Sheryl

I think it has more to do with timeline and evolution of a system which, in Thailand, is still quite new. Universal health care here is less than 20 years old and still evolving. It does not yet extend beyond acute care, and is struggling to finance even that. For an aging society to finance not only universal access to acute/curative care but universal access to hospice and long-term (e.g. nursing home) type care is a huge challenge.

Sorry to hear this. Please post pix and details of your dogs in case any one here might be willing to adopt any of them.

The problem is that these hernias can "strangulate" in which case the blood supply to part if the intestine is cut off. This is a very serious, even life-threatening complication. The risk of it is about 2.5% per year that the hernia goes untreated. (So by the ten year mark cumulative risk is 25% -- significant). For people in otherwise good health these risks well exceed the small risks of a surgical repair. The equation changes if the person has unusual risk factors for surgery.

There are government health centers but these will be crowded. MedConsult Asia is indeed a good bet. Otherwise, in Bangkok, clinics are OPD departments of hospitals. Private hospitals in Bkk are not all equally expensive. Good, less pricey options are: Camellian Hospital on Thonglor Mission Hospital (near Democracy Monument) Bangkok Christian on Silom St Louiso n Sathorn All of the above are not for profit and cost substantially less than the "international" hospitals.

Depends on the insurer. What you describe is the norm for international insurers -- though even they may dig a bit further if something about a claim rings alarm bells (usually these are claims submitted within a year or less of newly getting the policy for something that, by its nature, stands a good chance of being pre-exisitng). Many Thai insurers however seem to go back to thew original application again after a claim is made, and/or to dig through medical records again at that point, seeking evidence of a pre-existing condition. Worse, these investigations are done by non-medically trained people and the conclusions they draw are sometimes absurd.

They cannot check hospitals in other countries, no. Nor small stand-alone clinics. Remember that when seen by a doctor, much less hospitalized, they ask the relevant medical history and this gets recorded. Say you had a kidney stone back in your home country X years ago. Then admitted for same or related problem in Thailand. Your history of a prior stone -- which you would need to tell the doctor in order for him to properly diagnose/treat you - will then be on your Thai record and that is all it will take, no need for htem to have the original records from your home country. it is really very simple: do not try to conceal your medical history. You are more than likely to regret it if you do.

Most of these private hospitals are part of chains. Many of them owned by the same company. I don't know exactly how it works but it seems to take then no time at all to locate records, they probably have some ready means of contacting all the hospitals in a chain. Which is not to say that they might not miss one at an out of the way private hospital not part of a larger chain. But one should certainly not count on it.

Mesh is usually used in both laparoscopic and open repairs.

Assuming it is actually a hernia (not all groin lumps are) and that you have no unusual surgical risk factors repair is recommended but there is no immediate rush. The rationale for surgical repair is the risk of subsequent strangulation

The underlying problem is that the government health care system here does not yet include long term care or residential hospice care. These are acute care hospitals. Bed space is at a premium and they cannot afford to keep patients who need palliative care only, nor elderly in need of a nursing home. They also cannot provide much by way of inpatient rehabilitative care. Some of the larger government hospitals do have palliative care programs but only outpatient. Would at least provide pain relief though family would still have to provide the nursing care. If OP could say where he is located I could advise better. There are also private nursing homes which cost considerably less than private hospitals.

Re the various private hospital costs various posters have described: Health care costs have risen enormously in past few years For laparoscopic hernia repair nowadays rate is around 200k. M8ght be a bit less upcountry and in non-profit hospitals. But I have not seen it reach 300k, that is unusual. Open procedure about 50k less than lsparoscopuc (in private hospital).

There is no central database. But it is quite easy for insurers to access medical records from all the private hospitals in Thailand and when you sign an insurance claim you authorize the release of your medical information by any and all healrh care providers. Do not try to withold any information on your insurance application. If it is found that you have, the entire policy can be voided.

Off topic posts have been removed

Mesh is used pretty much everywhere. It is also usualky used in the West. Some public hospitals have capacity to do laparoscopic but many do not. Which hospital are you covered at? 300k is high for this at a private hospital. 200-225 would be more usual. So if you do opt for private, shop around bit.

None of these meds would cause low potassium. Heavy sweating could. So could diarrhea.

