Sheryl
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Posts posted by Sheryl
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For those who do not know, he is referring to compulsive skin-picking.
It usually responds well to cognitive behavioral therapy (CBT) which is not done by doctors but rather by therapists/counselors.
In deciding whether to seek such treatment the severity of the compulsion and whether it is causing injury to the skin would be factors.
Also worth considering that this is often due to underlying anxiety in which case even if you managed to stop doing it on your own, you'd likely have other symptoms/issues because thdle anxiety would still be there.
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On 4/1/2024 at 3:38 AM, fellwalker said:
Hi
One last consultation. The text below is from a new Zealand data sheet.
Which of the regimes do you suggest?The usual dose is 100 mg/day at bedtime at least 12 to 14 days per month, i.e. on days 15 to 26 of each cycle or in the last 2 weeks of each treatment sequence of oestrogen therapy followed by approximately one week without any replacement therapy and during which withdrawal bleeding may occur.
Alternatively 100 mg can be given at bedtime, from days 1 to 25 of each cycle, withdrawal bleeding being less with this treatment schedule.Regards
If I understand correctly your wife has had a hystetectomy so withdrawsl bleeding neither necessary nor possible.
Her choices are:
1. Concurrent therapy - estrogen and progesterone every day.
2. Estrogen daily and progesterone only from around the 12th of each month.
3. #1 but increase the progesterone dose (200 instead of 100) for the latter half of each month.
4. #1 but increase progesterone when and as needed
Was her hystetectomy total (i.e. ovaries also removed)? If so she has no naturally produced progesterone so I would rule out #2.
Otherwise it is really trial and error.
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Actually in my experience exception is made -- or used to be anyhow -- for foreigners actually resident in Cambodia as evidenced by a long term Cambodian visa and entry/exit stamps. Even at Poipet.
This info is pre-COVID at which time I often made border entries and observed many expats living in Cambodia being able to go in & out visa exempt multiple times, some even monthly. A few times the Thai IO, not realizing I had a re-entry permit and seeing it was my 3rd/4th land entry that year, asked me if I lived in Cambodia.
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You should see an ortho specialist and get an xray.
If the hip joint is badly degenerated then you may need to minimize weight bearing. Whereas if tight muscles are to blame walking and stretches will help.
No way to know without girst diagnosing the cause.
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On 3/31/2024 at 1:38 PM, FruitPudding said:
I suppose so.
I don't suppose any STDs can be transmitted through casual contact, such as with a person's hands, for example.
Although maybe @Sheryl would be a good person to ask for expert knowledge.
Indeed sexually transmitted diseases are spread sexually and not by casual contact
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Sorry for the delay, I had to research a bit.
If you can afford private care I recommend
https://www.medparkhospital.com/en-US/doctors/prof-dr-roongroj-bhidayasiri
If not, then come to the specialized clinic at Chulalongkorn Hospital
https://chulalongkornhospital.go.th/kcmh/en/ec/ศูนย์ความเป็นเลิศทางก-13/
tel. 08-1107-9999 or 0-2256-4000 ext. 70704.
This will take more visits and entail long waits but cost less.
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On 3/30/2024 at 3:04 AM, fellwalker said:
Sheryl
I much appreciate you ongoing involvement.
New data is coming to light.
Language differences have been identified as a problem and have been reconciled.
My wife used to have the “night sweats”, she described as being “hot”. These were resolved with Progynova.
Recently she has experienced what she calls “inside hot” which we have expanded to mean “agitated, tense, or nervous”.
I now appreciate the problems Doctors must have when dealing with language differences.
So it looks like it’s the side effects of the currently administered Progynova are at issue.
Your observation that post hysterectomy, her situation, progesterone may be taken as well as oestrogen suggest that this might alleviate the ”inside hot” symptoms.
There is no necessity for such an alternative drug to be “natural” a standard pharmacological product is acceptable to be taken by mouth.
Can you suggest one?
