MRI Scans.

[Tofer]

17 hours ago, Sheryl said:

Thank you for the update. I'm glad it all worked out for you.

 

Two questions, for future reference:

 

1 - When you say it didn't work out at Bangkok Hospital, what exactly was the problem? Did they nto have an open machine or what?

 

2 - Is the imaging center you refer to this one, or another?    https://www.mrithailand.com/en/

1. Bangkok hospital, Bangkok have the open scanner, as you advised.

It was entirely my problem with not being able to stay still for an hour in the scanner with my pain, and my underlying claustrophobic tendencies, since the overhead plate is over your face and very close. They administered a sedative and sleeping tablet, but they had no effect whatsoever, until about 5 hours later.

They were somewhat cursory in their approach, in that they did not have me change out of my clothes, simply whipped my shorts off on the scanning tray.

I was also unimpressed with the doctor who made the preliminary examination. He was quite aggressive and inconsiderate of my pain. Of course the environment was akin to a 5* hotel, however that's not what's important. I would not recommend them, especially since the MRI scanner in Prachachuen is better, in my opinion, and you don't require the obligatory doctors examination, as in the hospitals. However, I did have the referral from Dr. Weerasak of the BCH, so perhaps that's not a valid comment, although I imagine there may be a way to access a scan without a referral, but I'm not entirely sure.

 

The Bangkok Christian hospital is perfectly acceptable in it's presentation, and the medical team were excellent, in their manner and performance, plus you'll likely save a bit of money in comparison to the sparkling private hospitals.

The journey and hotel costs, were more than worth it, since the Phuket BH is both showing it's age, and the most expensive of all 3 hospitals I visited, although Dr. Treenarong there was very good.

 

2. Yes, that's the place. The MRI scanner is shown in the gallery photos, along with the very sympathetic and considerate operator. They went to great lengths to try to get me comfortable, to endure the hour long scan, but the pain made it absolutely impossible. They even offered to let me lay inside the machine for 10 mins to try to get accustomed to it, before commencing the scan.

The operator sits outside behind a large viewing window, which is also very reassuring when you're locked away in a small room and trapped within that machine.

My head remained outside the overhanging plate, and I was able to elevate it on extra pillows, to mitigate the sensations of choking / inability to swallow lying flat.

The only negative was the space available between the base and overhead plates, and with my slight excess of midriff, they had to squeeze me inside with my stomach strapped, which consequently forced my arched back into the base plate and ramp up cushions, causing additional pain.

 

I must add that, beyond my expectations, all 3 abortive scan attempts, including Phuket & Bangkok BH and the MRI centre at Prachachuen did not make any charge for their actual MRI scanning services, which included the gowns required to change into, which obviously then need laundering, machine cleaning, admin etc.

 

Edited November 10, 2021 by Tofer

[superal]

I had an MRI spinal scan at the Bangkok hospital in Korat last year . The doctor wanted to operate on me the next day to ease up the pinching by 4 vertebrae on the sciatica nerve . Operation in excess of 1 million baht . I declined as I had a need to return to the UK  . In the UK I asked my doctor for some pain relief tablets but instead was given a referral to my local hospitals spinal unit . The surgeon viewed  by MRI films from the Korat BH and said they were not clear enough to be enhanced on his computer and told me to have another MRI scan on their more modern equipment , which I did and it took 45 minutes .

However the interpretation did not reveal anything too untoward accept that of spinal stenosis cause by degenerative bone disease . He decided trying pain killers , which I did and no benefit , 2nd would be physiotherapy and finally surgery which he said would carry a risk and was loathe to operate .  When I sit down there is no pain but standing and walking ( maximum 100 meters is my limit )  just knots me up with the pain radiating to my hips and I have to sit down.

 If the cost of MRI is a major factor , there is a company based in Bangkok that specialise in MRI/ MRA scan only and appear to be very competitive . They recently quoted me 6000 baht for a neck scan on my carotid arteries . Company name is    Prachachuen MRI Center

[Sheryl]

1 hour ago, Tofer said:

1. Bangkok hospital, Bangkok have the open scanner, as you advised.

It was entirely my problem with not being able to stay still for an hour in the scanner with my pain, and my underlying claustrophobic tendencies, since the overhead plate is over your face and very close. They administered a sedative and sleeping tablet, but they had no effect whatsoever, until about 5 hours later.

They were somewhat cursory in their approach, in that they did not have me change out of my clothes, simply whipped my shorts off on the scanning tray.

