,000 baht including path charge.

If it is indeed a lipoma, then removal is optional. But I hesitate to advise this based an a diagnosis made here (especially at an upcountry hospital). While risk of it being other than a benign lipoma is small, it is not zero, and it would be wiser to get it excised and biopsied. ThUs both removing the annoyance and getting a 100% sure diagnosis. See what Mission Hospital quotes you, I suspect substantially less than the other quote you got.

You should get this done at a hospital not a clinic. And it should be biopsied after removal. Although it appeared on ultrasound to be a lipoma cannot be 100% certain without biopsy. Cost depends on size and depth. 28k is quite low for that hospital so they must think they can remove it as an outpatient under local anesthetic. I also question whether this this quote includes the path exam of the removed lesion, it is probably just the surgical temovsl. Mission Hospital will almost always cost less than Bahgkok Hospital. https://m.facebook.com/profile.php?id=100063785131090 Do not bother messaging them as doctor needs to physically examine it and review the ultrasound finding to know what will be involved in removal. Anything the clerks who handle emails tell you will just be a guess and may well be wrong. Go in person, see a general surgeon, and bring with you the ultrasound film and report.

This doctor https://www.bumrungrad.com/en/doctors/jun-srimanunthiphol Thyroid nodules are common and most are benign. I have them myself. If (as is usually the case) no need to do anything more unless symptoms develop. The biopsy is nothing, a simple office procedure under local anesthesia.