bamboozled

Come on, I'm SURE you have read more confused OPs... My apologies, it was mostly a case of too many questions in too short a post and visa questions are often complicated like a calculus equation.

Yes, I'm currently in Thailand having entered with a Non-O marriage obtained online. Length of stay is 90 days and will expire this May 19. I was unclear if this could be extended and if so what would be required. I do not have 400k in the bank but have been dutifully transferring at least 40,000 per month. But since this was with Wise, I'm not sure it will pass muster. My hope was to avoid having to do all the paperwork and rigamarole associated with a new visa. When normally going for the 90 day extension, none of this is required. But I don't think that's the case with the online visa I have. I hope I'm explaining myself. 

So you are suggesting that I will have to show the financial support (400k or 40k/month) and also all the documents/photographs/etc...and have my wife accompany me...just like applying for a new O-visa, yes?

I know I can get the 60 day extension to visit wife (to season the money) if my Wise transfers are not accepted. But I'm not sure my wife will be up to the task of going to immigration and helping in any way in this process (photos of us in front of house, for example). We are still together but she is mentally unfit, at the moment.

That brings me to the title of the OP where I wondered if Saigon was once again an option. If so, it might be worth considering.

Thank you, Dr. Jack!

I know, I know, just what you were all waiting for, more Non-O visa based on marriage questions!

I haven't been closely following travel rules between Thailand and Vietnam (Saigon) but I do believe things are opening up without too many hoops to jump through, yes?

If that is the case, and please correct me if I am misinformed, I have just read up on getting the aforementioned visa in Saigon on the Royal Thai Consulate Saigon website. It seems pretty much as it was a few years ago except now health insurance is required for the length of the visa (that would be 3 months) and one needs to present a financial statement showing "adequate" finances. I don't think that was necessary before. I'm curious what is adequate? Are they asking for the 400k or 20,000 baht?

Also, it says the visa is for 3 months and can be extended up to one year. This is normal visa-speak, yes? I can't recall as it's been a while.

I'm due this month to see immigration as the 90 day Non-O visa based on marriage that I got online when back in the US is ending. I don't believe these are extendable but please correct me if I'm wrong. I'm not sure I can easily get the 400k into a bank here and I'm assuming my Wise transfers over the past year are going to prove useless, based on reports of so many folks. This leads me to thinking a trip to Saigon might prove simpler, if it is indeed on the table.

Thoughts, gentlemen?

Thanks as always!

7 years ago....that's a long time. Someone told me it's pig bone. Is that true?

12 hours ago, Lacessit said:

I have had three dental implants in Chiang Mai, 55,000 baht each.

A good implant takes 3-4 months, anything shorter has a much higher failure rate. Mine are still going strong after about 7 years.

The best bone graft material is Swiss, Chinese bone graft material has dubious origins. We get what we pay for.

Did that include a bone graft? Your price is exactly what I was quoted yesterday....but without bone graft. And that's for the Korean Osstem brand. The higher end price is for the Swiss implant.

Well, I walked into Sriphat yesterday and then walked out. A complete madhouse. Probably cheaper but as Sheryl said, I'm sure the wait for anything at all would be very long and navigating the place is difficult. I then stopped at RAM around the corner and made an appointment with the urologist for today from which I've just returned. He looked at my ultrasound and came to the same conclusion that I should have the growth taken out without biopsy first, that it would be a wasted step. He said because of my age, 53, and the nature of bladder nodules, that 80% to 90% it will be cancerous. 120k to 150k cost. 1 night stay, unless they like having me around or there is some complication. Tomorrow, they'll send me the breakdown of the costs. And then I can decide which hospital I want to give my money to. Unless someone has any better idea..... Cheers, folks.

8 minutes ago, cucme said:

perfect job in Trat: ban more fun

Cost is 39.000 Baht per piece.

Takes about 4 - 5 months.

Very happy with the 3 implants.

That was last year.

That's total price for all? I have a quote from yesterday here in Chiang Mai. the cost is between 54k and 70k depending on which implant you choose. 10% discount for cash. Bone graft will add another 20k or so.

I'll consider myself lucky in my bad luck.

HI Sheryl,

Thanks for the news on the doc. Bkk hospital was a two day wait just to get the appointment so it seemed quicker to go to Sriphat. Do you know anything of this fellow at Ram: PHITSANU MAHAWONG, M.D.

My report just has a check next to Urine Analysis in the "normal" box. In the breakdown of tests, I don't see anything that says RBC or blood. No one mentioned that there was any issue that the urine pointed to. It just says I have the nodule and should do some follow up.

How would one find any issues with bladder or other organs in the abdomen if not with the ultrasound as a first line of inquiry?

I'll see what this new doc has to suggest and report back.