I was also unimpressed with the doctor who made the preliminary examination. He was quite aggressive and inconsiderate of my pain. Of course the environment was akin to a 5* hotel, however that's not what's important. I would not recommend them, especially since the MRI scanner in Prachachuen is better, in my opinion, and you don't require the obligatory doctors examination, as in the hospitals. However, I did have the referral from Dr. Weerasak of the BCH, so perhaps that's not a valid comment, although I imagine there may be a way to access a scan without a referral, but I'm not entirely sure.

 

The Bangkok Christian hospital is perfectly acceptable in it's presentation, and the medical team were excellent, in their manner and performance, plus you'll likely save a bit of money in comparison to the sparkling private hospitals.

The journey and hotel costs, were more than worth it, since the Phuket BH is both showing it's age, and the most expensive of all 3 hospitals I visited, although Dr. Treenarong there was very good.

 

2. Yes, that's the place. The MRI scanner is shown in the gallery photos, along with the very sympathetic and considerate operator. They went to great lengths to try to get me comfortable, to endure the hour long scan, but the pain made it absolutely impossible. They even offered to let me lay inside the machine for 10 mins to try to get accustomed to it, before commencing the scan.

The operator sits outside behind a large viewing window, which is also very reassuring when you're locked away in a small room and trapped within that machine.

My head remained outside the overhanging plate, and I was able to elevate it on extra pillows, to mitigate the sensations of choking / inability to swallow lying flat.

The only negative was the space available between the base and overhead plates, and with my slight excess of midriff, they had to squeeze me inside with my stomach strapped, which consequently forced my arched back into the base plate and ramp up cushions, causing additional pain.

 

 

 

Very helpful, thanks.

I had no idea the Prachachuen MRImplace had an open scanner, very good to know.

[Tofer]

2 hours ago, Sheryl said:

Very helpful, thanks.

I had no idea the Prachachuen MRImplace had an open scanner, very good to know.

You're very welcome, the least I could do, and thank you for all your efforts in supporting peoples medical enquiries.

[Tofer]

4 hours ago, superal said:

I had an MRI spinal scan at the Bangkok hospital in Korat last year . The doctor wanted to operate on me the next day to ease up the pinching by 4 vertebrae on the sciatica nerve . Operation in excess of 1 million baht . I declined as I had a need to return to the UK  . In the UK I asked my doctor for some pain relief tablets but instead was given a referral to my local hospitals spinal unit . The surgeon viewed  by MRI films from the Korat BH and said they were not clear enough to be enhanced on his computer and told me to have another MRI scan on their more modern equipment , which I did and it took 45 minutes .

However the interpretation did not reveal anything too untoward accept that of spinal stenosis cause by degenerative bone disease . He decided trying pain killers , which I did and no benefit , 2nd would be physiotherapy and finally surgery which he said would carry a risk and was loathe to operate .  When I sit down there is no pain but standing and walking ( maximum 100 meters is my limit )  just knots me up with the pain radiating to my hips and I have to sit down.

 If the cost of MRI is a major factor , there is a company based in Bangkok that specialise in MRI/ MRA scan only and appear to be very competitive . They recently quoted me 6000 baht for a neck scan on my carotid arteries . Company name is    Prachachuen MRI Center

That's the one, Pratchachuen MRI Centre. I was quoted B12,000 for the cost of a lumber MRI scan in their open scanner, via a referral from Dr Weerasak of the Bangkok Christian Hospital.

It was not the one I had, as I explained earlier, I returned to the Bangkok Christian Hospital for an anesthetic MRI scan, and this was in the old style tunnel / doughnut scanner. I'm led to believe the imagery of these older style machines is clearer than the newer open type scanners. The scan was B8,500, and the anesthetic plus health examinations was approx. B27,000.

 

I sat down with Dr Weerasak in front of my scan images, and it was extremely clear that I had a severely herniated disc, as the light coloured conduit (sciatic nerve channel) with grey streaks inside was completely trapped at my L4/5 disc, it was a completely black void with absolutely no evidence of any such channel / conduit. My pain level was running at maximum, so there was no pretending it was not severe. There was no question of my sitting on a plane back to the UK for 13-14 hours, I struggled with a 1 hour 20 minute flight from Krabi to Bangkok. Plus I would not have got the same instant treatment, as I got from Dr Weerasak late on a Friday night, when he should have been at home with his family.

