Best hospital options for unknown illness

[returntotheuk]

Hi Guys,

I am looking for advice on the best hospitals in Bangkok that are very good and not too costly. 

Unfortunately, my wife who is Cambodian, has been very ill for over 8 months. She has had numerous blood tests for many different things, MRI, CT scans, Lumbar punctures, Biopsies, x-rays, urine tests, poop tests and others that I can not remember. This has all been done in Ireland by infectious disease specialists, ENT doctors,  Dermo doctors and Eye doctors. We are now at a stage where we think we would be better off finding help in Thailand as the doctors here think as she is Cambodian, she is likely to have some kind of tropical disease that they do not see every day here in Ireland. We have already been living in Ireland 2 years. 

My wife was first diagnosed with tonsillitus, then the flu then meningitis! She has not recovered, and the doctors can not find what caused the meningitis and other symptoms which include swollen lymph nodes in neck and around the body, she also suffers from different kinds of rashes with joint pains that come and go. 

The specialist first thought it was TB meningitis, and started treatment for TB which is a 6-9 month treatment course but she has not got any better being on this treatment. The latest is that she may have a parasite called toxacariaris (not sure how to spell) and she had a maximum dosage of this treatment but doctor is not a 100% this is the problem. She is still on the TB treatment, been on it for 5 months already. 

Anyway, this gives you an idea of her illness but I am not sure what kind of specialist to go see so would appreciate it if anyone can recommend the best hospital for something like this, I would imagine smaller clinics would not be specialised enough but not sure. 

Thanks

[Sheryl]

Virtually no smaller clinics in Bkk anyhow. Doctors provide outpatient care from hospital OPDs.

 

From sounds of it she needs an Infectious Disease specialist.

 

Hospitals are never uniformly good and few are uniformly bad. You can get bad, good or so-so care in almost any hospital, depends on the doctor.

 

I thin your best bets, considering the complexity, cost and that long follow up may be needed, are either the Chulalongkorn University Hospital or the Mahidol Tropical Medicine Hosp. Both arr hovetnment hospitals anf as iinexpensive as it gets in Thailand. Since we cannot be certain it is a tropical disease my vote is for Chula.

 

I am away from my computer right now and about to board a long flight. I'll get back to you with specific doctor recommendations.

 

I will also send you, by PM, the contact phone number of a Cambodian woman in Bangkok who arranges appointments for Cambodians at Chula and will also arrange translation if needed. The added charge for this is small and it is well worth it as she seems somehow able to work the system and get appointments with specialists that might otherwise entail a long wait list.

 

It is essential that you get copies of all records, test results etc as well as actual films or CDs of scans, Xrays etc. Also ask the doctors for a detailed medical summary.

 

If the only reason for ruling out extrapulmonary TB is lack of improvement on TB meds then it is still a distinct possibility as there are strains of TB in Cambodia resistant to the usual drugs. Fortunately non-pulmonary forms of TB are less infectious than the pulmonary form.

 

Also while there, check to see if:

 

1. She has had blood test for ANA and lupus has been considered and ruled out (SLE is extremely common in Cambodia)

 

2. Has she at any point been treated with doxycycline or other tetracycline? Scrub typhus and other rckettsial diseases also common in Camb. If not this is a simple thing worth trying, so mention it to the docs.

 

More in about 1 days time.

 

 

 

 

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

[StefanBBK]

Sorry to hear about this. Hope she will recover soon.

Suggest before coming to Thailand you use a good tropical medicine center in the EU. Guess you could use your Irish insurance card. 

Not sure if I am allowed to post a link here, but this one used to be excellent. https://www.bnitm.de/en/clinic/opening-hours-and-directions/

 

Edited August 21, 2018 by StefanBBK

[mike787]

I like the returntotheuk comments, very helpful.  My philippine wife that I brought over to Thailand has milliary TB, with an extra-pulmonary component (meaning it has disseminated) to involve the GI.  Took her to Bummrungrad hospital for excellent treatment.  She is recovering now despite almost losing her. 

 

My mind is, if your going to throw everything at the wall  to see what sticks, Bumrungrad has not disappointed me.  I am speaking as a medical professional that has worked in Canada and the USA for 24 years; very impressed with Bumrungrad's physicians ability to diagnoses and treatment interventions.

 

I also can't emphasis enough as well...bring all medical information with you: images, blood work results, MD summaries, etc.  The doctors can help as much as you can help them...."you win-I win" philosophy helps!

