Rotator cuff tear surgery costs

[elephant45]

Dr Chanakarn at Rachavej, born in the usa and a US Citizen, and Thai passport holder. Sports injury specialist. Will not rip you off. He worked at University of Michigan Emergency Medical Care, one of the best medical colleges m the states.

[atyclb]

4 hours ago, Trentham said:

The following paragraphs are each separate responses of mine during an earlier TV discussion on Thai medicine. Read par. 5 on my experience with a rotator cuff diagnosis and make certain it is that which is the problem...............

 

In 2005 I went to Rutnin eye hospital for a check-up - everything was OK. A few weeks later I had a bad headache for a few days. I went Bumrungrad hospital and they diagnosed early onset Alzheimer's. I was talked into MRI's and other expensive treatment which included 6 powerful drugs that sent me close to crazy. After a few weeks of madness I took myself off the drugs and suffered severe withdrawals. They then told me the headaches were due to acute angle glaucoma and did laser surgery. That then led to endless visits [probably 15 times] for check-ups at 3000 baht per time. On a trip home to Australia I went to see an ophthalmologist who told me once you have laser surgery you DO NOT need to go for checks. And I obviously do not have Alzheimer's now 11 years on.

I can tell you an even worse story about BNH Hospital. In 2008 - 9 they treated me for reflux. On two occasions I went to their emergency dept. at 3 Am  in terrible pain. Once they gave me a suppository and said I was constipated and on the other they laid me on a trolley for an hour with a drip in my arm which almost knocked me out. Meanwhile they kept feeding me reflux pills. I went home to Australia for a holiday and went to a local GP for some more reflux pills when I ran out. He refused them and sent me for tests. 2 weeks later I was in Royal Melbourne Hospital with pancreas cancer. I am one of about 3% who survive it. I WILL NEVER TRUST A THAI HOSPITAL with anything worse than a cold.
 

I am a 73 year old redhead and living in rural Australia as a kid I got sunburn nearly every week. I have been getting sun spots [keratosis] frozen off since I was 40. I had them done here too at Bumrungrad several times before I learned not to go there. Each time I was prescribed antibiotics and topical creams which were as expensive as the procedure and sold to me by the hospital. Home in Oz I was never given them and never suffered for not using them.

Another time I was in Phuket and wanted to stay I bit longer. The airline would not let me change my ticket without paying a huge fee unless I had a medical cert. to say I could not fly. So I went to the hospital and told them I was severely congested both nasally and in my chest. I did not tell them it was just an act to get out of the airline fee. I just said I was sick and I was examined by a doctor and  given my certificate. In Nan hospital a friend was diagnosed as having macular degeneration. Terrified of blindness he went back to Oz for a check and there was nothing wrong. Considering my earlier post wherein I said I would not trust a Thai hospital with anything worse than a cold and remembering my Phuket experience I now retract that. I would not trust them with anything at all.

Well I will tell you two more stories about BNH Hospital. I had bought myself a set of weights. Suddenly I had a terrible pain in my shoulder. Off to BNH and was told I had a pinched nerve in my neck. Traction every day for one month [cannot remember the cost of each visit]  and was not cured. They referred me to their orthopedic guy who said I needed a 350,000 baht operation. No way - back to Oz and it was a torn rotator cuff. Then one night I broke a wine glass on the bench which then rolled onto my foot and a shard stabbed me. Blood everywhere so off to BNH [will I ever learn?] where I was told Xrays cannot pick up glass so I was just stitched up [both meanings]  and sent home. 4 days later a piece of glass emerged from the bottom of my foot so back to BNH where another doctor took an Xray and  found several small pieces of glass in there

I met an old Canadian bloke when he came here for some work on his wrinkly old face. Part of the surgery was around his ears. A week later he was at the airport on his way home and the bandage slipped. He went to the bathroom for a mirror to re-tie it. When he unwound the thing his ear fell off. He cancelled his flight and went back to the hospital. It was re-attached and he went off home again. I never saw him again so cannot give you the end result.

paradoxically and to your great benefit it was the chain of misdiagnosed and unnecessary treatments leading to your distrust and second opinion in oz that led to a miraculous survival of pancreatic ca. 3% group. go figure. most any 2nd year resident let alone an er doctor knows its worthwhile to x ray looking for glass.. Some glass can be seen on x ray.

