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Posted

Need a cheap gastrocopy by a gastrologist (a viewing of ones stomach to see any possible damaged tissue).

 

Dr. Rungsun did one of these for me less than a year ago for 9000B, but he is no longer working at his old clinic, and the present workers don't know his name or even much English.

 

Anyone know of someone cheaper, or perhaps a public hospital that will do the same work? Bumrungrad demands 33,000K ($1000), and I don't have insurance. The irony is that the work really isn't even necessary, according to the doctor covering my case. (Dr Pichai) whom I talked with on Monday.

 

Posted

If it isn't necessary then why do it?

 

If the one done a year ago was normal it is hard to imagine why a second one would be needed now unless there has been a dramatic change in symptoms

 

???

 

As for where - I have heard good reports of Chulabhorn Hospital, government cancer specializing in cancer prevention and treatment    http://www.cccthai.org/l-eng/index.php?option=com_contact&view=contact&id=1&Itemid=6

 

I think only about 5,000 baht there but can't guarantee (1) they will do (will depend on if doctor there thinks indicated) and (2) if they will use sedation (it is always done for colonoscopy but many times for gastroscopy not - I personally, having assisted in non-sedated gastrocsopies,  would not want to go through that)

Posted
2 hours ago, Sheryl said:

I think only about 5,000 baht there but can't guarantee (1) they will do (will depend on if doctor there thinks indicated) and (2) if they will use sedation (it is always done for colonoscopy but many times for gastroscopy not - I personally, having assisted in non-sedated gastrocsopies,  would not want to go through that)

I do not know the difference between gastroscopy and colonoscopy 

 however I have had maybe seven colonoscopies in the last 15 moths, the majority at Chulalongkorn, under two shot sedation and not felt a thing, with biopsies cost around 8,000/9000, and way cheaper than some places

I have also had ultrasounds up my ass with a probe at Chula, plus many 3T MRIs

 

I did have one done in Mapusa Goa India, at an old Catholic Convent, the gardens were magnificent, the man who did it was in green overalls and boots,( I was told he was the surgeon, not head gardner), I had to take rubber gloves for him, he had two bouncers who bounced on my stomach, when they were pumping water into my stomach

Zero pain suppression, Maximum pain inflicted

They had me screaming in pain and when finished blood pouring out my ass, I was despatched with my wife to a tap half a mile away that I hobbled to

For the next ten days I was wheelchair bound

 

The positive news was he confirmed my cancer and the cost around 1500 Bhatt, this is the cheap option !!

 

If you like pain and insanity  at nominal cost it fits the bill 

 

Back to the real world Chula is very professional and painless at sensible cost, they have a dedicated department doing this

Posted
I do not know the difference between gastroscopy and colonoscopy 
 however I have had maybe seven colonoscopies in the last 15 moths, the majority at Chulalongkorn, under two shot sedation and not felt a thing, with biopsies cost around 8,000/9000, and way cheaper than some places
I have also had ultrasounds up my ass with a probe at Chula, plus many 3T MRIs
 
I did have one done in Mapusa Goa India, at an old Catholic Convent, the gardens were magnificent, the man who did it was in green overalls and boots,( I was told he was the surgeon, not head gardner), I had to take rubber gloves for him, he had two bouncers who bounced on my stomach, when they were pumping water into my stomach
Zero pain suppression, Maximum pain inflicted
They had me screaming in pain and when finished blood pouring out my ass, I was despatched with my wife to a tap half a mile away that I hobbled to
For the next ten days I was wheelchair bound
 
The positive news was he confirmed my cancer and the cost around 1500 Bhatt, this is the cheap option !!
 
If you like pain and insanity  at nominal cost it fits the bill 
 
Back to the real world Chula is very professional and painless at sensible cost, they have a dedicated department doing this
I had a bit of seasoned 3 x 2 " hardwood stuck up there recently. No pain killers etc. I think the dr said it was a camera, but not sure because of my sobbing and tears.
Your Indian experience ....that's on another level.

Sent from my SM-J700F using Tapatalk

Posted

There is a huge difference between gastroscopy and colonoscopy. Sedation is always used for colonoscopy in any half way civilized place, and that includes most Thai government hospitals. It is simply too painful otherwise. Not sure where Carlyai went but worth his telling us so others can avoid it!

