retiree

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

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.

The Florida post has been debunked in detail in these and other threads. -- Retiree

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

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

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.

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

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.

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

Given this, I'd recommend a good quality (gym) elliptical machine for a good HIIT / cardio workout, i.e. 30-60 second repeats. The big advantages are: - extremely stable -- never entails a twisting motion, - it's easy to redistribute and reduce single knee load by offsetting your feet and/or using more arm effort. Main disadvantage is just luck of the draw on machine design -- the effective stride length, rotation, and inertia of these things varies a lot, and not every machine has a natural-feeling motion (some are too bouncy, others too flat). Good luck, -- Retiree

Uhh, I may be sorry I asked: Outcome of Schatzker type V and VI tibial plateau fractures https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690716/ Must feel pretty sore when you ride a bicycle ???? -- Retiree

"In most cases, a broken kneecap is caused by a direct blow to the front of the knee from a car accident, sports or a fall onto concrete." I am enlightened. I guess not paying your bookie is also a common predisposing factor ???? --Retiree

Can you guys possibly clarify what you mean by a "broken knee"? Thanks, Retiree

Au contraire mon frère, I must demur! Mr DIY is the greatest store ever! It perfectly fills the spot between the local 29 baht store (e.g. kitchen stuff if you're just renting a room for two weeks, pillows for your feet), and HomePro (pillows for your head, cheap to moderately expensive plumbing fixtures, appliances, TVs, etc). Mr DIY has: plastic pots for gardening, incredibly cheap very thick rubber mats (from India) for kitchen floor, very cheap but good quality cable and hair ties, rubber hoses & quick release fittings, holders for the bathroom & kitchens walls, terrific hot-water makers, clip-on mini-strobes for biking or walking at night -- I mean, really! is there anything they don't have? Horses for courses: not all, but many, high-quality products can be manufactured and distributed cheaply nowadays. I think that the company (which is Malaysian) has really skilled buyers doing their sourcing & purchasing. Although I personally would probably not buy any precision tools like cheap shavers there ???? -- Retiree

This is the standard way it's done worldwide. When the resin is exhausted it must be replaced (any hardware store sells bags of it), or renewed with salt (both cheap & easy) or it just lets the hard water flow through. If you're not using it, Lime-a-way is handy for cleanup inside -- I see it's on Lazada and Shopee. HomePro sells "HG" limescale remover, probably the same stuff. -- Retiree

TL;DR: her father's death is a singular event; it's about your wife, not you; do the right thing. Ms. Retiree's father died recently. Poor farmer deep in Isaan, just a bit of land and just a regular guy, but respected in the community where he'd lived for 80+ years and had 7 surviving children. His body was kept at home for four days of mourning, and about 1,000 people showed up. From where? Well, about 100 homes in his village, some 500 houses next village over, and in that range for other nearby villages. Not to mention many, many relatives scattered around the country who dropped everything and drove home when it was clear that his last trip to the hospital would be it. Aside from food & drink for the daily guests (the biggest total expense), the feeding and taking care of people who came to stay for the week, kicking in for gas money, buying kids new clothes if they need them, etc. cost a lot. Add to that the cost of the temple and monks (just across the field from the house -- for the four days at home, nine monks trudged across the field three times day, and you aren't paying for their time; rather, you're contributing to making sure that the wat will be in operation when somebody needs it), a hospital bill or two, some government fees, unsettled bills at the house and so on. According to Ms. Retiree, it would have been far, far cheaper if he had lived in Bangkok, and the service had been held at a temple here. We contributed 100K, partly because other brothers and sisters had helped her Dad much more over the years, and partly because her mother died years ago and this really marked the end of an era. All in all it ran 200 - 300K (the rest made up by a brother who has a small business, and by a small insurance policy). In contrast, an older brother died a while back and we sent 5 or 10K -- it was a different kind of event entirely. And one of the nieces got married at the house recently; people chipped in about 1K each which was plenty. Foreigners tend to look at these things like commodities: Such and such only costs X in Bangkok, why should it cost more out in the middle of nowhere? Well, it does. They only put on a big show to save face. No, that has nothing to do with it, and there was nothing show-like about it. There's no running water in the house, why waste money on a funeral? Well, events like these support the temple, and sustain and bind the community. They help ensure that everybody has a place to come home to in hard times, or to send their kids to be brought up in, when they go off to the city to try to find cash money jobs. And this last may be the biggest misunderstanding: hard cash can be tough to come by in the countryside, especially in a hurry. Indeed, imho it is usually the foreigner who is the one concerned about losing face, and in a laughably misplaced way: he is worried that it will appear that he can be taken advantage of! (not the OP, btw), even if it's not a substantial expense for him in the big scheme of things. My advice just to remember that this is about your wife, not you, and you want to be in her corner, helping her pull her weight in the family as she sees it, at one of the most stressful times in her life. -- Retiree

