voyagerUSA

For anyone who is interested I did finally visit SiPH to see the specialist and overall it does not feel much different from the usual high end private hospitals, a bit more businesslike and less "fluff" but overall efficient and to the point. Price, at least for just a consultation, similar to what I would have paid at the high end private places like Bangkok hospital. So if there is a particular specialist you want that cannot be seen anywhere else then it is worthwhile, but the downside is since most of these professors only there 1-2 days per week you need to book an appointment way in advance and cannot just do it last minute unlike with the private hospitals. This is for outpatient but I have no idea how their in patient compares.

Intense exercise 5-6 days a week (both cardio and weights) was prob the biggest change. Relatively healthy diet with once a week "cheat" day, maintain optimal weight within 1-2kg, and no more than 2 drinks per week. Plus annual health checks and recommended screenings etc.

Thanks for all the feedback. In fact, I was recommended a specialist at SiPH as being particularly excellent, which is why I wanted to know more about it. Setting up and learning the procedures at a new hospital is a bit of an investment of time and effort but if this hospital is a good resource for the future then it would be worth it. Just out of curiosity how come these govt hospitals have (in some cases) the best specialists? I imagine private hospitals pay more? Of course I am sure money is not everything and it might be a public service sort of thing.

So as I understand it this new hospital is actually a "private wing" of Sirijaj (which is a govt hospital) where private patients can see and get treated by the Sirijaj doctors for a higher fee without waiting in lines and better more modern equipment and environment. However browsing their website I see that most doctors only see patients once a week and (likely) therefore are booked up well in advance, unlike the regular private hospitals where you can see most doctors on 1-2 day notice. So if anyone had experience with this hospital how does it work and how can they really provide continuous care if doctors are only there once a week? Especially for a patient who needs to be hospitalized or has an urgent problem? What would be the advantage of this place over say Bangkok Hospital or Bumrungrad?

Rosuvastatin, but in fact all the statins are pretty similar just a matter of finding the one that at the right dose hits your LDL target, but what that target should be depends on your risk factors and this is where the judgment of a cardiologist up to date on latest research comes in. If you cant hit the target with just a statin then usually a second medication is added to the mix.

I eat very healthy have normal weight and low body fat % and exercise hard 5-6 days a week... so is not that. Anyways I am looking for information about a doctor in Bangkok not dietary advice...

Thank you I do live near BNH and have used them for other medical issues but have not thought about their cardiology department. They are sort of a low key place compared to the more famous Bumrungrad or Bangkok Hospital. All these places have centers for this or that but in my experience there is no holistic approach all that happens is they book you an appointment with one of the specialists but perhaps BNH is more holistic

double post

Oh yes there is a lot of info one can find on internet and in research papers etc, but I am not qualified to be the one prescribing my own medications and tests, determining the right dosages, worrying about interactions between drugs, deciding if my LDL should be under 60 or 100 etc. The division of labor should be I take care of the lifestyle side (diet and exercise) and my doctor takes care of the medical side (statins, and whatever else I might need)

Bangkok

One area that seems to be lacking in Thailand is a primary care physician who focuses on disease prevention. In particular I have some risk factors for heart disease (high cholesterol, CAC score that is high for my age) but was never told by any of the doctors I saw that I should be on a statin. When I did my own research and asked for it only then did they give me the statin but it was probably 5 years too late. The couple of cardiologists I have seen are (understandably) more interested in dealing with people who already have serious heart disease where they can use their skills, put in stents etc and seem to have little interest in managing my cholesterol and minimizing my other risk factors so that I am less likely to develop the disease in the future. I am wondering if anyone can recommend a good internist or cardiologist who more focussed on aggressive prevention?

I think Xolair was originally introduced as powder and later they switched it to prefilled syringes for convenience, but maybe that given the cost of this medication there is not so much demand for the syringes in Thailand and they have a limited shelf life even if refrigerated, whereas powder prob has much longer shelf life so they stick to powder at most hospitals. It is possible that the top hospitals like Bumrungrad do offer syringes but the price they quoted me was crazy, like 2x the price at Vichayut. Unfortunately, Xolair is expensive because even after like 20 years there is no generic substitute available so the branded can charge whatever they want for it. The question if Xolair can create a long term remission of urticaria or only suppress it is controversial and I got different replies to that from different specialists. Never tried ciclosporin, it is a somewhat risky medication and requires frequent blood monitoring. In my case antihistamines do help but need to take a huge dose, 3-4x the normal dose used for standard allergy treatment. My urticaria tends to quiet down, then flare up after any sort of infection like a flu or covid that revvs up my immune system.

On the issue of mpMRI for prostate it seems BNH Hospitals offers a special package for 18,000 bhat

I am on levocetirizine now which works to some degree, but I still get break through hives whenever I have some sort of infection. I found that Vichayut hospital offers Xolair for about 18,000 baht per 150mg. I have heard it is a bit cheaper at some public hospitals but difficult to access that. However, it seems that in Thailand they do not have the prefilled syringes that you can self administer, instead they use powder that must be especially prepared and dissolved so as a result you can only get the shots at the hospital.

Thank you Sheryl for pointing me in the right direction. I might have a Thai friend call them first see if they could give us a price for the medicine because I already have an allergy/immunology doctor at a private hospital. Of course, if I do decide to go on Xolair and to use Chula clinic as the source I know I will have to see the doctor there to prescribe it etc. I know there is no generic version despite this medicine being like 20 years old and so best case it will be 15-20,000 baht per dose :(