 

Gastroscopy is quite different - not really painful but uncomfortable due to gagging. So even some private hospitals may do it without sedation and you need to specifiy you want the sedation. Otherwise you will be wide awake with a device in your mouth that prevents you from closing it or making a sound, while a tube is passed down your throat to your stomach and you are gagging.

Posted (edited)
1 hour ago, Sheryl said:

There is a huge difference between gastroscopy and colonoscopy. Sedation is always used for colonoscopy in any half way civilized place, and that includes most Thai government hospitals. It is simply too painful otherwise. Not sure where Carlyai went but worth his telling us so others can avoid it!

 

Gastroscopy is quite different - not really painful but uncomfortable due to gagging. So even some private hospitals may do it without sedation and you need to specifiy you want the sedation. Otherwise you will be wide awake with a device in your mouth that prevents you from closing it or making a sound, while a tube is passed down your throat to your stomach and you are gagging.

I learn every day, yes pretty significant difference, (I have never been asked when having a colonoscopy do I want it up my ass or down my throat!!), English humour !! normally google when I do not know to hide my ignorance

 

I suppose  the sort of thing one gay ask another, I am not that way ! !!

 

For me I gag so badly when I go to the dentist I would need sedation

 

 

I have another theory generally with planning's explaining what you can may avoid bad experiences and  pain maybe optional

 

When in hospital recently and catheter up my penis twice I could not accept it a third time would have needed sedation, which is why I carry but very seldom use valium

 

For me I had another horrendous experience when having a wisdom tooth removed, at KhonKaen University teaching hospital, I was in pain and told would have to wait two months to be sedated and have it out

I wanted valium dentists in Thailand unlike the UK are limited on what they may prescribe

And what wound me up even more was my local pharmacy would always let me buy it

From that day forward I keep my own emergency supply at home, and recently have increased the buffer stock, I hope not to use it

 

For pain suffering this was close behind my Mapusa colonoscopy experience

 

My biggest concern in life is avoiding pain, dying I accep;t dying in pain no

 

Edited by al007
Posted (edited)
22 hours ago, Sheryl said:

If it isn't necessary then why do it?

 

If the one done a year ago was normal it is hard to imagine why a second one would be needed now unless there has been a dramatic change in symptoms

 

???

 

As for where - I have heard good reports of Chulabhorn Hospital, government cancer specializing in cancer prevention and treatment    http://www.cccthai.org/l-eng/index.php?option=com_contact&view=contact&id=1&Itemid=6

 

I think only about 5,000 baht there but can't guarantee (1) they will do (will depend on if doctor there thinks indicated) and (2) if they will use sedation (it is always done for colonoscopy but many times for gastroscopy not - I personally, having assisted in non-sedated gastrocsopies,  would not want to go through that)

I found I had a gastrocopy almost exactly a year ago, and it revealed only mild distal isophagitis grade A, apparently mild irritation of the stomach lining. (I can publish the full test results if you want to see them). This was explained by the doctor as my sometimes nervous disposition, for which I since then take the pill n-acetyl-cysterine, which eliminates the stomach pain.

 

Given what you (Sheryl) seem to say, this test request would seem to be just a repeat for the previous test, since my only stomach complaint this time was mild irritation 4 days ago when I went back on the Tramadol and my stomach was upset. Presently (and at the test 4 days ago) there is no stomach pain and neither doctor could find one by probing. Yet I'm being asked to take a $1000 test.

 

I have to say I don't intend to do this unless I get a significant pain in my stomach. I have by good luck found the Clonidine (which the Bumrungrad doctor introduced me to) to support myself if the doctor doesn't want to give me more treatment (even though he believes there is no need for a test, but must demand one anyway. <he shook his head in disbelief when he heard of this request by the gastrologist).

 

 

 

Edited by dblaisde
Posted (edited)

Given how common these addiction agonies are here, it seems amazing that doctors dont generally seem aware of a medicine like Clonidine to relieve such difficulties. This med was invented in the sixties and is approved in America and every other place I checked (some with Rx).

 

I dont feel my Tramadol (https://en.wikipedia.org/wiki/Tramadol) opiate withdrawal pain (using Clonidine simultaneously) at all. Of course I'm only a few days into it, but so far its really easy (but when I withdrew the first time, cold turkey, it was terrible). The drug can be taken for a longer period, but the wikipedia description tells you of the side effects, which are significant.

