Should I have hernia done in private or public hospital

[Sheryl]

9 hours ago, ubonr1971 said:

My dr at the private hospital said he can do it at the public but theres a long wait. then he said 'it will be a lot more comfortable here'...

Both points are true. 

 

But there is no medical urgency on the wait and you won't be in hospital very long.

 

So it really comes down to your preference and how much the cost savings are worth to you....and how bothered you are by govt hosp condiuions/vibe, which is very individual.  You will end up with the same medical result. 

 

If you go public try to get a private room (extra cost but usually not more than 1500 baht a day). That way you can have a Thai speaker stay with you as the nurses etc will not speak English (their English often  isn't great at a private hosp eithef but st least there is some). 

[ubonr1971]

13 minutes ago, Sheryl said:

Both points are true. 

 

But there is no medical urgency on the wait and you won't be in hospital very long.

 

So it really comes down to your preference and how much the cost savings are worth to you....and how bothered you are by govt hosp condiuions/vibe, which is very individual.  You will end up with the same medical result. 

 

If you go public try to get a private room (extra cost but usually not more than 1500 baht a day). That way you can have a Thai speaker stay with you as the nurses etc will not speak English (their English often  isn't great at a private hosp eithef but st least there is some). 

Im ok to pay the 150k for private. Unsure if I get to meet him prior to the op but hoping that I only have to spend 1 night in hospital. I assume the next day they will look to see if any alergic reaction to the mesh. Is that correct? If not surely Im good to go

 

After laproscopic hernia repair how soon can I start doing sit ups and push ups, bench press etc. Surely not 2 months...

 

Im into exercise and need a daily fix. Assume I can go for fast walk if Im up to it?

 

Finally, do you know at private hospitals can they give a strong sedative and do it under local anesthetic? I would prefer this instead of general anesthetic

 

thanks

[Sheryl]

1 hour ago, ubonr1971 said:

Im ok to pay the 150k for private. Unsure if I get to meet him prior to the op but hoping that I only have to spend 1 night in hospital. I assume the next day they will look to see if any alergic reaction to the mesh. Is that correct? If not surely Im good to go

 

After laproscopic hernia repair how soon can I start doing sit ups and push ups, bench press etc. Surely not 2 months...

 

Im into exercise and need a daily fix. Assume I can go for fast walk if Im up to it?

 

Finally, do you know at private hospitals can they give a strong sedative and do it under local anesthetic? I would prefer this instead of general anesthetic

 

thanks

 

The usual factor in how soon you can be discharged is how much pain you have. Thai hospitals are reluctant to prescribe narcotics  to outpatients so will tend to keep patients until they no longer need a narcotic pain killer. If your pain is minimal 1st day post op then yes, could likely go home then, otherwise maybe 2nd day.

 

You can start walking almost immediately but not too much for the 1st week (be guided by how you feel). Most people can resume brisk walking after about 1 week,

 

You will need to avoid lifting heavy objects and things like sit ups, bench presses etc  -- anything that exerts pressure on the abdominal muscles - for at least 6 weeks as it takes that long for the mesh to integrate with the body tissues. You risk hernia recurrence if you start too soon.

 

it is not possible to do this surgery under sedation + local . Laparoscopic is always done under general anesthesia. If there is a reason general cannot be used then open approach can be done under  regional anesthesia i.e. spinal anesthesia .

[sometimewoodworker]

Having just been quoted ฿245,000 which is in addition to the ฿36,000+ for a CT scan to confirm the diagnosis at Bangkok Hospital Udon Thani for an open or laparoscopic abdominal hernia I am seriously considering flying to India to get the procedure, it is likely to be about ⅔ds the cost including everything with better communication and English skills.

 

My question is has anyone tried this route and do you have any comments, that is apart from travel as we can deal with that.

[Mike Lister]

If the quote was for 245k at Bangkok Hospital, a middle ground quote would be a university hospital which aims to be priced between private and public hospitals.

[scubascuba3]

I'd be tempted to try out India, if all good and goes well then can use in the future for more expensive ops if necessary. Kolkata 

[Sheryl]

1 hour ago, sometimewoodworker said:

Having just been quoted ฿245,000 which is in addition to the ฿36,000+ for a CT scan to confirm the diagnosis at Bangkok Hospital Udon Thani for an open or laparoscopic abdominal hernia I am seriously considering flying to India to get the procedure, it is likely to be about ⅔ds the cost including everything with better communication and English skills.

 

My question is has anyone tried this route and do you have any comments, that is apart from travel as we can deal with that.

I can't recall specifically for hernia but there are AN members who have used hospitals in India.

 

You need to research both the hospital and the specific surgeon carefully as in India, like anywhere else, quality varies greatly.

 

The price you were quoted could not have been for open or laparoscopic as the 2 have very different costs. I expect it was for laparoscopic.  

