MRI Scans.

[Tofer]

On 11/14/2021 at 3:04 PM, 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

I agree with Sheryl, and it might be good to get a second opinion anyway.

[Sheryl]

13 minutes ago, Tofer said:

I agree with Sheryl, and it might be good to get a second opinion anyway.

And make sure that second opinion is from a specialist in spinal surgery (i.e. someone with advanced training specifically in spinal surgery, a fellowship or a residency in it) , not just an orthopedist. Several excellent ones in Bangkok.

 

Thsi makes a hige difference to the risk and also to the willingness to perform  the surgery. (The two being related - doctors with advanced training in spinal surgery have very low complication rates and hence are confident to operate. Your average ortho doesn't/isn't.)

[superal]

14 hours ago, Sheryl said:

And make sure that second opinion is from a specialist in spinal surgery (i.e. someone with advanced training specifically in spinal surgery, a fellowship or a residency in it) , not just an orthopedist. Several excellent ones in Bangkok.

 

Thsi makes a hige difference to the risk and also to the willingness to perform  the surgery. (The two being related - doctors with advanced training in spinal surgery have very low complication rates and hence are confident to operate. Your average ortho doesn't/isn't.)

That sounds about right cos my UK NHS surgeon was reluctant to give a definitive diagnosis , would not comment on the prognosis nor operate on me , which in turn has left me with no confidence in him . For the layman , it is not easy to be able to select an appropriate surgeon . I have just looked at the directory of spinal surgeons at my local UK NHS hospital . It lists their training / education / experience / awards , prizes and research papers . My surgeon is listed as a spinal consultant and is a member of the British association of spinal surgeons (BASS) . All of the above does not aid me in a selection for a surgeon as it means little to me but to a person with a medical background it would make easy and informative reading .

[Sheryl]

2 hours ago, superal said:

That sounds about right cos my UK NHS surgeon was reluctant to give a definitive diagnosis , would not comment on the prognosis nor operate on me , which in turn has left me with no confidence in him . For the layman , it is not easy to be able to select an appropriate surgeon . I have just looked at the directory of spinal surgeons at my local UK NHS hospital . It lists their training / education / experience / awards , prizes and research papers . My surgeon is listed as a spinal consultant and is a member of the British association of spinal surgeons (BASS) . All of the above does not aid me in a selection for a surgeon as it means little to me but to a person with a medical background it would make easy and informative reading .

What is his training/education? Does it show a residency or fellowship specifically in spinal surgery?

 

That he is reluctant to give a definitive diagnosis suggests either lack of skill on his part OR that the MRI & Xray findings are unclear or do not well correlate with the clinical picture. This (latter) can sometimes be the case and does make doctors hesitant to proceed for fear that surgery might not resolve the problem. Nerve conduction studies or a trial epidural injection can often help clarify matters.

 

Note that about 30% of back pain is actually from the Sacroiliac (SI)  joint, not the spine. And that any MRI on an older person is going to show some wear & tear, which is not necessarily the cause of the pain. If the pain is from the SI joint spinal surgery will nto help.

 

If you are in Thailand I strongly suggest you have a consultation with Prof. Wicharn at BNH (you'll need your Xray and MRI). Will cost you a little under 2,000 baht unless he prescribes medication (if he does, steroid has to be gotten at the hospital , the rest you can buy outside.

 

I have known Prof. Wicharn to figure things out that other doctors could not.

[superal]

36 minutes ago, Sheryl said:

What is his training/education? Does it show a residency or fellowship specifically in spinal surgery?

 

That he is reluctant to give a definitive diagnosis suggests either lack of skill on his part OR that the MRI & Xray findings are unclear or do not well correlate with the clinical picture. This (latter) can sometimes be the case and does make doctors hesitant to proceed for fear that surgery might not resolve the problem. Nerve conduction studies or a trial epidural injection can often help clarify matters.

 

Note that about 30% of back pain is actually from the Sacroiliac (SI)  joint, not the spine. And that any MRI on an older person is going to show some wear & tear, which is not necessarily the cause of the pain. If the pain is from the SI joint spinal surgery will nto help.

 

If you are in Thailand I strongly suggest you have a consultation with Prof. Wicharn at BNH (you'll need your Xray and MRI). Will cost you a little under 2,000 baht unless he prescribes medication (if he does, steroid has to be gotten at the hospital , the rest you can buy outside.

 

I have known Prof. Wicharn to figure things out that other doctors could not.

BNH ? is that Bangkok hospital in Bangkok ? I do not have my xray or mri  films so I suppose I would have to go through that again ? 

Today I had a quote from the Vejthani Hospital for an MRI at 18500 to 25000 without contrast plus doctor fees and they know I do not have insurance, told them too expensive . They said , sorry take care . Do people pay these prices ?

