griffer

Suzy.. I agree with what you are saying...I wasn't advocating that everyone with a twinge in their back hobbles along to Bumrungrad and slaps themselves down onto an operating table. I seem to remember Dr. Panya saying that something less than 3(or was it 5?) % of the cases he sees require surgery. I had reached the point where sitting was terribly uncomfortable...on a flight from Papua New Guinea to Singapore (6.5 hours) I needed 3 seats so I could lay down.....even after taking pain-killers.

I had been taking Ibruprofen and Celebrex (anti -inflammatories I believe)( not simultaneously) for extended periods with limited success.

(As an aside...especially for Felt 35...note that they take you into the operating theatre without any pre-med....so you are wide awake while they prepare the operating table...which consisted of a pyramid pile of cushions for me to be bent over on top of the table...and then they get all the lovely sharp instruments and long needles out on a stainless steel tray next to you...it took about 15 minutes for them to get ready and then they put you to sleep....you really feel like leaping up and saying "oh its not that bad really,.... think I'll trot off home now"...)

Sure...so I went to the Orthopedic centre and initially saw Dr. Panya Wongpatimachi...he assisted in the the operation. Unfortunately I don't have the the name of the other orthopedic surgeon ( the one who had been to The States) with me at the moment--I have his card in bkk-- when I return I will post it..

I am sure that Dr. Panya could give you his name if you contacted Bumrungrad.

Contact me privately if it would help.

hmmm--I went in on a Thursday afternoon( not a Friday)..otherwise it seems like it took a week for anyone to come and see me..

This is just intended as general information for anyone considering surgery in Thailand. I had heard of various levels of success and just thought I'd share my experience.

I will try and give plenty of detail and costs--apologies if it bores those who already know.

I had been suffering back pain for several years. It had progressively become worse. I visted a doctor in Bumrungrad Hospital Bangkok for the first time in September 2002. For those who don't know, Bumrungrad is one of the best hospitals in Thailand. Although relatively expensive for Thais, it is comparatively cheap for westerners. I arrived at the hospital without an appointment--I saw a doctor within about 45minutes.He sent me for Xrays --a nurse escorts you to the Xray department---I waited maybe 25 minutes--had the Xrays -- and then returned to the Doctor.He reviewed these and said they were indicative of a disc problem but to make certain it would be better to have an MRI scan. This was booked for the following evening.They took me down to the MRI machine to see it in operation.Apparently many patients get claustrophobic inside and they want to see what you think...you can ask to be sedated.

I arrived the next evening...half an hour before the appointment.You get changed and wait. You are taken into the MRI room and laid onto a sliding bed.Earphones with music playing are put on you and you are given a panic button. The bed slides into the machine. It is very claustrophobic.If you press the button they pull you out.You are in the machine for 30--45 minutes.

I came the next day to see the doctor. The results of an MRI are amazing.Its like a series of photos down through your body and understandable by even the untrained. He showed me where my disc had herniated and was pushing out against a nerve.

He suggested I try physiotherapy and certain exercises..and see how it goes. The alternative is surgery and it seemed premature for that.

The cost for the above set of Xrays/doctors consultaion/ MRI was about 14,000baht(an MRI scan is 10080 baht)You can also keep the MRI scans if you would like to take them to someone for a second opinion.

OK..so my back does not improve..I am back in March 2004...by now the pain is nearly constant..waking me at night..I am limping..the only relief is to lay down.

Back to see the doctor..Xrays..another MRI..we then try 2 weeks of physiotherapy.They manage to stop the pain for a few minutes at a time.They inject Novacaine into my buttock and back of my leg and that switches the nerve off for about 30 minutes and its bliss.

So..we are at the point where they are advocating surgery. I speak to a doctor friend in the UK and he seems to confirm their diagnosis. I try to get some prices out of BUPA UK...they seem to say the operation alone will be around 8000pds+ tests+aftercare.

So I take the plunge and sign up to go into Bumrungrad.I have to wait 1 week to get a bed and the necessary surgeon available. I go in on a Friday afternoon. I choose a private room(+private bathroom+TV+kitchen).

The surgeon and the original doctor visit me on Thursday afternoon and explain what they will be doing.The surgeon has spent 2 years working in a hospital in Chicago (USA), speaks english very well and seems very competant.

I have the operation at 6am on Friday morning.It takes about 1 hour 40 minutes.I come round about 9.30/10am. I felt rough. I had a morphine drip in my arm and a dispenser in my other hand...I could push the button and it injects more morphine into me..up to a certain level.

They took me back to my room and eased me back into my bed. The surgeon visited me about 2pm and said he felt the operation was a success. He gave me a small bottle with the part of the disc they had removed inside.Lovely...

He came the next day and asked me to allow him to lift my leg. I was dubious. Before the operation I could only lift my left leg about 9 inches off the bed.He lifted it about 2 feet and there was no pain.

By Sunday I was walking around, and I was discharged on Wednesday.

The cost..each physiotherapy session combined with a doctor consultation cost around 2000 baht. I had about 8 of these. The MRI cost 10080 baht. The Xray and consultation cost 4400 baht.The pre-op tests(cardiac/blood tests) 2800 baht.The actual operation ,room fees, nursing costs, medicine 155,353 baht.

So I make that around 188633 baht.

So far its been a complete success...I can only recommend the hospital and the doctors. If anyone out there is suffering like I was, I hope you are as fortunate as I have been.

the following is quoted from thaivisa page on tax in Thailand:

". Taxable Person

Taxpayers are classified into "resident" and "non-resident". "Resident" means any person residing in Thailand for a period or periods aggregating more than 180 days in any tax (calendar) year. A resident of Thailand is liable to pay tax on income from sources in Thailand on a cash basis, regardless where the money is paid, as well as on the portion of income from foreign sources that is brought into Thailand. A non-resident is, however, subject to tax only on income from sources in Thailand. "

hmm...

so if I stay longer than 180 days(overall) in a year I become liable for tax on money brought into Thailand from abroad?

seems with all the talk of how to extend visas on the board, that many people fall into this category..does it apply to those on retirement visas also?

Perhaps, without prompting, the Thai authorities may seldom implement this rule...?

I note the 'devil may care' attitude that some advocate on the board..because bending the rules has become commonplace(overstays,working visas,etc)..I just question the wisdom of living with that opinion in times when the present Thai government is determined to tighten rules, and their implementation.

While there seems to be many grey areas in Thai law, and sometimes confused officials, in the end you will either be legal or illegal...balck or white..that judgement eventually,potentially,to be made be a Thai. Probably most people know where they stand in regard to the law....and if not, maybe they better find out.