Surgery In Bumrungrad Hospital.

[smo]

Dear Griffer,

The few main points I wanted to share with you in this diskectomy experience that I also have gone through:

- Unlike you I did not have friends in the medical fields who could give me council. Actually, one of my close friends is an internal doctor. The word he mentioned at the beginning was “surgery” and he left it at that. Later on when I learned about the case of herniated disks and what to do with them did he elaborate on, just saying that “I did not mention it because I was afraid it would scare you.”

- The first part of my episode happened in the States. Last October I came down with sciatica, waking up one day and could not get out of bed because of tremendous pain in my right leg. I was diagnosed by a family clinic doctor who wrote “radiculopathy” on my diagnosis report. But she only said I was suffered from sciatica, gave me a prescription of ibuprofen and told me to take it easy. The next part was pure ######: since I did not have insurance and no guidance I did not go to an orthopedic doctor; and later I on when I had a better picture of my situation could not afford to. I floundered at the hands of chiropractors, accupressurists and physical therapists who kept telling me everything was going right and it’s gonna be fine. My chiropractor especially deliberately steered me away from any mentions of herniated disks/operations. After the holidays and many relapses, I no longer experienced pains, but numbness and loss of reflex occurred in my right leg. About this time I began to learn about “herniated disks”. I went to an orthopedic surgeon only to be asked how I could afford operation without any medical coverage.

- Finally I left for Bangkok in February, flying as a wheelchair passenger, determined to get the proper treatment after many researches on the internet, including council from a member of the Thaivisa forum who recommended his ortho doc in Bumrungrad. Also I could rely on the personal care of my Thai boyfriend to see me through hospitalization if it came to that. At this point I did post a note of the Thaivisa forum and got many good wishes from other members, but unfortunately the kind of postings such as yours which would have been instrumental to my search for treatment/doctors was nowhere to be found.

- The odyssey began. I saw several doctors both at Bumrungrad and Bangkok Hospitals, I got an MRI and the diagnosis was not 1, but 2 herniated disks at l4-l5 and L5-S1. I actually I saw all the spine surgeons at Bum except yours. Ironically he was the one that I was looking for, someone with training in the States and who does diskectomy on a regular basis. Talk about hiding in plain sight! I was also at a loss at what to do. My condition was getting better, I was able to walk and climb stairs and the people around me, the folks that were giving me physical therapy and the surgeon I had set my sight on, Dr. Areesak at Bum, and my boyfriend all were saying that I should wait and see how much more I could improve. I was losing my sanity at this point so I decided to go to VN, my home country where a relative had some recommendations.

- The detour in VN lasted 2 months. I was preyed to more quacks and unecessary treatment, for example, a CT scan to better see my herniated disks, epidural shots that might prevent surgery (I wised up and refused these). I was moving better, including swimming, but the “referred” pain in the hip remained. Finally, I got communications with a friend of a friend in the States who had had the same exact diagnosis and decided after one year of living with the pain/discomfort to get operated. That helped me made up my mind to return to Bangkok and go in for the operation.

- I returned at the beginning at June. In retrospect this was the time when you posted your account of diskectomy, but I was too busy getting going that I did not check the web at this point. In mid June I was operated on by Dr. Areesak, assisted by another surgeon at Bum, doctor Apichat. They both were UCLA-trained, though Dr. Areesak is currently a “teaching” doctor and Dr. Apichat is a general “bone” surgeon. I woke up from the op and was able to lift my leg right away, the pain gone. The post-op care was impecca ble even though I had the catheter going in my penis for the first 24 hours. I was released 2 days later.

I don’t really know where to begin to give advice to any one going through this kind of experience. To me it has been a devastating episode in my life. Even though the operation was successful, I don’t know if and when I will get back to the physical shape I was before, part of the bundle of nerves of my S1 "has been damaged" and the doctor can not say if it will come back. I also remember lying on the theparist's table, with him/her going about their business of giving me relief and telling me that everything was to be ok, but we both realised how futile it was to just keep going. What really killed me was the certainty that the people around me did not know any better than I did! I hope that my and your accounts of our own experience will give other sufferers some insight and guidance. One thing I have to say though, is that “man proposes, God disposes.” So if anyone is in this predicamment, I wish you plenty of luck and especially a clear mind to do plenty of thinking, researching, and then “proposing” your own fate.

smo

[ASIC]

I am not going to write a long story, but I had surgery in Bamrungrad and it was a 100% success. Went back to Europe to have it done there, but the doctor didn't even bother. Seems like he was too stuck-up for such a simple operation. So I went back to Bamrungrad. I was really treated well, the nurses were friendly, the doctor knew what he was doing, and after 5 hours of surgery the problem was gone for good. Only complaint. I think all the money went to the doctor, and very very little to the nurses who also did a heck of a job.

ASIC

[Captain Chaos]

I'll offer my two cents worth ....

Started getting severe back pains around this time last year. Had a two day episode where couldn't stand upright, walk etc. Went to Bumrungrad. They diagnosed an acutely herniated ('slipped') disc at L5-S1. MRI scan later confirmed this.

Three months of physio didn't really help. Had two more 'episodes'. Bumrungrad eventually recommended a discoscopy (spelling?). Did some research on this. To those that have had it and feel it has provided relief, I'm really happy for you. However, I was concerned that it seems to address the symptoms not the cause, and leaves a weakspot which may lead to more trouble later on. No particular complaints about the standard of care I got at Bumrungrad, but I always felt that they just had too many patients and maybe, just maybe, they drew their conclusions rather quickly.

I went for a second opinion at BNH. The doc at the spine clinic there concurred that as physio hadn't really given much relief, surgery should be considered. However, BNH are offering Total Artificial Disc Replacement surgery using the German 'Charite Disc'. This appears to offer a better, long term solution than a discoscopy (maybe - depends on lots of factors of course), plus the recovery time from the procedure may be shorter.