Sorry about the print style , cannot change ,have to turn off and start again.

[Tofer]

34 minutes ago, superal said:

BNH ? is that Bangkok hospital in Bangkok ? I do not have my xray or mri  films so I suppose I would have to go through that again ? 

Today I had a quote from the Vejthani Hospital for an MRI at 18500 to 25000 without contrast plus doctor fees and they know I do not have insurance, told them too expensive . They said , sorry take care . Do people pay these prices ?

Sorry about the print style , cannot change ,have to turn off and start again.

BNH is the Bangkok National Hospital, can't remember what they quoted for an MRI. A quick phone call will get you the answer.

Assuming you can cope with the tunnel / doughnut style MRI scanner, it's only B8,500 at the Bangkok Christian Hospital, maybe need a doctors examination and referral first, but that costs only B800. 

The Bangkok Hospital have  / had a promotion @ B9,000 for lumber spine MRI in an open MRI scanner, but you definitely have to subject yourself to their doctors examination and referral first, at B1,700 total.

The MRI Centre in Prachachuen have a more open scanner @ B12,500, not sure about needing a referral, as Dr Weerasak sent me there with his referral and scan request.

 

Rather than waiting until next June and paying to return to the UK, I personally would spend that money on one of the recommended surgeons, Sheryl highlighted, and get your life back now, assuming you are currently inThailand.

Edited November 16, 2021 by Tofer

[superal]

20 minutes ago, Tofer said:

BNH is the Bangkok National Hospital, can't remember what they quoted for an MRI. A quick phone call will get you the answer.

Assuming you can cope with the tunnel / doughnut style MRI scanner, it's only B8,500 at the Bangkok Christian Hospital, maybe need a doctors examination and referral first, but that costs only B800. 

The Bangkok Hospital have  / had a promotion @ B9,000 for lumber spine MRI in an open MRI scanner, but you definitely have to subject yourself to their doctors examination and referral first, at B1,700 total.

The MRI Centre in Prachachuen have a more open scanner @ B12,500, not sure about needing a referral, as Dr Weerasak sent me there with his referral and scan request.

 

Rather than waiting until next June and paying to return to the UK, I personally would spend that money on one of the recommended surgeons, Sheryl highlighted, and get your life back now.

Many thanks Tofer , I will follow up .

[superal]

1 hour ago, Sheryl said:

What is his training/education? Does it show a residency or fellowship specifically in spinal surgery?

 

That he is reluctant to give a definitive diagnosis suggests either lack of skill on his part OR that the MRI & Xray findings are unclear or do not well correlate with the clinical picture. This (latter) can sometimes be the case and does make doctors hesitant to proceed for fear that surgery might not resolve the problem. Nerve conduction studies or a trial epidural injection can often help clarify matters.

 

Note that about 30% of back pain is actually from the Sacroiliac (SI)  joint, not the spine. And that any MRI on an older person is going to show some wear & tear, which is not necessarily the cause of the pain. If the pain is from the SI joint spinal surgery will nto help.

 

If you are in Thailand I strongly suggest you have a consultation with Prof. Wicharn at BNH (you'll need your Xray and MRI). Will cost you a little under 2,000 baht unless he prescribes medication (if he does, steroid has to be gotten at the hospital , the rest you can buy outside.

 

I have known Prof. Wicharn to figure things out that other doctors could not.

Thanks Sheryl , I searched on the hospital web site with professor Wicharn but nothing came up but I searched on the hospital spine unit and this name came up Asso. Prof. Wicharn Yingsakmongkol , same man I guess ? 

[Sheryl]

Yews that is he and he is on the hospital website

 

https://www.bnhhospital.com/search-doctor/entry/4093/

 

 

[notasmartassknowitallfarag]

Great thread of information here, I too seem to be suffering from Sciatica for 4 months on and off. Although never extremely painful it is highly annoying and I just can't seem to get rid of it. Tried all the stretches. The named doctor at BNH suggested an electromyography at around 15,000 baht. It seemed a lot just to tell me I had sciatica! I thought the mri might be more useful, i'll go and get a second opinion. I really don't want surgery, as the risks seem high at 2% I read. I'm in my late 30s. 

Edited November 16, 2021 by notasmartassknowitallfarag

[Sheryl]

1 hour ago, notasmartassknowitallfarag said:

Great thread of information here, I too seem to be suffering from Sciatica for 4 months on and off. Although never extremely painful it is highly annoying and I just can't seem to get rid of it. Tried all the stretches. The named doctor at BNH suggested an electromyography at around 15,000 baht. It seemed a lot just to tell me I had sciatica! I thought the mri might be more useful, i'll go and get a second opinion. I really don't want surgery, as the risks seem high at 2% I read. I'm in my late 30s. 