 

As I noted before, I would have absolutely no reservations about recommending Dr Weerasaks' team at the BCH, I am 100% delighted with my treatment and the unbelievably satisfactory outcome. I no longer spend all day and night in screaming pain in all positions, sitting standing or lying down, and expect a full recovery of my mobility, when the operation wound is completely healed, and my back has recovered / strengthened in the next couple of months.

 

Should the need arise again, I would be completely confident to place my life in Dr Weerasaks hands, as I trust his, and his teams, expertise and professionalism implicitly. Had it not been for Covid, and the wait for vaccinations, I would have been there months ago.

 

Your quotation from Korat sounds somewhat excessive, although I am not aware of the extent of the surgery they proposed. It sounds like you would have needed micro discectomy surgery to remove the bone impingements on your nerve. FYI, my surgery, care, 1 night hospital stay and medication amounted to approx. B300,000, including the anesthetic MRI scan. Even without health insurance, I'm still quids in compared to the outrageous insurance premiums I would have paid over many years, and happily I can afford to take the risk.

 

I would unreservedly recommend you make a trip to the BCH and consult with Dr Weerasak about your problem. B600 for his initial consultation. Alternatively, if you are not desperate, he also practices from the public Chulalongkorn Hospital in Bangkok, which would likely be cheaper, but not so instantaneous.

 

Life's too short and precious to suffer such debilitating pain, get it sorted. ????

Edited November 10, 2021 by Tofer

[Sheryl]

1 hour ago, Tofer said:

 

I would unreservedly recommend you make a trip to the BCH and consult with Dr Weerasak about your problem. B600 for his initial consultation. Alternatively, if you are not desperate, he also practices from the public Chulalongkorn Hospital in Bangkok, which would likely be cheaper, but not so instantaneous.

 

He is also at Vejthani Hospital and Bangkok Hospital.

 

His impressive CV can be seen here  https://www.vejthani.com/doctor/dr-weerasak-singhatanadgige/

[Tofer]

On 10/26/2021 at 11:49 PM, Golden Triangle said:

I went to Bangkok Pattaya hospital when I started having balance problems, 25 k baht for a brain scan ( MRI ) that was about 3 or more years ago, I still have the CD of the event, they couldn't even get the date right. Took it to another hospital, same result, fall a huge scam.

 

Oh, and the problem gets progressively worse, chuffin great, not.

If you're still suffering, get along to see Dr Weerasak at the Bangkok Christian Hospital in Silom. I wholeheartedly recommend him.

[Tofer]

2 minutes ago, Sheryl said:

He is also at Vejthani Hospital and Bangkok Hospital.

 

His impressive CV can be seen here  https://www.vejthani.com/doctor/dr-weerasak-singhatanadgige/

Interesting, thanks.

 

I never got to see his CV, as the BCH didn't display it, but once I'd seen him I felt very comfortable in his hands, and didn't investigate further. Truth is I didn't have the time to...., it was a whistle stop schedule.

 

Not only is his CV impressive, he is a thoroughly good / decent and pleasant person, who truly has his vocation in his heart. I cannot imagine you would find any better.

 

I feel very sorry that his lovely wife and daughters have to take second stage to his work, and only hope I can repay him in kind with our open invitation for them to have a holiday based with us in Koh Lanta.

[superal]

40 minutes ago, Tofer said:

Interesting, thanks.

 

I never got to see his CV, as the BCH didn't display it, but once I'd seen him I felt very comfortable in his hands, and didn't investigate further. Truth is I didn't have the time to...., it was a whistle stop schedule.

 

Not only is his CV impressive, he is a thoroughly good / decent and pleasant person, who truly has his vocation in his heart. I cannot imagine you would find any better.

 

I feel very sorry that his lovely wife and daughters have to take second stage to his work, and only hope I can repay him in kind with our open invitation for them to have a holiday based with us in Koh Lanta.

Before he operated on you did he explain the risks and/or the percentage rate of success ? 

Your story is encouraging and there is nothing better than a good recommendation , thanks to you and Sheryl for taking the time to give such good info  .

[Tofer]

18 hours ago, superal said:

Before he operated on you did he explain the risks and/or the percentage rate of success ? 

Your story is encouraging and there is nothing better than a good recommendation , thanks to you and Sheryl for taking the time to give such good info  .

Yes he did, thoroughly and unhurried. The risks were the usual risk of infection, the anesthesia and of course the operation.

