Badrabbit

7 minutes ago, doctormann said:

That will have been EMS, i think, so ignore my remark about a courier.

 

I think that @Eff1n2retprobably has it right.

Has it right about what?

The address was printed from the form so it was 100% correct.

4 minutes ago, Eff1n2ret said:

If you put a letter 'I' instead of digit '1' in the postcode that might be sufficient to upset the reader - just guessing.

I printed the address off from the form so it was 100% correct.

2 minutes ago, doctormann said:

This from their website:

 

Post

If you want to send items by courier, check they can deliver to the postcode - otherwise they may return your post to you at your own cost.

The Pension Service 11
Mail Handling Site A
Wolverhampton
WV98 1LW
United Kingdom

 

Did you use a courier?  The address is indeed correct.

I don't know if it was a Courier I just took it to Thailand Post at a cost of approx 1100bht.

Now I guess it's coming back at a likewise cost.

I just noticed that text on the form ref check if Courier can deliver.

Sorry if this is the wrong forum to post this.

I sent my UK State Pension paperwork to..

International Pension Centre

The Pension Service 11

Mail Handling Site A

Wolverhampton

WV98 ILW

UNITED Kingdom

Just been informed via Thailand Post Track and Trace that the address is incorrect and delivery has been unsuccessful.

Now I guess it will be sent back to me at my expense.

This is the address on the paperwork, anyone used this address or are intending on sending there claim paperwork?

2 minutes ago, Sheryl said:

Appendicitis can certainly be life threatening and can present with a wide range of symptoms. Including yours. 

 

Lab results and ultrasound results are not static. As I explained before,  with time the picture on ultrasound can get clearer.

 

As per my last pist unless repeat CT is necessary costs of new work up unlikely to exceed 5k.

Okay thanks.

40 minutes ago, Sheryl said:

CBC (complete blood count) and repeat ultrasound would I think be priority to rule out appendicitis. IF the doctor thinks there is a high index of suspicion for appendicitis or gallstones/liver issue and Ultrasound was inconclusive then he might recommend repeat CT. If so I would seriously consider it, especially if you have good impression of the doctor's skill. Putting a cost limit in my be more expensive in the long run. But this only if doctor tells you he believes it is important.

 

Other labs that might be useful are as I listed previously: ALT, AST, bilirubin, amylase, lipase, CA 19-9 - unless these were done quite recently (as in, not more than 30 days ago).

 

And ask about a trial o PPI injection, costs very little. Works only if you are having noticeable pain at the moment they inject, as you need to see if there is a dramatic improvement after injection.

 

I think the blood work plus ultrasound and PPI shot would probably not exceed 5k. CT would of course be much more but, given that you had one already with no findings,  consider it  only if the doctor strongly suspects something that the US does not sufficiently rule in or out.

 

I don't have any of the symptoms accociated with the Appendix, I know test costs could spiral out of control I'm very worried about that, all I can say for certain is that I have this pain for such a long time, twice it became unbearable needing a rush to the ER, the 1st time it  cost 27,000bht for pain relief injection, Blood test, Urine test, X Ray, Ultra sound, CT scan with contrast only to be told " can not find anything" the 2nd time only cost 1300 for Pain relief injection plus pain killers, I told the Doc about the tests I already had so no point in repeating them, as long as something life threatening can be ruled out I could live with the discomfort.

17 minutes ago, Sheryl said:

It can be extremely painful, in fact can mimic a heart attack. But it can also be more mild.

 

It is not usually localized to the upper right quadrant such as he indicates, but that is possible.

 

Pretty easy to rule out with a trial of PPI which can be given as injection. If this is the sort of pain, injection will bring noticeable relief.

 

 

Sheryl I need to plan for tests, I can't just say "do whatever you need to do money is no object"

What tests should I get in order of priority, when I go next week 5k will be all I want to spend I can do the same each month if that is needed, my OPD insurance is 2500 per visit 30 days in one year which I would rather not use.

9 minutes ago, Sheryl said:

Not really relevant as reflux is regurgitation of stomach contents into the esophagus/pharynx.  Whereas gastritis is inflammation of the lining of the stomach and/or duodenum.

Okay, when I go to Mission I will request Appendix check, records from Private hospital does not include Ultra sound even though I did have one so will request that also.

13 minutes ago, mommysboy said:

Sounds like a muscle strain of some sort. 

 

 

I hope so but that would be a strain I have had for a very long time.

46 minutes ago, Sheryl said:

At Mission, ask for GI specialist. Or if things get really bad during the evening/night, go to the ER.

 

As the pain has gotten worse, may need to revisit issue of appendicitis. Sometimes it is hard to diagnose initially, even with CT. This would mean a repeat Ultrasound (even though you had one before - things can change and if there is continuing inflammation of the appendix it might be visible now when not visible before). Also will need at least a new CBC (blood count to see if white blood cells are elevated).

 

Although the pain is on the right side and thus not typical of gastritis, they might nonethless do a trial injection of a PPi (medication to suppress gastric acid) to see if that relieves the pain. Not expensive and if it does work, suggests an entirely different course of action/treatment.

I have had bad problems with Acid Reflux in the past not sure if that is important, 4 visits to Emergency plus seeing a specialist who suffered himself with Reflux they did not diagnose it, a friend told me to take tablets that his daughter used after suffering many years with Reflux, my next bad attack was cured by these tablets, not suffered since.

Records have been requested from private Hospital.

2 minutes ago, Sheryl said:

Mission Hospital is also private, just not for profit.

 

They will not be able to get your records, you have to do that.  It is easily enough done, just go to the medical records dept with our passport, hospital number and dates ((or date range) for the records you want. In the case of the CT tell them you want it on CD, they may sen d you to the Imaging Dept for that.

