QuantumQuandry

I was just about to contact Chula and I got my MRCP results back and I think I am good! "Prominent size of CBD, measuring about 0.8 cm in diameter without filling defect and noted normal distal tapering, possibly post cholecystectomy change." "Pancreas: Unremarkable" Renal Findings (The Follow-up Items) "Mild bilateral perinephric fluid." "A few bilateral renal cysts, up to 1.5 cm, Bosniak I." The discussion is no less appreciated, though! There is always the possibility that the MRI is wrong and it's good to have a backup plan. I will do another LFT in a couple weeks and make sure nothing is wonky. I suppose I still need to look into the "Mild bilateral perinephric fluid" but big sigh of relief about the no stone finding!

Ok. I have done a CBC, LFT, Amylase, Lipase and Cystatin-C, Urinalysis and Electrolytes a week ago. In addition to what you mentioned (FBS, coagulation profile and EKG), anything else you think they will surely want? Since that's only a little more, I might try to pre-empt them and just bring the results with me. That's quite significant. And if there is a complication, that could be even more significiant. I hadn't really considered Chula before as it didn't come up in my list of "safest/best hospitals". You think they are just as safe (in "ability to rescue" as well as likelihood of avoiding complications in the first place)? I am all for being a smart consumer and I am not obstructed so I think I can afford an extra week or so. But I don't want to compromise my safety. I will get the results of the MRCP tomorrow, wish me luck. From what I read, the odds of me having an obstruction in the next year are only like 5%, given that I am asymptomatic and tests show no inflammation/obstruction. Don't get me wrong! I am not putting it off if I have stones. I just mean an extra week or two to arrnage at Chula or SIPH or wherever. As for paying it forward...coincidentally, I was on the way home from my MRCP and an old employee of mine in the Philippines just pleaded to borrow 40,000 php for a hysterectomy. She was a good girl so I am going to help her out. Maybe an opportunity for a little karma, as well. Not that I am superstitious but she was a good person, anyway.

Do you have to do a walk-in during his office hours? Since it's a tad far, I was thinking to call and make an appointment after I get my MRCP, tomorrow. When you say "arrange admission" do you mean right then and there? Or schedule it in the future? When you say it's harder at Siph, do you just mean it's a longer wait or something else? Just trying to plan the trips. Trying to bring as much info they will need, with me. The MRCP, CT-Scan, liver tests, amylase, lipase, cystatin-c, etc. Can you give me an idea of the process for both Thonburi 1 and SIPH (or Chula for that matter)? Think she's worth braving SIPH? I guess I am not clear on the downsides of going to SIPH. He looks good, too. I may be wrong but I am still thinking this will be one trip, two at most? An extra couple hours to get to the other hospitals is a small price to pay for safety. It sounds like you think they are all equally safe, though. So I guess it's just price, then. Think I can get a decent estimate from them if I call and ask for a financial coordinator or email them? Maybe I should just email all of them or call all of them and get some estimates if they will oblige. Yes, I notice that about the prices. I was hoping the prices were correct in relation to each other, if not the actual price. But I guess that's wrong, too. That's one reason I wanted to make a post. I can't find a ton about prices online, either. That said, in Pattaya, I would say there's a pretty big diffrence between, say Bangkok Pattaya Hospital and Pattaya Memorial. Even just the same meds I have purchased in the past are 40-50% more at BPH, iirc. A trip to BKK is maybe 3k baht. Wasted time, too, ofc. But otoh, this is a fairly expensive procedure form what I understand, even if nothing goes wrong. Like 200,000? Hard to find prices. https://www.health-tourism.com/ercp/thailand/ has Bumrungrad at $6k ish and Chaophya at $2100 but that's probably old. Not sure if I will need general anesthesia, due to OSA and BMI. So I am thinking that even a 20% difference in price might be pretty substantial if it's 200k. And that's if nothing goes wrong. I am more worried about if something happens and I am there for a week or two, then the costs might get out of control. As a side note, I had my cholecystectomy not that long ago at Vimut-Theptarin. I should see if I can get the anesthesia and operation records. Maybe that iwll be helpful, as well. Thanks again for your insights. Is there a way I can pay you back? Do you take donations? =)

Thank you @Sheryl . I really appreciate and respect your advice on health matters in Thailand. I apologize if any of my questions are silly. I haven't had a lot of health problems in Thailand, so far. Except for the cholecystectomy that likely led to the retained stones I have now. Agreed. I understand ERCP can be dangerous if it turns into Cholangitis so I am not putting it off indefinitely. I have done kidney tests (all normal) and I am asymptomatic so I am trying not to rush too fast. I have an appt. to get an MRCP done here in Pattaya, tomorrow, at the imaging center to confirm my stones since I read that CT-Scans are only ~80% accurate for CBD stones. I need to wait a bit to let the Mounjaro leave my system, anyway, from what I understand. From what I understand, the hospital isn't as important for the procedure itself (except there is some new tech called spyglass, maybe?) but if there is an emergency, say from my OSA, then the ability to save my life may depend on having the correct specialists and facilities on hand, rather than having to transfer me? Oh, really? Ok, I thought Thonburi 1 was cheaper! I have been finding it difficult to estimate costs. I tried to use LLMs for this part. With some discrepancies, they ranked them as SIPH, Phyathai 2, Samitivej Sriracha, Chaophya, Thonburi 1. Note: From what I could find, there are 3 Thonburis (Thonburi 1 (cheaper), Thonburi 2 (mid tier), Thonburi Bamrungmuang (luxury)? Please correct me if I am mistaken, I am going to assume you and I are talking about Thonburi 1. I want to spend money on safety but save money on luxury, especially if something goes wrong and I am stuck in a hospital room for a week or more. I don't need frills and if I need to use google translate with the staff, that's fine. But I don't want to skimp on the actual health aspect. Dr. Leelakusolvong looks like a solid choice! He seems like he might be hard to get an appt with, though, since he's pretty famous. Assoc. Prof. Nonthalee Pausawasdi also looks good (research papers on post-ERPC pancreatitis prevention). Know anything about her? If Dr. Leelakusolvong is unavailable anytime soon, who would you suggest as a backup plan? Any other hospitals you would recommend for me that are high in safety and relatively low in cost, with 'luxury' being a non-factor?

