retiree

25 minutes ago, Mr Derek said:

I have done a modicum of research and have found no scientific paper that contradicts my theory that it is impossible for a virus to become more transmissible AND more lethal.

Uhh ... 

https://www.livescience.com/1918-flu-variant-deadlier-later-waves-lung-tissue.html

which I believe refers to this:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9090925/ 

Evolution doesn't want the weakest to survive and breed. 

Lol tell that to the male black widow spiders.   Or the next Neanderthal you run into ????   Evolution doesn't care about strength. 

-- Retiree 

3 minutes ago, Neeranam said:

It is the national curriculum by the MOE

Can you provide a link to the source text? Or paste it here?  

20 hours ago, Neeranam said:

just  found what I translated from Thai -  this is the definition of Thainess - 

Where is the Thai source of this definition?    Parts of your translation do not make sense, e.g.

  By Group method thought process. operating process,  Process face circumstances  [sic]

I found that a stirrup air cast like this works better than tape.  They weigh almost nothing, last an awfully long time, can barely be felt, and really prevent the ankle from rolling or turning.   I used to rely on these for running on rough trails up in the mountains.  

https://www.amazon.com/Aircast-Air-Stirrup-Ankle-Support-Brace/dp/B00YBZQEOQ 

-- Retiree 

7 hours ago, polpott said:

As viruses evolve they tend to become more infectious but less harmful.

Uh, smallpox.  HIV.  Polio.  Ebola.  Rabies.   A little more than a century ago measles was both more lethal, and far more infectious than Covid-19, see e.g. 

https://jmvh.org/article/measles-mortality-in-the-armies-of-the-early-20th-century/  

https://www.science.org/content/article/how-europeans-brought-sickness-new-world 

Unless a virus were to kill an infected person almost immediately, there is little evolutionary benefit to a drop in lethality, which is why the viruses listed above and others were scourges for centuries or millennia before better public health systems and (in most cases) effective vaccines were developed.

Worse yet, even if what you said were true, and the fatality rate of Covid-19 declined by 90% (to roughly 0.1%, as opposed to the 1% average over the epidemic*), imagine what would happen if it were as contagious as the common cold, which hits about 80% of the population at least once a year.**   Total deaths would stay as they were last year.   And, as the TallGuy points out, every case is an opportunity for a new, more virulent mutation to emerge.  

From my pov, simple measures like masking are no more or less necessary for now than washing your hands in the bathroom -- the danger of any single encounter is extremely small, but the cumulative effect across society adds up.    Saying "oh, what's the point, shouldn't we learn to live with cholera?" (and a dozen other formerly common diseases) still seems ill-advised to me until the combination of incidence and mortality gets down (at least for one winter) to something like the historical hospitalization and death rate for influenza, which society has long been willing to accept.  

-- Retiree

* Google says worldwide 624 million cases, 6.56 million deaths = 1%. 

** https://www.statista.com/statistics/684010/frequency-of-catching-colds-adults-us-by-age/

Question:  for the tiny amount you add to coffee, does UHT whipping cream taste any different from regular whipping cream?   And does it really not spoil much, much longer in the fridge?

-- Retiree 

1 hour ago, Bubbha said:

was the quarterly payment system established via the FBU office in Manila?  

Medicare bills every quarter from the start:  From their site:  You get a bill from Medicare every 3 months to pay your premiums.   I pay this from my bank just like an ordinary bill payment.   Fyi, I just logged on to my account at medicare.gov -- it says:

We sent your October bill on 09/28/2022 in the amount of $476.60. Your October bill covers your Medicare premiums through January 2023.Your payment is due on 10/25/2022.

That bill will probably arrive in the mail very close to the due date, but I will have paid it by then. 

-- Retiree 

Same situation.   I set up a quarterly auto-pay system via my US bank because I wasn't collecting SS yet.  Medicare has its own monthly debit system, but it was more paperwork to set up.  I also get a bill here in Bangkok from the Manila office that invariably arrives right around the due date, after I've already paid it via the US bank.   They do allow a lot of slack if your payment is late, though. 

And no, only usable in the US. 

-- Retiree 

This is kind of interesting (as long as it's your toe & not mine ???? ).  I think this is the most current big comparative study; note that amorolfine is seldom tested:  

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012093.pub2/full 

Topical and device‐based treatments for fungal infections of the toenails

Conclusion seem to be that it's awfully tough to treat, but the OP's original stuff works best:  Efinaconazole (Jublia).  