I'd already been under anesthetic, the previous day for my MRI scan, so was unconcerned about that. Infections can be treated, post op. if necessary, so a relatively minor concern. 

I was concerned that he was working so late after being at Chulalongkorn Hospital, but he assured me he was only in for a couple of meetings, and he was bright eyed and bushy tailed while reviewing my scan images at 8-8.30pm in the evening. I was thoroughly reassured that he was conducting himself professionally, with due care and concern.

 

He explained the operation risks which, worse case scenario, were potentially loss of the use of a foot only, in my case, if he touched and damaged the nerves, and he described the alarm system which would be hooked up to my nervous system to indicate if he touched the nerve during the operation.

 

Being perfectly honest, I was not in the least bit nervous about the operation, even whilst lying awake for 20 mins inside the operating theatre, watching the surgical team prepare, whilst I waited for the anaesthetist to knock me out. Quite frankly, I was in a living hell anyway, with my sciatic pain and disability, so there was little to lose, in my mind.

 

I would not recommend someone so highly in respect to such an important subject, unless I was completely confident in their abilities and professionalism. I would send my child to see him if the need arose, and would certainly not spend so much time suffering as I did, should the need arise again.

 

Dr Weerasak literally saved my life overnight, since the life I had pre-op. was no life at all. You've seen the CV Sheryl posted, and I've looked at many others in my early days of searching. I don't believe I've seen any better. Have a look around by all means. When I met him, I took him at face value, since I'd not seen his CV on the BCH website.

 

I can fully understand your concerns, and rightly so, but I personally would not hesitate for a second, another time around.

 

If you're suffering, why not simply take a trip to see him, and see for yourself, you don't have to commit to any treatment, if you're not confident. He will spend as much time as you need to explain the whole procedure for you to feel confident and comfortable.

 

Compared with a visit to my GP in the UK years ago, wherein I was cut short and told she only had 10 mins / patient, and I was not at liberty to raise an additional issue of concern, my consultation with Dr. Weerasak was akin to meeting a friend for a relaxed chat and, believe me, I like to chat... He had a queue of patients waiting outside, but never once indicated any haste to get done with me.

 

Good luck.

Edited November 11, 2021 by Tofer

[Sheryl]

On 11/11/2021 at 1:08 PM, Tofer said:

You've seen the CV Sheryl posted, and I've looked at many others in my early days of searching. I don't believe I've seen any better.

There are a couple other spine specialists  of comparable skill and dedication I know of. Most notably  Prof. Wicharn at BNH Hospital and Dr. Tayard at Bangkok Hospital. BUT these are more expensive hospitals.

[Tofer]

I've just seen a video of an ''upright MRI scanner'' in USA. It looks far less confining and stressful than the ones you are required to lie down in with a massive machine squashing your nose and stomach.  

 

How I wish this had been available last week in Thailand, but hey ho, it's only money, and I survived the anesthetic.

[superal]

17 minutes ago, Tofer said:

I've just seen a video of an ''upright MRI scanner'' in USA. It looks far less confining and stressful than the ones you are required to lie down in with a massive machine squashing your nose and stomach.  

 

How I wish this had been available last week in Thailand, but hey ho, it's only money, and I survived the anesthetic.

I can understand your ordeal cos the first time I had an MRI it was a bit scary being so confined and the 45 minutes seemed like hours but I have had 3 since and learned how to control my nerves and put myself into a semi hypnotic state .

[Tofer]

3 hours ago, superal said:

I can understand your ordeal cos the first time I had an MRI it was a bit scary being so confined and the 45 minutes seemed like hours but I have had 3 since and learned how to control my nerves and put myself into a semi hypnotic state .

That's the biggest hurdle over with then.

 

Now go and see the doctor with your MRI and X-ray images , and hopefully get yourself sorted, once and for all. ????

[superal]

16 minutes ago, Tofer said:

That's the biggest hurdle over with then.

 

Now go and see the doctor with your MRI and X-ray images , and hopefully get yourself sorted, once and for all. ????

Unfortunately all images are in the UK 

[Will B Good]

Just now, superal said:

Unfortunately all images are in the UK 

I asked for mine and the were emailed to me.

[superal]

6 minutes ago, Will B Good said:

I asked for mine and the were emailed to me.

Private or NHS ?

[Will B Good]

Just now, superal said:

Private or NHS ?

Private.

[superal]

3 minutes ago, Will B Good said:

Private.