According to this: https://www.nsw.gov.au/covid-19/vaccination/nsw-covid-19-vaccination-rates COVID-19 vaccination rates in NSW 97.0% Received first dose of a vaccine 95.4% Received second dose of a vaccine ... more than 68 per cent of people eligible for their third dose have received it. Despite the substantial protection from COVID-19 provided by vaccination, older age remains a significant risk factor for serious illness and death with COVID-19, particularly when combined with significant underlying health conditions. When nearly everybody in NSW is vaccinated, then the relatively smaller numbers who do get Covid-19 are also likely to have been vaccinated. Looking at Table 1 of the pdf file, of 122 deaths in the reported week 90 were aged 80 or more (45 were 80-89, and another 45 90 or older). Only 5 people under 60 died (note that numbers have been declining, but 21,711 Covid-19 cases were reported in the past seven days). Oh -- according to this, life expectancy in NSW in 2018-2020 is 81.2 (males), 85.4 (females). https://www.abs.gov.au/statistics/people/population/life-tables/latest-release -- Retiree

My impressions are that a) infection is usually an issue for the lower wisdom tooth extraction, but b) delayed infection is far more common for these, and c) prophylactic antibiotics immediately following extraction aren't much help for delayed infection (it's more about patient's dental anatomy predisposing development of a problem). So, the proper course of action (like watchful waiting, maybe?) would rely on the dentist's judgment. Can crouchpeter (or any other lurking dentists) shed some light on this? -- Retiree

Gosh, it's almost as though you knew the American Heart Association evidence-based guidelines on the recommended use of antibiotic prophylaxis ???? We continue to recommend VGS IE prophylaxis only for categories of patients at highest risk for adverse outcome while emphasizing the critical role of good oral health and regular access to dental care for all. Randomized controlled studies to determine whether antibiotic prophylaxis is effective against VGS IE are needed to further refine recommendations. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000969 Fwiw, when I first read this thread I agreed with the "take the antibiotics" group -- it's what I've always gotten over the years. However, it turns out that thinking has changed in light of evidence, e.g. this Cochrane review from 2021. After raising some concerns about the quality of evidence, it says: We concluded that antibiotics given to healthy people when they are having teeth extracted may help prevent infection, but the decision to use an antibiotic should be judged on an individual patient basis based on their state of health and possible complications of getting an infection. ... On average, treating 19 healthy patients with prophylactic antibiotics may stop one person from getting an infection. https://www.cochrane.org/CD003811/ORAL_are-antibiotics-effective-way-prevent-infection-following-tooth-removal Interesting topic, -- Retiree

My bad -- I incorrectly thought the OP was healed up, and just avoiding running now. Apologies, and I 100% agree -- do nothing that causes pain, and ease very slowly into anything with a high stress load even after you're pain-free. HIIT involving any injured area is a definite no-no if you're less than whole (or as whole as one gets at our age ???? ). Swimming can be a lot more strenuous if you use a snorkel (and maybe a float for your legs), so you can just concentrate on stroking (rather than not drowning ???? ). I'd do it more if I didn't tend to get rashes. The other best thing I've found for cardio with just upper body is pressing at different angles (from flat, to sitting upright) using a Smith machine for safety if possible, or the same with pulling at different angles (from overhead, to horizontal seated) using a height-adjustable cable / pulley. I usually go for whatever weight I can manage for either 1 minute sets, or 100-rep sets. It's not very heavy but can be very hard, esp. if you try not to rest -- just alternate exercises & stay in motion. Imho also excellent with dumbbells a couple of days a month when you are healthy. I've also tried using just the arm things on an elliptical trainer (standing on boxes on either side) but it was always awkward. Same for arms-only on rowing machine -- too awkward. Btw, not saying killer workouts, even brief HIIT ones, are necessary -- favored workout intensity is entirely up to the individual. Imho this is an excellent study, out last month, that discusses how high and low effort can be balanced (see Table 2 in the full paper pdf): Long-Term Leisure-Time Physical Activity Intensity and All-Cause and Cause-Specific Mortality: A Prospective Cohort of US Adults https://www.sciencedaily.com/releases/2022/07/220725105618.htm discussion, but no graphs http://sbgg.org.br/wp-content/uploads/2022/07/1658917123_1_Physical_Activity_Intensity_and_All-Cause.pdf It's a good follow-up to this 2016 paper, which focused on total METS (effort), not workout intensity: Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013 https://www.bmj.com/content/354/bmj.i3857 They both have the same takeaway: ... adults who perform two to four times the currently recommended amount of moderate or vigorous physical activity per week have a significantly reduced risk of mortality (2022 paper) ... People who achieve total physical activity levels several times higher than the current recommended minimum level have a significant reduction in the risk of the five diseases studied (2016 paper) -- Retiree

Somewhat similar situation. Best solution I've found is treadmill HIIT. I typically warm up 5 minutes, then go: - highest incline (15 degrees) to reduce the number of steps needed, - highest speed I can walk, arms free, with a fast but normal stride for 30-60 secs (8.0 of 15.0 on these machines), - 30 seconds on / 30 seconds off for 10 minutes (I hop my feet to the side panels, but don't slow the machine), - never more than twice / week -- it's kind of a killer w/o for me. At 70ish this is the best pure cardio I've found, with 5 minutes at pace. I usually manage to get my heart rate over 170 max, and over 155 bpm for 5 - 6 minutes total (using a Scosche wrist monitor). I sometimes vary the incline / speed / and interval. Holding the handles / sidebars makes it a bit easier if you're afraid of stumbling. There's not much knee bend, so I don't get any pain. A good elliptical striding machine is also great (maybe even too good) for knee-sparing if the design is such that you can get your H/R up high enough (some of them suck). -- Retiree