Siriphat hospital just told me on the phone that Dr. Siphat is only seeing Thai patients, after trying to steer me to different Dr.s. This seems a bit strange since supposedly his English is very good. I'm not sure what to make of it. Now I am supposed to see a Wisan Anutrakulchai,M.D. Anyone have input on this, by chance or know of this doctor? I could try Bkk Hospital, too, of course.

6 hours ago, lopburi3 said:

Think pregnancy ultrasounds.  A lot of information can be seen with very high accuracy.

That's true. But the ultrasounds of a fetus are much more defined than the blobs around the organs....from what I've just seen with my own ultrasound. It's easy to recognize a fetus. Nonetheless, I think you're right. If you know what you're looking for, I guess the nodule is not so hard to understand.

12 hours ago, SammyJ said:

I hope yours turns out ok--i am having the ultrasound at CM ram this week and then will see what the next step is--some good things shared here that provide a good perspective on costs and doctors.  I want a dr that will answer my questions and be patient with whatever in explaining the options as sometimes they forget that the discussion is about a serious medical situation with  "my body",, not theirs! 

 

Unfortunately, after living in Thailand a great many years, this does not surprise me and reminds me of how it used to be in the US so many years ago--there, doctors expected patients to sit and listen, as pre-internet, they were the only fountains of information and did not expect to be questioned or for the patient to offer suggestions.  Now, in most of US, anyway, it is expected the patient be informed and have an interactive discussion with their doctors--again, we are discussing serious treatment options with "our bodies" and I would not stay with any doctor who does not understand that.

Sammy J, why are you having an ultrasound? And why do you suspect there will be some follow up necessary?

It was a routine check-up at Rajavej. Everything else is in order, no blood or anything amiss.. Just saw the nodule on the ultrasound and then I met with the urologist a few days later (he didn't show up that evening for his normal schedule as he supposedly had an emergency operation) and he said to take it out. Well, he asked me what I wanted to do and I deferred to him since he's the expert.

1 minute ago, Sheryl said:

It is  very unlikely that a repeat ultrasound would not also show what looks like  a nodule.

 

Th cystoscopy will enable them to directly see what it is that is appearing like a nodule.

 

Is there any blood in your urine?

No blood. I don't have any symptoms of anything...unless I am so used to whatever symptoms I have that I don't recognize them as such. For a layperson, looking at the ultrasound, it appears like it's very difficult to discern anything with accuracy. But I just read up on it and I guess that's not true. Thanks for the input, Sheryl.

I suddenly thought...how accurate are ultrasounds? What's the possibility that I don't have a nodule and they misread the ultrasound? Hmm, I wonder if the first move would be to have another ultrasound.....

Is this happening everyday at Airport Plaza? I'm about due for my 3rd boost.

22 minutes ago, lopburi3 said:

Having bladder removed took that also - so one less thing in the old age cycle to worry about.

 

In any event suspect you have found early so likely even if cancer your prognosis should be good.  My check was due to blood in urine (which seemed to only occur after evening walks, which can be nothing, so waited longer than I should have). 

Oh shoot, that stinks. I'm glad to hear you got through that. I guess I should use this as a public service announcement to prod folks to get a regular check-up. I've kind of been doing that every couple years and look what turned up, nice and early...the nodule. The check-up is under 5k at Rajavej for men for their premium service. A little bit more for women depending on a couple add-ons. I have no idea how to compare it to another hospital but I would think an ultrasound is an ultrasound and a blood test for X, Y, Z is pretty standard as is an EKG, etc.... Sure, depends who's reading the chart, I guess, but I've been happy enough with it. You can add on different tests, too, as you wish.

10 minutes ago, elektrified said:

Sorry, my misunderstanding. I thought prostate was mentioned.

No worries! I'm sure to have that on down the line, too!

1 hour ago, Sheryl said:

 

This is not making any sense to me.If the nodule is benign  there is no need to remove it. If it cancerous or pre-cancerous then in addition to removing it you would need further follow up.

 

And you should not be seeing a doctor who rushes you like that.

 

I suggest you see one of the 2 doctors so far recommended in Chaing Mai for cystoscopy and biopsy under local anesthetic.  Sripat will likely cost less than Bangkok Hospital but may take longer to book.

 

If the biopsy comes back malignant then IMO you should at that point definitely come to Bangkok and see  Dr. Charuspong Dissaraan.

 

 

 

Thank you, Sheryl. I didn't like the rushed part either....and feeling stupid asking questions like I'm wasting the Dr.'s time. As mentioned, I didn't know anything about bladder nodules....just what I'm learning now. I will def see one of the above mentioned doctors in this thread and report back..

