nonthaburial

A while ago, there was a poster who was shouting the praises of a hospital and Doctor in Chiang Mai for heart surgery etc.

Unfortunately after spending a long time looking through the old posts I cannot find this one. However does anyone know a good hospital in Chiang Mai OR Bangkok who can carry out angeoplasty at a reasonable cost.

I recently had an angioplasty in Bangkok, at Paolo in Saphan Kwai.

While I do not have any specific info about a venue in Chiang Mai, it might be helpful to understand how the logistics work. This applies to PRIVATE hospitals, only. Government hospitals offering this type of procedure are likely to be teaching hospitals (which I will address later).

First, the hospitals 'rent' space, and support personnel to the doctors to perform these procedures. The doctor, usually called a 'cardiac interventionist' gets a call from the cardiologist who admits you, and helps get you prepared. Then he shows up, does the deed, maybe stops by afterwards to be sure you are not rapidly exsanguinating, and on to the next case, in the same, or another hospital.

What this means is that wherever you go, the expertise of the doctor is not connected to the hospital. What IS important is the experience, and state of preparedness of the Cardiac Catheterization Lab personnel and facilities. Do they have all the various medications, contrast dyes, even stents in stock? Do they do the procedure often, or is it a 'emergency-only' procedure for them?

Now for specifics: At Paolo Memorial, they have a respectable ICU/CCU, with skilled nurses, one of whom, I firmly believe, saved my life. There are TWO cardiologists, one of whom simply turned his back on me and walked out, after I asked a couple of pointed questions. After I described the incident to her, the nurse in question gave me an understanding look, and immediately called the other cardiologist, who took excellent care of me, and whose treatment was the exact opposite of that insisted upon by his 'colleague'. He seemed concerned, however, about whether I would actually proceed, and wanted my assurance before he called the interventionist. I have been through this before, and knew I needed the angioplasty, so I told him to proceed.

The interventionist was quite thorough, and spoke perfect English. He was relatively young, and had been trained in the US. He understood all the issues, including the need to hydrate the patient (me!) before the procedure to prevent kidney damage from the dye, and to use some medication to further protect the kidneys.

I should mention, at this point, that this was being paid for by Thai Social Security, which I was entitled to by participation through my employer. I have no other health insurance. This would become important.

When the time came, I was wheeled down to the Cath Lab, and all went smoothly, except they didn't have the super-safe dye I would have preferred. They had the second best, and I was assured by doctor that he would either get it all done in the safe exposure time, or, if extensive repair was needed, he would find all the problems, and wait 24 hours to redo the catheterization and fix everything. So far, OK.

The procedure began, and he found two blocked areas, and then the fun began: the doctor said I needed one of the new drug-eluting stents, which slowly release medicines to keep the artery from re-closing. Unfortunately, however, the Thai insurance only would pay for a normal, unmedicated stent.

The negotiations began in earnest, with questions about my income, any other insurance (asked and answered repeatedly during my stay), etc. I had to plead poverty, because, in truth, I worked for a Thai company, and wasn't making a lot of money. After several phone calls to the stent salesman, and hospital administrators, all while I was on the table, catheter in my crotch, and slightly sedated, he finally said that his 'best price' was 60,000 baht, of which the insurance would only pay 25,000, so could I pay the additional 35,000?

Pretty hard to say no at that point, and I had exhausted my negotiation skills, so, of course, I acceded.

From that point onward, everything went well, and I am alive to relate this to you. They did try to inflate the bill, after the fact, but I got the doctor on the phone, and reminded him that we had an agreement, and he relented, bringing the bill back down to 36,000 from 51,000. I got out with a payment of 10,000, and a promise to pay the balance in three installments. FYI, the total cost was in the neighborhood of 350,000 baht, mostly paid by the Thai system.

I feel I was lucky, but this should provide you some insight into how the game is played.

I would have the same procedure, by the same doctor, and, especially, with the same nursing staff, and at Paolo again, if (heaven forbid) I ever needed it.

I realize this is long, but I would like to add one more thing, regarding government and/or teaching hospitals.

If I were in your shoes, I would get down to Siriraj or Chulalongkorn as quickly as possible, and get seen by a cardiologist there. I don't know if Chiang Mai University has a medical school (I know they have a dental program), but if they do, they may be your best bet.

The same doctors that practice for-profit medicine at the private hospitals, often teach or do research at the medical schools and affiliated government hospitals. The treatment you will receive will be the best available, if the accouterments are not exactly Bumrungrad style.

Give me competent medicine over fine art on my walls, and a McDonalds on the mezzanine, any day. Bumruingrad, Samitivej, BNH, and others of the 'boutique' hospitals are, IMHO cashing in on their publicity, and have little accountability for their service. A few years ago, I thought they were great, but they have steadily declined into hype and PR, with an arrogant attitude, and with little recourse for their patients in the event of a 'boo-boo' - which may be costly, healthwise.

I hope more members will post their experiences with cardiac care in Thailand.

Best of luck to you. And remember, an informed patient has a better chance of a good outcome. Don't blindly place your trust in ANY doctor. Ask questions, take responsibility for your own care, even if such action is considered impolite or unseemly. Better to be a live prick, than a dead sycophant to some arrogant medico.

Sateev

Thank you so much for a very informative piece of writing. Highly appreciated.