Thought so , mine was with the overrun NHS who I don't think would take too kindly to that request .  As it stands my next appointment in the UK with the NHS spinal surgeon is next June and that is just for a review of my condition . He is reluctant to operate on me and preferred me to take pain killers , none of which work or 2nd step was to be physiotherapy . BTW , I took my Thai MRI pics with me to the UK but the surgeon said they were inferior and could not be enhanced on his computer and so I had another MRI done . Trying to contact them , even when in the UK , is very long winded as they put you in a queue and sometimes up to number 20 something . ( once I queued for 45 minutes, spoke a couple of words and was cut off ) . I was not a happy bunny .   Sorry to say that the once great NHS is broken and as an example there are waiting times of up to 5 years for hip or knee replacement operations and with the winter around the corner plus the covid pandemic there are serious concerns for the NHS .

[Will B Good]

37 minutes ago, superal said:

Thought so , mine was with the overrun NHS who I don't think would take too kindly to that request .  As it stands my next appointment in the UK with the NHS spinal surgeon is next June and that is just for a review of my condition . He is reluctant to operate on me and preferred me to take pain killers , none of which work or 2nd step was to be physiotherapy . BTW , I took my Thai MRI pics with me to the UK but the surgeon said they were inferior and could not be enhanced on his computer and so I had another MRI done . Trying to contact them , even when in the UK , is very long winded as they put you in a queue and sometimes up to number 20 something . ( once I queued for 45 minutes, spoke a couple of words and was cut off ) . I was not a happy bunny .   Sorry to say that the once great NHS is broken and as an example there are waiting times of up to 5 years for hip or knee replacement operations and with the winter around the corner plus the covid pandemic there are serious concerns for the NHS .

"Sorry to say that the once great NHS is broken......

 

Many claim all done purposefully to drive us towards private care!!!

[Sheryl]

2 hours ago, superal said:

 As it stands my next appointment in the UK with the NHS spinal surgeon is next June and that is just for a review of my condition . He is reluctant to operate on me and preferred me to take pain killers , none of which work or 2nd step was to be physiotherapy .

 

Al what exactly is the nature of your problem?

 

It is common to initially treat back problems with just pain killers/anti inflammatories but if pain persists for months should usually move on to other approaches.

 

Epidural steroid injection is common next step (though obviously depends on your underlying problem). This serves 2 purposes: (1) it relieves the pain - in some cases (about 40% of patients) permanently, others temporarily and (2) it can help confirm the exact source of the pain (e.g. which nerve or nerve root)  in case surgery is ultimately required.

 

Some people just opt for periodic injections of this type, as long as it controls the pain for 5-6 months that is an option (should not do more than every 6 months).

 

At top tier private hospitals injection costs about 30-34k, might be less at a non profit.  But nto super less - it is not a simple thing, it is done under fluoroscopy in an OR suite and injection is into the spinal canal.

 

 

[superal]

13 hours ago, Sheryl said:

 

Al what exactly is the nature of your problem?

 

It is common to initially treat back problems with just pain killers/anti inflammatories but if pain persists for months should usually move on to other approaches.

 

Epidural steroid injection is common next step (though obviously depends on your underlying problem). This serves 2 purposes: (1) it relieves the pain - in some cases (about 40% of patients) permanently, others temporarily and (2) it can help confirm the exact source of the pain (e.g. which nerve or nerve root)  in case surgery is ultimately required.

 

Some people just opt for periodic injections of this type, as long as it controls the pain for 5-6 months that is an option (should not do more than every 6 months).

 

At top tier private hospitals injection costs about 30-34k, might be less at a non profit.  But nto super less - it is not a simple thing, it is done under fluoroscopy in an OR suite and injection is into the spinal canal.

 

 

      You ask , what is the nature of my problem ,  the UK surgeon thinks spinal stenosis in my lumbar region .Now that you mention it the UK surgeon spoke about epidural injections but said only 2 a year and that there was no guarantee that they would work ( must be an accurate point of injection to the problem area ) . The spinal stenosis , surgeon says the cause is degenerative bone disease . Below is an extract that I found in a search . If it is accurate what is the point of having epidural injections that are pain killers and are  masking the problem which if left untreated can be terminal . Do you agree with the statement below ?

What happens if you ignore spinal stenosis?

