FBN

thank you

It does sound the advice is clearly to go to BKK.

I will have to pay for this check and any treatment myself and so I want the best hospital/professionals and at a fair price. I can pay, but I don't want to have the feeling of a foreigner's walking wallet.

What is the best recomendation for 1.Best treatment and followed by 2.reasonable cost??

GERD heals by scar tissue forming at the junction of the esofagus and the stomach. This causes narrowing of the stomach inlet and leads to the sensation of "difficulty in swallowing" (dysphagia in medical terms). After 15 years of suffering from this, it may be the most likely cause in your case.

Well controlled Barium swallow X-rays, or newer techniques, will show the actual movement of anything swallowed through to the stomach; ordinary scans may not reveal that much.

This condition surely justifies reasonable money spent on it as there are some more sinister causes for this...

Please don't be alarmed at this but be sure to get a very good opinion from a Gastro-enterologist at a reputable hospital...

An insomniac; just like many out there: Jack Nicholson is a jewel...

"There are a number of mechanical devices which

Please feel free to contribute! I am collecting these...

A few more:

How long does a bout of TD last on average? I arrived home from Thailand on Saturday morning, Sunday the TD started, and i'm now into day 4. I started taking immodium yesterday afternoon which has seemed to have a minor effect.

Stomach upsets may continue to a more or lesser extent while the traveler still consumes "foreign" food. Normally does not last more than 3-4 days.

Immodium is fine as starter plus yoghurts etc. Immodium works by reducing gut motility (cramps) but also works on the cells in the intestine to reduce excessive secretion of fluids.

Charcoal tabs may help as well but when taken in conjunction with medication, may also limit the effect of medication. (Function of charcoal is primarily to absorb toxins from the gut; it is not absorbed).

Fever, blood or mucus in stools with cramps usually indicate an infection and antibiotics may be needed. For traveller's diarrhoea, Ciprofloxacin is usually indicated.

Dysentry (Amoebic infection) and Shigella usually causes bloody stools with fever and severe cramping and will need different antibiotics.

If the current treatment (Immodium and perhaps Cipro) does not clear this up, stool examination to identify the bug will be needed.

Stay hydrated with electrolyte balanced fluids.

Please don't attempt this on your own; get an ENT doc to have a look first and confirm the diagnosis. You can cause lots of trauma to your ear canal and may even cause a rupture of your ear drum if too much pressure is applied.

There are ear drops you can use to "soften" the wax before attempting the ear syringing but you have to confirm that there is no underlying infection or even a prior defect in your ear drum before using this or it could cause lots of damage.

Perhaps a thread to pay tribute to the great minds out there (some of them admittedly not so great) that come up with these quotes that just sometimes brightens the day!

Here are some:

My wife seems to think that she needs a cesarean section although a doctor told her to have a natural birth. She thinks that a cesarean section is no big deal. I told her that it is a serious operation but she doesn't believe me. I found out from some other people that many Thai's prefer to go under the knife to have birth. What is that all about? Is there anything I can tell my wife to make her change her mind. At the moment it is our only disagreement (which is rare). I guess it is her body, but I'd like her to seriously think it over. She is as stubborn as a mule though, so I'm guessing that whatever she says is going to happen will happen.

C-section or not is a medical decision; best is to avoid any emotional issues around this and the only way you can do it is by sitting down with your wife with an experienced obstetrician that you both trust and discuss the indications and/or any contra-indications. Ask all the questions you need and let the final decision up to the attending physician.

C-section rates are relatively high in Thailand, may be close to the US rates..

Previous abdominal surgery may complicate a C-section due to adhesions etc (it all depends what the surgery was done for) and a normal delivery, if there are no contra-indications, may be a safer option. It remains a medical decision though.

Good luck and may the little one be healthy by which ever way he/she gets into this world!!

Boksida:

Not Kipling. Actually Robert W Service (1874 - 1958); Known for his works in the Yukon in the gold rush period. He is the guy that collected his poems and, when he had enough for a book, paid a publisher $100 to print it.... (poemhunter.com)

My apologies, you are quite correct. Isn't he the same guy who did the one about The Shooting of Dan McGrew?

The same...

I am amazed at amount of friends who are expats that suffer from depression. Am wondering who else suffers from this mongrel of a thing and how you cope with it.

also wondering about the motivation for living an expat life and if your depression possibly plays a part in it (for those suffering with depression)

i think it is very prelevant among expats...especially long-term ones. combination of causes...homesickness, burning of bridges so some cannot go home, financial problems (major cause) and of course relationship problems. also, the realization that thailand is not the end of of the rainbow many thought it would be. it's nice but it's not home many find out. plain old boredom is also a cause and also being separated from ones own language and culture i think starts to play a big part after years of separation from it. i guess that's why maybe i estimate 75% of LT exparts are alcoholics. hit the bottle (either alcohol or prozac...chose your poison)

Yeh, I think you are very right. At the other end, personally, I am starting to question my motivation to choose expat life and am wondering if all this travelling is actually depression motivated. I go somewhere and get sick of it after about 3 or 4 years and then want to go somewhere else, applies to relationships also. I guess thus your end of the rainbow theory.

