Urologist in CM for bladder nodule

[SammyJ]

18 hours ago, bamboozled said:

Thanks again, Lacesit. Touch wood for me, too, that it's not cancer. I've read some info on the net saying that bladder nodules are more often cancerous than not. But only some sites say that. I do not have a clear idea of what the real story is. I guess that's what I'd like to know, and if it isn't cancerous, is it safe to go on my merry way leaving it in there. If it's something that sooner or later is going to have to come out, cancerous or not, I guess I would think to get it over with in one fell swoop. I wish the Dr. had taken the time to answer my questions. I think I will look up your guy, or the Dr. recommended at Siriphat Hospital, and get a second opinion. I paid somewhere between 30k and 40k for a colonoscopy with general anesthesia, and removal of a polyp or two, maybe 5 years ago (if my memory serves me) so I was surprised this one is 100k. Perhaps it's apples and oranges and 5 years later.

I hope yours turns out ok--i am having the ultrasound at CM ram this week and then will see what the next step is--some good things shared here that provide a good perspective on costs and doctors.  I want a dr that will answer my questions and be patient with whatever in explaining the options as sometimes they forget that the discussion is about a serious medical situation with  "my body",, not theirs! 

 

Unfortunately, after living in Thailand a great many years, this does not surprise me and reminds me of how it used to be in the US so many years ago--there, doctors expected patients to sit and listen, as pre-internet, they were the only fountains of information and did not expect to be questioned or for the patient to offer suggestions.  Now, in most of US, anyway, it is expected the patient be informed and have an interactive discussion with their doctors--again, we are discussing serious treatment options with "our bodies" and I would not stay with any doctor who does not understand that.

[bamboozled]

I suddenly thought...how accurate are ultrasounds? What's the possibility that I don't have a nodule and they misread the ultrasound? Hmm, I wonder if the first move would be to have another ultrasound.....

[In Full Agreement]

On 3/17/2022 at 3:32 PM, lopburi3 said:

Suspect you did not check the medical section - below is a recommended Doctor in CM.  As one who had serious cancer and bladder removed (5 years ago) believe next step will be the camera insert which is not that painful (mostly full bladder feeling as they fill with water) and may allow them to obtain a sample for biopsy.  It is an outpatient procedure.  In the bad luck event of cancer some can spread rather quickly so time is important.   I used Dr. Charuspong Dissaraan who was working at Bangkok Hospital at the time and highly recommend him.

The following urologists have been favorably  recommended by TV members in the past:

Bangkok
Dr. Viroj Chodchoy at Bumrungrad   - has treated a number of TV members for prostate cancer and other problemshttps://www.bumrungrad.com/doctors/Viroj-Chodchoy  

Dr. Charuspong Dissaraan at Bumrungrad. US trained. https://www.bumrungrad.com/en/doctors/Charuspong-Dissaranan

*Dr. Umaporn Nuanthaisong (female) – Sukhumvit Hospital once a week and also at  Bangkok Hospital and at Chula (try their after hours clinic, 13^th floor) http://www.sukumvithospital.com/en_doctorprofile.php?id=188https://translate.google.com/translate?hl=en&sl=th&u=http:

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=2682&doctor=Dr._UMAPHORN_NUANTHAISONG

//www.chulalongkornhospital.go.th/&prev=search

*Dr. Suntchai Wirotsaengthong – BNH hospital https://www.bnhhospital.com/en/find_doctor/detail/135

* These two have been particulalry recommended for management of chronic prostatitis

 

 

Pattaya

Dr. Pornchai Chayaboon Panyasuppakun, Bangkok Pattaya Hospital  https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=208&depid=28

Dr. Jimmy Kongcharoen Bangkok Pattaya Hospital https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=205&depid=28

 

Chiang Mai

Prof. Bunnakit Lojanaphiwat at CM Ran Hospital, also at Sripat (CMU Hospital) and  he also has his own clinic tel 0818824085http://www.chiangmairam.com/searchdoctor1?major_id=&doctor=103

 

That's impressive research, lopburi3.

[Sheryl]

8 minutes ago, bamboozled said:

I suddenly thought...how accurate are ultrasounds? What's the possibility that I don't have a nodule and they misread the ultrasound? Hmm, I wonder if the first move would be to have another ultrasound.....

It is  very unlikely that a repeat ultrasound would not also show what looks like  a nodule.

 

Th cystoscopy will enable them to directly see what it is that is appearing like a nodule.

 

Is there any blood in your urine?

[bamboozled]

1 minute ago, Sheryl said:

It is  very unlikely that a repeat ultrasound would not also show what looks like  a nodule.

 

Th cystoscopy will enable them to directly see what it is that is appearing like a nodule.