As mentioned in my prior post, Utrogestan. It comes in both 100 and 200 mg doses, 100 mg is enough for most women. As it can induce slight sleepiness best taken at night. If you ever travel to Phnom Penh can get Progestogel there which is better as easier to titrate and slower acting.
Do not take a synthetic progestin. These are entirely different drugs than progesterone and except for shedding of the uterine lining (not relevant in your case anyhow) do not have the same action as progesterone.
I would still recommend switching from Progynva to Oestrogel as it allows better dose titration. Basically one wants the very lowest estrogen dose that controls the hot flashes/night sweats. Often this will be much less than standard dose.
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10 minutes ago, soi3eddie said:Quite possibly. Maybe unlikely but who knows. For me, I'm on Non-O retired but never spend more than 180 days in Thailand. Wonder how that might affect me.
If you spend less than 180 days in a year in Thailand you are not resident for tax purposes.
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On 3/28/2024 at 3:57 AM, superal said:
Thanks and I hope you are right . However after searching on Google I cannot find any statement to back you up , only info shows similar to mine . Has there been an amendment which eliminates tax on pensions ? Starting January 1st 2024 and counting 180 days residency , after which the new rules kick in
There is no amendment to that effect and pensions are taxable unless specifically exempted in a Dual Taxation Agreement (DTA) between Thailand and the country in question.
DTAs differ markedly in this regard so it is essential to read yours. Off the top of my head I can tell you this:
USA = Social Security can only be taxed in the US. Ditto government pensions. But private pensions can be taxed by Thailand.
UK = government pensions can only be taxed by the UK. Other pensions (including State pensions) can be taxed by Thailand.
And, of course, any tax paid in Thailand can be applied as a tax credit on one's home country tax return and vice versa.
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13 hours ago, fellwalker said:
Hi Sheryl
If it’s good enough for you then my better half will be in good company.
Can you say where it might be sourced, perhaps on line? Not sure pharmacies will have it out here in the sticks.
Regards
https://bangkokdrugstore.com/product/oestrogel-80-g-2/
While estrogen alone will deal with hot flashes, stabilizing mood swings often requires both estrogen and progesterone. The common idea that progesterone replacement is unnecessary in women without a uterus is incorrect, progesterone has multiple effects and is just as important as estrogen in HRT.
Unfortunately while the same company that makes Oestrogel makes a natural progesterone gel (Progestogel) it is off market in Thailand. There is a micronized oral form called Utrogestan which is the next best thing. While it is not currently listed on the Bangkokdrugstore website I got it from them in the past so could inquire. Or, it is definitley available from https://medtide.com
You have to first create an account to do a search
Also likely you can get both from https://medisafepharma.com/
Have to use the Messenger function to ask.
Medisafe also can provide Femiest, a vaginal estrodial, which is often needed to deal with vaginal dryness, the systemic estrogens are often not enough for that.
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15 hours ago, scubascuba3 said:
I get my Creatinine levels checked every 4 months from Red Cross, once a year or so i go to Lifecare lab for their package 4, their results for creatinine and eGFR are way different, so look inaccurate, i keep meaning to tell them but it will probably be ignored
As I have explained eGFR is not a blood test but a mathematical calculation and labs can well vary in whether they accurately incorporate the age, sex body size and ethnicity of the individual patient.
Creatnine level on the other hand is a direct measurement and any lab with properly calibrated equipment would be able to do it.
How different were these creatnine messures and was there any difference in fluid intake prior?
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Posts contravening community standards have been removed
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Also:
https://aseannow.com/topic/1252811-what-was-it-like-to-have-a-cataract-operation-in-thailand/
https://aseannow.com/topic/1211416-cataract-surgery/
https://aseannow.com/topic/1237793-recent-well-maybe-pre-covid-cataract-surgery-in-thailand/
https://aseannow.com/topic/960641-cataract-surgery-prices/
https://aseannow.com/topic/1171894-cataract-surgery-in-cm/
https://aseannow.com/topic/1215820-cataract-surgery/
As there have been many, many threads on this it might help if you mentioned where in Thailand you live.