I'm curious -- isn't this a canonical use case for trying an online Canadian pharmacy?  Apparently requires US prescription, but is far, far cheaper than US prices.  

-- Retiree 

Another approach -- make sure you have a relaxed rest position.

I have had extensive dental work over the years, with enough root canals, crowns, fixed bridges, and now a few implants to qualify for infrastructure week.  After a certain point, especially with multi-tooth bridges, it became very difficult to get the ideal all-around tooth contact I'd had before.   I found that I was causing myself a lot of pain by constantly testing my bite, esp. near the site of the most recent repair.  

Eventually I heard about making a conscious effort to maintain a relaxed rest position -- teeth aren't in contact except when chewing.  It took a few weeks to learn to relax my jaw all day long (and resist the impulse to tap tap tap), but it made a big difference in comfort for me.  

Good luck, 

-- Retiree

Mongkut Medical is the biggest place on Ratchawithii.  It looks like it's similar to Diamond Pharmacy, but is open Sunday, and is just around the corner from the SkyTrain stop.  The name isn't well-marked (it's under the awning), but it's the only wide storefront with two doors and lots of shiny stuff.   

Both of these have interior pix, and links to the street view. 

Mongkut Medical Supplies Co.

Diamond Pharmacy

-- Retiree 

11 hours ago, Kopitiam said:

Well, it works like that here in Phuket.  I can accept it that it doesn't work this way in other immigration offices.  

Thanks, that's interesting to know.  Have anyone else had this experience in other provinces?

-- Retiree 

39 minutes ago, Kopitiam said:

Once you do an extension renewal, your 90-day reporting re-starts from the day of extension approval.

That is definitely not so.  The 90-day clock only restarts if you leave and re-enter the country.

-- Retiree 

The first block of Ratchawithii Road west of the Victory Monument, on the north side of the street, has a series of semi-wholesale pharmacies.   Stock of generic and brand-name drugs will vary a bit, and the biggest isn't necessarily the best.   They also have all kinds of medical stuff, from tiny little pill mortars and empty capsules to wheelchairs and beds.  

-- Retiree 

PS: not to be confused with Ratchathewii District, which it is in. 

Couldn't get a full answer from FedEx Bangkok on this.   I have a US FedEx account, but their site won't give me consistent price info. 

All I really want to know is this:  should I just get a Thai FedEx account, too, to ensure I get the proper customer price (around $30 / 1,163 baht)?     

Fyi, I'm in Bangkok.  For an envelope of documents from Bangkok to US, using slowest option (about 5-7 days), using FedEx websites: 

 - FedEx US gives me a discounted price for FedEx International Connect Plus of about $30 (logged in with my US account),

 - FedEx Thai gives about the same discounted price for FedEx International Priority. -- 1,163 baht (but would require a Thai account),

 - a filled out FedEx waybill page (logged in with my US account) says $131.97, 

 - finally, the first page (still logged in with US account, but a cookie must have changed) has started quoting in baht, and now says 2,145 baht.

Anybody out there been through this?  Not worried about a few bucks; just don't want to end up with the $131.97 charge. 

-- Retiree 

1 hour ago, Aussieroaming said:

costs about 30k baht, which I looked at and it seemed pretty complete. 

For 30k baht I'd expect my scale to lie to me. 

2 hours ago, OneMoreFarang said:

I still doubt if all these properties can be accurately measured with a little current and weight sensors. 

BMI is just a calculation from weight & height.  The others are all derived from one basic measure:  inferred water content (muscles -- high water content -- conduct better). 

It turns out that the distribution of weight, height, and inferred water content map fairly consistently to all of the other measures, e.g. for a given BMI, high muscle content has a higher metabolic rate than high fat.   Four problems:

 - the hand and foot devices are more accurate than just feet,

 - the inferred model varies by ethnicity, sex, and at the extremes,

 - subject test states (e.g. dehydration) can effect daily results, and 

 - while average performance can be good (as verified by more direct measures), individual reports can have high variance.

There is extensive discussion of this stuff in the context of evaluating these devices to determine eligibility for high school wrestling in the US, which sets minimum body fat requirements, e.g.: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421483/     

and this comment and response

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=3159&context=medicine 

Bottom line is that if you measure yourself under the same diet / exercise conditions every day then day-to-day trends (but not necessarily numbers) are probably meaningful.  And, if you validate your body fat result against a more accurate test, then the numbers are more likely to be meaningful.   Otherwise, pick up an extra battery at the 7/11 and just track weight or BMI.  