I'll not get into the medical options, as that depends on each individual, but it has worked brilliantly for me. More importantly, I felt that the team at BNH were less rushed and had more time to check out the details. Just my experience / opinion, but I know where I'll be going in future ....

[kathyjune]

Griffer - it seems that you have had some serious problems - with your back. Thanks for the info.This must be the place to go if you need help. Can Americans just walk in during an emergency?

[drbones666]

Statistically we know that 50% of all back ops fail within one year. By the 7 year mark it's almost 100% failure.

The total disc replacement is a very promising op and I've not heard anything bad about it yet but it is still considered experimental.

In my experience it's what the patient does that has the most effect on back pain and disc damage. Most people are damaging their discs on a daily basis. How is the poor disc supposed to heal if you keep tearing it? Trouble is, most advice given by professionals is the same stuff they were saying 50 years ago. Didn't work then, doesn't work now. Also, despite plenty of research showing that strengthening of the "core" (stupid term) muscles has little to no effect on low back pain.

Treating and living with low back pain is a bitch. Most people don't want to hear what it takes to stay out of pain and those that op for the simple way out usually find themselves in pain again, even after the 2nd or 3rd op.

[ProThaiExpat]

While I agree largely with drbones666 general tone, he word use raises many questions in my mind.

Torn annulus fibrosis does not heal if herniated, thus the avenue for the nucleus propulsis to find a nerve root to impinge on and create pain remains for ones life.

"The total disc replacement is a very promising op and I've not heard anything bad about it yet but it is still considered experimental."

I wonder what this sentence means. Total removal of disc material has been around for fifty years or more. It is rarely sucessful as it leaves nothing behind to prevent vertebral bone on bone grinding. Does that statement mean they are inserting prothesis in place of the removed disc material? It seems so, based on the previous post about the German insert. Would sure like to know about this proceedure, which is certainly new. How is it maintained in position after insertion. It certainly provides cushioning after the disc material is removed.

The major cause of post surgical long term back pain is the scar tissue left behind by the surgeon. With micro-surgery this has been greatly reduced.

Fusion of the adjacent vertebral bodies was the usual scenario once the disc material was removed in classic discectomies/laminectomies in the past. I will research the German prothesis and update my knowledge on a subject I have been associated with for many years.

[ProThaiExpat]

We live and learn!!! Seems though they limit use to the last two intervertebral space in the lumbar spine!! Mechanically it makes a lot of sense to replace the completely removed old disc material with a prothesis, however only one level can be so treated according to the literature and many patients have disc failure at more than one level.

"The CHARITÉ™ Artificial Disc was originally developed at the CHARITÉ University Hospital in Berlin, Germany in the mid-1980's by Prof. Karin Büttner-Janz, Prof. Kurt Schellnack, leading spine specialists. Further refinements to the design were incorporated with the cooperation of the staff at Waldemar Link GmbH, a leading European based medical device manufacturer.

In 2003 DePuy Spine acquired the Link Spine Group, Inc., and gained exclusive worldwide rights to its principal product, the SB CHARITÉ™ Artificial Disc. The FDA approved the CHARITÉ™ Artificial Disc in October of 2004 after extensive review of the two year U.S. clinical trial results. In addition to these studies, total disc replacement with the CHARITÉ™ Artificial Disc has been performed in Europe for over 17 years and has been used in treating thousands of patients worldwide with successful results.

This makes the CHARITÉ™ Artificial Disc the first and most clinically tested total disc replacement in the world. A breakthrough in non-fusion technology, it offers an innovative surgical option to physicians for treating some patients with degenerative disc disease and related conditions."

[kathyjune]

Has anyone had colon surgery here? Which Doctor?

[Head Snake]

I had double dischotomy, fusion and pedicle screws inserted. My surgery was back in 1993 in the US and it is a success for me and continues to be.

If you have back pain, get an MRI. It shows you the truth.

I tried Chropractors. I don't think too highly of them based on my experience. I know others who swear by them; but, not me.

Good luck to all who have this condition. It is NO FUN.

[Captain Chaos]

For those that are interested, here's a sideview x-ray of my artificial disc. It was taken in November 05, about 3 months post-op'. The chromium end plates show up well, the high density polyurethene insert in the middle obviously doesn't, although you can make out the metal strip that runs through dead centre.

I make no claims about what is the best approach to back surgery, or indeed, bearing in mind some comments in this interesting thread, whether surgery is the best / only approach. I do know that I was impressed by BNH (rather less so by Bumrungrad) and that the replacement disc approach has delivered everything promised .... so far.

If anyone wants to discuss anything more specific, then they're welcome to PM me.

CC

[donna]

Dr Panya did an operation on my left shoulder. hurt like hel_l. but he fixed it up. i have nothing but praise for the man.

[capt morgan]

Just returned to USA from bumrungrad..Had laminectomy (spell) on L4 L5 and fusion including S1

Had surgery march 21, 2006 I feel it was success, no pain except soreness of incision, but no back pain.I am very pleased with my experience at that hospital

If interested in more info PM me

[jcnlv]

I thought I would share my experiences with medical and dental care in Thailand.

I'm back from Thailand almost 5 weeks now. I am one of the millions of self-employed, uninsured Americans. I have been having problems with my hip and lower back and thought that I had a heart attack a few months back. After spending thousands of dollars on tests with local doctors, a friend who lives in Thailand suggested I go there for a complete examination. I had seen the 60 minutes show on Bumrungrad Hospital in Bangkok and decided to go there for additional opinions on my problems.

It was very impressive. The doctors there were wonderful. The facilities are state of the art and all for a fraction of the medical and dental cost here. I had the comprehensive checkup and a full orthopedic exam. I also ordered and had ala-karte eye and hearing tests, some skin growths removed and tested.

