carpal tunnel syndrome surgery

[domdom]

Good morning

 

Does anybody have an idea of the cost of such a surgery for one hand and which could be the less expensive hospital (offering although a good quality of surgery) in or around Pattaya to do this.

This question is for a thai national without health insurance.. I magine it is ambulatory and so done within a day ?

Thank you

Have a nice day

[Sheryl]

Thai nationals can receive this and most other necessary medical treatment free of charge  but have to first attend the hospital they are registeted at under SS or the "30  baht" scheme as the case may be.

 

A trial of conservative treatment will be done before surgery is considered. Splits and anti-inflammatories and possibly steroid injection if these do not suffice.

 

Even if s/he has alteady done this, they will need to get it established in the record of the relevant hospital. This means a number of repeat visits over a period of months and it is important to explain this. Not  unusual for Thais to assume that if the initial treatment does not work "that doctor cannot help me" and stop going back when what they really needed to do was perservere and keep going back and telling the doctor the problem had not improved. That is absolutely required  to meet the requirement for surgery.

 

If surgery proves necessary shpild be done by a hand specialist

 I am not sure if thete are any in Pattaya but will check.

 

At a private hospital likely to cost about 30-40k depending on which ospital.

 

 

[timendres]

Before you proceed with surgery, but sure to get a proper diagnosis.

There are multiple causes of CTS, and they do not all require surgery.

In my case, it was mostly inflammation of the tissue surrounding the nerves that was the cause of the nerves being squeezed causing the CTS. The doctor diagnosed this by prescribing anti-inflammatories, and putting a splint on the wrist to limit motion. Within two weeks the problem disappeared. Then it became a matter of managing the use of my wrists to limit the inflammation.

[domdom]

Thank you Sheryl..

She told me she has absolutely no cover.. she goes for treatment for type of high blood pressure at Banglamung..She tells me it is the place people go when they have no insurance.. But treatment is not good.. she has blood tests... but doesn t have any record neither the doctor tells her how the results are.. She tells me she waits very long time and finally sees the doctor for 2 minutes who gives medicine for one month but no more comments apparently..

I imagine she is also shy to ask..

Cost you announce is quite reasonable.. in this case I imagine one single visit to orthopedist will lead to surgery immediately without the pre treatments you re talking about ?

Thank you

Have a nice day..

[domdom]

Thank you.. Did you see a doctor in Pattaya or is it in another thai location ?

Have a nice day

[BritManToo]

4 minutes ago, domdom said:

I imagine she is also shy to ask..

She's not to shy to ask for your help.

[Thomas J]

First, I have had carpal tunnel surgery back in the USA.  You have to have a nerve conduction test to show that you do have nerve impingement.  The surgery is a piece of cake. There is a small incision made at the wrist and a small tendon is severed relaxing the impingement.  It is done on an outpatient basis and just a local anesthesia. 

[Sheryl]

No, no doctor will operate without first trying conservative measures. This is standard medical practice. They might also require a nerve conduction study which itself may cost (if done privately) something like 10k.

 

ALL Thais have cover. By definition anyone not coveted by one of the two Social Security schemes is covered under the "30 baht" scheme. 

 

It could be that her cover is at a hospital in a home province though. This is commonly the case in Pattaya and Bangkok.

 

Banglamung is a government hospital and plenty of middle class Thais go there. It is not just "a place for people with no insurance" which in any case almost no Thais have since they do not need it.  If she is listed in a house registration in Pattaya she can get care for free there (or for a token 30 baht) otherwise has to pay full fee. Banlamung does not have the capacity to do hand surgery and if they decide it is indicated would have to refer elsewhere.

 

There is no blood tedt for carpal tunnel syndrome. If blood tests were  done for her hand problem then they were considering possible other diagnoses.

 

What you might do is accompany her on her next visit and ask the doctor what the diagnosis is, plan of treatment etc. Things will then be much clearer.

[domdom]

18 minutes ago, BritManToo said:

She's not to shy to ask for your help.

