kmw
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Posts posted by kmw
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Dr wittawat, is great, I see him once every two months, he works mainly at Bangkok Hospital Chiang Mai, but also works at government/public hospitals, I asked if I could see him there, but he refused and advised wait times a long and consultations quick, however after doing maths with my insurance premiums, gaps, etc it works out costing only slightly more expensive at Bangkok Hospital Chiang Mai,
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Dr wittawat, is great, I see him once every two months, he works mainly at Bangkok Hospital Chiang Mai, but also works at government/public hospitals, I asked if I could see him there, but he refused and advised wait times a long and consultations quick, however after doing maths with my insurance premiums, gaps, etc it works out costing only slightly more expensive at Bangkok Hospital Chiang Mai,
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6 hours ago, AverageBloke said:
I'm just asking out of interest, does the Targin work much better than taking say 200mg of Tramadol ?
I don't really take tramadol, perhaps every now and then 2 x 50mg, but what is important to me is sleep, so not needing to wake up every few hours to take some tablets, also targin has the anti constipation elements, I guess one could take tramadol at 200 I'm sure thier are long release options but then would need additional medications to pass stools, trust me you get very clogged up,
I'm also on other medications as well, trust me you don't want to know, so it's all a juggling act unfortunately,
The pain doctor also started going on about self injecting fentanyl into the back and patches but I stopped her in her tracks,
4 hours ago, samuttodd said:This may help you figure out some medicine equivalents for a dose. For example, Hydrocodone is worth 1, Tramadol is worth 0.1. So it would take 10 mg Tramadol doses to equal 1 mg Hydrocodone.
This may help you figure out some medicine equivalents for a dose. For example, Hydrocodone is worth 1mg , Tramadol is worth 0.1mg. So it would take 10mg of Tramadol to equal 1mg Hydrocodone.
Thanks that is interesting, would you happen to know of a ER extend realease version? As we know it's only been in the last several years that big pharma have started to look seriously at ER and anti abuse methods of administration
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Just got back from Bangkok Hospital, targin has gone up in price to 187 for unit and morphine the same,
As you can see the doctor i spoke to was the pain specialists at Bangkok Hospital, and it's in my best interest to self medicate as inpatient has set me up for a bill of around 800k thb 3 times every year so far, so being out patient is 1/4 the cost,
She even decided to give me a full two months worth based in the worst case scenario if me needing both morphine and Oxycodone/nalaxone every single day, even though I told her chronic is not daily but usually ranges between 1-3 times per months, and also told her I had about half of the medication from December, yet she insisted I have just a bit more just incase,!!! Incase I want to be an addict? Jeez
I have a feeling she rotates hospitals and is paid in some kinda bonus structure in relation to how much over priced medication she can sell,
Oxycodone/nalaxone I can get a pack of 20 prescribed by my GP then off the local pharmacy and the cost is about aud 25
I did also ask her about other hospitals and she said only private will be able to but it's unlikely they will right off the bat not agree to hand over the amount Bangkok Hospital will,
Anyway enough of my ranting just really sucks that people that need to manage pain thier really is no option here in Thailand unless your willing to pay or your insurance is willing to cover, mine does but my yearly premiums over the last 3 years have been going up 17% due to it now being a pre existing condition,
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3 hours ago, PPMMUU said:
I strongly agree with Sheryl that you need a proper pain specialist.
Your combination of pain medication is weird.
Yes I do see the pain specialists at Bangkok Hospital, she only works on Fridays, and then oncologists are the other person in the hospital that can prescribe these types of pain killers, and also I have several specialist in Sydney that I keep in contact with, the only reason Bangkok Hospital were able to provide these opoids as out patient is because they spoke to a few of my doctors in Sydney,
The pain specialists was also offering me fentanyl patches, in replacement for then targin, however I don't want to go down that path, as that's the strongest pain medication available and probably the most addictive,
Also the combination of medicine they give me may sound weird, but I don't take them all at the same time, I've had this condition for about 3 years and know what is around the corner,
I did have to use one of the immediate release Morphine tablets the other day, didn't like it at all, cognitive functions were all out the window, they gave that to.me as they were unable to give me just a normal 5mg of Oxycodone,
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7 minutes ago, Tayaout said:
I have chronic pain from my right knee to my shoulder due to a ski accident. When it comes back, it's so bad that I can't sleep nor find any position that make me feel better. I went to Bangkok and got a prescription for marijuana oil. Surprisingly, it fix my pain 100%. I tried between 1-8 drops. 2 drops work for me and has almost no psychoactive effect. It takes 2-3 hours before feeling the effect. It's best taken at the end of the day since it make me feel sleepy. Pain relief last 1-3 days. I would try this before opioid since it's not addictive.