Sciatica is a symptom, not a disease, and can have many different causes.

 

Even after MRI might still need EMG or Nerve Conduction Study as just because something is seen on MRI, doesn't mean it is necessarily the cause of the pain.  However these tests are usually done when surgery is contemplated, to ensure that the surgery is likely to relieve the pain (as opposed to correcting an incidental finding in MRI which is not the source of the pain). And it sounds like your pain is not bad enough to warreant surgery even if a surgically correctable cause is found. 

 

That the doctor suggested EMG without MRI suggests to me that he may suspect a non-spinal cause such as SI joint or piriformis syndrome, both of which can cause sciatic nerve pain.

 

IF MRI suggests a spinal cause, might try an epidural injection into the level of the spine suspected to be the cause may serve to confirm diagnosis. This would also stop the pain, at least temporarily and in about 40% of people long term. Costs about 30-35k in a private hospital.

 

I have no idea what the 2% risks you refer to are - -risks of what exactly and for what type of surgery?  There are different types of surgery, with different levels of risk, and different types of complications each with different levels of risk.  But in any case I would not myself be inclined to consider surgery for a pain that is only annoying.

 

 

 

 

 

 

[Sheryl]

5 hours ago, superal said:

BNH ? is that Bangkok hospital in Bangkok ? I do not have my xray or mri  films so I suppose I would have to go through that again ? 

Today I had a quote from the Vejthani Hospital for an MRI at 18500 to 25000 without contrast plus doctor fees and they know I do not have insurance, told them too expensive . They said , sorry take care . Do people pay these prices ?

Sorry about the print style , cannot change ,have to turn off and start again.

If you cannot get ypur films and MRI sent here then yes would have to repear them. MRI of lumbar spine is 7,200 here www.mrithailand.com

 

 

[superal]

13 hours ago, Sheryl said:

If you cannot get ypur films and MRI sent here then yes would have to repear them. MRI of lumbar spine is 7,200 here www.mrithailand.com

 

 

Will I need a referral ?

[lopburi3]

19 hours ago, superal said:

BNH ? is that Bangkok hospital in Bangkok ?

BNH is the old Bangkok Nursing Home renamed "Hospital" several decades ago - it is a premiere private hospital in Bangkok and one that has always attracted top doctors.

 

19 hours ago, superal said:

Vejthani Hospital for an MRI at 18500 to 25000 without contrast plus doctor fees and they know I do not have insurance, told them too expensive . They said , sorry take care . Do people pay these prices ?

In my experience quotes are normally higher than reality as Doctor may order more than expected after consultation.  But as reference my whole Abdomen MRI a month ago (3 hours) was about 24,000 (without adding contrast/fees).  But Vejthani is not a low priced facility.  

[Sheryl]

3 hours ago, superal said:

Will I need a referral ?

No. And they will give you the CD to take with you.

[Sheryl]

2 hours ago, lopburi3 said:

BNH is the old Bangkok Nursing Home renamed "Hospital" several decades ago - it is a premiere private hospital in Bangkok and one that has always attracted top doctors.

 

In my experience quotes are normally higher than reality as Doctor may order more than expected after consultation.  But as reference my whole Abdomen MRI a month ago (3 hours) was about 24,000 (without adding contrast/fees).  But Vejthani is not a low priced facility.  

 18,000 is unusually high even for top end private hospitals in Bangkok. It is more even than Bangkok Hospital, a BDMS facility.

[lopburi3]

4 minutes ago, Sheryl said:

 18,000 is unusually high even for top end private hospitals in Bangkok. It is more even than Bangkok Hospital, a BDMS facility.

I agree and is why I suspect quote was not specific for lower lumbar or condition.   Even when asked by doctors/nursing staff those providing quotes are often way off the mark in my experience (at several major hospitals) and anything provided online is doubly suspect.

[superal]

Just a quick update . I attended the clinic below and had 2 MRI and 1 MRA . The first 2 MRI were on lumbar and also cervical , 3rd was MRA on my carotid arteries . Inside scanner for 1 hour 30 minutes for first 2 , taken out briefly for 1 minute or so to have contrast injection set up , then back in for another 30 minutes MRA . Not a particularly pleasant experience but \i knew what to expect as I have had MRI scans before , secret is to be relaxed and self hypnotic . The staff were very helpful and totally professional . I would not hesitate to use them again . Total cost including contrast was 22500 baht . Received scans on a cd  and the doctor will call me in 2 days to give her interpretation of the results ( speaks English )

 

PRACHACHUEN IMAGING CENTER CO.,LTD (Headquarter)

86 Thetsaban Songkhro Road, Lat Yao Subdistrict, Chatuchak District, Bangkok 10900

TEL: +662-953-9469 l LINE @mrithailand 

[The Hammer2021]

On 11/16/2021 at 1:13 PM, superal said:

BNH ? is that Bangkok hospital in Bangkok ? I do not have my xray or mri  films so I suppose I would have to go through that again ? 