Good afternoon

 

I don t appreciate this type of comment.. You don t know the situation, and on top of it she does not ask anything.. and if so, pls let me know if it is in any case your problem.. Mind your own business..

 

She is a very nice honest hardworking woman.. I know her for nearly 20 years and she never asked for anything..

I inquire because paying her surgery is not a lot for me if I find a reasonable price, and she suffers a lot.. She grows plants and always lifts the pots of plants which is heavy..

Stupidity and nastiness seem to have no limit..

[domdom]

Well noted Sheryl

So when she tells me treatment is free, maybe she then pays 30 bahts.. In fact I always thought she had free treatment and I thought it was in Queen Sirikit, as I thought it would be free there for poor thais, but she told me that this hospital is expensive..

I don t wish to go with her to Banglamung and spend hours there for nothing as you also say they don t do the surgery.. A doctor or hospital with reasonable fees would be good and I would definitely accompany her and see what is going on and what could be done.. if you have a reco, would be great.. The blood tests were for high blood pressure and cholesterol, I don t think she never spoke about her hand problem.. She told me as I saw her suffering one day and I told her I thought it would be this carpal tunnel syndrome, but I think till date she did not enquire about it as her pain is unchanged..

Thanks a lot..

Have a nice afternoon

[Sheryl]

I can recommend a doctor in Bangkok but not in Pattaya I am afraid.

 

Prof. Panupan Songcharoen is excellent, he did my own caral tunnel surgery some 15 years ago

 

He is at several hospitals but the most convenient would be Phyathai 2 which is near Victory Monument

 

https://phyathai2international.com/doctor.php?pid=148&lang=en

 

He is there on Sunday mornings only.

 

If he agrees it is CPT he might do a steroid injection first along with instructions on splinting (this assumes she has already tried NSAIDs with no result). This will give her relief within a matter of days but unless she also rests the hand using splints, in a few months it will return

 

You can get her  hand splint at most pharmacies and also from Lazada. She should wear it at night and also whenever she has to do something that uses that wrist (which she should try to minimize) They cost maybe 600 baht or so

https://www.lazada.co.th/products/futuro-reversible-splint-wrist-i102225043-s102454797.html?spm=a2o4m.searchlist.list.15.58e022aeimom1C&search=1

[domdom]

Thank you Sheryl,

 

I am sure she didn t have any investigation nor treatment yet.. I will follow your reco, first go to pharmacy and buy a hand splint, then I will enquire in my hospital to see if they have a qualified orthopedist for this, take an appointment and see what he says..

A good thing I already have some price info, as I didn t have a slightest idea of the cost of such a surgery if needed..

Let s go step by step

Have a nice afternoon and thanks again

[erymax]

There is a hand surgeon in Laem Chabang, a friend of mine has done it for 2-3K baht. If the history, symptoms and the examination fit to a CTS, operation is an option of treatment without EMG or Nerve Conduction test.  

 

[domdom]

Thank you

Can you give me the name of this hand surgeon ?

Is your friend happy with the resuts he got ?
 

[Sheryl]

If she has not had any treatment yet and if she has no contraindications to NSAIDs she should take them as well (ibuprofen, diclofenac or the like).

 

Contraindications to NSAIDs would be: any sot of bleeding disorder or taking anticoagulants, kidney or liver disease, gastritis or ulcer.

 

Splinting, refraining as much as possible from repetitive wrist motions and NSAIDs are the initial treatment (if it is CPT) and no point in seeing a doctor if these have not yet been tried.

 

But I wonder how you have arrived at this diagnosis? Since you mention you saw her suffering.CPT does not usually cause pain. Rather it causes tingling, numbness and sometimes weakness in the hand. A very clear indication that numbness and tingling (often worst at night and disturbing sleep) is due to CPT is that the little finger is completely unaffected. Sometimes also the one next to it, but always the little finger is fine. The numbness/tingling is most pronounced on the thumb, index and middle finger areas.

 

 

[erymax]

I need to contact my friend and ask him.

[domdom]

Thanks

I send you my mail by private message

Thank you

[Sheryl]

I forgot to include this link in my last post

https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/diagnosis-treatment/drc-20355608