samasama

"i'd easily entrust my 15yo younger brother to do it."

If it was so easy, why didn't you do it? Too, antibiotics are very cheap in BKK, and I can't imagine walking around BKK with a festering carbuncle on my butt, window-shopping for medical treatment.

i gave it a shot, but it didn't work out. figured it's much easier done by someone else and not by myself with a mirror and a box cutter. also tried self-prescribing antibiotics.. it worked just fine for the infection/inflammation, but the mass was still there under the skin. after getting off the antibiotics for a little while, it came back.

Prediction.

1. The cost of living between Thailand and the West starts to narrow and becomes less attractive to European Expats, but more attractive to wealthy Asians.

2.Cambodia continues to develop and becomes the new Thailand.

3.The generals start to loose their grip on Myanmar and Myanmar becomes the new Cambodia.

4.Laos becomes an industrial zone of China and/or Vietnam.

Would be interesting and not too far-fetched if it happened that way.

#4 is a likely event, but would be altogether sad if it happened.

I've heard a good deal about Thaksin's continual funding of the red shirts. A Thai girl I met told me about a web site you could go to and claim 500THB for joining in on a protest. What I'd really like to find out is how many of the red shirts are being compensated and what is their proportion to the total. Clearly, Thaksin as deep as his pockets go, cannot afford to bankroll the entire movement. There's clearly plenty of popular sentiment behind it.

And where is this web site? Anyone have a link? I'd like to see it. Google translate it!

interesting responses.. looking over my post, i realize it comes across as more whiny than i intended. and this on a board where there are people with serious ailments: hiv, cancer, among others. i realize this and can therefore understand the kind of feedback i get for what amounts to no more than just a flesh wound. anyway - entertained, incredulous was what i was aiming for. anyway it looks like my point was clearly lost. i should've been more brief, clearer:

1 - really i just wanted to see if anyone else found it unusual that a doctor would just cut you wide open without so much as a heads up for an elective procedure (not unusual according to jsixpack). this after you thought it was agreed that only a lancing would be done. it was definitely not an emergency, the infection always remained local to the abscess and even the doctor at bkk general pointed out that it could wait till i got back home. he merely added that surgery would be necessary since, at the stage it was at, it wouldn't resolve on its own. i understood that, i really did, which is why i wanted only the temporary relief of a lancing with the actual surgery being done back home.

2 - i was surprised at the cost of the treatment. after getting the follow up, it seems that the procedure i got was essentially the same as what i would've gotten at bumrungrad or bangkok general had i chosen one of them. but at like 2-3% of the cost and without the conflicting, mildly scary diagnoses. 1500thb versus 50-70kthb.. it was completely no nonsense, almost too basic at camillian. i know you're paying for the bumrungrad/bkk general cachet/comfort and whatnot but doesn't anyone find that price difference absolutely staggering?

@carib:

i realize in hindsight that waiting on it was stupid, but aside from the nasty drainage, there was no pain or no other symptoms. i really did believe that it might get better on its own as they often do.

@jsixpack:

found your response to be the most insightful while remaining sharply critical at the same time. i don't get one thing:

> If he'd asked, you'd have had to say yes anyway, unless you're just an idiot, which is probably what the doctor had you pegged for.

why would anyone have to say yes to an elective surgery like that? i can understand that you should shut your mouth and forfeit your own judgment if you're being wheeled in on a stretcher in the midst of a heart attack or even if you've just broken your arm and it needs to be set. but for a persistent abscess/cyst that's been around for months? and not knowing the patient's circumstances?

@warpspeed:

> I can't even be arsed to respond to all the contradictions and ignorance in that thread (and not from the doctors) Six pack and > Carib did well enough..

ok, my ignorance, i'll always volunteer it gladly. but what contradictions specifically?

nothing life threatening just a psychologically traumatizing 10cm long x 2cm deep wound on my bum, so the histrionic title may be a bit much. but still..

i am, i really am. disturbed. this is after having visited a few of bkk's hospitals, including the venerable bumrungrad medical resort. brief background: been traveling/working for going on nearly a year now throughout asia. about 5 months back, i developed a bit of an embarrassing skin abscess (ie - an infected pus-filled mass beneath the skin). embarrassing because it was huge, embarrassing because it was on my bum (not in my bum, on my bum, extending nearly 8-9cm radially from the center of my left cheek towards my thigh and to the side of my anus. so i had to put it off. it'll go away on its own or so i thought.. instead it decided to grow... and grow it did to the point that i needed to do something about it. it would drain at random, thus forcing me to wear 'panty liners' at one point. i'm a dude i should also mention. couldn't have that.