[cheeryble]

The prices given above are unnecessarily high.

 

I have been given a price for endoscopic shoulder work by Dr Chanakarn (Rajavet CM).

180-220kbaht.

Dr Prasit at Ram CM spoke of 200k.

(I'm guessing the main reasons for surgery....rot cuff, impingement, bone spurs etc have similar or the same prices as there's nothing expensive going in it's mostly cutting sewing or grinding bone, in fact I don't know why its as high as 200k....seems a crazy price for working through three tiny holes close to the surface....... but it is.

 

You can add an MRI cost to that.......8 -10,000baht.

 

They are both shoulder specialists trained in the US I believe.

 

They are both very approachable and efficient.

Dr Chanakarnis may be best approached via his clinic near the Rajavet, west side of the river.

Dr Prasit has a new clinic on the Canal Rd East side opposite half way between the small animal clinic and Phucome Hotel.

 

I have a problem both sides, making it ca 400k and personally have held off on surgery given my age combined with the question (previously answered, whether accurately I don't know) of how many repairs not only work but last the course, not to mention recovery time.

I have worked and stretched both shoulders lightly, but after quite a long time I really can't do yoga with shoulders and can't swim crawl without a float between my legs have come to a decision to at least get the worst shoulder MRI'd and get a fuller opinion.

At near 69 it would be lovely to have them working, but I still can do most things without a prob, hike, run, cycle etc...... even if they;re weaker I can lift heavy objects, and even if I have to help reach out one arm with help from the other occasionally. .....it's therefor a real option to live with it. It's certain positions which are a problem but maybe not a problem worth 400k. for unguaranteed results.

Undecided.

 

BTW as for the very rude post previously, rooms in the Ram have gone up to 1800, and Sripat (Rajivet) pleasant private rooms were previously about the same the same as Ram at about 1500-1600, may be slightly dearer now like Ram, certainly not 8000. Compulsory nursing fees are to my mind a bargain at under 500 per 24 hours. I have visited in the wards and have found them to be perfectly reasonable if not superluxury. The Ram doesn't have wards except ICU and nursery and the rooms are very good.

Edited October 21, 2017 by cheeryble

[pennine]

I had a damaged rotator cuff after a fall. Doctor in Samui wanted an MRI so I went to Bumrungrad in BKK. Doctor there said not necessary, wait to see if it heals, it takes time. It was very sore for weeks, but is now almost fully recovered after fall in June.

Incidentally,  I had an emergency operation to fix a broken elbow after being hit by a motorbike. It was done at Bangkok hospital Samui and even the surgeons overseas when I went back home, said what o good job had been done.

[cheeryble]

3 minutes ago, pennine said:

I had a damaged rotator cuff after a fall. Doctor in Samui wanted an MRI so I went to Bumrungrad in BKK. Doctor there said not necessary, wait to see if it heals, it takes time. It was very sore for weeks, but is now almost fully recovered after fall in June.

Incidentally,  I had an emergency operation to fix a broken elbow after being hit by a motorbike. It was done at Bangkok hospital Samui and even the surgeons overseas when I went back home, said what o good job had been done.

 

You might like to use a few stretching techniques which you can find on Youtube, It helps.

One is the simple one of walking you fingers higher and higher up the wall in front of you til you're stretching eventually with your body against the wall.

Go easy.

Edited October 21, 2017 by cheeryble

[Nice Boyd]

6 hours ago, bosun said:

I am sure your friend has done the rounds already ...  but I took my MRI scan of a rotator cuff tear from Bkk hospital to the UK's leading shoulder surgeon in Harley Street. He recommended everything but surgery ! Sure enough 6 months later I was active again . Now my other rotator is very painful and this time I went to Bumrungrad to a sports injury surgeon.