Is the Paolo hospital the one located behind the Grand Hotel on rachada ?? As it happems I am BKK based, and only enquired abouyt CM after reading a previous post.

thanks PeaceBlondie, I actually thought of putting into that forum in the first place, but didnt want my knuckles wrapped !!

Disappointed to get no responses as this is quite urgent.

Anyone in CM have experiences / informayion please

A while ago, there was a poster who was shouting the praises of a hospital and Doctor in Chiang Mai for heart surgery etc.

Unfortunately after spending a long time looking through the old posts I cannot find this one. However does anyone know a good hospital in Chiang Mai OR Bangkok who can carry out angeoplasty at a reasonable cost.

Have just completed setting up a company here and will probably need to purchase a car for the MD in the near future.

Ideal type of vehicle would be Honda CRV, LR Discovery, Fortuner, Ford Escape etc.

Would be interested in a vehicle up to 4 years old in good clean condition.

Price could be negotiable

Would need to be available in or around BKK

More important is how can you find them ??

Or is the Pope a Catholic ???

Interesting how Asian based airlines seem to have scooped the awards

Well I have used this new service and found everything to be just great. I think I put Guy under a bit of pressure last Thursday by asking for flights at very short notice.

Guy came through with flying colours and had me confirmed very quickly. There was one problem tho, and that was Guy had to send my e-ticket three times before it was received, certainly not his fault, but there may be something wrong with servers etc.

Thanks Guy now can you please start to think about my proposed Cairo visit.

The positives I found by using this service (1) very quick responses (2) Hassle free (3) no communication problems, didnt have to sit and say H for Hanoi O for orange N for nancy K for korea etc etc (4) No need for credit cards (5) Not rushed to pay before ticket issued etc.

Great and you have a fan in me

Locate a pax travelling with only hand luggage, befriend, bully, seduce or by the gods bribe and check in together. Great Filipina trick this one.

The UK is full of ENGLISH SPEAKING people. Thailand is not.

That statement is open to debate I would suggest

This sounds like fun, anyone know where I can buy a raincoat and trilby. Dont worry about the pipe I have that already !!

Read in the philippine Media yesterday that the Government there have now amended their immigration rules to allow tourists to stay for up to 24 months

................... Last night, took a piece of aformentioned cow. Stabbed the beast to death (both sides) with a fork. Then took all spices required and spent 20 mins massaging these in. Just to make sure I am onto a winner went out and picked a papaya leave, wrapped it all up and placed into recommended plastic bag and put into the fridge.

Just now, decided to check it out, looked good so placed it out in the atmosphere to let it settle. MISTAKE, turned my back - steak disappeared but dog got a nice smile on her face.

Operation to be repeated at a later date and dog now banished to the garden !!!!

RIGHT THEN ...................

I think it goes like this. Upon arrival first time with 90 day visa, get issued the WP, then a couple of weeks before your 90 day visa is due to expire, go to Immigration and submit ALL the paper work again and apply for a visa extension.It is likely that Immigration will give you a small extension under the heading "Under Consideration". With that small extension go to the Labour Dept and get the WP extended to follow the visa.

When you go back to immigration the day you have been asked to return, you are likely to be given (if all docs are correct) a 6 month extension. The process then repeats itself

OK whilst we are on this subject, I own a Olympus digital camera and its gone Txxxts upmon me and needs repairing. In Bangkok if any one can help

I thought the game was scrappy and bearly worth watching.

Over the 90 minutes I reckon Chelsea looked the better and more balanced side, despite playing many reserves and not being able to score in the penalty shoot out.

Man U have many "passengers" in their team: Giggs over the hill and the likes of Fletcher etc etc just not up to standard.

Can't see them winning anything this year.......

Well what a strange statement as if you had been watching a little closer you may have noted they won the shield yesterday

I can offer two <deleted> moments:

A fuel taker overturned on the side of Highway 2 leaking fuel (hope diesel but could have been any) with the recovery team collecting the fuel in buckets & bowls etc. With no sign of any fire crew on site in case.

From time to time I drive up behind older trucks that appear to be driving at an angle along the road there being an in-line offset of about a foot or so bewteen the front wheel and the rear axles.

Seen this many times myself, professionally known as crabbing due to accident damage.

I can assure you the Taxis in Hong kong many years ago were terrible rip offs, top tip, when a taxi stops dont stand at the door haggling, as soon as it stop leap in and tell him where you need to go and then say meter please.

It seems as if most drivers are intimidated if you Are actually sitting in the taxi behind them , and I dont think using this theory in 30 years has ever let me down

Dont forget to add the stop over time in Kuwait. Onb both legs and the hours clock up

Geographically you will be flying out of BKK in the opposite direction to where your destination is, couple that with the number of hours you stop over in Kuwait, then work it out for yourself whether the cheaper ticket is worth the hassle

I would think that the trip to NY would be via Kuwait - not the best option and thats why its cheaper

For all the years I have lived in Asia, I have never ever been able to cook a steak myself that I would consider to be tender and lovely to the taste.

All my efforts tend to end up with a piece of cow whose texture is about the same as a flip flop.

I had a friend in Manila who used to serve the most elicious steaks and he used to say its in the "hanging" that makes it so good.

I never really fathomed that one out, but can anyone here explain how a steak is prepared. Should it be left in the fridge for 3-4 days to ripen or whatever. And when ready for the cooking, whats the best way to cook it ? Quickly seared or slowly fried etc

For Hong Kong experts then John Gordon Davis and his "Typhoon" and "Years of the hungry tiger" are a must read