 

It is not routine to require a CT scan first unless there is doubt about the diagnosis which is not usually the case. 

 

If I were you I'd consider going to Khon Kaen University Hospital, quality is good and cost will likely be similar ti going to India once you take into account airfare etc.  

 

Not that should not fly for at least 48 hours after laparoscopic surgery and a full 10 days after open surgery. And sometimes even when laparoscopic is planned they have to switch to open during the procedure (especially likely to happen in patients who have had prior abdominal surgery or re obese). In other words you might ave to stay longer than planned in India afterwards.

 

[sometimewoodworker]

52 minutes ago, Sheryl said:

The price you were quoted could not have been for open or laparoscopic as the 2 have very different costs. I expect it was for laparoscopic.  

You’re absolutely correct, the laparoscopic was 245,000. The open surgery was 240,000 so little difference It’s almost irrelevant. The laparoscopic was fixed price. The open surgery was variable.

 

That is why I am considering an India trip.

[Sheryl]

1 hour ago, sometimewoodworker said:

You’re absolutely correct, the laparoscopic was 245,000. The open surgery was 240,000 so little difference It’s almost irrelevant. The laparoscopic was fixed price. The open surgery was variable.

 

That is why I am considering an India trip.

These quotes are quite high, and difference in price between open and lap should be much greater (typically at least 50K).

 

Even the laparoscopic is less expensive at top hospitals in Bangkok e.g.190K at Medpark   https://www.medparkhospital.com/en-US/packages/laparoscopic-hernioplasty

and  219k at Bumrungrad https://www.bumrungrad.com/en/packages/laparoscopic-inguinal-hernia-repair-1-side

 

Open is not listed but would be usually around 150k or less

 

And of course government university hospital would be less still

 

 

[SAFETY FIRST]

12 hours ago, sometimewoodworker said:

I am seriously considering flying to India to get the procedure

I worked offshore India for a few years, traveling to and from monthly, flying to different airports, Mumbai, Hyderabad, Chennai etc. 

It's not a pleasant experience, the airports, streets are congested, waiting in queues for flights etc. the passengers won't give you space, standing, almost touching you, breathing on you, it's not where you want to be after an operation, saying that, even before operation. 

 

I liked working in India, I liked working with the Indians, reliable and hard working but if I was having an operation I would be spending the extra money to have the operation here in Thailand, too many unknowns and 'what if's' for the inexperienced. 

 

If you decide to go to India, I'd be flying business class and staying at a quality hotel which will add to the price.

 

[sometimewoodworker]

10 hours ago, Sheryl said:

Not that should not fly for at least 48 hours after laparoscopic surgery and a full 10 days after open surgery. And sometimes even when laparoscopic is planned they have to switch to open during the procedure (especially likely to happen in patients who have had prior abdominal surgery or re obese). In other words you might ave to stay longer than planned in India afterwards.

Thank you very much for pointing out something that I had no knowledge of. 
 

8 hours ago, Sheryl said:

These quotes are quite high, and difference in price between open and lap should be much greater (typically at least 50K).

 

Even the laparoscopic is less expensive at top hospitals in Bangkok e.g.190K at Medpark   https://www.medparkhospital.com/en-US/packages/laparoscopic-hernioplasty

and  219k at Bumrungrad https://www.bumrungrad.com/en/packages/laparoscopic-inguinal-hernia-repair-1-side

 

Open is not listed but would be usually around 150k or less

Again thank you for those links I will certainly consider other options. 
FWIW I now have a partial breakdown of fees

Quote

Surgeon doctor fee             55,000 THB.

                Anesthesia doctor fee        10,000 THB.

                Operating room, Medical supply , special medical supply , medicine                   145,000 THB.

                Hospitalization                     60,000 THB ( 3 days)

                The estimated total cost 260,000 – 270,000 THB.

So it’s a total money grab!

[sometimewoodworker]

15 minutes ago, SAFETY FIRST said:

I liked working in India, I liked working with the Indians, reliable and hard working but if I was having an operation I would be spending the extra money to have the operation here in Thailand, too many unknowns and 'what if's' for the inexperienced. 

 

If you decide to go to India, I'd be flying business class and staying at a quality hotel which will add to the price.

I had already decided on both the business class flights and quality hotel if I go there.

 

It’s the absolute money grab that I can’t stand. My insurance will be enough to cover the bill, though the surgeon fee is so high it is only partially covered. 
 

I would rather spend my own money on travel than give it to BKK Hospital.

 

Due to some extremely fortunate circumstances, I can reasonably easily afford the trip, though I haven’t decided yet.

If going I will probably go to Chennai. I am going to talk to a doctor their, probably, tomorrow or later today at the Fortis Malar Hospital.

 

You have given me a couple of points I will need to discuss, again thanks

[Sheryl]

4 hours ago, sometimewoodworker said:

Thank you very much for pointing out something that I had no knowledge of. 
 