so fast forward to bkk. first to bumrungrad. you have a 'fistula in ano' i'm told. basically it's a tunnel that runs from inside your anus, expressing itself somewhere in the skin outside. you sure about that? 60-70k baht for a fistulotomy. when would you like to schedule? whoa <deleted>? no way i'm outta there.

i had an abscess in the same spot about 4-5 years ago. it was just an abscess. i had it lanced, i went on my merry way. off to bangkok general for a 2nd opinion. this time the exam was more thorough, including an unpleasant rectal exam. "no - you don't have a fistula, don't worry," i'm told. but you do have a chronic condition called hidradenitis suppurativa. what? i've only had a serious boil just one other time in my life; i get some pimples on my face, back and butt but that's about it. could you just lance the thing? no no, that won't fix the problem, it'll come back. i can do the surgery for you. it must be inpatient though (would you like the vip suite?) and requires spinal anesthesia (and thus an anesthesiologist). it requires a long incision to be made and the total will be (ballpark figure here) just around 50k baht. to remove an abscess/cyst? in thailand?

so i hit up the internet and looked for a few hospitals that don't specifically target medical tourists. bangkok christian comes up, st. louis, camillian and a few others. fine. i happened to be staying near camillian. sure, it wasn't as impressive as bumrungrad or bangkok, but that was exactly what i was looking for or so i thought. after registering, i'm in the doctor's office in about 10 minutes. fast service here, very nice i thought. after briefly explaining the problem, he says 'let me have a look' and we head off to the er. ok after motioning me back to his office, the doctor suggests that i need surgery to have it removed, but i explain 'no no'. i just want the thing lanced so i can be on my way. can you just drain it? make a small incision and drain? ok, ok, just small incision and drain he agrees. i'm back in the waiting room. i'm not fully impressed by the doctor but i figure any idiot can do a lancing; i'd easily entrust my 15yo younger brother to do it. one of the nurses comes over and tells me that they need to prep the operating room first. no no, i repeat myself to her, i don't want surgery for this, just a draining.

we head back to the same examination table in the er. i confirm, just 'drain it' ok? 'yes', he agrees. and in about a minute flat, i'm pricked with local anesthesia and though i can't see nor feel it, i'm pretty sure the scalpel is in me as i do feel something warm oozing down my skin. when i ask how it's going, he responds, 'all done.' the whole thing? it took maybe 3-5 minutes. seemed about right for a lancing. they bandage me up, but something's not right. there's a whole lot of gauze for what should be a small incision. 'how large was the incision?' i ask one of the nurses, gesturing at about a cm. instead, her eyes widen and she gestures at about 10cm. at this point, i'm reeling. what?!? where's the doctor? trying to keep my cool. i confront him and ask him what the hel_l he did. he said draining isn't enough, it won't fix the problem. he had to open up the entire thing in order to treat it properly. but without asking?! i need to travel. you can travel fine he says. it's no problem. i want to hit him. i really want to smack him good. he doesn't seem to understand the concept that you can't just cut someone open without telling them first. moreso when the patient specifically explains that they do not want surgery. seemingly unconcerned, he starts to hurry off to see another patient. i start to follow him but what am i going to do here? with him? with my anger? i get ready to leave. there's just the matter of the bill. only 1500 baht! for EVERYTHING. what?! this was supposed to be a 50-70k baht procedure. i argue at first. i shouldn't have to pay anything but then i stop myself.. money really wasn't the issue at the moment. i just needed to leave and see for myself. i toss the money at the cashier and sprint back to my hotel.

seeing it for myself just made things worse. not having a lot of faith in the doctor's work, i went to samitivej for the follow-up. the wound would have to stay open, he explained to me. he couldn't stitch it up since there's an active infection. it made sense, he seemed quite competent as well, but again i got that uncomfortable feeling of being more of a customer than a patient over there. the feeling that comes when you see a charge of 980 baht for 2 pieces of gauze with 'silver for its antiseptic properties' which would cost just 4 baht for the standard cotton variety at the local pharmacy. when you're hit with a 640 baht medicine charge even though no medicine was dispensed, after the medicine was explicitly declined. i'm convinced after my experiences in thailand and elsewhere that for minor ailments, you're always better off away from the big cities. as of now, the wound's healed up enough so that i think i can move on with my travels. so it's off to india finally next week. wow bangkok, you've left me with quite a memory. thanks for reading my tale of minor woe.. take care in these parts, folks! ;-)