Men has been known to suffer from this 100's of years ago; this attachment dates back to the California Gold Rush days.. Anonymous, as far as I know; not from my pen..

Well that sucks - why can't it have a good ending, like for instance the guy is happy now because he has seen everything and been in 100's of different relationships and can tell lots of stories and he lived happily ever after.

BTW Thanks for the comprehensive info.

Some anxiolitics which are mildly anti-depressant usually will do the trick

I don't suppose you can give an example medication in this category

Xanax (Alprazolam) have been used in these cases to some good effect and sometimes in combination with antidepressants. Please keep in mind that this is prescription medication with significant side effects if not used properly (under management of an experienced physician). It is a member of the Valium/Bensodiasepine family which is also known to cause depression with long term use and it is addictave as well.

Boksida:

Not Kipling. Actually Robert W Service (1874 - 1958); Known for his works in the Yukon in the gold rush period. He is the guy that collected his poems and, when he had enough for a book, paid a publisher $100 to print it.... (poemhunter.com)

I am amazed at amount of friends who are expats that suffer from depression. Am wondering who else suffers from this mongrel of a thing and how you cope with it.

also wondering about the motivation for living an expat life and if your depression possibly plays a part in it (for those suffering with depression)

i think it is very prelevant among expats...especially long-term ones. combination of causes...homesickness, burning of bridges so some cannot go home, financial problems (major cause) and of course relationship problems. also, the realization that thailand is not the end of of the rainbow many thought it would be. it's nice but it's not home many find out. plain old boredom is also a cause and also being separated from ones own language and culture i think starts to play a big part after years of separation from it. i guess that's why maybe i estimate 75% of LT exparts are alcoholics. hit the bottle (either alcohol or prozac...chose your poison)

Yeh, I think you are very right. At the other end, personally, I am starting to question my motivation to choose expat life and am wondering if all this travelling is actually depression motivated. I go somewhere and get sick of it after about 3 or 4 years and then want to go somewhere else, applies to relationships also. I guess thus your end of the rainbow theory.

Men has been known to suffer from this 100's of years ago; this attachment dates back to the California Gold Rush days.. Anonymous, as far as I know; not from my pen..

The_Men_That_Don_t_Fit_In.doc

Depression in expats is fairly common. Consulting in all the countries I have been to (resident in no 7 now over the past 25 years), it has been a condition which was both difficult to define and manage. Fellow parctitioners and I used to refer to it as the "Expat Syndrome". More common in wives of working husbands in foreign countries but also among young, mostly first time expats. These are all fairly obvious causes but there is more to it and these causes are less well defined.

Depression precipitated by anxiety and/or prolonged stress (so called "reactive depression") requires utmost caution in diagnosing and managing. Newer antidepressants tend to precipitate acute anxiety in the early stages; so much so that patients usually can't tolerate treatment. The replacement of or rather the prevention of the actual breakdown of serotonin is necessary to overcome the depression but an increase in serotonin leads to the original condition (anxiety) so this has to be managed at the same time. Some anxiolitics which are mildly anti-depressant usually will do the trick...

Most importantly, do not self-diagnose and try over the counter drugs (you may be able to buy almost anything here in BKK).

Psycho-analysts/psychiatrists familiar with this condition and able to manage it effectively in expats are few and far between here in Thailand. Unfortunately, a short consultation is the norm after which a handful of drugs are usually given; not ideal..

A previous poster mentioned a whole list of "natural" remedies which, in my opinion, is definitely worth a try. The stress/alcohol/relax/hungover/more stress/alcohol cycle is a common cause of depression in expats as alcohol is very much part of the expat lifestyle and can become a pattern very quickly.

The side effects of this lifestyle are a reduced ability to do physical excercise, loss of motivation and creativity; all of which are effective stimulants and counter measuresto combat depression.

Overall good advice in this forum from posters...

Try Down Under Pub in Soi 23 close to Jasmyn Centre (on the corner of SKHVT & Soi 23).. Perhaps the pub the previous poster referred to. No bar girl and no hassles; pub food is good too..

(No, I don't have shares!!)

we all need to get together with the media and share all of these rude and anti-human rule changes. they are killing the core people who really love living here and putting money flow into the economy. trust me...MONEY TALKS.

i begged readers to join me with the retirement visa changes on dependents...NOBODY OFFERED.

i ask again...LETS SPEAK UP TO CNN..BBC...anyone...THE NATION.

is this just a sounding board...or a group of strong farang who are REAL winners ...not REAL whiners?

JOIN ME...lets make some noise. IT WILL WORK.

i will meet anyone...anyplace to form a group to go to the media about all of these racist laws popping up.

if you dont act now...YOUR VISA WILL BE NEXT.they will find a loophole in every case.

any takers?

