Skillful and Experiences Surgeon In Bangkok

[Sheryl]

P.S. in terms of apartment go to Agoda.com and filter for service apartment

 

What will be available will depend on your dates.

 

I have stayed at Dazzle Residence (Soi 7) in the past, nice apartments, but it looks like within the next week they have only 2 bedroom units available which of course cost more.

 

The hospital guest relations or international office might also have a list of apartments

[The Hammer2021]

On 7/27/2022 at 8:14 AM, fuehrio said:

Not sure if defamation applies if I mention the full name but it starts and ends with an A...one of the company mostly used by foreigners living here.

Does it sound  like a hatchet?

[Kristie J]

1 hour ago, Sheryl said:

That is a problem as it seems you are from Cambodia or other ASEAN country and entered under bilateral agreement. Those stays cannot be extended except for medical extension, but you can only get a medical extension if you are unable to travel (for example, if you have had the surgery already but not yet fit to travel home). In that case the hospital can help arrange extension for you.But if you are just waiting for the operation, you cannot get extension, you would have to go back to Cambodia and then come again. If you have to do that I recommend you try to get a tourist visa after going back as that will allow you to stay up to 90 days (you get 60 days on arrival and can extend another 30 days). In addition, on tourist visa you can leave and return within that time period by getting a re-entry permit.

 

There is no reason to think the remaining lobe of the thyroid would not function after surgery. What does sometimes happen is that if the biopsy of the removed lobe indicates the cancer has spread beyond it, they may have to go back and take out more.

 

In your case, if it were me and if Dr. Jun and the surgeon concur with a  lobectomy, I would go ahead and do that in hopes of saving the other lobe of the thyroid. This can help avoid or minimize the need to take hormones. Even if you do need to take hormone the amount you'd need and the amount of hormone flunctuation would be less than with a complete removal of the thyroid.

 

Endoscopic surgery gives a better cosmetic result (smaller scar) is easier on the patient, easier recovery, usual less time in hospital. However it usually costs more.

 

Regarding repeat biopsy what id Dr. Jun suggest? and did you ask about possibility of getting Afirma Gene test?

for Afirma test, the hospital says they will get back to me after they get a clear information which for now I haven’t gotten anything. 

I didn’t raise the repeat biopsy question because when I first i meet her, I told her that I came with a thought of getting surgery and I want her opinion on it. She said ‘it’s the right and good thought’. My chest X-ray shows the windpipe got pushed a little to the right side because of the big nodule on the left, and that leads to affecting my sleep and breathing sometimes. 
so she said even if it’s not cancerous, due to the size of the nodule, she still recommend half removal. As oddly as it may sound, I took another scan on my thyroid early august, somehow it nodule shrink a little. Dr. jun think it may shrink a little but not much more than that. 

The shrinking size make me hesitate the surgery, of course I am hoping it could go back to normal. But it’s unlikely right? 

[Kristie J]

1 minute ago, Kristie J said:

for Afirma test, the hospital says they will get back to me after they get a clear information which for now I haven’t gotten anything. 

I didn’t raise the repeat biopsy question because when I first i meet her, I told her that I came with a thought of getting surgery and I want her opinion on it. She said ‘it’s the right and good thought’. My chest X-ray shows the windpipe got pushed a little to the right side because of the big nodule on the left, and that leads to affecting my sleep and breathing sometimes. 
so she said even if it’s not cancerous, due to the size of the nodule, she still recommend half removal. As oddly as it may sound, I took another scan on my thyroid early august, somehow it nodule shrink a little. Dr. jun think it may shrink a little but not much more than that. 

The shrinking size make me hesitate the surgery, of course I am hoping it could go back to normal. But it’s unlikely right? 

beside that I don’t have any other symptoms which make me so hesitate in cutting it out. considering it still functions.
is it the right way to think? Like right now, I am fill with thoughts of many things. 

[Sheryl]

1 hour ago, Kristie J said:

for Afirma test, the hospital says they will get back to me after they get a clear information which for now I haven’t gotten anything. 