 

Keep in mind that I'm very new to all of this. Be highly suspect of my first experiences (I am). Ill try to report back with a final summary, especially since I searched this website and found no other mention of Clonidine.

Edited by dblaisde
Posted

Just had an endoscopy at the Paolo Kasetsart hospital  ( formally named the Mayo )

 

Very professional and the cost was 10,000  baht. This is one month ago.Also had blood tests to check for cancer while I was at it.

 

Quote :  There is a huge difference between gastroscopy and colonoscopy.

 

You better believe it  :laugh:

Posted

If I understand correctly OP Dr Pichai thinks the test unnecessary and I have confidence in him.

 

It also sounds unnecessary to me if it is based solely on the temporary stomach upset you describe (as was consulting a GI specialist if that was the only reason). Or was it recommended by Dr Rungsun to follow up in a year based on the gastroscopy a year before? Did he say the endoscopy should be repeated?

 

 

Posted (edited)
12 hours ago, Sheryl said:

If I understand correctly OP Dr Pichai thinks the test unnecessary and I have confidence in him.

 

It also sounds unnecessary to me if it is based solely on the temporary stomach upset you describe (as was consulting a GI specialist if that was the only reason). Or was it recommended by Dr Rungsun to follow up in a year based on the gastroscopy a year before? Did he say the endoscopy should be repeated?

 

 

Correction first: I rechecked the date on my last gastrocopy and it was a bit older than I said (11/2/16, February 2) but as gastroscopys go thats less than the 3 or 4 years usually required for a normal repeat.

 

My (temporary stomach upset) had been going on a few days longer (that is, prior to seeing the doctor a few days ago), due I think the shock of being back on the Tramadol and the terror of the previous 3 weeks cold turkey. But Im afraid to say that in general I'm a nervous type.

 

The first 3 days back on Tramadol felt very strange for some reason. But I think it was psychological. I could control the unexpected body jitters and stomach tension if I HAD TO, by deep breathing or distraction through reading fiction or losing myself in a long walk outside.
 
After about 3 or 4 days my entire body (it wasn't just stomach) released a lot of tension, and this slight irritation in a few of the stomach muscles went away and it has stayed away.

 

Im a nervous person unfortunately, and went to the first gastro doctor originally for this mild stomach irritation I didn't understand. The cause as the doctor said, Im a worrier, and he suggest possible remedies for me to think over, even surgical ones. I got to work on my own and looked in Wikipedia under obsessive thinking (my problem) and found that a vitamin called NAC (n-acyetl-cysteine) is useful for reducing obsessive thinking. I tried it, it worked and that was the end of that problem. Why the problem recurred again for a few days I think is simply due to extreme stress of this new situation to me, a nervous person to begin with, and fairly friendless at this time of year in Thailand.

 

**So: I don't see why all this adds up to: I owe Bumrungrad Hospital 34,000 baht/$1000. I'm perfectly willing to monitor my body for any strange developments and act promptly if the situation requires. I don't have insurance either so I have to save my money for when I REALLY need it.

 

Again, thank you for trying to help us.

 

Edited by dblaisde
  • 2 weeks later...
Posted
On 11/9/2017 at 12:33 AM, Sheryl said:

If I understand correctly OP Dr Pichai thinks the test unnecessary and I have confidence in him.

 

It also sounds unnecessary to me if it is based solely on the temporary stomach upset you describe (as was consulting a GI specialist if that was the only reason). Or was it recommended by Dr Rungsun to follow up in a year based on the gastroscopy a year before? Did he say the endoscopy should be repeated?

 

 

Hi Sheryl,

 

At this point, I need a doctor who is good at Tramadol recovery.

 

The recovery so far is difficult and confusing. The worst part are the uncontrolled rushes, where my heart rate races, I lose the ability to talk coherently or even think. These happen every few minutes or sometimes not for a few hours, and aren't getting any lighter.

 

So I want your recommendation for a Doc. Thanks. Ignore this if you've got other things to do, as I imagine you might.

 

PS: I started taking Anapril (Enalapril) yesterday, because it apparently controls heart speed. Its also gives me relaxation, a new feeling lately and desperately needed. Hope this is in the rules.

Posted

I'm a little confused here as I already referred you to Dr. Pichai who is a specialist in addiction? Are you seeing him regulalry? Have you discussed the racing heart etc with him?