Same advice. Basically shoulder surgery has some of the worst success rates of any joint surgery. Please ask your friend to think very very carefully and as others have mentioned choose very carefully as it is a big risk especially if he is a bit older. All the best

And sorry the cost is around 350,000 plus at the leading private Thai hospitals

What type of Alternatives?

[cheeryble]

7 minutes ago, Nice Boyd said:

What type of Alternatives?

From what I gather with rotator cuff tears.......which account for some repeat some of shoulder problems.......recovery can be done with physiotherapy (perhaps self administered after a start with a pro) dependent on how serious the tear is.

From what I can gather ballpark is more then 50% torn consider surgery, less than 50% torn DIY may work.

For different problems like impingement I have seen it may be possible to develop the muscle to pull downwards to open the joint. I'm obviously no expert but what I'm saying is the "alternatives" need to match the problem.

Steroids are sometimes efficacious though for real problems they are used more for diagnosis. They work wonderfully often trouble is they can't be used ad infinitum, just a couple or more times.

Edited October 21, 2017 by cheeryble

[peergin]

7 hours ago, connda said:

Personally if it was me, I'd take the long waits at Maharaj in Chiang Mai.  Had top notch surgery for an inguinal hernia repaired there in 2010 for about 18,000 THB total.  Yeah, dealing with the day long waits to get the surgery scheduled was a pain, and about 3 months on the waiting list, but it was elective surgery and I had no complications, and once admitted into the hospital - it was excellent!  Doctors and staff were fantastic!  I have nothing but praises.

No doubt about it!!!

[NancyL]

13 hours ago, connda said:

"As far as an emergency is concerned I would agree with you - (Their emergency department is first rate), but as far as an operation and in patient service - you would be better off at a dog kennel."
I really am sorry, but you are totally out of your mind.  I spent three nights in a single room in Maharaj.  That should have been 24,000 THB by your calculations.  My entire stay, surgery, doctor's fees, hernia mesh, private room, drugs, nursing care, food, aftercare, etc, was 18,000 THB.  I could go point to point with your assertions.  But I won't because they are ludicrous and highly inaccurate, and I have no idea what your agenda is.  

Within the past 18 months or so, Maharaj (CMU University, Suan Dok) hospital has indeed instituted foreigner pricing for room rates that are significantly higher than what Thai people pay.  Private rooms are nearly impossible to get.  I've only know two expats (who didn't need ICU) who were able to get private rooms -- one was suspected of having TB and was put in an isolation room and the other was a single father caring for a 12 year old son and the staff took pity on him and pulled strings to get him and his son a private room.  Otherwise, the private rooms seem to go to Thai people who have insurance policies.  

 

Some of the wards are as described, very crowded, hot with just rotary fans, insects, and patients dying and moaning within inches of you.  Don't get a bed next to the window because the rain can come in during a driving storm.  These conditions are especially true of the wards for general medical cases.  The orthopedic wards are better.  They're on the northern side of the complex, so they don't get the direct sun and are cooler.  Also, the orthopedic patients aren't dying.  They get better and go home, so the attitude of the staff is more upbeat.  

[Sheryl]

11 hours ago, cheeryble said:

From what I gather with rotator cuff tears.......which account for some repeat some of shoulder problems.......recovery can be done with physiotherapy (perhaps self administered after a start with a pro) dependent on how serious the tear is.

From what I can gather ballpark is more then 50% torn consider surgery, less than 50% torn DIY may work.

For different problems like impingement I have seen it may be possible to develop the muscle to pull downwards to open the joint. I'm obviously no expert but what I'm saying is the "alternatives" need to match the problem.

Steroids are sometimes efficacious though for real problems they are used more for diagnosis. They work wonderfully often trouble is they can't be used ad infinitum, just a couple or more times.

