Sheryl

Do not self-prescribe a test, as you may waste time and money. See this excellent, Harvard-trained shoulder specialist: https://www.bumrungrad.com/en/doctors/mason-porramatikul He will know if more tests are worthwhile (e.g. likely to affect treatment plan). Sometimes physical exam alone is enough.

No it is not. Migraine disease is a neurological condition that features not just headache but other symptoms as well. There are severe headaches that are not migraine.

Supposed to take only when there is migraine. 2 tablets at a time. Repeat only if no relief and do not exceed 3 doses (6 tabs) in a day or 10 tabs in a week. Side effects can be significant and this is no longer recommended as a first line treatment. Contra-indictaed in high blood pressure and heart disease. read these carefully: https://www.mims.com/thailand/drug/info/ergotamine + caffeine?mtype=generic https://www.mayoclinic.org/drugs-supplements/ergotamine-oral-route/proper-use/drg-20526910 Preferred treatment would be Sumatatriptan (brand names Siagran and Sumigran). Has a doctor diagnosed you as having migraines? As not every severe headache is a migraine.

This is all secondary to the bunion. Which will indeed continue to get worse until/unless surgically corrected. There is no non-surgical solution though orthotics etc may give temporary relief. in the right hands success rate for bunion surgery is very high. https://www.bumrungrad.com/en/doctors/Bavornrit-Chuckpaiwong https://www.phyathai.com/en/doctor/assoc-prof-dr-bavornrit-chuckpaiwong https://www.siphhospital.com/en/medical-services/doctor-biography?id=202 Same doctor, different hospitals. Bumrungrad the most expensive and SIPH (Siriraj private wing) the slowest/most time consuming.

Of course not. But OP does not have BPH. He has prostatitis which IS usually due to infection.

Prostatitis IS usually due to infection. And as previously said Finasteride does NOT treat Prostatitis. It treats benign enlargement of prostate which is an entirely different problem.

Not the norm here to write a "prescription". In fact no prescription system as such. But you could easily have gotten a copy of your medical record, which would show the medication advised, at no cost on request. There is no Thai generic equivalent for Seretide. Perfectly common for specialists to work on weekends. Due to its proximity most senior doc at Siriraj have hours there.

He may have gotten it done at a lab. Since results are in normal range (though at very upper end of normal for the SGPT/ALT) hardly any reason to see a dietician or spercialist. If he is overweight, addressing that (diet, exercise) would be wise in any case. @roger101 did you by any chance take an antihistamine or other medication in the 24-48 hours before the blood test? As this will cause mild transient elevations. I assume the reference range shown in your lab report must have had a lower cutoff than 56 for the SGPT? In Thailand they often use lower than internationally normal cut offs for liver enzymes. Usual normal range for this enzyme is 7 - 56. At most you have only a very, very slight elevation which could easily be explained by being overweight or by medication.

@Mike Lister Hyperthyroidism will cause elevated BP. Once corrected, BP will of course be lower. Your pre-op readings were too high. The BP levels you now report are normal and not a cause for worry. Note that it is common for BP machines to underestimate diastolic BP a bit. (But even if not, nothing really wrong with these diastolics. Your pulse pressure is around 60 which is fine. Some people normally run a bit more than that. ) Hyperthyroid burns fat so once corrected, if food intake remains unchanged, soem gain is possible. You may need to to adjust diet and exercise a bit.

Absolutely no indication for dosage increase at those levels. FT4 already towards upper end of normal and TSH is at low end of nromal. If anything might be able to decrease slightly.

Finasteride does NOT treat prostatitis. It treats benign enlargement of the prostate (BPH) which is an altogether different condition.

Both ultrasound and MRI can be useful. Sometimes nothing more needed than physical examination and Xray. What you need to do is see an ortho specializing in knees and see what tests he considers necessary. As for cost of MRI, depends on where done. Stand alone imaging centers cost less than hospitals. Where are you located?