 

Is there any blood in your urine?

No blood. I don't have any symptoms of anything...unless I am so used to whatever symptoms I have that I don't recognize them as such. For a layperson, looking at the ultrasound, it appears like it's very difficult to discern anything with accuracy. But I just read up on it and I guess that's not true. Thanks for the input, Sheryl.

[lopburi3]

1 minute ago, bamboozled said:

No blood. I don't have any symptoms of anything...unless I am so used to whatever symptoms I have that I don't recognize them as such. For a layperson, looking at the ultrasound, it appears like it's very difficult to discern anything with accuracy. But I just read up on it and I guess that's not true. Thanks for the input, Sheryl.

Think pregnancy ultrasounds.  A lot of information can be seen with very high accuracy.

[Sheryl]

6 minutes ago, bamboozled said:

No blood. I don't have any symptoms of anything...unless I am so used to whatever symptoms I have that I don't recognize them as such. For a layperson, looking at the ultrasound, it appears like it's very difficult to discern anything with accuracy. But I just read up on it and I guess that's not true. Thanks for the input, Sheryl.

Who did the ultrasound and why was it done then?

 

If part of a routine physical exam, were there no RBCs or blood shown in the  urinalysis report?

[bamboozled]

It was a routine check-up at Rajavej. Everything else is in order, no blood or anything amiss.. Just saw the nodule on the ultrasound and then I met with the urologist a few days later (he didn't show up that evening for his normal schedule as he supposedly had an emergency operation) and he said to take it out. Well, he asked me what I wanted to do and I deferred to him since he's the expert.

[bamboozled]

12 hours ago, SammyJ said:

I hope yours turns out ok--i am having the ultrasound at CM ram this week and then will see what the next step is--some good things shared here that provide a good perspective on costs and doctors.  I want a dr that will answer my questions and be patient with whatever in explaining the options as sometimes they forget that the discussion is about a serious medical situation with  "my body",, not theirs! 

 

Unfortunately, after living in Thailand a great many years, this does not surprise me and reminds me of how it used to be in the US so many years ago--there, doctors expected patients to sit and listen, as pre-internet, they were the only fountains of information and did not expect to be questioned or for the patient to offer suggestions.  Now, in most of US, anyway, it is expected the patient be informed and have an interactive discussion with their doctors--again, we are discussing serious treatment options with "our bodies" and I would not stay with any doctor who does not understand that.

Sammy J, why are you having an ultrasound? And why do you suspect there will be some follow up necessary?

[bamboozled]

6 hours ago, lopburi3 said:

Think pregnancy ultrasounds.  A lot of information can be seen with very high accuracy.

That's true. But the ultrasounds of a fetus are much more defined than the blobs around the organs....from what I've just seen with my own ultrasound. It's easy to recognize a fetus. Nonetheless, I think you're right. If you know what you're looking for, I guess the nodule is not so hard to understand.

[SammyJ]

10 hours ago, bamboozled said:

Sammy J, why are you having an ultrasound? And why do you suspect there will be some follow up necessary?

 

10 hours ago, bamboozled said:

Sammy J, why are you having an ultrasound? And why do you suspect there will be some follow up necessary?

On the run this morning, but will share via message--when possible, i do not share too many medical details on public forum.  sometimes needed to get advice.

[bamboozled]

Siriphat hospital just told me on the phone that Dr. Siphat is only seeing Thai patients, after trying to steer me to different Dr.s. This seems a bit strange since supposedly his English is very good. I'm not sure what to make of it. Now I am supposed to see a Wisan Anutrakulchai,M.D. Anyone have input on this, by chance or know of this doctor? I could try Bkk Hospital, too, of course.

Edited March 21, 2022 by bamboozled

[Sheryl]

1 hour ago, bamboozled said:

Siriphat hospital just told me on the phone that Dr. Siphat is only seeing Thai patients, after trying to steer me to different Dr.s. This seems a bit strange since supposedly his English is very good. I'm not sure what to make of it. Now I am supposed to see a Wisan Anutrakulchai,M.D. Anyone have input on this, by chance or know of this doctor? I could try Bkk Hospital, too, of course.

He is on faculty at CMU and has published in international journals. I haven't heard any specific feedback on him.

 

Please check the results of your check up urinalysis report and see if it shows any "RBCs" or blood. Is it really  none, not even trace?

 

You can discuss with urologist whether a repeat ultrasound (preferrably done by him) makes sense before procedeeding to cystoscopy.

 

By the way abdominal ultrasounds are not recommended by any public health authority as part of a routine checkup because they tend to lead to unnecessary tests and procedures. Private hospitals like them for the same reason. 