I have actually thought about that, but when I was young and tried it, we call it pot in Australia, at both times I just kept on vomiting, they call it greening out, so am a bit scared, if my illnless was external I would give it a try but I have issues with an internal organ, so I'm not sure if marijuana oil would penetrate that far, but will ask one of my doctors next time about it, thank you for your recommendation
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Thanks for your reply, yes the Oxycodone Naloxone / Targin thats makes it expensive, its just a long lasting Oxycodone, as just taking a single Oxycodone only works for a few hours so its pointless for sleeping,
The rest of the expenses are for doctors, vitals, hospital charges, etc
Your probably correct that Targin being needed to be imported hence the price wont change much, however I do know Bangkok Hospital mark ups are massive on anything and everything, take example the Tramadol, so im hoping I can get Targin at a medical clinic, even if only slightly less, I will still save 1000 thb per doctor for a 5 minute chat while she types up the script for me to collect from the inhouse pharmacy.
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23 minutes ago, DogNo1 said:
OP: Feel free to not reply but I'm curious about the identity of your illness????
Have pm you
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Hi all, thanks for all your replies,
I have tried all other options, anti histamines, SSRI, Bezos, anticonvulsants, etc they dont work as well as the Opoids, an yes have tried hydroxyzine hydrochloride and it does give it a bit of a boost, but I think when you start mixing medication its a downward spiral,
When it comes to my acute condition I will be in ICU and they IV me with fentanyl and morphine, does not work, the pain subsides only very little, so always end up being sedated, 2 weeks later im awake and fine/discharged,
For the ongoing chronic, I somewhat seem to manage this, I dont want to be addicted so I dont take the opiods at times, just normal OTC stuff, and maybe one oxycodone to at least give me a few hours sleep, as chronic last generally between 3-4 days,
As one poster said it makes it harder for genuine people like myself get access to this type of medication outside the hospital
bangkok hospital have no issue giving me these meds as have been with them for the last 3 years, its always a drive in drive out,
I really would like to change hospitals, so am thinking about going to RAM or any other private or even semi private, but they are not just going hand out this medication will probably need to see several doctors and start from scratch.
Also yes I just checked my December visit,
Targin cost 3,366 thb
Morphine cost 150 thb
Yes I also travel back to Sydney once or twice a year and my local GP takes care of everything, I always get 2 months supply and run the risk of half of it being confiscated on arrival, but have been lucky so far.
I still have hopes that one of these local clinics will be able order and then deliver as they both said it will be much less then half of what im currently paying,
Will keep you all updated,
Also I think LOS has bigger problems to tackle such as drink driving, alcohol, ice/meth, etc, but thats a totally different can of worms,
Again thanks for your reply
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Hey all, hope everyone had a good NYE,
I've finally decide to post as I've had enough of mixed answers from pharmaceutical staff, doctors that have own clinic's, and also hospitals,
in my mid 30s I have a condition that is acute and ends me up in ICU generally 2-3 times a year and is ongoing chronic at least once per month,
I go to Bangkok Hospital as that's where my insurance recommends me to go, but my insurance premiums for both in and out patient are starting to go through the roof as Allianz pays out about 1 million thb per year against a 100k policy and that was for last year, i need to renew my policy in the next few months so I am looking around yet probably won't change as they have me trapped.