I found that for my age (58) I am in pretty good shape. The main cause of my problems - 20% overweight and not getting enough exercise, and my tall frame (6' 4-1/2") that puts added stress on my back. They discovered a gall stone during the abdominal ultrasound, and they recommended changing my blood pressure medicine, which turned out to be a very good change. I was so impressed with the fact that I was told that I did not need any of the more radical treatments I had considered. I was not pushed into any kind of treatments which was something I thought might happen. I had been thinking of hip and/or back surgery, angiogram etc. The doctors instead suggested diet and lifestyle changes.

After considering my options I elected to have my gall bladder removed there, rather than risk an emergency happening here in the states that would send me to the "poor house". They did a laproscopic surgery. I was in-patient for only 48 hours and then was back out sightseeing and shopping and walking, climbing stairs and all - like nothing had ever happened. $3,400 total... including a beautiful private room with all the amenities. My sister said her laproscopic gall bladder surgery bill to her insurance in Los Angeles was around $30,000... and she ended up having complications after the surgery from having her abdomen inflated causing her lots of pain. My surgery was problem free.

I was treated like a VIP everywhere. It was quite an experience. All the various doctors I saw had studied and or interned in the states and spoke very good English. They spent so much time with me going over all my tests, xrays and all, that I felt they really cared. The technicians all seemed well trained and the nurses and administrators were like a different breed from my experiences here in the US medical establishment.

Dental work just as good. My teeth have been an embarrassment that has bothered me since I was young... small and with large spaces. I have had many bottom molars removed over the years. My friend recommended a clinic in Bangkok and I had my teeth all fixed while I was there as well. They did 4 veneers, 4 crowns, a root canal and a full lower partial. The clinic was not only beautiful http://www.thantakit.com/ but had all state of the art equipment, staffed by some of the most considerate, gentle and caring personnel imaginable. My dentist went to school at New York University, spoke perfect English and really went out of the way for me. All the work came to $2600 total and my teeth now look and feel great.

I spent around $10,000 for everything - including all the medical and dental work I had done, my airfare, 3 weeks hotel, great food, entertainment and lots of shopping. I had a fantastic time. I bought some new custom suits and a bunch of shirts plus bought my wife all kinds of clothing and beautiful fashionable leather goods at a tiny fraction of what they cost here.

My experience at Bumrungrad and the dental clinic were everything I could possibly have hoped for. I was very satisfied.

jcnlv

[dekka007]

Dr Panya also done a ACL ligament reconstruction surgery on my knee last year using a ham string graft.

Good as new 1 year later nearly to the day. Highly recommend him.

[ArtfulD]

Im considering surgery at Bumrungrad or BNH, Ive yet to see a Dr at either as Im back in the UK but the delays here are frustrating. Im interested in hearing about peoples experiences, from what Ive read/seen BNH seems to have the more advanced spine centre.

My condition is a fairly complex one I think so im curious as to if its too risky. I want to have a Pectus Carinatum (Pigeon Breast) correction (protruding sternum) and a upper spine fusion/straightening (ankylosing spondylitis has already fused my spine at the upper levels with a bad curvature and bad neck postion) ive seen a documentary on a 45 year old man getting something similar fixed at Bristol in the UK and they had to break his spine first to straighten him out before placing the screws and plates...

Must admit makes you wary incase a mistake happens and you end up paralyzed! But ive litterally lost like 6 inches in height over the past 7 years.

[Head Snake]

Thanks to the OP and other posters for the input.

It looks like my second back surgery is on the horizon.

Ms. Sciatica has returned and she is a bitch.

I've arranged my MRI at Bumrungrad for today and hopefully, I can see if I can go golfing tomorrow based on the results.

The best thing is I feel comfortable with this hospital after reading this thread. That is very important as you really don't know if your first or second opinion is valid. With an MRI and a qualified surgeon and professional hospital staff, you know you are getting good opinion.

Edited May 18, 2006 by Head Snake

[oopapasan]

I thought I would share my experiences with medical and dental care in Thailand.

I'm back from Thailand almost 5 weeks now. I am one of the millions of self-employed, uninsured Americans. I have been having problems with my hip and lower back and thought that I had a heart attack a few months back. After spending thousands of dollars on tests with local doctors, a friend who lives in Thailand suggested I go there for a complete examination. I had seen the 60 minutes show on Bumrungrad Hospital in Bangkok and decided to go there for additional opinions on my problems.

It was very impressive. The doctors there were wonderful. The facilities are state of the art and all for a fraction of the medical and dental cost here. I had the comprehensive checkup and a full orthopedic exam. I also ordered and had ala-karte eye and hearing tests, some skin growths removed and tested.

I found that for my age (58) I am in pretty good shape. The main cause of my problems - 20% overweight and not getting enough exercise, and my tall frame (6' 4-1/2") that puts added stress on my back. They discovered a gall stone during the abdominal ultrasound, and they recommended changing my blood pressure medicine, which turned out to be a very good change. I was so impressed with the fact that I was told that I did not need any of the more radical treatments I had considered. I was not pushed into any kind of treatments which was something I thought might happen. I had been thinking of hip and/or back surgery, angiogram etc. The doctors instead suggested diet and lifestyle changes.

After considering my options I elected to have my gall bladder removed there, rather than risk an emergency happening here in the states that would send me to the "poor house". They did a laproscopic surgery. I was in-patient for only 48 hours and then was back out sightseeing and shopping and walking, climbing stairs and all - like nothing had ever happened. $3,400 total... including a beautiful private room with all the amenities. My sister said her laproscopic gall bladder surgery bill to her insurance in Los Angeles was around $30,000... and she ended up having complications after the surgery from having her abdomen inflated causing her lots of pain. My surgery was problem free.