 

Then bring it all with you.

 

Is this Mission Hospital in Bangkok or in Phuket? If in Bangkok I recommend you see Dr. Nick Walters (American GP) to coordinate the overall diagnostic process.

Mission in Phuket, I'll go to Private Hospital and get the records today.

3 minutes ago, Sheryl said:

Maybe ask about it if everything else still comes up negative. (if you are 45 you should have one every 2 years anyhow for routine screening)

Okay I'll see what happens tomorrow at Mission Hospital, I will stress to them that I have already had tests at a Private Hospital, maybe get them to get the treatment record from the Private Hospital so as to check what has been recorded.

I'm worried about huge cost using OPD my insurance only covers 2500 per visit, I can't afford to lose my savings on something that might be difficult to find, I might in the end be forced to go inpatient.

3 minutes ago, Sheryl said:

I don't see any reason to look at the kidney. Liver, gall bladder, pancreas, appendix and just possibly colon would the the likely places to look. You might like to consult a GI specialist instead of the kidney specialist you have been seeing.

 

Have you had a colonoscopy in past 5 years or so?

 

 

Never had this or any other exploratory procedure.

8 minutes ago, Sheryl said:

Maybe also look at the position you usually sleep in, could it be straining the right side?

 

I say this because (1) You have already had pretty thorough work up including CT and ultrasound which showed nothing and (2) you describe it as an ache rather than sharp pain.

 

With right sided abdominal pain the important things to exclude are gall stones/inflammation of gall bladder, liver mass or inflammation, appendicitis, chronic pancreatits; and very rarely, pancreatic tumor. The tests you have already had, should have revealed these if present assuming the CT and ultrasound were of the whole abdomen.  If you want further assurance without much expense, could get these blood tests if not yet done or not done recently: ALT, AST, bilirubin, CBC, amylase, lipase, CA 19-9.

Thanks, I'm going to Hospital tomorrow as its bad this morning, pain killers not working now, feeling despondent about it all, I will suggest Kidney and Liver check.

Just now, Sheryl said:

If they said Gallbladder clear they will have visualized the liver.

 

I am wondering if it could be a muscle ache. 2 hrs a day walking is a lot. Have you tried resting a few days to see if it makes a diffetence?

It's not 2 hrs at once but 1 hr then another hour later in the day, I've always thought it could be muscle related, I will take your advice and not walk for a few days.

Thanks Sheryl.

3 minutes ago, Sheryl said:

Pain in that area could be gallbladder or liver issue.

 

Have you seen a GI specialist/ had an ultrasound? Had your liver enzymes checked?

Had Ultra sound, Doctor said "Kidneys and Gall bladder clear, can't remember the Liver being mentioned, maybe a Liver check is a good idea.

6 hours ago, Sheryl said:

OP: when yo usay right sided pain, right side where: right side of  the abdomen or of the back/flank? Makes a world of difference. Can you clarify, thanks

 

And does it seem to get worse in relation to eating and of so, what type of foods sets it off?

 

What exactly does the pain feel like?

 

Also what type of doctor (specialty) are you seeing?

The right hand of this Man is the area of pain, very difficult to pinpoint exactly.

I can't say if food sets it off but that could be a possibility.

Pain is more like a big ache rather than a stabbing pain.

Type of Doctor is not a general Doctor but a Specialist who deals with Kidney etc.

Hope this helps.

The pain has gone by taking the prescribed pain killer tablets.

2 hours ago, Zaphod said:

Sounds like kidney stones to me.  An MRI screen can see/detect those if that's the cause. 

No fun those. 

I have had 3 Ultra sound scans in the last 4 months no Kidney stones detected.

45 minutes ago, Pravda said:

Do you exercise by any chance?

Yes walking 2 hours per day.

34 minutes ago, bamboozled said:

I don't know your financial situation and I certainly understand being worried about money. I was struck by how bad you described your pain and I assume it's very worrisome. And then you mention you will wait to save money before getting a 2nd opinion. Unless you really don't have the money at all perhaps reconsider your reluctance and go and get that second opinion. Here in CM at Rajavej you can get a whole physical for 7k I think. If you limit the testing to be about your pain, I would assume it would be less. Except if there are some expensive specific tests but you are in control and can determine if you want them or not. If your pain is so bad and reoccurring, do you really want to wait and down the road find out some bad news that could have been avoided? Again, I'm like you and would be apt to kick the can down the road. No one likes a doctor. But reading your story from afar, go get the second opinion. Good luck.

Thanks for the reply, Doctor advised the MRI so I'll get that as soon as I can, I've lived with this pain for a long time(it's mostly mild but on 2 occasions it got alot worse) Injection helped and tablets are helping also, it's now back to a mild annoyance.

1 hour ago, simple1 said:

OP: Are you able to go to another medical facility for second opinion? 

I could do yes but I'm reluctant as cost could spiral out of control, international Hospital said "can not find anything" I'll get the MRI when I can afford it.

I've had this pain in my right side for a very long time(Kidney area) about 4 months ago it got so bad I went to Emergency, I had CT Scan, Ultra Sound, X Ray, blood test and Urine test, nothing found, just back from the Hospital as it became very painfull again, they gave me pain killer Injection plus tablets, my question is will an MRI scan find the problem?

The pain is always there but mostly very mild, twice now it became unbearable, I need to find out what the problem is hence asking about MRI.

2 minutes ago, jackdd said:

All you need to buy a motorbike is money.

Wow mate, well done for that reply!

4 minutes ago, clivebaxter said:

Why bother, if you want to free up the 800k use an agent, not strictly legal but what here is?

Use an agent for what and how? never done it so how does it work?