Most rototar cuff injuries will respond to non-surgical management and that is the first approach; about 20% will not respond and require surgery.

 

In this specific case all the information is second hand as it is not the OP but a friend in the US, so we don't really know what has already been tried. But we do know that he has been advised that he needs surgery and apparently his insurance company has agreed to pay for it (subject to his deductible) and US insurance companies don't do that readily.  So most likely conservative management has already been tried and failed, MRI shows a complete rather than partial tear and he has already had at least 1 second opinion. 

[RIC23]

I just dislocated my right shoulder & had surgery which cost 450-500K in BKK Inter Hospital

Would have been cheaper to go back to OZ & get it done, I think

[hml367]

19 hours ago, connda said:

"As far as an emergency is concerned I would agree with you - (Their emergency department is first rate), but as far as an operation and in patient service - you would be better off at a dog kennel."
I really am sorry, but you are totally out of your mind.  I spent three nights in a single room in Maharaj.  That should have been 24,000 THB by your calculations.  My entire stay, surgery, doctor's fees, hernia mesh, private room, drugs, nursing care, food, aftercare, etc, was 18,000 THB.  I could go point to point with your assertions.  But I won't because they are ludicrous and highly inaccurate, and I have no idea what your agenda is.  

I agree with Connda.

 

I had surgery and a stay at Maharaj.  Private, air conditioned room charged for 5 days - I thought I was there 6 days, but I looked at the bill and I was charged for 5 days.  

 

At any rate, surgery, nursing care, medication, lots of water into my  body 24 hours a day.... everything, the bill was 55,780 thb. 

[serpent32]

On 10/21/2017 at 1:13 PM, Sheryl said:

Costs will vary enormously depending on the hospital.

 

Least expensive option is a government hospital.  In Bangkok, either Chulalongkhorn or Siriraj. In Chiang Mai, CCU Hospital. Be aware of long waits, red tape and other inconveniences though so if here on only a short trip might nto be practical.

 

Best guess I can give re price would be around 400,000 baht at a private hospital (a little more at some and less at others, but around that) and maybe 150,000  at a government hospital, but these are just estimates.

 

If traveling from another country, India would be less expensive than Thailand. Care in a top tier private hospital in India costs similar to public channel in a government hospital in Thailand.

Definitely depends on the hospital some are ridiculously cheap and others are more expensive but still reasonable compared to the United States anyway.  Health care costs is one of the many reasons why we decided to retire here.  My wife's a Permanent Resident so we don't have to live here we want to live here.  My Tri-Care insurance surprisingly covers some of our health care as well.  

[serpent32]

Some of these prices quoted even for the more expensive hospitals are WAY MORE than I've ever seen or have paid.  Obviously it depends on the procedure but I know it doesn't cost the quoted prices above.  I had a colonoscopy for less than 40,000 Baht recently and I paid out of pocket for it.  

[serpent32]

16 hours ago, Nice Boyd said:

What type of Alternatives?

350,000 Baht uh no.  Shop around trust me on this.  

[Jonmarleesco]

Last time I had a quote, it was B200,000. That would have to have been some eight to ten years ago. We're in Thailand, so no doubt it is now closer to K300. There is always Chula. But I declined the treatment and it duly resolved itself.

[Sheryl]

1 hour ago, serpent32 said:

Some of these prices quoted even for the more expensive hospitals are WAY MORE than I've ever seen or have paid.  Obviously it depends on the procedure but I know it doesn't cost the quoted prices above.  I had a colonoscopy for less than 40,000 Baht recently and I paid out of pocket for it.  

There is a world of difference between a colonoscopy and orthopedic surgery!!

 

BTW a colonoscopy usually costs not more than 25K at top tier private hospitals and under 10K at govt. If you paid anything near 40K you were overcharged.

[cheeryble]

8 hours ago, Sheryl said:

Most rototar cuff injuries will respond to non-surgical management and that is the first approach; about 20% will not respond and require surgery.