Today I had a quote from the Vejthani Hospital for an MRI at 18500 to 25000 without contrast plus doctor fees and they know I do not have insurance, told them too expensive . They said , sorry take care . Do people pay these prices ?

Sorry about the print style , cannot change ,have to turn off and start again.

Does MRI use contrast? I thought that was CT Scan.

[lopburi3]

5 minutes ago, The Hammer2021 said:

Does MRI use contrast? I thought that was CT Scan.

MRI also use contrast if there is a need for it - such as cancer detection in my case.  

[Tofer]

6 hours ago, superal said:

Just a quick update . I attended the clinic below and had 2 MRI and 1 MRA . The first 2 MRI were on lumbar and also cervical , 3rd was MRA on my carotid arteries . Inside scanner for 1 hour 30 minutes for first 2 , taken out briefly for 1 minute or so to have contrast injection set up , then back in for another 30 minutes MRA . Not a particularly pleasant experience but \i knew what to expect as I have had MRI scans before , secret is to be relaxed and self hypnotic . The staff were very helpful and totally professional . I would not hesitate to use them again . Total cost including contrast was 22500 baht . Received scans on a cd  and the doctor will call me in 2 days to give her interpretation of the results ( speaks English )

 

PRACHACHUEN IMAGING CENTER CO.,LTD (Headquarter)

86 Thetsaban Songkhro Road, Lat Yao Subdistrict, Chatuchak District, Bangkok 10900

TEL: +662-953-9469 l LINE @mrithailand 

Good to hear you're getting sorted.

[Sheryl]

Both MRI and CT can be done with or without contrast media.

 

For orthopedic issues contrast is usually not used. Contrast is necessary  when blood vessels need to be visualized or a tumor is suspected.

 

Use of contrast carries a risk of potentially serious (even fatal) allergic reaction.  These are  infrequent and, if it occurs within a hospital setting with emergency meds, equipment and personnel on hand,  readily managed. However if it occurred in a stand alone Thai imaging center you might well die.  For which reason I cannot  recommend people have MRI or CT with contrast in an imaging center here despite the considerable cost savings. Without contrast, no problem. With it - up to you, but I cannot in conscience recommend it. 

 

 

[superal]

15 hours ago, Sheryl said:

Both MRI and CT can be done with or without contrast media.

 

For orthopedic issues contrast is usually not used. Contrast is necessary  when blood vessels need to be visualized or a tumor is suspected.

 

Use of contrast carries a risk of potentially serious (even fatal) allergic reaction.  These are  infrequent and, if it occurs within a hospital setting with emergency meds, equipment and personnel on hand,  readily managed. However if it occurred in a stand alone Thai imaging center you might well die.  For which reason I cannot  recommend people have MRI or CT with contrast in an imaging center here despite the considerable cost savings. Without contrast, no problem. With it - up to you, but I cannot in conscience recommend it. 

 

 

Phew , didn't know that and I wish I knew it before having the contrast when having the MRA on my carotid arteries . Just one question Sheryl ,  the MRA and contrast  , I felt the tourniquet and then the needle but that is all . When I had contrast / hormone in my heart for a stress test in the UK , I felt a warming sensation but this time  I felt nothing . After the scan I was told to drink plenty of water to flush the contrast from my kidneys , which I did , but I did not see any colouration  from my urine . Is this normal ?

[lopburi3]

4 minutes ago, superal said:

Phew , didn't know that and I wish I knew it before having the contrast when having the MRA on my carotid arteries . Just one question Sheryl ,  the MRA and contrast  , I felt the tourniquet and then the needle but that is all . When I had contrast / hormone in my heart for a stress test in the UK , I felt a warming sensation but this time  I felt nothing . After the scan I was told to drink plenty of water to flush the contrast from my kidneys , which I did , but I did not see any colouration  from my urine . Is this normal ?

Non medical but for me CT contrast has produced warm/hot flash but not MRI (but have to catch breath once when start MRI contrast and trying to lie still/hold breath).  

[superal]

48 minutes ago, lopburi3 said:

Non medical but for me CT contrast has produced warm/hot flash but not MRI (but have to catch breath once when start MRI contrast and trying to lie still/hold breath).  

Hold breath ? yes same for me many times when having MRI stress test on my heart , thanks