 

I will add I like your approach to treating her; if one door doesn't open, find another, or make an opening...never give up!

 

Good luck to both of you!  

 

[atyclb]

should also explore the multitude of autoimmune diseases and some probably not even discovered yet.  a rheumatologist could help

 

have a look at this list;

 

https://www.aarda.org/diseaselist/

 

 

[pogal]

siriraj hospital for cheapness and competence but hard to get in and possibly long waiting times. 

 

Otherwise the big 3 as mentioned by others. Be prepared to pay a lot though. 

[Ron19]

Unhelpful off topic post removed.

[rwill]

I second Siriraj as a good choice for treatment and cost.

 

 

https://goo.gl/maps/vhWhWs6rgb62

 

 

[Mario666]

3 hours ago, StefanBBK said:

Sorry to hear about this. Hope she will recover soon.

Suggest before coming to Thailand you use a good tropical medicine center in the EU. Guess you could use your Irish insurance card. 

Not sure if I am allowed to post a link here, but this one used to be excellent. https://www.bnitm.de/en/clinic/opening-hours-and-directions/

 

 

Before coming all the way to Thailand you may want to try the Liverpool School of Tropical medicine to get a diagnosis.

 

Short trip for you.

 

https://www.lstmed.ac.uk/services/clinical-diagnostic-parasitology-laboratory

 

Good luck!

[Jonnapat]

2 hours ago, pogal said:

siriraj hospital for cheapness and competence but hard to get in and possibly long waiting times. 

 

Otherwise the big 3 as mentioned by others. Be prepared to pay a lot though. 

Agree with you about Siriraj.

They have treated my prostate cancer for the past 10 years and have experts in every field.

[Pdavies99]

In  my opinion, what would you get in Thailand that you cannot get in Ireland...other than you will be loaded up with at least 10 different drugs and they will have a different diagnosis at each hospital, other than get your money out!

 

I have over many years had various illnesses whilst living in Thailand, and despite going to expensive hospitals for treatment I was never correctly diagnosed!  Fortunately in the UK they have facilities for diagnosing tropical illnesses and do not guess or use Witch doctors!!

 

I expect some have good experiences in Thailand, but not me.

 

I believe Siriraj and Bumrungrad are good in many cases, but what would they offer that you cannot get in Ireland, I'm sure Ireland has a tropical Diseases Dept.

Edited August 21, 2018 by Pdavies99

[jimn]

54 minutes ago, Pdavies99 said:

In  my opinion, what would you get in Thailand that you cannot get in Ireland...other than you will be loaded up with at least 10 different drugs and they will have a different diagnosis at each hospital, other than get your money out!

 

I have over many years had various illnesses whilst living in Thailand, and despite going to expensive hospitals for treatment I was never correctly diagnosed!  Fortunately in the UK they have facilities for diagnosing tropical illnesses and do not guess or use Witch doctors!!

 

I expect some have good experiences in Thailand, but not me.

 

I believe Siriraj and Bumrungrad are good in many cases, but what would they offer that you cannot get in Ireland, I'm sure Ireland has a tropical Diseases Dept.

Sorry to be pedantic, but Ireland is not in the UK. How do you know what experience the hospitals there have of tropical illnesses. A lot of guesses going on here including me. Seems like the suggestion of the Liverpool School of Tropical medicine to get a diagnosis is a good one. Failing that the 

Siriraj and Bumrungrad in Thailand. But again who knows I certainly am not an expert. Good luck

[Pdavies99]

9 minutes ago, jimn said:

Sorry to be pedantic, but Ireland is not in the UK. How do you know what experience the hospitals there have of tropical illnesses. A lot of guesses going on here including me. Seems like the suggestion of the Liverpool School of Tropical medicine to get a diagnosis is a good one. Failing that the 

Siriraj and Bumrungrad in Thailand. But again who knows I certainly am not an expert. Good luck

 

[Pdavies99]

Pedantic maybe, having lived in Ireland and the UK and Thailand, and having had Lupus I know that Thailand failed to diagnose this correctly!

(London School of Tropical Diseases Diagnosed in 48 hours.      https://www.lshtm.ac.uk/    )

 

I know Ireland is not the UK and nor is Liverpool in Ireland!!  Thank you!

[Tchooptip]

  "hospitals in Bangkok that are very good and not too costly". 