 

In this specific case all the information is second hand as it is not the OP but a friend in the US, so we don't really know what has already been tried. But we do know that he has been advised that he needs surgery and apparently his insurance company has agreed to pay for it (subject to his deductible) and US insurance companies don't do that readily.  So most likely conservative management has already been tried and failed, MRI shows a complete rather than partial tear and he has already had at least 1 second opinion. 

You're right there Sheryl i should have mentioned that if you have a full tear it will not only have no strength in that working direction but it starts to shrink up and I believe after some time becomes inoperable.

So i guess that's a different category of importance.

i would add that personally I can lie down to sleep comfortably...if i couldn't I would look upon surgery differently if it didn't at least partially heal itself.

[twix38]

Best to get treatment wherever possible in your home country. Far too hit and miss here.

 

My brief experiences.....  

 

Bumrungrad. Endoscopy resulted in tablets for anxiety!!! In UK found I had Barratts oesaphagus LGD. A pre cancerous condition.

 

Infection that would not clear and remedy was to guess and re-prescribe. I had 15 different combinations of antibiotics and was even blamed when one was contra-indicated for tendon damage I had when 3 weeks after taking, I found in Google. Told to stop taking then and I was blamed! A PSA test whilst being treated for prostititis that came back low and told oh well its not that then after taking pills for it for 3 weeks and on and on.

 

Dental implant that caused swelling and ear pressure problems for 6 weeks and told ENT Dr who ignored this and after ear test prescribed 3 pills incl steroid and nasal spray which all did nothing as it was tmj

 

Bunch of clowns and whilst some are good there is no accountability and it is, try this and then oh, lets try this and this.

 

Had infection in wound from motor bike accident and again went through 12 different antibiotics and a drip where whole arm went numb and so was stopped. Finally told if this not work you go home your country. Fortunately the last double combo worked but my insides and stools were terrible after all these antibiotics!

 

Imv Thai healthcare should come with a warning that they will try but many are just going to experiment with loads of pills and tests (and money) and the result is far far too often they get it wrong. That's the crux of it - Far too often they get it wrong and in one way or another the patient suffers. The Dr who missed my barratts is still at bumrungrad and I got nowhere when I complained. Terrible!!

Edited October 23, 2017 by twix38
Update

[Sheryl]

I feel like a broken record here but...you really need to research and choose your doctor with care here, there are very good ones to be found but you have to seek them out, and the care you get from one doctor in a hospital has no bearing ion what a different doctor, even in the same department, of the same hospital, would do (referring here to private hospitals). 

 

Doctors in private hospitals in Thailand are independent contractors who simply use the hospital's facilities; they are not employees of the hospital and they have complete latitude as to how they practice.There are no standard protocols. There are no departmental meetings to discuss or standardize medical protocols. The care you get from any doctor is not reflective of what "the hospital" does other than that the hospital leaves it to the individual doctor to decide - and they all do that.

 

Government hospitals do have treatment protocols and thus are more uniform in what they do, but of course there are other drawbacks - very long waits, crowding, and much of the care given by medical students/interns or residents in training; extremely limited time with doctors allowing for little discussion or questioning.

[greenchair]

On 10/21/2017 at 2:36 PM, Trentham said:

Thailand has a medical industry - NOT a medical profession.

Elaborate on that. I have had a couple of operations in Thailand in low to medium grade hospitals. The care was amazing and I didn't get ripped off. 

[Trentham]

17 minutes ago, greenchair said:

Elaborate on that. I have had a couple of operations in Thailand in low to medium grade hospitals. The care was amazing and I didn't get ripped off. 

Read my earlier post no. 17, page 2 of this thread.

[greenchair]

58 minutes ago, Trentham said:

Read my earlier post no. 17, page 2 of this thread.