[bamboozled]

HI Sheryl,

 

Thanks for the news on the doc. Bkk hospital was a two day wait just to get the appointment so it seemed quicker to go to Sriphat. Do you know anything of this fellow at Ram: PHITSANU MAHAWONG, M.D.

 

My report just has a check next to Urine Analysis in the "normal" box. In the breakdown of tests, I don't see anything that says RBC or blood. No one mentioned that there was any issue that the urine pointed to. It just says I have the nodule and should do some follow up.

 

How would one find any issues with bladder or other organs in the abdomen if not with the ultrasound as a first line of inquiry?

 

I'll see what this new doc has to suggest and report back.

[elektrified]

On 3/18/2022 at 9:03 PM, bamboozled said:

Thanks, Elektrified. Does it matter that this is a nodule in my bladder and not something to do with the prostate? I have not read that a biopsy of a bladder nodule is particularly painful. To note, I had general anesthesia at Rajavej midway through a colonoscopy as it was too painful. Does that run counter to your thought that no other hospital offers general anesthesia? Not trying to be combative.... I certainly don't look forward to the feeling of a snake biting me from the inside, don't get me wrong. Tomorrow, I will meet with a urologist at Rajavej and get the lay of the land and then make some decisions about my next move. If I'm assured the next move is pretty straightforward, I'll probably take the path of least resistance and financial obligation and move forward at Rajavej. If things get funky, I'll have to reevaluate. Thank you!

Once again, my apologies for the confusion! (I was reading a thread about prostate issues just above or below your post and confused the two). What I meant about the general anesthesia was only related to prostate biopsies. Of course all hospitals offer general anesthesia during surgery. But in Chiang Mai - only RAM offers general anesthesia during prostate biopsies.

 

Best of luck with your issues. As I replied to the gentleman in the other thread who inquired about C.M. urologists in general.....for simple things, probably any of them will be O.K. For anything complex, I would go to Bangkok and seek help there. My urological issues were badly mismanaged here. And the technology has not progressed much in the 15 years I've been here. They may have 3T MRI here now - I'm not sure. They were discussing it for years. But Bangkok has many more urological experts and new technology available there.

[elektrified]

21 hours ago, In Full Agreement said:

 

That's impressive research, lopburi3.

As I stated earlier (or in the prostate thread), the C.M. surgeon whom Lop refers to - Ajarn Bannakit - is not seeing patients at this time.

[lopburi3]

3 minutes ago, elektrified said:

As I stated earlier (or in the prostate thread), the C.M. surgeon whom Lop refers to - Ajarn Bannakit - is not seeing patients at this time.

Actually I was posting a quite of a locked forum topic as have no knowledge of Chiang Mai doctors as living in Bangkok.  But as said it seems the doctor listed in Chiang Mai has ceased normal patient care.  

[lopburi3]

17 minutes ago, bamboozled said:

How would one find any issues with bladder or other organs in the abdomen if not with the ultrasound as a first line of inquiry?

As mentioned many find that there is an issue in bladder from blood in urine.  Red pee is a red flag for most of us - and gets our attention to follow up.  The ultrasound would likely be such a follow up test.  

[bamboozled]

I'll consider myself lucky in my bad luck.

[bamboozled]

Well, I walked into Sriphat yesterday and then walked out. A complete madhouse. Probably cheaper but as Sheryl said, I'm sure the wait for anything at all would be very long and navigating the place is difficult. I then stopped at RAM around the corner and made an appointment with the urologist for today from which I've just returned. He looked at my ultrasound and came to the same conclusion that I should have the growth taken out without biopsy first, that it would be a wasted step. He said because of my age, 53, and the nature of bladder nodules, that 80% to 90% it will be cancerous. 120k to 150k cost. 1 night stay, unless they like having me around or there is some complication. Tomorrow, they'll send me the breakdown of the costs. And then I can decide which hospital I want to give my money to. Unless someone has any better idea..... Cheers, folks.

[Sheryl]

20 minutes ago, bamboozled said:

Well, I walked into Sriphat yesterday and then walked out. A complete madhouse. Probably cheaper but as Sheryl said, I'm sure the wait for anything at all would be very long and navigating the place is difficult. I then stopped at RAM around the corner and made an appointment with the urologist for today from which I've just returned. He looked at my ultrasound and came to the same conclusion that I should have the growth taken out without biopsy first, that it would be a wasted step. He said because of my age, 53, and the nature of bladder nodules, that 80% to 90% it will be cancerous. 120k to 150k cost. 1 night stay, unless they like having me around or there is some complication. Tomorrow, they'll send me the breakdown of the costs. And then I can decide which hospital I want to give my money to. Unless someone has any better idea..... Cheers, folks.

 Sent you a PM