1. Siriraj now has a surcharge for foreigners using the public channel. So do other large government hospitals in Bangkok. 2. If not speaking Thai, very difficult to use a Thai public hospital unless you have a Thai speaker who can go with you. And it always takes a much longer time than being seen in a private hospital - sometimes by a factor of days or weeks. 3. Plenty of pulmonologists that treat adults at Siriraj private wing (scroll down to "chest center") but it is not at all clear from what you say, that you really need a pulmonologist. an internist or possibly even an allergist might be better. Also, very unlikely to be able to get an appointment soon, waits of a few weeks are the norm. https://www.siphhospital.com/en/medical-services/find-doctor?doctor_id=0&medical_id=101&day=&startTime=&endTime= 4. As you want to get things taken care of quickly, public hospital is not IMO the way to go as there are long waits for appointments, takes many trips top do what could be done in one day at a private hospital (for example if you need pulmonary function test or other test, rarely possible to get done on same day ordered and wait could be weeks.) What I would suggest you do is go to a non-profit private hospital that is mid-range in price, such as St Louis, Camellian or Bangkok Christian. Or, since you seem really set on the Bangkok Noi area, then Thonburi Hospital, where many Siriraj faculty practice. Cost difference between Siriraj private wing and Thonburi Hospital is minute. Specific doctor suggestions: https://www.siphhospital.com/en/medical-services/doctor-biography?id=681 https://www.siphhospital.com/en/medical-services/doctor-biography?id=71 also at Thonburi Hospital on Wednesdays (the first doctor listed here: https://www.thonburihospital.com/doctorprofile/?doctor_name=&department=&specialist=357

Closed per OP request

Recommended for all over 65.

If you have prostatitis, your prostate is by definition already inflammed. Diet will not help this. Treatment is prolonged course of antibiotics. (somewhat shorter is an identified STD is the cause)

There is no such thing as "too much protein in the kidneys". In kidney failure, the body has difficulty excreting waste products of protein metabolism. Nothing to do with protein being accumulated in the kidneys.

SGOT (more commonly called AST these days) of 15 is perfectly normal. SGPT (more commonly called ALT) is at the very upper limit of normal. (Depending on the lab, some might use a reference range that makes this an elevated finding) The AST:ALT ratio could be suggestive of non-alcoholic fatty liver. While that may sound scary it is actually extremely common and often due to being overweight. You certainly do not have severe liver disease with these values. Another thing that can elevate ALT is certain medications.

Off topic posts have been removed.

Topical for where on the body? Archifen Ear drops are for pain in outer ear (lidocaine combined with an antibiotic) Cathejell With Lidocaine is a lubricant combined with lidocaine, used for catheter insertions etc Kamistad Gel N is for application to mucous membranes (cold sores etc) Racser cream is for application to intact skin Racser viscous is for pain in mouth or throat Oxacain is a topical lidocaine spray

Lidocaine is not an opiate. Injectable lidocaine cannot be bought OTC. There are various topical preparations containing lidocaine that can be. OP needs to specify what form/for what purpose he needs it.

Whatever you do, do not take unknown medications from the "black market"!!! Potentially dangerous. Presumably the injection and tablets given by the doctor were anti-inflammatories. Since they did not help and the pain remains severe after 3 weeks it is time to see a proper spine specialist and have an Xray (at your age vertebral feacture is a possibility) and depending on what that shows, maybe an MRI to see what is going on. I know it is a long drive but I recommend you go to Khon Kaen and consult Prof. Sueachai Sae-Jung at Srinagarind (KKU hosputal) through their "Special Medical Center". There are reasonably priced hotels right near it.

Are you trying to be seen through the public channel or private wing? The latter requires an appointment made with a specific doctor. https://www.siphhospital.com/en/medical-services/find-doctor Or you can call Call Center 1464 For the public channel just show up, as early in the morning as possible. Note that you will be seen (at least initially) by a junior doctor or doctor in training not a senior specialist and they might require you to see a general doctor first before letting you see a pulmonologist..if they think indicated. I am not sure they even have an adult pulmonary clinic, website of the pulmonary division suggests not. https://www2.si.mahidol.ac.th/en/pediatrics/division-of-pulmonology/ There is an allergy clinic, ENT clinic abd a pediatric pulmonary clinic but I find no mention of an adult pulmonary clinic. If I knew what your problem was, I could advise bettrr.

A kidney abscess does not affect the ability of the kidneys to process wastes (even complete loss of 1 kidney does not). The protein intake issue is for people with significant kidney failure and not applucable to yoyr wife. Chicken will not hurt in the least. Neither will any other food

At any hospital you will have to have a doctor consultaion first to get the EKG ordered. Only exception would be through a check up package which eould include other tests so cost more. Or if you had doctor order from affiliated hospital. Government hospital will be least expensive. No absolute guarantee they will order rhe test but probably will if given good explanation. Lifecare labs will be least hassle.no need to consult doctor first. Cost more than hovt hospital but less than private hospital. http://lifecare.siam2web.com None of these places are going to send the EKG to your doctor but they can all provide you with copy of it which you can scsn and send him yourself. Are you sure you need jyst an EKG and not a rhythm strip?