I was treated like a VIP everywhere. It was quite an experience. All the various doctors I saw had studied and or interned in the states and spoke very good English. They spent so much time with me going over all my tests, xrays and all, that I felt they really cared. The technicians all seemed well trained and the nurses and administrators were like a different breed from my experiences here in the US medical establishment.

Dental work just as good. My teeth have been an embarrassment that has bothered me since I was young... small and with large spaces. I have had many bottom molars removed over the years. My friend recommended a clinic in Bangkok and I had my teeth all fixed while I was there as well. They did 4 veneers, 4 crowns, a root canal and a full lower partial. The clinic was not only beautiful http://www.thantakit.com/ but had all state of the art equipment, staffed by some of the most considerate, gentle and caring personnel imaginable. My dentist went to school at New York University, spoke perfect English and really went out of the way for me. All the work came to $2600 total and my teeth now look and feel great.

I spent around $10,000 for everything - including all the medical and dental work I had done, my airfare, 3 weeks hotel, great food, entertainment and lots of shopping. I had a fantastic time. I bought some new custom suits and a bunch of shirts plus bought my wife all kinds of clothing and beautiful fashionable leather goods at a tiny fraction of what they cost here.

My experience at Bumrungrad and the dental clinic were everything I could possibly have hoped for. I was very satisfied.

jcnlv

What was the name of the dental clinic?

[oopapasan]

Dr.adam...yep, it would be naive to believe the best doctors for evry speciality works out of Bumrungrad..

as you say, through the medical profession you have heard of many higher quality specialists working out of other hospitals. The point here is that you have heard this "through the medical profession".How does joe public find this out?...well, he can't. He can ask around,hmmm..and it still comes down to someones subjective view...

I think the ordinary punter is probably going to have to take his chance on one of the big hospitals and see how the doctors shape up. As I said, I tried to get as much info as possible before the op and cross-checked it with someone in the UK.

It seemed to stack up. But any operation has some level of risk..whether I had it in Thailand or the UK.

As for the doctors in private practises being able to charge appropriate to their skill....there is something like that happening in Bumrungrad..I haven't got details..but as I understood the set-up, the doctors charge independently of Bumrungrad, though still under their billing system, and Bumrungrad takes a percentage back out of what they charge.

dr.bone... crikey so I've got a 50% chance of getting through the first year..better get some parachuting in quick....

they are amazingly high failure rates that you quote...and within 7 years I'm back to square one? is there anywhere on the web where this is documented? seems bizarre...

i guess anyone who is back to square one by implication had the op done 8 years ago...my understanding is that these ops have improved markedly over the recent times....so I hope your figures were calculated by using statistics from the early roman empire..

another link for those interested is this

http://www.alphaklinik.com/Slipped-Disc-with-Stenosis.html

its a klinik(?) in germany specialising in this type of surgery..if you follow the links it will actually show you what happens in the op. It was another of the places I considered going. They are willing to do the op with you still conscious..crikey..."pass me the scalpel, will you please, patient"...

Chriopractors couldn't make it to medical school--wannabes

[Head Snake]

I got my MRI done. Same type of price schedule as the OP; so that was a pleasant surprise.

It turned out I started to feel better after 2 nights in the hotel bed. I think my bed at home has lost its support.

I also went golfing that Sunday and felt no ill effect. I actually played better knowing my back has not degenerated since the last I saw a MRI 12 years ago.

Most people get an MRI as a last step. I think it should be done first to avoid a bunch of mistreatments.

[CBPMSM]

This is just intended as general information for anyone considering surgery in Thailand. I had heard of various levels of success and just thought I'd share my experience.

I will try and give plenty of detail and costs--apologies if it bores those who already know.

I had been suffering back pain for several years. It had progressively become worse. I visted a doctor in Bumrungrad Hospital Bangkok for the first time in September 2002. For those who don't know, Bumrungrad is one of the best hospitals in Thailand. Although relatively expensive for Thais, it is comparatively cheap for westerners. I arrived at the hospital without an appointment--I saw a doctor within about 45minutes.He sent me for Xrays --a nurse escorts you to the Xray department---I waited maybe 25 minutes--had the Xrays -- and then returned to the Doctor.He reviewed these and said they were indicative of a disc problem but to make certain it would be better to have an MRI scan. This was booked for the following evening.They took me down to the MRI machine to see it in operation.Apparently many patients get claustrophobic inside and they want to see what you think...you can ask to be sedated.

I arrived the next evening...half an hour before the appointment.You get changed and wait. You are taken into the MRI room and laid onto a sliding bed.Earphones with music playing are put on you and you are given a panic button. The bed slides into the machine. It is very claustrophobic.If you press the button they pull you out.You are in the machine for 30--45 minutes.

I came the next day to see the doctor. The results of an MRI are amazing.Its like a series of photos down through your body and understandable by even the untrained. He showed me where my disc had herniated and was pushing out against a nerve.

He suggested I try physiotherapy and certain exercises..and see how it goes. The alternative is surgery and it seemed premature for that.

The cost for the above set of Xrays/doctors consultaion/ MRI was about 14,000baht(an MRI scan is 10080 baht)You can also keep the MRI scans if you would like to take them to someone for a second opinion.

OK..so my back does not improve..I am back in March 2004...by now the pain is nearly constant..waking me at night..I am limping..the only relief is to lay down.

Back to see the doctor..Xrays..another MRI..we then try 2 weeks of physiotherapy.They manage to stop the pain for a few minutes at a time.They inject Novacaine into my buttock and back of my leg and that switches the nerve off for about 30 minutes and its bliss.

So..we are at the point where they are advocating surgery. I speak to a doctor friend in the UK and he seems to confirm their diagnosis. I try to get some prices out of BUPA UK...they seem to say the operation alone will be around 8000pds+ tests+aftercare.