I didn’t raise the repeat biopsy question because when I first i meet her, I told her that I came with a thought of getting surgery and I want her opinion on it. She said ‘it’s the right and good thought’. My chest X-ray shows the windpipe got pushed a little to the right side because of the big nodule on the left, and that leads to affecting my sleep and breathing sometimes. 
so she said even if it’s not cancerous, due to the size of the nodule, she still recommend half removal. As oddly as it may sound, I took another scan on my thyroid early august, somehow it nodule shrink a little. Dr. jun think it may shrink a little but not much more than that. 

The shrinking size make me hesitate the surgery, of course I am hoping it could go back to normal. But it’s unlikely right? 

It is unlikely extremely unlikely to go back to normal by itself. In fact it may grow even bigger.

 

Since it is already affecting your sleep and breathing then it is not important to get the Afirma Gene test because anyway it has to be removed. And you will get the definite biopsy result once they have removed it. Even if it turns out to be benign, the surgery will ntoi have been unnecessary because even benign nodules need to be removed if they are large enough to cause symptoms.

 

 

[Sheryl]

1 hour ago, Kristie J said:

beside that I don’t have any other symptoms which make me so hesitate in cutting it out. considering it still functions.
is it the right way to think? Like right now, I am fill with thoughts of many things. 

"besides that" = besides the fact that it is large enough to be pressing on your windpipe and affecting your breathing?

 

That is reason enough to remove it.

[fuehrio]

6 hours ago, The Hammer2021 said:

Does it sound  like a hatchet?

More like a Volcano

[lopburi3]

10 hours ago, Kristie J said:

Hi, Yes, I raised the concern to my doc and she told me not to worry about it because they have immigration office at Bumrungrad. 

 

By minor effect on swallowing, you mean it hurts when swallow?

I am sorry to hear about your other thyroid not working properly. How do you adjust to taking pill everyday? I had to ask because kind of feel a little anxious about the surgery. 

 

and did you do the biopsy twice? Mine says indeterminate which make it very hard to decide on surgery. 

if it’s benign, and it would be unjust to cut it. 

Just a bit different when swallow sometimes - nothing major but 10 years later it sometimes hard to get pill down if do not eat or drink something first (but this is a one in a hundred event).  The pill is a tiny once a day 30 minutes before eating breakfast - for me take before walk dog and then eat - no issue at all.  Have TSH tests about once a year to be sure still in range.  I had the one indeterminate and doctor felt best to operate as mass was large and suspect and believe have to wait long period before re-testing and even then likely not to be definitive.  Only had history of skin cancers up to that time.  But had to delay operation several months due to pre-op EKG/stress test finding blockage and having 2 stents.   No pain from thyroid operation and hospital stay was short.

[The Hammer2021]

2 hours ago, fuehrio said:

More like a Volcano

So not AXA. I give  up.

Pompey?

[Kristie J]

14 hours ago, Sheryl said:

It is unlikely extremely unlikely to go back to normal by itself. In fact it may grow even bigger.

 

Since it is already affecting your sleep and breathing then it is not important to get the Afirma Gene test because anyway it has to be removed. And you will get the definite biopsy result once they have removed it. Even if it turns out to be benign, the surgery will ntoi have been unnecessary because even benign nodules need to be removed if they are large enough to cause symptoms.

 

 

do you believe in treating it traditional way? My dad want me to try drinking certain tea made from wood, and use cream for a month to see the result. If it doesn’t work, then surgery.

right now, I’m wavering with options. 

[Sheryl]

6 hours ago, Kristie J said:

do you believe in treating it traditional way? My dad want me to try drinking certain tea made from wood, and use cream for a month to see the result. If it doesn’t work, then surgery.

right now, I’m wavering with options. 

No.

 

Neither herbal teas nor creams will make any difference.

 

If the nodule is cancerous then waiting a  month is a bad idea.

 

If it is benign (non-cancerous) it still needs to come out due to its size but a one month delay won't do any harm.

 

Problem is we don't know which it is.

 

This surgery has a  very, very low mortality rate (less than 1 in  10,000). Less than 10% of patients experience any complications and these  are usually mild and temporary (like ioarseness for a week or two).  What exactly are you concerns/fears?

[Kristie J]

2 hours ago, Sheryl said:

No.

 

Neither herbal teas nor creams will make any difference.

 

If the nodule is cancerous then waiting a  month is a bad idea.

 

If it is benign (non-cancerous) it still needs to come out due to its size but a one month delay won't do any harm.