-- Retiree 

https://www.lazada.co.th/products/i2909569615-s10649187345.html

Excellent scale, 499 baht.  Came in a few days.

3 hours ago, fredwiggy said:

As has been mentioned, unless you are suffering from a disease or genetic anomaly, sunlight provides all the Vitamin D you need

Yes, that's what I've been puzzled by.  WaveHunter has mentioned his "serious vitamin D deficiency" five times in this thread, despite not having any "noticeable symptoms," being an "avid surfer, spending several hours a day out under the Florida sun catching waves," and being "nutrition-conscious and active in sports my whole life."

I would have thought that a genetic inability to process sun into vitamin D would become manifest in childhood.  If it were due to some type of surgery or disease, I would have thought his doctor would have treated the underlying cause, rather than just a "one week course of super high Vitamin D."

Afaik the "routine blood tests that exposed it" only became "routine" when cheap tests became available.  The problem is that these tests were not necessarily reliable, and erred on the side of reporting deficiency.  This from 10 years ago: 

Newer Vitamin D Tests Often Inaccurate: Study

https://www.webmd.com/women/news/20120625/newer-vitamin-d-tests-often-inaccurate-study 

Faster, Less Expensive Tests May Overestimate Vitamin D Deficiency

In a symptomatic and affected population this would not be a problem -- in effect, there are fewer opportunities for the false report to occur.   But in a large asymptomatic and unaffected population, many, many folks will be unnecessarily alarmed about a "problem" that might not be meaningful even if the report were accurate.   

Hence, screening for Vitamin D is not generally recommended.  Instead, folks are advised to take an ordinary multivitamin supplement (as I do myself) if their lifestyles might indicate any possible deficiency ('cause hate veggies and never get any sun!): 

Do not routinely test for Vitamin D

https://www.bmj.com/content/378/bmj-2022-070270

Screening for Vitamin D deficiency in adults

https://jamanetwork.com/journals/jama/fullarticle/2778487

overall evidence on the benefits of screening for vitamin D deficiency is lacking

VITAL Findings — A Decisive Verdict on Vitamin D Supplementation

https://www.nejm.org/doi/full/10.1056/NEJMe2205993

providers should stop screening for 25-hydroxyvitamin D levels or recommending vitamin D supplements, and people should stop taking vitamin D supplements to prevent major diseases or extend life.

Now, if people want to get worked up about asymptomatic ailments and cures, more power to them.  However, this kind of needless testing and treatment imposes substantial costs on society.  For example, in the US in 2016: 

https://www.nytimes.com/2018/08/18/business/vitamin-d-michael-holick.html

Vitamin D tests are now the fifth-most-common lab test covered by Medicare ... Doctors ordered more than 10 million for Medicare patients in 2016, up 547 percent since 2007, at a cost of $365 million.

And more recently in Australia:

https://www.sydney.edu.au/news-opinion/news/2022/08/24/cutting-down-vitamin-d-tests-could-help-lower-carbon-footprint-of-healthcare.htm 

An estimated 76.5 percent of Australia’s vitamin D tests provide no net health benefit, meaning that there were 3,410,108 unnecessary tests in 2020.  Total Medicare costs of unnecessary vitamin D tests amounted to more than $87 million (AUD) in 2020; in comparison, the total cost of all vitamin D tests was over $114 million (AUD).
 

As a US taxpayer (and Medicare payer) I think that greater benefits would accrue from getting folks worked up about -- and spending that money on -- problems like smoking, obesity, and exercise, all of which have far more demonstrable (and preventable) health consequences.  

-- Retiree 

8 hours ago, WaveHunter said:

It's an unfounded myth that sunlight alone provides sufficient vitamin D for most people. 

Uh, so how did the human race survive, exactly?  given that there are almost no substantial sources of dietary vitamin D other than blubber, and a few types of fish. 

And a follow-up question -- how did almost all other living, mobile species survive?