So I take the plunge and sign up to go into Bumrungrad.I have to wait 1 week to get a bed and the necessary surgeon available. I go in on a Friday afternoon. I choose a private room(+private bathroom+TV+kitchen).

The surgeon and the original doctor visit me on Thursday afternoon and explain what they will be doing.The surgeon has spent 2 years working in a hospital in Chicago (USA), speaks english very well and seems very competant.

I have the operation at 6am on Friday morning.It takes about 1 hour 40 minutes.I come round about 9.30/10am. I felt rough. I had a morphine drip in my arm and a dispenser in my other hand...I could push the button and it injects more morphine into me..up to a certain level.

They took me back to my room and eased me back into my bed. The surgeon visited me about 2pm and said he felt the operation was a success. He gave me a small bottle with the part of the disc they had removed inside.Lovely...

He came the next day and asked me to allow him to lift my leg. I was dubious. Before the operation I could only lift my left leg about 9 inches off the bed.He lifted it about 2 feet and there was no pain.

By Sunday I was walking around, and I was discharged on Wednesday.

The cost..each physiotherapy session combined with a doctor consultation cost around 2000 baht. I had about 8 of these. The MRI cost 10080 baht. The Xray and consultation cost 4400 baht.The pre-op tests(cardiac/blood tests) 2800 baht.The actual operation ,room fees, nursing costs, medicine 155,353 baht.

So I make that around 188633 baht.

So far its been a complete success...I can only recommend the hospital and the doctors. If anyone out there is suffering like I was, I hope you are as fortunate as I have been.

[CBPMSM]

MEDICAL TREATMENT AT BUMRUNGRAD HOSPITAL IN BANGKOK THAILAND Dec 5^th thru Dec 18th

Having suffered from back pain off and on for 6 years, I was desperate to find relief. I took the usual route of cortisone shots that helped a few days and prednisone that also helped temporarily. Then I tried chiropractic treatment, then acupuncture. I also tried aquatic aerobics and this seemed to be helping, but after Hurricane Wilma it became worse by the day. Nothing seemed to relieve the sciatic pain running down my leg. Finely at the advice of my orthopedic friend, now retired, and a dear friend that was an RN, opted not to do what they called a band aid fix with epidural injections, and instead go for surgery.

Back in May I was in Thailand when stricken with extreme sciatic pain. I was taken to a hospital there. It was not Bumrungrad, but I was very impressed with the attention, concern, cleanliness, timeliness and general concern they had for me. After being properly clothed in a hospital gown almost immediately, I entered a room so spotless I would not have hesitated to eat off the floor. After a short interview, the doctor gave me what I thought was a message but his card says he is an actual MD. This was at least 2 hours. He then leads me over to a sauna and I am in there another 30 minutes to an hour. He explains that since we were scheduled to fly out in a couple of days they could only try to relieve some of the pain. He gave me a prescription and was led down stairs to pay the bill. I was worried, I knew it would be $1000.00 and my insurance would probably not cover any of it. You really can't put a dollar figure on your health so I was prepared to pay. I was shocked; the total bill was US $12.00!

Although my pain eased up for a week or so it progressively became worse. I could not stand up more than a couple of minutes without being in excruciating pain. I started to do research. I got an MRI and was diagnosed with Lumbar Stenosis of L4 and L5.

Several years prior to this I was diagnosed with high cholesterol and shortly after that my insurance company pulled out of the state and other insurers wanted to write a policy with this pre existing condition. I had never used the insurance. I soon got other insurance but didn't feel it would cover me if anything very serious happened or I would be out in the cold should anything related to high cholesterol enter the picture.

Like many Americans I am disgusted with medical treatment in the United States, but feel that WE the people have been entirely responsible for the situation we are in. Every day you see advertising by lawyers advocating mal practice suits. The drug companies advertising their product encouraging patients to ask their doctors for this or that drug. Insurers are telling the doctors what they can and can not do. Courts give huge settlements to patients. Hospitals prefer the doctors to over prescribe insured patients so as to pump up the bill. Even genetic defects are blamed on doctors. In short good doctors can not practice without extremely high mal practice insurance rates which naturally they must pass on to their patients. Cost of drugs must include the cost to pay huge settlements. The list goes on and on. We the people have created this night mare. .

A great analogy might be doctors in the US are like a heard of sheep, with naturally a couple of black ones mixed in. A pack of hungry wolves are attacking them at every angle. When will we realize medicine is not an exact science? Things can and do go wrong, but huge settlements lead to good doctors leaving their practices. Wouldn't it be better to keep our good doctors, and a better method used to police the bad ones? Mistakes happen, but it would be better to strip the repeat offender of his or her license rather than to punish everyone with almost unaffordable health costs. We would certainly keep good doctors and eliminate the bad ones. The way we are doing it now is working just the reverse.

I knew I wanted a doctor that was allowed to practice and not be dictated as to what he could do or not do when it came to my back.

Having remembered my experience in Thailand I did a search on the internet for Spinal Stenosis surgery in Thailand. Google came up with Bumrungrad Hospital in Bangkok.

I go to their website. I soon realize this was the same hospital featured on 60 minutes a few months back. I make an inquiry and within 12 hours I receive my first email. I respond with my diagnosis and symptoms and receive a 2^nd email from Dr Nanthadej Hiranyasthiti. He wants my MRI. He does not want to recommend surgery until he actually sees this and me. I am hurting and having talked to a surgeon here in West Palm and my retired orthopedic friend, I was convinced I needed the surgery. I get a reply back from the hospital that the complete bill will run around $7500 including a 5 day stay in the hospital with private room and round the clock registered nurses. This was substantially less than I had been quoted for a one day stay in a hospital in West Palm Beach. Being a firm believer that you get what you pay for, I was skeptical but remembered my prior experience in Bangkok back in May.