 

Problem is we don't know which it is.

 

This surgery has a  very, very low mortality rate (less than 1 in  10,000). Less than 10% of patients experience any complications and these  are usually mild and temporary (like ioarseness for a week or two).  What exactly are you concerns/fears?

Mortality rate isn’t what concern me, I am more scared of the fact and consequences that I have to live with half thyroid. And I don’t even know if the others nodules on the other side will grow too or not. 

[Sheryl]

44 minutes ago, Kristie J said:

Mortality rate isn’t what concern me, I am more scared of the fact and consequences that I have to live with half thyroid. And I don’t even know if the others nodules on the other side will grow too or not. 

Living with just 1 lobe of the thyroid is not a problem. In fact you can live a perfectly normal life with no thyroid at all, and many people do.

 

If the thyroid is removed completely, you have to take hormone replacement. 1 small pill a day. If just half is removed, often hormone replacement is not needed but sometimes it still is, usually at a  lower dose.

 

Many people who still have their thyroid gland also have to take thyroid hormone every day, for example if their thyroid gland is underactive. I do, for example.

 

The medication is very inexpensive and easy to fine. 1 very small pill a day in the morning. I am not sure why this worries you? And how does not having surgery prevent the development (or growth) of nodules on the remaining lobe? I am having trouble following your reasoning.

 

Are you saying you have nodules on both lobes already?  What exactly does the ultrasound show on the other lobe?

[Kristie J]

22 minutes ago, Sheryl said:

Living with just 1 lobe of the thyroid is not a problem. In fact you can live a perfectly normal life with no thyroid at all, and many people do.

 

If the thyroid is removed completely, you have to take hormone replacement. 1 small pill a day. If just half is removed, often hormone replacement is not needed but sometimes it still is, usually at a  lower dose.

 

Many people who still have their thyroid gland also have to take thyroid hormone every day, for example if their thyroid gland is underactive. I do, for example.

 

The medication is very inexpensive and easy to fine. 1 very small pill a day in the morning. I am not sure why this worries you? And how does not having surgery prevent the development (or growth) of nodules on the remaining lobe? I am having trouble following your reasoning.

 

Are you saying you have nodules on both lobes already?  What exactly does the ultrasound show on the other lobe?

Yes, the other side has two very tinies nodules. The doctor says it nothing to concern for now, but to do the check up on it every now and then.

 

To put it simply, perhaps i just want to go back to live the way I was without losing any part of my organs, if that make sense to you. 

[Sheryl]

32 minutes ago, Kristie J said:

Yes, the other side has two very tinies nodules. The doctor says it nothing to concern for now, but to do the check up on it every now and then.

 

To put it simply, perhaps i just want to go back to live the way I was without losing any part of my organs, if that make sense to you. 

You wish you did nto have this condition, that is natural.

 

But you do have it, so need to deal with that.

 

This is not a vital organ. You can live without it altogether and certainly live with part of it removed.

[lopburi3]

As said it is not something that requires much effort to live without.  They removed most of mine and remaining did not work well so as said one tiny pill a day takes care of it.  For me euthyrox 50mcg which from drugstore is about 1.35 baht a day.

[fuehrio]

21 hours ago, The Hammer2021 said:

So not AXA. I give  up.

Pompey?

I've sent you a DM

[Kristie J]

16 hours ago, Sheryl said:

You wish you did nto have this condition, that is natural.

 

But you do have it, so need to deal with that.

 

This is not a vital organ. You can live without it altogether and certainly live with part of it removed.

is there anything else I should know about? The side effect, the consequences or anything during and after surgery? 

I scheduled the surgery on Monday morning and feeling very anxious right now.

 

[Sheryl]

1 hour ago, Kristie J said:

is there anything else I should know about? The side effect, the consequences or anything during and after surgery? 

I scheduled the surgery on Monday morning and feeling very anxious right now.

 

Are you having endoscopic or open approach?

 

You will be asleep for the whole procedure. They will bring you into the operating room, put in an IV in and inject something, that will be the last thing you know before you wake up in the recovery room. Sometimes they start the IV before you enter the operating room, but the anesthetic injection will be after you are in there.  Before they inject, they will put prepare you for monitoring during the surgery by putting on a blood pressure cuff and heart monitoring etc.