Again thank you for those links I will certainly consider other options. 
FWIW I now have a partial breakdown of fees

So it’s a total money grab!

It is. And it is the OR charge that should be dramatically different between laparoscopic and open since no need to use endoscope for the latter

[Sheryl]

4 hours ago, sometimewoodworker said:

I had already decided on both the business class flights and quality hotel if I go there.

 

It’s the absolute money grab that I can’t stand. My insurance will be enough to cover the bill, though the surgeon fee is so high it is only partially covered. 
 

I would rather spend my own money on travel than give it to BKK Hospital.

 

 

Would your insurance cover the 190K at Medpark Hospital?

 

Note too that when there is an issue with insurance typically it gets resolved in negotiations between the hospital 3rd party payment opffice and the insurer. Often the hospital ends up reducing a charge or "repackaging" the breakdwon.

 

I would not expect that from an upcountry private hospital (those are usually best avoided for a number of reasons) -- especially one that came up with such seemingly odd cost estimates to you -- but big hospitals in Bangkok, yes. 

[John49]

After my recent medical procedure (see my post “Prolapsed Rectum”) and my 3 miserable days in an expensive private hospital in Bangkok, I would also consider a medical trip to India as an option, as suggested above.

 

I did not have a Thai speaker with me in the Bangkok hospital and experienced almost nil communication with 9 out of 10 nursing staff during my stay.

On the evening after my operation, I had a BP of 200/142 for up to 2 hours with only a nurse aide (no hat) available, who spoke no English and had no authority or ability to respond other than going to look for a real nurse (with hat).

(Quote: A blood pressure reading of 200/142 indicates Hypertension Stage 3. It is the most severe case of high blood pressure and usually needs immediate attention by a doctor or health care professional. It is also referred to as Hypertensive Crisis.)

Also, I had 3 days and 3 nights of diarrhoea, that could have been avoided and better managed.

 

I have worked twice in India and found it a difficult place to live, especially with overcrowded roads and footpaths.

The standout aspect of working in India were the several people I worked with – intelligent, hardworking and morally sound, despite it being ‘corrupt’ within the political classes, etc.

Assuming you can find the right hospital and doctor, the thought of being able to communicate in English easily, including the nursing staff, would be a big positive.

I had long chat with an Indian tourist recently, he told me that the best hospital chain in India were Apollo.

[sometimewoodworker]

1 hour ago, Sheryl said:

Would your insurance cover the 190K at Medpark Hospital?

Easily,  and I’m certainly considering that though, I’m going to try Khon Kaen University Hospital first on the basis that it’s easier travelling.

1 hour ago, Sheryl said:

Note too that when there is an issue with insurance typically it gets resolved in negotiations between the hospital 3rd party payment opffice and the insurer. Often the hospital ends up reducing a charge or "repackaging" the breakdwon.

That would be me, as I pay directly and my insurer reimburses me.

 

[sometimewoodworker]

18 minutes ago, John49 said:

I had long chat with an Indian tourist recently, he told me that the best hospital chain in India were Apollo.

Regrettably, though I spoke to both Apollo and Fortis, Fortis was the one of the 2 who had someone willing to talk to me first so that is who I am contacting, though I may also contact Apollo.

 

23 minutes ago, John49 said:

Assuming you can find the right hospital and doctor, the thought of being able to communicate in English easily, including the nursing staff, would be a big positive.

That was one of my points to consider

 

24 minutes ago, John49 said:

 

I did not have a Thai speaker with me in the Bangkok hospital and experienced almost nil communication with 9 out of 10 nursing staff during my stay.

 I will not have that situation as SWMBO will be with me.

 

However the consultant in BKK hospital did not inspire me with confidence, as though he spoke good English it was so heavily accentuated and fast that he was very difficult to understand, (note that was before I saw his fee that is hart attack inducing)

[sometimewoodworker]

FWIW the Srinagarind Hospital that is closely allied to the Faculty of Medicine, of Khon Kaen University has given a ball park figure of 100,000 -> 120,000 the surgeon was excellent at communicating, and easy to understand. I was scheduled for the 9th but since I just caught a cold it has been postponed for 10 days. One reason for the extreme cost difference  is that unlike Bangkok hospital that charges 26,000 per night they charge under 4,000

I well update when there is something to report. 

[sometimewoodworker]

Just a FWIW.

I’m now 5 days post opp from a laparoscopic umbilical hernia . The total cost with 5 days stay was 124,000 or roughly ½ the Bangkok Hospital quote. I highly recommend the Srinagarind Hospital for professionalism, though checks for blood pressure at about 2 hour intervals didn’t allow a very restful night (my blood pressure was all over the place so the checks were understandable) The food was a good effort, though not fine dining.

I will be happy to elaborate if there are any questions