I do further research. Dr. Nanthadej is highly qualified, Not only board certified, but fellowships : Spine Surgery, Chicago and Member of North American Spine Society as well as numerous Thai accreditations. Most of the doctors at Bumrungrad have trained and practiced throughout the US and Europe. I do further research on Bumrungrad. Google searching I try to find anything negative about Bumrungrad. I come up with "O negative blood is in short supply but the hospital has donors on call as a back up". (I am not O negative). I can find nothing else. It is the undisputed number one hospital in Asia, and one of the few hospitals in the world that are internationally accredited.

I am hurting, and purchase airline tickets before receiving Dr. Nanthadej's reply. I am determined to get treatment at Bumrungrad. Shortly after I get an appointment date Hurricane Gamma threatens and I feel I just can not leave Florida at this time. I explain in an email about another hurricane threat. I tell Dr. Nanthadej we have already gone thru the English alphabet, and into the Greek alphabet, and then say we should probably use the Thai alphabet since it has 44 characters. (I hope this man has a sense of humor!) Hurricane Gamma fizzles out and armed with another appointment we fly to Bangkok. The hospital is within walking distance of the area we stay in when we conduct our botanical tours. I am very comfortable as I know the area well.

On the flight from Taipei to Bangkok we meet 2 Americans that live in Chiang Mai, a city several hundred miles north of Bangkok, and that were just returning from New Orleans where they had lived for many years. I strike up a conversation and ask them if they had ever heard of Bumrungrad. Not only had they heard about it but she had had gall bladder surgery there as well as a few nicks and tucks and he had several procedures also. We find out she is a doctor. They assure me I have come to the best hospital in the world. They would never think of ever going anywhere else. I am certainly becoming more comfortable with my decision.

We arrive 2 days early. We check out the hospital. Wow! I am impressed. We see a steady stream of high end cars coming in and out of the hospital directed by 8 policemen. International patients are throughout the facility. A McDonalds , Au Bon Pain, Starbucks and several other restaurants are on the 2^nd floor visible from the immaculate lobby. Could this really be a hospital? It is more like a 5 star hotel

I sign in, as I had already pre registered. This takes all of 3 minutes. They put a bar-coded band around my arm with my name, patient number date of birth etc.

My appointment with Dr. Nanthadej is at 10:40. On the dot I am led to his office. We discuss my problem and he explains the procedure. I like him immediately. He says he enjoyed my humor in the emails. He was interested to find out how I had heard of Bumrungrad and I explain. In my research the Staph infection rate in US hospitals was not acceptable to me. I had been told that in some cases it was as high as 27%. Dr. Nanthadej says that total infection rate for all types of infections at Bumrungrad was less than .007% and he felt the orthopedic section was even less than that. He explains to me some other risks with the procedure however. I was convinced I needed to have a fusion. He explained that he really does not think that in my case I need this even though it is several thousand dollars more that I am willing to spend. I tell him that I am a very active person but that I am only a nurseryman, he is the doctor and I will respect his decision. We agree that he is to make the final decision on the operating table.

He sets up my operation in two days and prepares me for pre op tests immediately. I am led to another Doctor by the name of Wiwat and I wait about 2 minutes. I like this man too. He interviews and examines me and writes out several other steps.

I get led to blood testing. This time the wait is less than a minute. My veins are hard to find and most everyone has to stick me several times. Not so, first time she hits the vein. She draws blood. Then she shows me the labels with my name and patient number on it. Is this your name she asks, and then proceeds to place the labels on the blood samples. I see there is no chance for mistaken blood.

Blood clotting test was next and I just get into another chair in the same office and this test is done. I dread needles but this was all practically painless. From here I am led to X-ray and I have to wait a full 2 minutes, then EKG was practically instantaneous. Boy does this hospital have its act together. I become even more impressed. I am told the doctor will call me about the results and am led to the in patients admission where I choose a room, and sign some forms. She tells me I must pay for the work done today.

The payment office is just behind registration. A big computer monitor board is above and displays your patient number. You sit in comfortable chairs with a table of refreshments while you are awaiting your turn. There are about 16 stations. My number comes up in less than 3 minutes. The bill was slightly under $100. This alone would have taken many trips and several weeks to happen in the US. Dr. Wiwat calls on my cell phone and all is a go for the surgery.

I am given pre surgery instructions and told to be at the hospital by 9 in the morning. We are on time. I pay for the estimate of $7500 in advance. I am led to my private room. It is huge complete with a nice bathroom, refrigerator, safe , state of the art electric bed, a sofa big enough for someone to sleep on , chairs, TV, DVD player, telephone, and closet and cabinet space, as well as an private outdoor balcony with a beautiful view of downtown Bangkok. I ask about internet access. They bring me a converter and connection. This room costs approximately 70.00 per day with meals and round the clock nursing staff all of which are RN's.

At about noon I am given an IV. At about 1 they come in and tell me that surgery has been delayed for an hour or two. At about 3:30 I am taken to pre op and Dr. Nanthadej greets me and apologizes for the delay. He explains he had 2 emergencies. I answer back that if he is too tired I will wait until tomorrow. He says no that it actually limbered up his fingers. We both laugh. Shortly thereafter I meet the anesthesiologist Dr Sunantha .She asks about prior surgeries and any allergic reactions. She reassures me, and tells me what to expect after the surgery. I immediately like her too. I am wheeled into the operating room. It looks ultra modern and I'm pretty sure it was equipped with a huge laminar flow. This is a sophisticated filtering system that is capable of filtering out the smallest bacteria in the air. Dr. Sunantha asks if I am ready to go to sleep. I do not remember answering.

Several hours later I wake up and think I have dosed off. To my surprise the operation was over. I immediately feel that my leg pain is gone. I barely feel the incision. I call home and tell everyone I am OK. I am wide awake. I am so happy it is all over.