 

There will be a tube put in your throat for breathing during the surgery but it will be put in after you are asleep already and taken out as soon as you begin to wake up.

 

There will be soreness at the incision site for about a week, they will give you pain medication. You might also feel some soreness inside your throat from the tube that was used during surgery (like a sore throat that you get with a cold), this usually goes away in a day or two.

 

About 10% of people have temporary effects like hoarse voice, redness at the incision site, usually goes away in a couple of weeks.

 

They will take blood samples after the surgery to see if your thyroid hormone levels are in normal range and if necessary prescribe medication

 

A couple of days after the surgery you will get full biopsy report of the specimen, this will give definitive answer on whether it was cancer or not. If it was cancer, this report will indicate if they probably got the whole thing.

 

 

[Kristie J]

On 9/2/2022 at 11:33 PM, Sheryl said:

Are you having endoscopic or open approach?

 

You will be asleep for the whole procedure. They will bring you into the operating room, put in an IV in and inject something, that will be the last thing you know before you wake up in the recovery room. Sometimes they start the IV before you enter the operating room, but the anesthetic injection will be after you are in there.  Before they inject, they will put prepare you for monitoring during the surgery by putting on a blood pressure cuff and heart monitoring etc.

 

There will be a tube put in your throat for breathing during the surgery but it will be put in after you are asleep already and taken out as soon as you begin to wake up.

 

There will be soreness at the incision site for about a week, they will give you pain medication. You might also feel some soreness inside your throat from the tube that was used during surgery (like a sore throat that you get with a cold), this usually goes away in a day or two.

 

About 10% of people have temporary effects like hoarse voice, redness at the incision site, usually goes away in a couple of weeks.

 

They will take blood samples after the surgery to see if your thyroid hormone levels are in normal range and if necessary prescribe medication

 

A couple of days after the surgery you will get full biopsy report of the specimen, this will give definitive answer on whether it was cancer or not. If it was cancer, this report will indicate if they probably got the whole thing.

 

 

Thank you for the process detailing. Now, I have a clear idea of what to expect or prepare for. 

Just in case, I will be staying by myself after surgery. My family hasn’t been very helpful emotionally, only triggering, so I really need to keep my distant from them. 
 

anyway, I will be doing the open one as Dr. Jun recommended. she said if I was her daughter, she would make me do the open one. But if I am singer, or superstar or celebrity, then I can choose the endoscopy to avoid the visible scar. Also, since the neck has quite an amount of blood vessels, she said open is more recommended. 

she recommend Dr. Angkoon for endoscopy, and Dr. Watana for open, and asked me to meet Dr. Watana first. I met him, he explained the process and everything, and make me feel

like I can trust him. That’s why I just choose to go with open. 

[Sheryl]

Sounds good.

 

I have full confidence in Dr. Jun's advice and in any surgeon she recommends. So I think you are in very good hands.

[Kristie J]

On 9/4/2022 at 12:45 AM, Sheryl said:

Sounds good.

 

I have full confidence in Dr. Jun's advice and in any surgeon she recommends. So I think you are in very good hands.

So the surgery went perfectly well. I didn’t get any hoarseness after that, a little pain at the neck, but bearable. I didn’t use painkiller either. 

But reaching high note is a little hard at the moment because it’s too new. 

Also, the nodules are not cancerous. My surgeon requested multiple tests on it.

I didn’t get as anxious as I thought I would in the operation room, because I feel I can rely and fully trust the surgeons, my general anesthesia dr and as well as his team. I feel very well taken care of.

now, I’m back home, safe and sound and healthy again. 
 

I want to say thank you and I’m grateful for your advices, recommendations and concerns. Thank you so much. I wish I can repay it some days.

 

I hope your nodule is okay and stay benign as it is now.

I wish you healthy, happy and all the best in life. 

[Sheryl]

Thank you for the update as I was thinking of you and wondering how it went.  I'm glad to hear it all worked out well.

[Kristie J]

On 9/11/2022 at 10:09 PM, Sheryl said:

Thank you for the update as I was thinking of you and wondering how it went.  I'm glad to hear it all worked out well.

hello, I just want to update you that everything is good after six months, my high note slowly coming back. and I will do a whole check up as Dr. Jun recommended in a year time.