 

Keep an eye on your BP on that enalapril.

Posted (edited)
20 hours ago, Sheryl said:

I'm a little confused here as I already referred you to Dr. Pichai who is a specialist in addiction? Are you seeing him regulalry? Have you discussed the racing heart etc with him?

 

Keep an eye on your BP on that enalapril.

BP as in blood pressure.  So far no problems.

 

I have to be honest and say I found Dr. Pichai <quote>not very nice <unquote>. He simply spent 10 minutes lecturing me like Charles Bronson (after my promise that Id pay Bumrungrad 33,000 baht for him telling me about the wonder-drug clonidine (its not)). He said this should fix everything. Id have 2 weeks of nastiness (variable, I know) from my body readjusting itself to no-tramdol and Id be fine. No need to come back to see the good doctor (Ok for me since there was nothing in his manner I liked), though he scheduled an appointment anyway. After a week, end of meds, and feeling rotten, I said, well...lets wait for ~2 more weeks until Im supposed to be feeling my old self.

 

Its been close on two weeks of recuperation hell so I did some reading, and got pointed to the medicine (Enalapril) I told you about, which at least keeps Hell at bay. The nasty shivers are still with me, but less disabling due to the Enalalpril.

 

My main fear is that the Enalapril will somehow interfere with the recovery process, which I wanted you opinion on. My plan is to stay on Enalapril until I loose the shivers, get off Enalapril, and see how that feels. Ill seek doctor help only if this scenario goes on longer than say, a month.

 

I have no wish at all to see Dr. Pichai again in that context: Ill drop by to hand in my less-that-2 years old gastrocopy at some point though. Thanks again.

Edited by dblaisde
Posted

The 33K was demanded before he would treat me (prescribe me Clonidine). He first sent me to the Gastocopy guy there, who did an exam and found nothing. I came back to Dr. Pichae with this news and he said *Well, no symptoms but we've got to do the test anyway.*  The test estimate said about 33K. (Thats where my 33K is coming from. I know it can be done more cheaply).

 

Afterwards at home I found a Gastrocopy I had done less than 2 years ago (by a very reputable doctor) stating no serious conditions found (I think I gave more detail awhile ago). In this case, I believe I can give him this old test and still be right, according to the med protocol for gastrocopy tests.

 

Does this answer your question? (Thanks again)

 

Posted (edited)
On 11/23/2017 at 12:35 PM, Sheryl said:

I'm a little confused here as I already referred you to Dr. Pichai who is a specialist in addiction? Are you seeing him regulalry? Have you discussed the racing heart etc with him?

 

Keep an eye on your BP on that enalapril.

Sorry, my reply is just above, but I failed to send it as a reply. Dunno if you'll be informed of it if its not in reply format.

Edited by dblaisde
Posted

So the 33K was for gastroscopy, not fee for treatment by Dr. Pichai? What does that have to do with clonidine?

 

33K is about what Bumrungrad charges these days for gastroscopy and indeed it can be done for much less elsewhere.

 

But I still don't understand the connection between this and treatment of your addiction.

Posted (edited)
4 hours ago, Sheryl said:

So the 33K was for gastroscopy, not fee for treatment by Dr. Pichai? What does that have to do with clonidine?

 

33K is about what Bumrungrad charges these days for gastroscopy and indeed it can be done for much less elsewhere.

 

But I still don't understand the connection between this and treatment of your addiction.

Well, the gastroscopy was dictated by Dr Pichai as a qualification for him to treat me. Thats the only way they are connected, but its a serious connection: He said he would not tell me the name of the treatment (Clonidine) or prescribe it unless I agreed to get a gastroscopy (which his own tech guy said I had no need of). Dr Pichai recommended Bumrungrad as the place to have it done.

 

He basically said: *I require you to promise to take this expensive test, which my lab man says you have no obvious need of. In return I will tell you the name of the drug (Clonidine, it turned out) you need and give you a prescription for it. Then the disease will disappear after a few weeks.*

 

So I don't think there *is* a connection between the gastroscopy test requirement and dispensing the treatment, since the Gastro man said there were no symptoms that the test was required. When I brought back the Gastro man,s no-symtoms opinion, Dr Pichai said *Well, they say they couldn't find a need for a test,  but the hospital will want one anyway so you're getting one*. And then he said firmly I have to promise to take the test or that would be the end of my meeting with him.