 

It occurs from spinal stenosis that causes pressure on the spinal cord. If untreated, this can lead to significant and permanent nerve damage including paralysis and death. Symptoms may affect your gait and balance, dexterity, grip strength and bowel or bladder function

[Sheryl]

3 hours ago, superal said:

      You ask , what is the nature of my problem ,  the UK surgeon thinks spinal stenosis in my lumbar region .Now that you mention it the UK surgeon spoke about epidural injections but said only 2 a year and that there was no guarantee that they would work ( must be an accurate point of injection to the problem area ) . The spinal stenosis , surgeon says the cause is degenerative bone disease . Below is an extract that I found in a search . If it is accurate what is the point of having epidural injections that are pain killers and are  masking the problem which if left untreated can be terminal . Do you agree with the statement below ?

What happens if you ignore spinal stenosis?

 

It occurs from spinal stenosis that causes pressure on the spinal cord. If untreated, this can lead to significant and permanent nerve damage including paralysis and death. Symptoms may affect your gait and balance, dexterity, grip strength and bowel or bladder function

 Usually the stenosis is not putting pressure on the spinal cord itself --- if it does, that is a medical emergency requiring immediate surgery - but you would know because you'd suddenly have severe weakness in both legs, unable to walk, and likely loose bowel and bladder control.

 

More commonly what is happening is that due to the stenosis there is pressure on a nerve root (nerve existing the spine which then branches off into multiple other nerves).  The result is pain, which may radiate down the thigh or leg, and there may be some slight weakness usually just in one side.

 

Findings on MRI do not always corrolate  well with symptoms - many people have significant stenosis with no symptoms at all (though the symptoms may develop in later years) and symptoms can sometimes be severe in areas that don't look as bad as others on the MRI. Sometimes there is pain in one location but not another despite stenosis elsewhere. For example I have significant stenosis at L4-L5 and lesser narrowing at L5-S1 (but with some narrowing of the spot where the nerve exits on the right side). I have constant  sciatic nerve pain only from the L5-S1 area on the right side i.e. the narrowing at L4-5, though significant, is not  currently causing me constant or frequent pain (I get pain just occasionally and can deal with it through stretches, heating pad etc).  Since the L5-S1 pain is constant and intolerable I will have decompression surgery (conservative measures having failed and epidural injection giving full relief but only for short time). And since they are going in anyway they will also decompress L4-L5, but they would not be operating on L4-5 otherwise since despite the MRI findings there is not yet  much pain there (probably would develop later though).

 

The epidural injections reduce nerve irritation and swelling of tissues around the nerve. For reasons not well understood, in about 40% of patients the relief is long term (permanent or at least for many years). In others, the pain returns but how long that takes is variable. If the injection gives relief for 5-6 months some people opt to just get the injections every 6 months and avoid/postpone surgery. In my case the injection gave full relief but only for 3 weeks so that is not an option - the injections indeed cannot be given more than every 6 months.

 

The injection also serves the function of confirming where the pain is coming from. If the injection does not bring full relief, at least temporarily, then the pain is not coming from that spot. Thus it serves a very important function aside form pain relief - it confirms the diagnosis and this is very important before having surgery, since as mentioned pain does not always correlate  exactly  to MRI findings.

 

For these reasons surgery would not usually be done without first trying the injection. (Unless there is spina cord compression which is a whole other matter).

 

 

[davidkas]

On 11/9/2021 at 10:00 AM, Tofer said:

 

I hope this feedback and knowledge will help someone else in the future.

 

Thank you so much for this honest and complete review of your experience. And thank you to all the other positive comments. I have taken down all the relevant details as I am sure I am not far away from surgery in the same vertebrae. I am down to bone on bone between the L5/S1.

I have had a couple of MRIs over the last few years and the latest only took about 20 min using the latest machines (fortunately I don't have any problems going inside) The newer machines are faster and higher resolution - if you can find one. Mine were done in Saudi Arabia.

[superal]

1 hour ago, Sheryl said:

 Usually the stenosis is not putting pressure on the spinal cord itself --- if it does, that is a medical emergency requiring immediate surgery - but you would know because you'd suddenly have severe weakness in both legs, unable to walk, and likely loose bowel and bladder control.

 

More commonly what is happening is that due to the stenosis there is pressure on a nerve root (nerve existing the spine which then branches off into multiple other nerves).  The result is pain, which may radiate down the thigh or leg, and there may be some slight weakness usually just in one side.