Have an idea: Let's get together in front of the Immigrations Building and strip naked!! Did it work for the ladies who did that a while ago? Imagine a group of aging, balding farangs with paunches naked in front of a government builing in BKK... the mind boggles but its guaranteed to get some CNN...

Apologies IMSOBAD for my facetious comment above but I could not resist...

This is a serious issue but the reason nobody joined on this before may be that they all thought (like I do now) WHAT IF it did NOT work...

The management of visas for foreigners and residencies does not seem to be rational or objective to our way of thinking, ergo, is there any guarantee that the outcome of such a protest will be handled objecively?

Immigrations say jump and we say "How High??".. A foreigner in a foreign land; it goes with the territory..

photos please george.

Workers strip "naked"...!!!

About the same creative journalism as in "Airbus 380 has accident in flight" in BKK...

Immigration lines on September 1st at 12.45pm were some of longest and worst I have ever seen since travelling to Thailand, not even at Don Muang was it that bad.

I arrived from Vietnam and couldnt believe what I was seeing, people queing all way down to duty free shops.

Immagration booths just with 1 person staffed and at least 50people in each line. I was lucky to get through within 60 minutes due to kindess of some Vietnamese people, which recognised me from airplane, standing in faster moving queue, and didnt mind me joining them. Otherwise, I would be still standing there and waiting for my turn - it was apalling and unbeliavable. Others were in line for at least 2 hours to get through.

I understand that it was lunch time, but still something is wrong here, badly....

Mess at the baggage claim was immense, as no one was able to collect their stuff, more suitcases were thrown from belts from incoming flights and i was lucky to find everything.

What h...is going on??

Arrived at 7pm on the same day and the queues were just as bad. My Thai wife had gone through the Thai desk and retrieved our bags and I was still in the queue waiting. Definately the worst I have known it.

Certainly something going amiss - I arrived at around 10.45pm on a Friday a couple of weeks ago - the immigration queues weren't as bad as described here but enough to reach back to the where the entry ramp joins the immigation concourse - certainly the worst I've seen for such a late night arrival time ...

... when my wife and I flew out to Sing' at around 3.00pm the following Monday we could see that the queues were very bad at arrivals immigration as we walked past.

I seem to recall that Don Muang was pretty busy from mid-morning until the early evening as a rule - not routinely as bad as SVB seems to have become - was it?

CC

Just returned from a weekend in Phuket via Don Meuang; fortunately domestic so no problem but "Phuket Gazette" reports that an "electronic visa" checking system is on the cards for Thai airports..

Is there any other confirmation/information on this??

Immigration lines on September 1st at 12.45pm were some of longest and worst I have ever seen since travelling to Thailand, not even at Don Muang was it that bad.

I arrived from Vietnam and couldnt believe what I was seeing, people queing all way down to duty free shops.

Immagration booths just with 1 person staffed and at least 50people in each line. I was lucky to get through within 60 minutes due to kindess of some Vietnamese people, which recognised me from airplane, standing in faster moving queue, and didnt mind me joining them. Otherwise, I would be still standing there and waiting for my turn - it was apalling and unbeliavable. Others were in line for at least 2 hours to get through.

I understand that it was lunch time, but still something is wrong here, badly....

Mess at the baggage claim was immense, as no one was able to collect their stuff, more suitcases were thrown from belts from incoming flights and i was lucky to find everything.

What h...is going on??

Definitely getting worse over the past 3 mths. It creates such a bottleneck that baggage handling is becoming a problem. The luggage belts get overloaded as passengers are stuck in the immigration section, unable to collect luggage in time so you have consecutive flights' baggage lining up for the same belt.

Perhaps they have K. Jenrira cloned..

"Smething is gotta give..."

Anywhere to lodge a formal "but anonymous!!!" complaint??

Arrived from Kazakhstan yesterday afternoon and selected a line for immigration. My usual "luck" prevailed. Landed in a line "serviced" by a K. Jenjira (I took time out to note her name for reasons to be revealed shortly..). On a perfectly legal Non Imm O visa, working here now for 7 years and doing lots of international travel on consulting jobs; I go through this process approximately 20 - 25 times per year.

It is quite apparent that lines for immigration are getting longer and taking longer to clear over the past 3-4 months.

K. Jenjira took approximately 3-7 minutes per passport; I know this because I had ample opportunity to to time her; I was 20th in line...

She had a problem with nearly every passport. I have never had any problems but this time had to explain my residential address, which was clear on my immigration card, then had to explain why I was coming back. This I did in Thai to the best of my ability and with all the politeness that I could manage after having been exposed to the rigors of Kazakhstan for 3 weeks and 36h of sleep deprivation..

K. Jenjira just pouted; she was one of those "shool marm" types. Small mouth, pouting lips, perpetual frown, glasses, the lot.. Only about 30 ish.. Poor husband..

So, fellow travellers, be warned, K. Jenjira is out there, it may be your turn next!!

My advice is to go to the front of the line, check out the name and the face of the person in the booth at the serving end of it and then either come back the next day (most of the same faces will still be in her line) or try your luck with a male officer..