Stress alone cannot put a healthy heart into A-fib (if it could everyone would be in AF!). However excessive caffeine use can sometimes trigger it and so can low potassium. The qestion is, why was your potasdium low? What regular medications are you on? If your heart rate is now regular you may have been in what is called paroxysmal AF. With just a borderline rise in Trop T and no EKG sign of ischemia the only reason to have kept you would gave been if you were in severe heart failure which the doctor obviously did not think was the case. He opted for conservative approach and this seems to be working. It may be worth getting a thorough cardiac work up at some point but does not sound urgent. Assuming everything checks out OK on repeat visit, suggest you get full revords of the event and follow up while in UK.

Sports clinics are known for this type of thing and best avoided. By your own account second cardiologist said no angio needed. So hardly the case that all or most doctors in US are likely to advise unneded stenting. You encountered unethical practices in a partucular type of commercial establishment known for that sort of thing. Having some blockage does not mean a stent is indicated. >70/75% blockage and symptomatic yes but even then not always. Depends on which vessel and overall clinical picture. Having a heart attack yes.

Warfarin is indeed a cheaper option but has a very narrow therapeutic range so higher risk of bleeding episodes and requires regular monitoring through frequent blood tests. NT-probnp test helps determine if you are in heart failure and if so how severe. I have no idea what they would charge for it. Combination of clinical findings, chest Xray and maybe echocardiogram are usually sufficient to diagnose heart failure so if the test turns out to be costly you could ask the doctor if really essential/how likely is it to alter the treatment plan. With Troponin T import thing is that it be back in normal range. Exactly where in that range does not matter. However if you are in heart failure a slight elevation may remain. You do not mention it but I trust they gave you something to lower your heart rate? Heart failure in a-fib results from thd ventricles going too fast in an effort to keep up with the atria. It is important to control that and usually possible with medication.

The best place in Khon Kaen for this is KK University Hospital (Srinagarind) https://srinagarind.md.kku.ac.th/ It has a private wing https://www.smckku.com/en/

As above. Available here but expensive and no generic equivalent. However a lot cheaper than in US.

"They" do not decide whether to stent or not. Patient decides based on doctor recommendation. Of course, best to think it through beforehand and discuss pros and cons with doctor beforehand. Doing a CT angiogram first will add to costs and still be less conclusive than an angio. Where it is useful is if the patient is asymptomatic as it may avert the need for an angio. If significantly symptomatic he should definitely proceed to angio IMO. We have no idea if this patient is symptomatic or not. And that, together with the extent and location of any blocakge, makes a big difference in terms of whether stenting is of likely benefit

Not remotely true. A doctor will not even do an angiogram unless there are clear indications for it. And they will often say no stent needed (or needed yet) based on angio findings. The indications for stenting are quite clear.

OK then the extent of blockage is not sure. But yes, likely one or more stents will be needed. Stent is done during angiogram if findings indicate it. As the stents themselves are the main cost driver, cost will greatly depend on how many. BKK Christian in BKK, about 250k if 1 stent (Includes angio), more if more. Khon Kaen Queen Sirikit Heart Center (not to be confused with Queen Sirikit Navakla Hospital in Sattahip) will be less but of course more of a trip. The savings will especially add up if he needs more than 1 stent.

lKKU Heart Center would certainly be the best in terms of good quality at lowest price but is quite a distance from Pattaya. Queen Sirikit in Sattahip Pattaya does not, AFAIK, have a cath lab or do interventional cardiology. BPH does but quite expensive. In Bangkok I would recommend Bangkok Christian Hospital, this cardiologist (he is older and no longer does the angios& stents himself but will oversee it) https://www.bch.in.th/find-doctor/doctor-profile/?smid=4730 OP please clarify, to know he has 70% blockage (of unspecified number of arteries, plural?) he must have already have had an angiogram. Where was the angiogram performed and why was stent not inserted at the same time? How many arteries are blocked and what % for each? Stents are usually done at 75% blockage and even then not always if it is a minor artery affected. Does he have the angiogram report on disc? The angio alone carries a cost which is why stent placement done at same time, to avoid paying for it twice.

Nothing "revolutionary" about amoxicillin + clavulanic acid, been around for years You would definitely have seen improvement by now if it were working.. Can you post a pix? I am a bit confused by your reference to it seeming ready to burst as that is more suggestive of an abscess than a diffuse cellulitis Possible that you will have to be admitted for IV antibiotics. What hospital are you going to ?