The medication I need is
Tramadol 50 - can get anywhere
Oxycodone 5
Oxycodone nalaxone / targin 10/5
Morphine (rather fentanyl, as that's what I get in Australia, hospital would not give as out patient so Morphine as a replacement)
Ive had this condition for 3 years and am able to manage my own pain, I know Morphine I can only get at the hospital and rarely use the immediate release tables, however with Oxycodone, visited a few pharmacies and some freely give out tramadol and some don't, the mark ups on the medication I need is day light robbery at Bangkok Hospital, I've visited 3 doctors so far, one said no, only hospital, and the other said yes, but he would need to order it from a government supplier list and needed to obtain some kind of authority, then i come back and pick it up, yet could not provide a price but said maybe he would providez, and the other said maybe as he need to check a few things and asked me to come back in a week again, probably the same as the other but he was very tight lipped about the whole thing,
I can easily get these medications at Bangkok Hospital, I used to have to go every month but now they are giving me 2 months supply because I keep telling my doctors I hate the place and threaten to leave, so it's starting to get expensive, each trip roughly cost me monthly roughly 15-17k per month and about 25k every 2 months,
So I would like to know is thier a cheaper way to obtain this medication outside the hospital? Locally in Chiang Mai? As I know it's much cheaper, for example tramadol at Bangkok Hospital charge me 576 thb, where I can get it around the corner for 60thb.
All the doctors/clinics were surprised that I have this medication as out patient and all didn't know about Oxycodone nalaxone/targin so were taking photos of me, my passport, medical certificate, and the drugs themselves, I honestly felt like a criminal,
So what's the go with opiates here and are they only restricted to hospitals? I travel back to Sydney a few times a year and can easily obtain this medication with my GP and it's even subsidies under Medicare and other schemes,
Ive attached photo of the meds
Any information would be greatly appreciated as I've been going around in circles with independent doctors and clinics over the last few weeks,
Thank you in advance
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3 hours ago, JohnnyBKK said:
I know a digital nomad who got a work permit because he was paranoid, for that he needed to create a thai company and he hired some thai workers on paper, those workers had nothing to do but he still needed to pay taxes for them.
Every year it was a huge hassle to file yearly reports, pay VAT, taxes, etc. He closed the company and left the country.
Now in Chiang Mai there is a BOI company that make unlimited work permits for digital nomads, it's the only easy legal way to do it, you pay some taxes on your earnings too of course.
In practice, 98% of digital nomads are just tourists (elite visa) or married to a local. They open offshore companies and never pay any taxes anywhere. This is not legal but there is absolutely no way of knowing what you are doing if you never engage with any thai customer. Most people who get in trouble is because they told someone what they were doing and someone reported them to the local police.
Yes your totally correct, BOI companies can issue unlimited work permits via the DOE,
Same with that iglu company, and a few companies in Bangkok and Chiang mai,
I think that most digital nomads will move on after a few months, so no real issues with visas, but long term on line workers tend to move under the ltd or boi systems, ltd is a bit of a hassle hence why all are going for the boi recently
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The police and medical clearance is based on the employer or your school not immigration/work permit/ext of stay I have a friend who teaches in Bangkok who has to police every year but medical only when he started,
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This depends, if you are on a BOI smart visa, no need to do tm30 and no need to do 90 day, only yearly reporting, employer and the boi take care of this
If you are on a BOI work permit with an extension of stay yes you need to do tm30 and also 90 day report, but you can use the one stop office so away from the normal immigration, in and out within 5 minutes for anything related you need to do with immigration, ie re entry permits, tm30 and 90 day,
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This is quite normal, the company I work for issues many work permits and also cancells as well, after the work permit and extension of stay is cancelled it's better to come back to Thailand on a visa, as if you try to come back on a visa exempt we have found many ex employees get refused entry or grilled a lot at the airport as the IOs think your comming back to work here illegally, even if your genuinely a tourist, turning up in a suit sorry is the the worst idea
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3 hours ago, Matzzon said:
In my opinion the Smart Visa is created to benefit the Thai system, which you seem to clearly have missed. But ok, if you are able to bring your foreign company to Thailand and get going with the requirements for a legal company office with the requirements for working legally. Yeah, why not. Give it a shot.
