[30 Day Visa Exemption Scheme]

Thai Embassy website London has info on the 30 day visa

exemption scheme:

www.thaiembassy.org/london/en/services/7742/84451-Tourist-Visa.html

 

I am looking at travelling to BKK with my son (dual Thai/UK) who has his own Thai

passport. 

I would like to pop down to Sydney, Australia for a few days then return BKK before

leaving for home in UK.

 

Does the visa exemption allow for the re-entry into BKK from Sydney or do I need

a re-entry permit?

[Lobectomy in Bangkok]

Some further clarification - the CT report describes the nodule (12x14mm) as calcified.

Several docs have said this is "probably" benign and may be the result of a previous unknown

TB infection which my immune system dealt with. This is not therefore 100% benign.

There has been no change in size over 3 CT scans.

I have had 2 biopsies already - the lobectomy is the 3rd attempt at getting biopsy/diagnosis.

The nodule in the RML plus some ground glass opacities will therefore be effectively resected

by the lobectomy. There are also ground glass opacities in RUL and LUL.

So the only way left it appears to get a diagnosis is to have the lobectomy which is at the centre of my

current treatment options.

Treatment in the UK would involve a large hit in the wallet but as a self payer that should be expeditious.

I have booked a telephone call with my VATS surgeon and hopefully he may get back today.

[Lobectomy in Bangkok]

The "ground glass" refers to the appearance on the CT scans of the area of infection.

Additionally there is a small nodule in the right middle lobe.

I've now had 3 CT scans which show no change in appearance.

I agree with the least invasive approach and so I've already had 2 biopsy attempts as described

above without success, ie. pathology can't see any malignancy, TB etc. This does not mean these

are not present just that the biopsy techniques have limitations.

The lobectomy now seems the only option to get good biopsies and would cover both the nodule

and the "ground glass" areas in the middle lobe.

I'm still keen to take the least invasive route which is why I would prefer the VATS procedure which if

carried out well would provide far less discomfort and recovery time, especially avoiding cracked ribs

which can take a long and painful recovery period.

[Lobectomy in Bangkok]

Thank you for the comments - there's clearly some experienced clinical expertise on

this forum!

I will contact the VATS surgeon here again for a chat regarding his expertise with VATS

and also ask directly if the UK option would be best in his opinion.

I do feel VATS is the best procedure and I take the point that it could convert to open surgery

in the event of unforeseen operative complications.

From my research so far this appears rare (that research of course does not cover Thailand).

May I ask if you were in a position of needing a similar procedure where would you prefer to have

it done?

[Lobectomy in Bangkok]

Firstly no insurance for UK, only this region but if needs must I would pay for UK treatment.

I have googled and searched pretty extensively so far without producing much apart from training

- the VATS man has had some experience in the UK but I don't know if that included VATS.

The reason the other surgeon gave for not doing VATS was that he felt he didn't have enough depth of field

using the camera, especially with large blood vessels in a confined space.

He also said he was 68 years old and had lots of experience. A perfectly nice communicative man who had

plenty of time to discuss issues and put no pressure on me whatsoever.

This lobectomy, in my view, is an extreme way to get a biopsy but appears now to be the only way because of the

positions of the nodule and the "ground glass".

Which is why I initially chose the less invasive bronchoscopy and needle aspiration although they both come with

lower percentage (up to 50%) success rates,

My review of VATS outside Thailand is that it appears to be the procedure of choice in UK and USA even for bigger

lobectomies than my middle lobe,

Less time in hospital with much less recovery time and possible complications reduced as well.

The VATS surgeon suggested I took my scans to the UK on a then proposed vacation to see if the doctors

in UK "had any ideas". This vacation has been scuppered temporarily by a pneumothorax caused by the needle

aspiration but the suggestion was at the same time reasonable but also left me wondering why?

I guess I need to ask him directly about his "scoreboard".

I am also anxious to find out what's going on obviously so that I can get diagnosed and start any medication asap.

[Lobectomy in Bangkok]

Returned from UK with dry cough and low grade fever - x-ray followed by CT scan showed

nodule plus "ground glass" in the lungs.

Tried brochoscopy plus CT guided needle aspiration to obtain biopsy without success.

Have now seen 2 thoracic surgeons - Samitivej and Bumrungrad - with differing views on

which procedure to use in order to remove the right middle lobe for biopsy which both

agree is now the only viable way to obtain enough material for pathology.

Samitivej goes for "vertical muscle sparing thoracotomy" whilst Bumrungrad goes for

VATS procedure.

Basically the first is more like "open" chest surgery with the possibility of cracked rib(s)

while the VATS is more endoscopic and should provide less days in hospital and quicker recovery.

My main concern with both is the record of the surgeons - how can I get data on numbers of

procedures performed and outcomes.

Or do I hotfoot it back to UK and pay someone I can get data on quite easily?

[Extra Sockets In New Build Plus Safety Check]

Looking for an electrician to fit extra sockets in a new build near Don Muang.

House not yet purchased - looking at options for improving current build.

To include mains, phone, loudspeaker sockets/cable.

An overall safety check would also be good.

House has bare walls but has had floor tiles and coving fitted.

Derek