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Rock hard Thai mattresses (which is 95% of all Thai mattresses) will do this -- all the more so if one is thin.
For home, get a good memory foam topper, well worth the expense and makes a world of difference.
For travel, get an air mattress and bring it with you. If buying from lazada search for "air bed". And make sure to get the little electric pump to inflate it.
I never stay in a Thai hotel without having packed my air mattress. For exactly the reason you describe.
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Dermal preparation is preferred to oral (no liver pass) and also easier to titrate.
I and many others use Oestrogel. As the name implies, it is a gel. One tube I think costs around 300 baht or a bit less and lasts me at least 3 months but your needs may vary. It comes with an applicator to measure out dose but I find less than that works for me.
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12 hours ago, david_je said:
My "My Docs" only shows insurance cert, notice on personal data and paying premium. Is it hidden somewhere in there? Thanks.
Very odd. This is how mine looks:
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Please keep it civil and on topic, or I will have to close the thread.
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The General Conditions are on the customer portal. Just click on "My Documents".
Mine shows only from 2023 but that may be because my 2024-2025 premium is not yet due/posted.
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OP I suggest https://www.samitivejhospitals.com/center/detail/special-needs-child-center
Make sure the work up includes hearing tests as sometimes delayed speech is due to hearing problem
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4 hours ago, Dolf said:
0.04%
There is no fixed rate of risk.
It depends on many, many factors:
- the woman's viral load
- whether she has any breaks in the skin or mucosa (invluding where you can't see)
- whether the male partner has any breaks in the skin/mucosa
- how vigorous (or rough) the sexual activity is
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The online customer portal for April should have all relevant documents including general conditions
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2 hours ago, roger101 said:
Since that test, I have had 2 more AST and ALT tests. Both show absolutely normal readings (14 and 23 and then 18 and 23). I am thinking of cancelling my appointment at the Liver Centre.
They only sent me there because my ALT was 56. Blood tests and a Fibroscan are involved (don't ask me what that is). Any views on what I should do?
I don't want to waste money on unnecessary tests if they are not needed.
I would skip the appointment unless there are other symptoms (such as jaundice). Your prior reading was barely above the normal range and readings since are completely normal.
An isolated reading at or slightly past upper end of normal range is really nothing to worry about.
Simply taking an antihistamine (or many other meds) can account for this.
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Where in Thailand are you located?
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The eFGR is just a calculation based on creatnine level and age, sex, and body size.
Thai labs (even in hospitals) often fail to adequately account for age and size so I would look more at your creatnine than at your eFGR (note that the "e" means "estimated"). And make sure creatnine is measured when adequately hydrated as dehydration wil increase it. There is no need to fast before a creatnine test.
@NewGuy see Prof.Dr. Khajohn Tiranathanagul at Chulalongkorn after hours clinic
https://chulalongkornhospital.go.th/specialclinics/
He is there on Sunday mornings and Thursday evenings (start from 4 PM onward). 3rd floor of the Phor Por Ror building which is large highrise on the corner of Rajadamri and Rama IV, directly connected by overhead walkway to both Silom MRT and Saladaeng BTS.
You have to make appointment first through the Call Center at least 1 day in advance 02-256-5193. They will give you an appointment number, make careful note of it.
And assuming you have not previously been a patient there, you need to start by going to the ground floor of the building to register and get a patient hospital card. Bring your passport, and show them your appointment number when you do as they will issue you both the hospital card and an appointment slip which you then show at the nurses' counter on the 3rd floor. Special Clinic starts issuing queue numbers at 4 PM.
The time of your appointment has little or nothing to do with when you will actually be seen. Be prepared for as much as a 5 hour wait and bring plenty of reading material.
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Hip Pain
in Health and Medicine
Posted
Good ones: Home Pro, Central.
Cheaper/not as good ones (especially in terms of (1) how thick and (2) how long they last): Tesco and the like; lazada and shoppee.
I exoect Ikea has them as well.
Note that a lot of what is online is foam but not really memory foam do will sag with use.