Throughout the night the nurses checked in on me. I have little or no pain. Everything is administered thru the IV portal. I even think the anesthesia was administered this way, but I do not remember. I sleep the whole night and they never awaken me. I remember when my dad had cancer they would wake him every 15 minutes with an injection etc. He was miserable, and exhausted simply from lack of sleep.

The next day I am cared for like I am a king or president. They were particularly vigilant of any change in temperature or blood pressure. I knew they were going to be on top of any possible infection. Both doctor Nanthadej and Wiwat come in to check on me. They reassure me that everything is fine. Dr. Nanthadej explains that he opted not to do the fusion and that I would be getting a refund. We joke and I tell him I plan to buy some stock in Bumrungrad and to make a little bit of profit. He laughs.

The food selection is unbelievable. There are four choices including Oriental, Western, Japanese and Chef's choice. I have found them all to be delicious, but if you don't like it you can always call room service for a huge selection of meals served downstairs from the many restaurants. Gee should I have room service bring me the Rock Lobster salad with fresh tomatoes and cumbers with Balsamic vinegar, or should I just accept one of menu choices that just happened to be thinly sliced tuna with mashed potatoes in a red wine sauce. McDonalds has a restaurant on the second floor of the hospital, and also delivers to your room. "McBumrungrad McDelivery"

Customer service comes in and asks me if there is anything they can do to make my stay more pleasant. I tell her that I am at a loss for words for how pleased I am. Phenomenal, remarkable, fantastic, do not portray my happiness. I can barely withhold the tears. I am out of pain after suffering severely for 8 months and off and on for over 6 years. She knows I sell plants and wants to know if I would like to be moved to the garden floor with an outside balcony garden. My outside balcony only overlooks downtown Bangkok.

The next day Dr Nanthadej again visits me and checks the incision. He gets me up to walk. I have a bit on tingling in my leg but he says this will go away in time and to take it easy. He says I will be ready to be released the following day and he can see the almost disappointment in my eyes. He says I can stay for as long as I wish. (After all a private room with meals included is only US $70.00 a day. I feel great and will surely be able to lift small buildings in another day. As it turns out I do stay an extra day but one day short of the estimated 5 days. I think Dr. Nanthadej sees that I could be too anxious and impatient to heal and possibly orders a reduction in pain medicine. I have not so good a day, but more importantly I learn this is actually going to take some time as they had explained.

I get on the internet and book the Bumrungrad Hospitality Suites for the remainder of the stay. They almost immediately call me with a reservation but apologize for not having accommodations for several nights but will be glad to get me reservations at hotels within walking distance of the hospital.

Dismissal day: Dietician comes in and asks how I found their services. Are they kidding? Customer service wants to know if I had any suggestions on how to improve.

Dr. Nanthadej again visits me, and writes out prescriptions for my recovery. All the nurses, much of the staff, meal servers and even the cleaning crew, have come to say good bye. I get tears in my eyes. And then they do too.

They send me down to the 9^th floor for final payment. I am surprised to get a sizable refund with total costs including doctors, operating room medical supplies, prescriptions including that used during my recovery, private room, meals, nurses, anesthesia , X-ray , telephone and internet service which I used a lot, for the 4 day stay is $4631. I am elated. Surely this can not be right.

Sure enough, I go back up to my room to move out, and the nurses inform me there was a slight error and that I needed to go back to the 9^th floor. I get there and the cashier is all apologetic; he made a $19.85 error in the hospital's favor and needs to refund this back to my credit card!

One of the staff meets me with my suitcases, and takes me to the Bumrungrad Hospitality Suites, a service the hospital supplies to patients and their families to stay during their Bumrungrad visit. I feel like I know them by now as we have made reservations thru the internet, as well as talking by phone Check in was fast and efficient. The facility is no more than a block from the hospital and an easy walk for me now.

The rooms here are even nicer than the hospital's with beautiful bathrooms and a showers and tubs you almost have to have instruction to operate. Now this is getting pretty close to heaven. The kitchenette has dishes and microwave with Washer and dryer and even dishwasher in the two and three bedroom apartments. The rooms are so spotlessly clean and polished you better not walk around in you stockings as the floor could be slippery this way. I guess they take extra precautions for cleanliness here to keep down the ever present threat of infections.

Some of the apartments even have adjacent connecting apartments. I took many photographs of this facility and will have a CD PowerPoint presentation by the time this is published. I never got to use the pool on the top floor.

/My first day as an out patient I decide to get some trays made to whiten my teeth. Actually, I wanted to see if other departments were as efficient, and wonderful as the Orthopedic. And yes, it was an absolute pleasure. I will have my trays in 2 days.

That evening I go to the Emergency center as instructed by Dr. Nanthadej to have my bandage changed. I walk into the center and greeted with a person that led me straight to a whole line of beds. I never stopped walking in the process. They asked what I needed and I showed them my paper from Dr. Nanthadej and they immediately changed my bandage. I told the nurse or she may have been a doctor, that I would see them tomorrow. She gave me a computer generated bill and I walked up to the counter at emergency to pay the 274 baht. I jokingly said would you take 275. Anyway that amounts to $6.88.

The following day I have become very comfortable with Bumrungrad and go to make an appointment for another problem. They say we can make an appointment for you tomorrow or you can go standby today. I decide to "go standby". Exactly 23 minutes later I am in the doctor's office. He prescribes an ultrasound. I am led to that department and wait another 4 minutes. After the ultrasound I am told to go back to the doctor. The reception says what is referred to as Tinglish here, "Oh Mr. Pearson take one hour to read Ultrasound, you go have fun for one hour. I love it. I go to the lobby for lunch and return an hour later. My ultrasound is ready and the doctor explains what is going on and that it is not cancerous but to check it annually or if it becomes painful. Charge for all this is $62.90.