 

Findings on MRI do not always corrolate  well with symptoms - many people have significant stenosis with no symptoms at all (though the symptoms may develop in later years) and symptoms can sometimes be severe in areas that don't look as bad as others on the MRI. Sometimes there is pain in one location but not another despite stenosis elsewhere. For example I have significant stenosis at L4-L5 and lesser narrowing at L5-S1 (but with some narrowing of the spot where the nerve exits on the right side). I have constant  sciatic nerve pain only from the L5-S1 area on the right side i.e. the narrowing at L4-5, though significant, is not  currently causing me constant or frequent pain (I get pain just occasionally and can deal with it through stretches, heating pad etc).  Since the L5-S1 pain is constant and intolerable I will have decompression surgery (conservative measures having failed and epidural injection giving full relief but only for short time). And since they are going in anyway they will also decompress L4-L5, but they would not be operating on L4-5 otherwise since despite the MRI findings there is not yet  much pain there (probably would develop later though).

 

The epidural injections reduce nerve irritation and swelling of tissues around the nerve. For reasons not well understood, in about 40% of patients the relief is long term (permanent or at least for many years). In others, the pain returns but how long that takes is variable. If the injection gives relief for 5-6 months some people opt to just get the injections every 6 months and avoid/postpone surgery. In my case the injection gave full relief but only for 3 weeks so that is not an option - the injections indeed cannot be given more than every 6 months.

 

The injection also serves the function of confirming where the pain is coming from. If the injection does not bring full relief, at least temporarily, then the pain is not coming from that spot. Thus it serves a very important function aside form pain relief - it confirms the diagnosis and this is very important before having surgery, since as mentioned pain does not always correlate  exactly  to MRI findings.

 

For these reasons surgery would not usually be done without first trying the injection. (Unless there is spina cord compression which is a whole other matter).

 

 

Many thanks Sheryl for taking the time to write such an informative post , really appreciated .

[Sheryl]

1 hour ago, davidkas said:

Thank you so much for this honest and complete review of your experience. And thank you to all the other positive comments. I have taken down all the relevant details as I am sure I am not far away from surgery in the same vertebrae. I am down to bone on bone between the L5/S1.

 

If down to bone on bone you may  need a fusion. With or without artificial disk placement.

[davidkas]

1 hour ago, Sheryl said:

If down to bone on bone you may  need a fusion. With or without artificial disk placement.

Yup that's what it will be eventually but they say until I can barely walk, start loosing control of my bowls or so much pain I am unable to live any kind of life they wont consider surgery

[Sheryl]

1 hour ago, davidkas said:

Yup that's what it will be eventually but they say until I can barely walk, start loosing control of my bowls or so much pain I am unable to live any kind of life they wont consider surgery

Who is "they"? NHS?

 

Be careful not to leave it too long as if nerve damage occurs, it is not reversible. The surgery will just prevent further damage.

 

If it is really bone-on-bone the pain should already be pretty bad.

[Tofer]

On 11/13/2021 at 2:49 PM, superal said:

Unfortunately all images are in the UK 

Bangkok Christian hospital is B8,500 for a lumber MRI, and probably a bit cheaper than the B2,400 I paid for 4 X-rays at the Bangkok Hospital Phuket.

[Tofer]

On 11/13/2021 at 3:20 PM, superal said:

Thought so , mine was with the overrun NHS who I don't think would take too kindly to that request .  As it stands my next appointment in the UK with the NHS spinal surgeon is next June and that is just for a review of my condition . He is reluctant to operate on me and preferred me to take pain killers , none of which work or 2nd step was to be physiotherapy . BTW , I took my Thai MRI pics with me to the UK but the surgeon said they were inferior and could not be enhanced on his computer and so I had another MRI done . Trying to contact them , even when in the UK , is very long winded as they put you in a queue and sometimes up to number 20 something . ( once I queued for 45 minutes, spoke a couple of words and was cut off ) . I was not a happy bunny .   Sorry to say that the once great NHS is broken and as an example there are waiting times of up to 5 years for hip or knee replacement operations and with the winter around the corner plus the covid pandemic there are serious concerns for the NHS .

In which case, I wouldn't bother with the UK, assuming you can afford, or have health insurance, to cover private treatment in Thailand.

 

You could still make it more affordable by visiting the government hospitals where these good surgeons also practice, just be prepared for more of a wait and some queues. You won't get the 2 day whirlwind service I got in the private hospitals, but still no where near the years waiting you noted in the UK, and no airfares to UK. 

 

Hope it all works out for you.