Your kinda correct, I work for a boi company, boi enables multi national corporations to set up shop here all have been under different names being subsidiaries, on Thai soil with no need to pay any tax, no need to employ any thai nationals, it's basically basically smoke and mirrors, it's designed to attract foreign investment by blue chip without the need for them to set up here properly as a corporation
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Hey SMART T here, also S as well was an option for me, I work for a boi company so they did everything for me, the 100k is not much and if your employer is a start up even 50k per month is fine from what I hear,
Sorry but jackdd is incorrect if you don't have your own company in Thailand, but yes you need to be employeed by a company in thailand or to be employed if your company is listed on the board of investment they are able to issue both work permits approvals and also smart category visas, work permits take about 2 days to get issued and smart visas about 5, you still need to come in on a non immigrant business visa, boi can issue the invitation for you, while you can change from say a tr visa to a work permit or smart visa, this will take roughly between 2 weeks and up to a months, so the b visa is the best option and also the quickest
Also you don't need a visa or legal agent if your going direct as a visa holder with an employer, hope that make sense
Worst case scenario just get a boi work permit, while it's not a smart visa the extension of stay is 1 year, but you can use the one stop office for eveything still, so no issues with lines at immigration anywhere
If you want your company to be boi send me a pm and I will try to help you out, it's a bit of a long process and usually takes about 6 months, but the are much better long term benefits in comparison to a normal thai limited company,
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Your old company would and should cancell your work permit already, however your extension of stay if different you need to do yourself before leaving Thailand or getting a new visa, work permit and ext are different
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15 hours ago, Leaver said:
I don't need the service, but it is interesting, and may possibly be an option for some, if not many, in the future.
Thanks for your post.
No worries, also you don't need to put all of your salary through them, they are from I gather happy whatever you can give them, I know that one of my friends does affiliate marketing online makes him about $100 aud a month, puts it through iglu to keep them happy, so any income from abroad is fine, even if you invoice yourself lol
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1 hour ago, Leaver said:
I had a look at the website.
Based on your post, if that is how it's operating, how can it be legal?
You would basically have everyone living here on tourist visas join iglu and circumvent the law.
I can see what iglu is, as a business model, but just wondering how they are going vet their applicants in the future.
It's legal they are a boi company, I have no idea how many people who are taking advantage of the loophole, only know if 2 people personally, but they run a catch 22, as people need the work permit before they can start working
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46 minutes ago, JackThompson said:
Well, if there is a way to use IGLU w/o actually paying them much/any (except the 10k for WP), that does sound like a good deal. I didn't know that was an option, and not sure how they make money / stay-afloat that way.
Agreed, however I think most of the digital nomads use iglu for the correct purposes, in relation to how iglu makes money the WP is risk free in the hopes the holder drives revenue through them in the future, probably why they take the massive 30% of income, being much higher then the usual minimum 5% tax on everyone else
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29 minutes ago, JackThompson said:
More like $2500 * 30% * 12 = 9000 USD = 270K Baht / yr.
The Iglu advantage is that you can get into the Thai national health, and qualify for applying for PR or Citizenship after 3 yrs. But, if going that route, one might as well just get an actual job in Thailand, and Get Paid, instead of paying Iglu.
Don't actually need to pay iglu, I have 2 friends who use iglu just for the work permit, it's no financial risk to iglu as the multi entry permit is paid out of pocket by the holder, iglu need to issue the boi work permit prior to the holder working, and because it's project based it's 3 years based on review, I don't personally use iglu but it is currently the cheapest and unorthodox way to stay in Thailand long term, one of my friend just last week got his work permit extended for another year, yet he had yet to push any income through iglu, yes they will take 30% of income, but they will reimburse the 10k 9800 or whatever it is in the first pay cycle
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I personally don't really understand the need for the tm30,
I've been here almost 5 years and have never file the tm30, i live with my other half and we travel around both domestic and international every few months, extensions and most recent S visa never had any issues,
Wondering has anyone actually been recently fined by immigration for the landlord/house master for not declaring??
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Hey an option you could look at is a work permit, no degree or education required, cost is about 10k thb per year through iglu they issue a boi work permit and you don't even need to be working, you can google iglu, generally it's for online project based freelancers, also you can use the one stop at immigration for everything, so in and out within 5 minutes, 90 day reporting etc,
I know of two people that use iglu for long term stay in thailand and they don't even work, you need to pay out of pocket for the boi work permit and they reimburse you if you put work through them, they do take 30% but you don't really need to put your income via them, I personally don't use them but I think this would be your best option
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Had a friend try to get a non b in HK, they turned him away and gave him a setv instead after kicking up a stink, this was 2 days ago, staff at HK advised the website has incorrect info on it, apparently they are really busy and are only issuing visas for hk residents currently
Urologist in Chiang Mai
in Chiang Mai
Posted
Hahaha, yes indeed, every time I see him I get a graphic memory to leave with