Had my GB out about 6 months ago and according to recent CT-Scan at Pattaya City Hospital (where I live), I have "few CBD stones". Which is bad news, means I likely have retained stones if the CT-scan is correct and I need an ERCP to get them out safely. Apparently, the ERCP is a somewhat challenging operation, unlike the original Cholecystectomy (which went without a hitch). I have been doing some research on which hospital to choose, based on what I can read on this forum (including the one thread on SIPH), as well as LLMs and talking to anyone I can find. I would like to try and further that knowledge by posting here. Possible complications: BMI 36 with OSA so prob require General Anesthesia/intubatin instead of the standard sedation. Priorities: 1. Safety/surgery and anesthesia success. 2. Cost (paying out of pocket. I am retired here). I do not care about luxury, brand names or fancy rooms. Hopefully I will only be there one night, just to make sure my pancreas is ok. Hospitals I have been looking at, seriously, in order of my current ranking of them, for my specific needs: Thonburi 1. Not so expensive and high level doctors with high volume for this kind of thing. SIPH (Siriraj Piyamaharajkarun Hospital). Same high level docs but more expensive with the added advantage of a physically connected to Siriraj Public Hospital, in case of life-threatening complications? Samitivej Sriracha. Closer. Not sure that matters much unless I need a followup consult or something. But not as good 'life-saving measures' on site as the others? Could require transferring to a tier 1? Phyathai 2. Maybe shorter wait time for procedure, since it's the only purely private one in the list? Open to other ideas but this is where I am at, at the moment. Open to discussion, would like @Sheryl 's opinion, as well, if possible.

Funny you mention predictable. When I saw the attitude of the post, I knew it was one of 3 or 4 people that wrote it. Of which you were one. Predictable, indeed.

Strangest thing... So I went to repeat my WISE transfer from last month, noticed the lack of "For long term stay" option, canceled out of the transfer and ended up in this thread where the prevailing theory is to use buying property. BUT...I go back into my Wise account, hit repeat transfer again, planning to put in that it's for buying property...and guess what? The "For long term stay in Thailand" option is back! I don't know if it's replicable or a glitch or what happened. Just throwing it out there. Edit: Just went back to test another transfer. Same thing, the option is there now. Maybe it's been changed back, coincidentally, while I was researching it.

Makro delivers to me for free. Afaik, GO does not. That's pretty much all I need to know. Delivery saves me time, money and hassle.

Frankly, I am tired of anyone using Hitler as a proxy bad guy for whomever they don't like.

You know, I was actually musing to myself that maybe the best thing they could have done was some quick thinking and call an ambulance at the debate and then say he had a mini stroke (or whatever) but now he's recovered lol

The way I see it as a swing voter / moderate: Trump is a unsubtle and rampant liar. He serves himself and his ego. He is not at all patriotic. And he looks bad, to the world. HOWEVER...most of the scary <deleted> he said in the previous election turned out to also be lies and his actual policy turned out to be fairly normal for a republican. No mass deportations, barely any wall built, Mexico didn't pay for it, etc. My guess is that's because he spent time golfing and letting everyone else do policy. So he's not my ideal candidate, by a long shot. But based on his previous run, he wasn't a disaster, either. Biden did some ok <deleted> (Infrastructure law), <deleted> up some other <deleted> (immigration). I don't hate him. I don't like him. He's...ok-ish. If it was 2020 Biden vs. Trump now, I would probably not vote nor particularly care who won. But now, he's cooked. And the dems are exposed as the liars they (rightly) accuse Trump of being. I think they did some damage to their own party which is bigger than this particular election. In fact, I am guessing they may have to do some self-reflection and reinvent themselves. I am hoping that means returning to core democratic values and giving up on this hardcore identity politics crap. I mean, they have been losing minorities to Trump. If that isn't a wake up call, what is? Are they going to make up all the ground with Gen-Z voters that are being destroyed by inflation? I don't see it happening. I will vote for Trump over Biden if that's how they play it. If Biden steps down and we get a democrat I can respect (maybe Shapiro?), I might consider voting for him. That said, I think the dems are cooked, either way, this election. Maybe better to cut your losses this time and really focus on reforming your party around a candidate that can form more complete sentences that tonight's barfine.

I see this as a very positive step, it's just that it needs the second step to be complete. Two geriatric embarrassments running for office. Biden gets pulled now for obvious reasons. Trump has...I don't know, a medical issue. And we have two new candidates that are relatively normal? Maybe?!

Someone's got a real short memory...

It doesn't matter because it isn't going to affect what the president does. He was going to call for all of that, anyway. And you weren't going to vote for him, anyway.

As someone who is pretty depressed at the thought of voting for either side, at this time... This Hunter trial doesn't matter to me. Even if Biden had been somehow slightly involved, like trying to cover it up, I wouldn't care. And honestly, the Trump conviction didn't matter to me, either. If I have no experience with a candidate, then those things might matter. But I have already seen the two candidates. I already know what kind of presidents they are and what to expect from them. Nothing in these trials, so far, has really been shocking news that is going to affect my vote.