I have to say I did go to bumrungrad and he took a scalpel to my husband's severely burnt foot. I would never go to that rip off hospital again. I go to middle and government hospitals and never have a problem. Sirilat is a nightmare to wade through but I got excellent care there. 

Chublakorn hospital did a wonderful job also and saint Lois is also reasonable. I don't feel I was cheated by those hospital at all and the service is great. 

[twix38]

Sheryl wrote: "Your stories re not, in fact, about treatment given by hospitals. Hospitals are buildings and do not treat. They are stories about treatment given by specific doctors. These exact same hospitals have some excellent doctors, but one must do due diligence in seeking them out. All hospitals have mediocre and even some downright incompetent doctors. "

 

Absolutely. Nobody is blaming the Bricks and Mortar (Hospital building). It is of course the Doctors. Though the general lack of accountability does in part stem from the system where Doctor's attend various hospitals and it becomes a more hands-off and independent (contractors) situation away from formal or adequate Hospital oversight and satisfactory accountability. So, I agree it's primarily the Doctors (not the Hospital) and great care must be taken. For me though there are just too many times that Doctors here fall short - even after researching and the ones recommended -  and fall into a pattern of over testing and over prescribing (for money) and will very often still fail at a correct diagnosis 1st time, possibly 2nd time and may get there 3rd attempt onwards. Followed by a complete lack of responsibility or accountability. 

 

The worst aspect though are ramifications from poor/wrong diagnosis and treatments. imv this also happens too often generally if my experience is typical. They can do real damage whilst attempting various remedies or missing real problems/creating new ones, and they do! Prehaps we should discuss about these Doctors who are in the system, but who are not proficient. Who is going to deal wih this in Thailand when the system is set up as it is and there are these independent contracting Doctors without sufficient oversight left to mis-diagnose and worse for years!

 

With all the many opportunities and various Doctors for various ailments over years, it is mind blowing just how poor virtually all of my experiences have been, but they all share some core themes - an apparent inability some 75% of the time to get it right first time, over prescribing and no accountability for mistakes.

 

That's not including price gouging on many Private Hospital's own pharmacy drug costs!

Edited October 30, 2017 by twix38
update

[yannic]

had it done in Bumrungrad by Dr. Mason Porramatikul, cost was 400,000 THB

[cheeryble]

37 minutes ago, yannic said:

had it done in Bumrungrad by Dr. Mason Porramatikul, cost was 400,000 THB

Out of interest what was the diagnosis, when operated, full recovery time, and what was the improvement?

I’d like to be fixed, but as I can live with my condition, I’m interested in rates and degrees of success

 

Edited October 30, 2017 by cheeryble

[yannic]

Just now, cheeryble said:

Out of interest what was the diagnosis, when operated, and what was the result?

rotator cuff tear both shoulders and result was that it went better. Took a long time to heal, but that was probably because of age. When you are in the 20s healing is faster than in late 40s. Dr. Mason was actually good, he is a shoulder specialist.

[cheeryble]

3 hours ago, yannic said:

rotator cuff tear both shoulders and result was that it went better. Took a long time to heal, but that was probably because of age. When you are in the 20s healing is faster than in late 40s. Dr. Mason was actually good, he is a shoulder specialist.

Thanks.

so was the 400k for the pair?  ........double this would be a huge amount, the price of a very expensive heart bypass which is a hell of a lot more work and manpower

[JSixpack]

22 hours ago, yannic said:

had it done in Bumrungrad by Dr. Mason Porramatikul, cost was 400,000 THB

 

I've seen Dr. Mason before and he was really great. Very reasonable charge for Bummie.

Edited October 31, 2017 by JSixpack

[serpent32]

On 10/22/2017 at 5:14 PM, Sheryl said:

There is a world of difference between a colonoscopy and orthopedic surgery!!

 

BTW a colonoscopy usually costs not more than 25K at top tier private hospitals and under 10K at govt. If you paid anything near 40K you were overcharged.

Yes but does that include the cost of the IV sedation medication during the procedure?