Bumrungrad compared to other hospitals is like comparing Cirque du Soleil with a summersault or Disneyworld to a merry-go-round.

Unless I am in an emergency situation and can not make the flight to Bangkok, will be the only way I will ever seek hospital medical treatment in the states, if the current medical crisis continues. I will crawl back to Bumrungrad if I have to. It is a world class state-of-the-art facility, staffed with the most sincere and caring, compassionate people on earth. There is not one thing I can suggest to them to improve upon what they have there. (Except that it sure would have been nice to have a diet coke on ice immediately after the surgery) I told one of my doctors this and he said all you had to do was ask!

They provide translators for other languages, but I found English to be no problem.

It is very convenient to get around as it is very close to the Nana Sky Train station with free shuttle service from there to the hospital every 20 minutes during the day.

I can not sing enough praises about this facility

[Gary A]

Obviously people and their experiences are different. Years ago I had back problems and when your back hurts everything else hurts too. I went to an old MD who specialized in back problems. His advice was to do some exercises to strengthen my back muscles and to take it easy. No more masonry work or heavy lifting.

I was impatient and went to a chiropractor. After a couple of treatments I could no longer stand the pain. It was MUCH worse. I went back to my original doctor and after he examined me, he told me that my back muscles were very irritated and the spasms were causing the pain. Whatever exercises or whatever I was doing to STOP immediately. After I told him about the chiropractor he was VERY angry and told me that if I EVER went to a chiropractor again not to bother to come back to see him.

After I eliminated the back breaking block laying and cement work, my back has not bothered me.

[CBPMSM]

It’s been almost two years since my operation and I would like to add the following:

We have tried to have this story published but the local papers and television stations have refused to publish this because “ their medical advertisers would pull their advertising.”

Even the AARP article (Sept 2007) slants it as a “bargain” rather than the superior facility that it is. I went there because of the Staph infection rate in this country is unacceptable ….the pricing was just a bonus.

My personal opinion is that good medical doctors and nurses in this country have their hands tied with insurance, mal practice attorneys and subservient hospital employees hurting them at every opportunity.

I felt a personal friendship developed with Dr. Nanthadej, Dr Sunantha, and the personnel at Bumrungrad before, during and after my operation. I knew going into the surgery that they were going to do their very best. I also know that is one of the highest medical honors to be working at Bumrungrad. Mistakes are not tolerated.

Sorry folks, I strongly feel that multi million dollar mal practice settlements only drive up the medical costs. I am surprised at how many people ask me about what I would have done if the procedure failed. I felt so comfortable before the surgery that this never entered my mind. We must accept that medicine is always a practice and is not an exact science. I knew that I was in capable hands and before the surgery I knew that Dr. Nanthadej was going to do his very, very best. I can not imagine going into a hospital and they mark “Operate Here” in magic marker and I have never seen the person operating on me.

Bumrungrad has my total vote of confidence, from the doctors, nurses, chefs, administrative and service personnel. They are all quality, cleanliness and service conscience. I can usually find fault with just about anything I am confronted with, but with Bumrungrad, I could find NOTHING. I am seriously considering spending my final years in Thailand just to be close to this facility.

[nawkhingsinlin]

I am new member, I have a problem coz I have 4 scar in my arm so I want to remove it form my arm . Ples tell me which Hospital is cheapest

and Good doctor name in Thailand , I live in myanmar so how long live in hospital when during operation. Ples reply me ........Many Thanks

[Sheryl]

Yanhee Hospital would be a good bet. You can contact them by email at [email protected], be sure to include a photograph of the arm. They will probably send you a form to complete, after the doctors have reviewed the forms and photo they will tell you the cost and how long needed for the treatment.

Depending on the depth and width and type of the scars it may or may not be possible to completely remove them.

If after you get quotation from Yanhee it is too expensive for you, can try Bangkok Christian Hospital whioch is nonprofit. However Bangkok Christian is not as easy to deal with by email as Yanhee.

[scorecard]

I've read all the posts in this thread. I've lived in Thailand for more than 2 decades and for many years I patronized the 'expensive' hospitals, to some extent because I had total medical cover for self and family from my employment. But:

- Hospital 1 in Bkk :

-- Walked out of doctors room twice in disgust.

-- On one occasion female doctor told me that's "It's rude for patient to ask questions, you should have respect for the doctor and just answer the questions". Next visit I indicated that I did not want to see the same doctor, but in fact I was ushered into her room. I objected and said I wanted to see another doctor, hospital then tried to charge me for two doctors. after heated discussion with senior admin. staff I indicated that I would have my secretary call the medical council of Thailand. Suddenlt the second charge was dropped.

-- Toddler in the family mis-diagnosed 3 times in 24 hours. Nurse also made mistake in medication of same toddler (using chart for another patient), couldn't care less attitude when I pointed out they were using wrong chart,and I was basically told I should mind my own business.

-- Talked into total CAT scan (25,000Baht) which turned out to be totally unnecessary.

- Hospital 2 in Bkk:

-- Operated on my hand, but operated in the wrong place. Did serious damage to nerves. Also seriously overcharged on the operation, which they admitted, but then said "Never mind, I'm sure it will be OK next time".

- Hospital 3 in Bkk:

-- Visited this place after getting no satifaction for back pain in the other two places. Hospital 3 specialist, after 5 minutes of discussion, no tests, no x-rays wanted to admit me next day and open me up with a 50 centimeter cut. I walked out.

- Hospital 4 in Pattaya:

-- Took teenage nephew there for food poisoning, 1 hour later bill for 10,000Baht.

-- Son's wife went to dentist who slipped and made a serious gash down her chin. No apology whatever, taken to outpatients area for them to clean the wound and apply a closure and bandage. Then the hospital had the gall to ask for 3,000Baht for emergency treatment. That was cancelled when I threatened to call the police.