Puzzled,

-- Retiree

Re gels: drugstores have Neotica gel (piroxicam 0.5%), and Volaren/Emulgel (1% diclofenac), also local brands.  2% Emulgel is available from Thai stores on Lazada or Shopee.   I have found that my mileage varies with all of these.  Note that systemic absorption of the NSAID is very low, hence studies like:

Long-term tolerability of topical diclofenac sodium 1% gel for osteoarthritis in seniors and patients with comorbidities
These results suggest that long-term DSG treatment is safe in patient subpopulations with an elevated risk of NSAID-related adverse events, such as the elderly and those with the comorbidities of hypertension, type 2 diabetes mellitus, and cerebrovascular or cardiovascular disease.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3508560/

Re Celebrex (aka celecoxib), the 2005 study was criticized for high dosages (not certain it was this one, but they only consider 400mg / 800mg / day) and found dose-related risk increase:

https://www.nejm.org/doi/full/10.1056/nejmoa050405
Cardiovascular Risk Associated with Celecoxib ...

Unlike other Cox-2 inhibitors, Celebrex wasn't banned.  The FDA action prompted a much larger RCT that compared 200mg/day Celebrex to (pain-relief equivalent doses of) ibuprofen and naproxen in an older population (average age 63 +/- about 9.5 years):

"At moderate doses, celecoxib was found to be noninferior to ibuprofen or naproxen with regard to cardiovascular safety."

Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis (2016)
https://www.nejm.org/doi/full/10.1056/NEJMoa1611593

(It was also safer in regard to GI problems, see below; note that all subjects were given the PPI Esomeprazole (20 to 40 mg))   The methodology is interesting to read -- 24,000+ subjects, recruited specifically because they had (or could have) heart conditions to begin with:

   "A key inclusion criterion was established cardiovascular disease or an increased risk of the development of cardiovascular disease"

otherwise the incidence of adverse effects would have been so low that a much larger sample would have been needed to adequately power the test (i.e. make the statistical analysis reliable). 

Following the 2016 study a new FDA panel was convened.  See e.g.: 

https://www.npr.org/sections/health-shots/2018/04/25/605226604/fda-panel-affirms-safety-of-painkiller-celebrex

FDA Panel Affirms Safety Of Painkiller Celebrex
"The drug celecoxib, which is sold by Pfizer under the brand name Celebrex, poses no greater risk for causing heart attacks and strokes than two other widely used pain relievers, the committee voted at the end of a two-day hearing. The vote was 15-5. One member abstained.
...
"The study found the risk of dying, suffering a stroke or having a heart attack among patients taking celecoxib was 2.3 percent during a 30-month period, compared with 2.5 percent for naproxen and 2.7 percent for ibuprofen.
"In fact, celecoxib was less likely to cause certain complications, such as gastrointestinal problems like ulcers and bleeding, as well as kidney problems such as kidney failure and the need for dialysis, according to the study. "

While those numbers are high, remember that the 24,000, 63-year-old(-ish) subjects were chosen because they had heart issues to begin with.

Interesting topic.

-- Retiree 

Self-Selected COVID-19 “Dead” Cohort Reveals Unfavorable Health Outcomes and Fully Justified Discrimination in Global Survey

A rigorous survey of 1,052,605 Americans who died of Covid-19 produced zero (0) responses in agreement with either survey question:

 - Are you satisfied with your current health?

 - Have you been a victim of unjustified discrimination? 

Reasons for the lack of response in agreement included inability to move (100%) and lack of awareness of the survey.    We conclude that public dialogue about the touted “safety and effectiveness” of vaccines, contrasted with strategies to enhance immune resilience, all in the context of authoritarianism versus autonomy, self-care, personal responsibility, and freedom of choice is needed. 

It is hoped that a broader survey of the 6,539,537 dead worldwide will cast additional light on this issue.

1 hour ago, Custard boy said:

the Chinese Government pay the shipping charges from China to Bangkok Airport

That's the way the Universal Postal Union (previously General Postal Union) has worked since 1874. 

https://en.wikipedia.org/wiki/Universal_Postal_Union

Every sending country pays to have its mail delivered to the destination country.  The sending country then reimburses the recipient country for local delivery through a system of "terminal dues" that are periodically adjusted. 

In 2010 "the United States Postal Service made a $275 million surplus on international mail," and as a net exporter of mail "voted with the developing countries to keep terminal dues low" : 

https://en.wikipedia.org/wiki/Universal_Postal_Union#Shifting_balances_and_the_United_States

After the US lost money in the 'teens, it threatened to withdraw from the UPU.  The rules were changed in 2019 (by unanimous vote of 192 member countries) to phase in recipient-country control of the terminal dues system:

https://www.upu.int/en/News/2019/9/UPU-member-countries-reach-unanimous-agreement-on-postal-remuneration-rates

-- Retiree