Thanks again, Lacesit. Touch wood for me, too, that it's not cancer. I've read some info on the net saying that bladder nodules are more often cancerous than not. But only some sites say that. I do not have a clear idea of what the real story is. I guess that's what I'd like to know, and if it isn't cancerous, is it safe to go on my merry way leaving it in there. If it's something that sooner or later is going to have to come out, cancerous or not, I guess I would think to get it over with in one fell swoop. I wish the Dr. had taken the time to answer my questions. I think I will look up your guy, or the Dr. recommended at Siriphat Hospital, and get a second opinion. I paid somewhere between 30k and 40k for a colonoscopy with general anesthesia, and removal of a polyp or two, maybe 5 years ago (if my memory serves me) so I was surprised this one is 100k. Perhaps it's apples and oranges and 5 years later.

5 hours ago, Lacessit said:

I have regular checks for bladder cancer with Dr. Wittawat Rawiyotai at Bangkok Hospital in Chiang Mai. Speaks good English, answers all my questions. Does cystoscopies under local anesthesia, 18,000 baht.

The last cystocopy I had was in November. He found an inflamed nodule which he biopsied, about 5000 baht extra. No issues with the biopsy.

Apologies if that information is too late to be useful, I've only just seen the thread.

It's very useful, thanks. I just got finished speaking with the urologist at Rajavej. He recommended taking out the nodule at a cost of 100k (estimated) and a 2 - 4 day hospital stay. I felt rushed and that the various scenarios were not discussed much. I asked about just doing the scope/biopsy but he seemed to suggest it was better just to take it out and not worry about it anymore. That sounds nice in a way but I have no knowledge yet about how dangerous a  non-cancerous nodule is. I didn't realize taking one out was such a big procedure....this would be under general anesthesia. So, Lacessit, were you ever diagnosed with cancer and what is your take on having a nodule in the bladder? I guess you/your doctor are not of the idea that a nodule necessitates removal. I did not really have time enough to discuss much in depth with the Dr. today as he seemed anxious to see the next patient. That didn't seem so great and so I'm still in the research phase. Thanks!

Thank you, Sheryl. I'll report back for the masses what I find out today.

5 hours ago, elektrified said:

Having had two biopsies, I recommend you have yours at Chiang Mai Ram. Ram is the only hospital in Chiang Mai that offers general anesthesia during the 20-30 minute biopsy. No other hospital has the required life support equipment in the radiology department and therefore will not give you general anesthesia. At RAM, the O.R. for urology procedures has all the radiology equipment inside. The biopsy will be ultrasound guided. If you don't get the Propofol IV at RAM (anesthesia), they will only give a quick injection of topical anesthetic and when the machine enters your prostate 12-20 times it will be uncomfortable/painful as hell. My friend described it as feeling like he was being bitten by a snake in his prostate over and over!

Thanks, Elektrified. Does it matter that this is a nodule in my bladder and not something to do with the prostate? I have not read that a biopsy of a bladder nodule is particularly painful. To note, I had general anesthesia at Rajavej midway through a colonoscopy as it was too painful. Does that run counter to your thought that no other hospital offers general anesthesia? Not trying to be combative.... I certainly don't look forward to the feeling of a snake biting me from the inside, don't get me wrong. Tomorrow, I will meet with a urologist at Rajavej and get the lay of the land and then make some decisions about my next move. If I'm assured the next move is pretty straightforward, I'll probably take the path of least resistance and financial obligation and move forward at Rajavej. If things get funky, I'll have to reevaluate. Thank you!

I had seen his name from years before, Bannakit, and was hoping to locate him. I had wondered where he had ended up A shame he's not seeing patients.

1 hour ago, lopburi3 said:

Read up on cystoscopy.  Sounds worse than it normally is but if they see anything needing biopsy they can cut a small sample during procedure.  It is not a really high priced exam and will take about an hour or so including getting ready - you will likely be able to enjoy the video in real time.  

I'm imagining it's similar to a colonoscopy, in some ways., which I've had a few of including taking out a benign growth or two. Hey, if you got both the colonoscopy and cystoscopy at the same time and they met in the middle, clipping and snipping the whole way....what fun!

5 hours ago, Sheryl said:

Moved to health forum.

 

Unfortunately the urologist listed in what Lopburi quotes for Chiang Mai has since retired.

 

There was one recent positive review for a urologist now at Sripat:

https://sriphat.med.cmu.ac.th/en/doctor/detail/339

You can read what soemoen had to say about him here, though it appears he is no longer at Bangkok Hospital CM, he is at Sripat

https://aseannow.com/topic/1007906-im-recommending-a-great-urologist-in-chiang-mai-other-than-ajarn-bannakit/

 

If ti turns out to be anything serious  really should come to Bangkok for this IMO.

 

You won't find better than Dr. Charuspong Dissaraan.

Thank you, Sheryl, for the help. I did see that thread though it too is pretty dated. I had this ultrasound at Rajavej and at this point I guess I'll meet with their urologist on Sat., if he shows up, that is. I have no idea how difficult a biopsy is...which I'm assuming will be the next step. I would think t's fairly straightforward. If things turn out for the worse, I will certainly consider my options, Bkk included. Thank you, Bam