 

---

The next day I found my existing gastroscopy test of <2 years ago, which makes the test even less necessary.

 

Is this clear or am I driving you insane or do you want me to take a swim in the river? :)

 

 

Edited by dblaisde
Posted

It is inconceivable that a pyschiatrist would have decided you need a gastroscopy, much less overrule the judge of a GI specialist on this matter.  Your prior posts clearly state it was a gastroenterologist who said you needed one and, that the pyschiatrist was surprised by this/expressed doubt it was really necessary.

 

"he shook his head in disbelief when he heard of this request by the gastrologist"

 

 

.

Posted (edited)
14 hours ago, Sheryl said:

It is inconceivable that a pyschiatrist would have decided you need a gastroscopy, much less overrule the judge of a GI specialist on this matter.  Your prior posts clearly state it was a gastroenterologist who said you needed one and, that the pyschiatrist was surprised by this/expressed doubt it was really necessary.

 

"he shook his head in disbelief when he heard of this request by the gastrologist"

 

 

.

>>It is inconceivable that a psychiatrist would have decided you need a gastroscopy, much less overrule the judge of a GI specialist on this matter. 

 

Well...the Bum. gastro guy said verbally to me he could find no symptoms, but ordered a gastroscopy anyway. I explained this to the psychiatrist, who said that despite what the gastro guy said about  >no symptoms<, I had to take the gastroscopy anyway, and he wouldn't proceed with his treatment unless I promised to take one. All Id done previously to get sent to the gastro man was say that Id had a general stomach pain and tension, but that was in addition to  everywhere else: neck, shoulders, legs, etc, and I explained that.

 

I apologize to you for my fuzzy thinking and expression through this whole mess. Thats due mostly to post tramadol hangover (he hopes). I really don't want to alienate you as you've been a good friend in the past. I'm sorry that Ive been irritating. (and I don't say that ironically). I wish it weren't so.

 

(I want to apologize also for the lack of quotation marks. My computer is on the fritz, and Im waiting for a new keyboard.)

Edited by dblaisde
Posted

Don't worry about irritating me.. what concerned me was that you were making statements that were nto only defamatory but likely libelous (i.e. untrue).

 

there is a world of difference between:

 

1 - pyschiatrist requires that you get medical clearance as to your overall health before he treats your addiction, and as you were complaining of abdominal pain and also had a history of esophagitis  this entailed a consultation with a GI specialist  who -- rightly or wrongly, but again likely influenced by your reports of abdominal pain and prior history -- ordered a gastroscopy before you would give you the all clear,  and that would cost 33K if done at that same hospital (which it does not have to be)

 

and

 

2 - psychiatrist refuses to treat you unless you give him , or the hospital, 33K first

 

I think #1 or some variant thereof is the case whereas you were describing it as #2

 

Now in terms of what to do:

 

With tramadol or anything else It is seldom as simple as just detoxing from the medication one is addicted to, as addiction does not happen in a vacuum, it usually  results from attempts to self-medicate an  underlying pyschological condition such as anxiety or depression, and this will again manifest as soon as the drug is stopped. Indeed, it can be hard to distinguish between  symptoms due to drug withdrawal and symptoms of the underlying anxiety disorder re-manifesting because the drug no longer masks them.  Hence it is advisable to be under the treatment of a psychiatriost specializing in addiction disorders so that you not only safely come out of the addiction but also get on appropriate treatment for the underlying problem. Without that, even if you successfully detox, it will just be a matter of time before you get addicted to something else, because the  unaddressed underlying problem remains and  causes you distressing symptoms.

 

It is perfectly reasonable -- and indeed, good medical practice -- to want to first exclude any serious underlying health problems before treating someone for an addiction disorder.  If I understand correctly your efforts to get a medical clearance for this ran into difficulty when a GI specialist decided a gastroscopy was necessary and things have been at a stalemate ever since.

 

You could either (1) return to the GI doctor and explain that your abdominal pain has totally resolved (assuming it has) and see if he will agree to provide medical clearance without the gastroscopy. But he may or may not agree. (2) Have the gastroscopy somewhere else, at lower cost, return to the GI doctor with the CD of it as well as report at which point he should give the all clear and you can them proceed to be treated by the addiction specialist.

 

As previously mentioned this government hospital  would be under 10 K https://www.facebook.com/chulabhornhospital/

 

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