 I only know a few ones that are not very good and too costly 
 

[German farang]

I'm sorry to hear that & hope you find a good solution.

Back in Europe you might inform you here;

https://tropeninstitut.charite.de/en/

& here;

https://www.bnitm.de/en/

Wish you both all the best!

[atyclb]

23 hours ago, returntotheuk said:

My wife was first diagnosed with tonsillitus, then the flu then meningitis! She has not recovered, and the doctors can not find what caused the meningitis

 

interesting how they diagnosed meningitis but didn't know the cause.  the possible causes are limited and the lp and csf tests done should almost invariably tell the story. viral meningitis is an exclusion diagnosis that is if nothing else tests positive the the assumption is viral.  it is very surprising the irish docs did not say likely viral in such a scenario. ireland has a damn good medical education system and highly competent doctors.

Edited August 21, 2018 by atyclb

[atyclb]

2 hours ago, jimn said:

Sorry to be pedantic, but Ireland is not in the UK. How do you know what experience the hospitals there have of tropical illnesses. A lot of guesses going on here including me. Seems like the suggestion of the Liverpool School of Tropical medicine to get a diagnosis is a good one. Failing that the 

Siriraj and Bumrungrad in Thailand. But again who knows I certainly am not an expert. Good luck

 

is northern ireland the uk ?

[Aquaman2016]

 
is northern ireland the uk ?

Yes. It is the United Kingdom of Great Britain and Northern Ireland.


Sent from my iPad using Thailand Forum - Thaivisa mobile app

[gavlar]

I'm no expert but my partner's daughter has had similar problems and eventually seen specialists at Rama hospital in Bangkok having been referred from Udon Thani. 

It seemed they did every test possible over a protracted period of time....even sent blood samples to Singapore for tests not available in Thailand. They never came to any final conclusion but thankfully her body  has settled down for now. I have to say Rama showed great interest and professionalism  with a number of specialists from different areas all inputting into trying to get to the bottom of her issues. If she ever relapses even marginally  we are to fly straight to Bangkok and they will see us immediately. Might be worth considering. 

[KBsinter]

19 hours ago, gavlar said:

I'm no expert but my partner's daughter has had similar problems and eventually seen specialists at Rama hospital in Bangkok having been referred from Udon Thani. 

It seemed they did every test possible over a protracted period of time....even sent blood samples to Singapore for tests not available in Thailand. They never came to any final conclusion but thankfully her body  has settled down for now. I have to say Rama showed great interest and professionalism  with a number of specialists from different areas all inputting into trying to get to the bottom of her issues. If she ever relapses even marginally  we are to fly straight to Bangkok and they will see us immediately. Might be worth considering. 

Yes very good hospital,have been an inpatient for 4 yrs ,this hospital 

is a goverment hospital,but an up market one, has an affordable price structure

some what between  lower end  and high end Establishments good luck in your search................

[faraday]

Outpatient, I think.

[KBsinter]

oops, I go on a regular basis, feels like I am an in patient...................lol   

[Sheryl]

Ok I am home now.

 

At Chula I suggest one of these:

 

Prof. Chusana Suankratay

Prof. Teerapong Tantawichien

Prof. Wanla Kulwichit

 

Check your PMs, I have sent you the contact info for the Cambodian liaison person I mentioned. I would suggest having your wife call her ahead of your trip  -preferrably by a week or more - to make appointments. 

 

Prior poster's suggestion of the London School of tropical medicine was very good, however, especially if you do not have other reason to head back to SEAsia. This is a world class institution, and would certainly be up to date on patterns of drug resistance in Cambodia and so forth.

 

I also suggest you specifically ask her  doctors  if (1)  drug resistant extrapulmonary TB has been considered  (TB being the most likely cause of the clinical signs you describe, for a Cambodian patient) and (2) is rickettsial diseases such as scrub typhus have been ruled out. #2 is somewhat of a long shot but I have encountered it in Cambodia and the treatment is simple.

 

 

[Janner1]

Both London and Liverpool have excellent reputations regarding Tropical disease research and treatment in fact I would hazard the suggestion that London has an higher level of discovery and treatment in the world.

 

So if you are Northern Irish you will get any treatment free, if Southern Irish use your EU card while we are still in the abomination laughingly called the EU.

 

Good luck to you and your lady I sincerely hope discovery treatment and recovery are just around the corner