Bone Marrow transplant needed.

[delgarcon]

My GF and I are looking after a 9 yo Thai girl, who has Thalassemia Beta and will be in need of this transplant, if she is to live a normal life. So far she has had 2 blood transfusions at the Surat Thani government hospital, at no cost, but as I will have to pay for surgery, I would be grateful if anyone knows of a pediatrician that specialises in this field that I can get in touch with.

[chiang mai]

@Sheryl may know and will almost certainly respond

[Sheryl]

There are many hematologists in Thailand who perform bone marrow transplants.   While a small number specifically focus on pediatrics, most treat both adults and children.   A pediatrician  is not who you would consult for this. 

 

Where in Thailand are you located?  Either Bangkok or Songkhla would be best for this, which is easier for you? 

 

I assume when you say surgery you actually mean the bone marrow transplant (which is not surgery). This is a complex procedure  as it is first necessary to treat with immunosuppressant drugs or radiation , during which period the patient is  very  vulnerable to infection.  There are other significant risks as well, including rejection of the donor marrow,  for which reason this is not commomly performed in management of thalessemia and reserved for very severe cases which  cannot be adequately managed with standard treatment (transfusions, chelation, folic acid, sometimes splenectomy). Ftom what you say it does not sound like she has yet maxxed out on standard therapy. 

 

Risk vs potential benefit of bone marrow transplant has to be carefully assessed for the individual patient so I would not be so certain she will end up being advised to have  this procedure.    Risks are significant. The potential benefit is tied to likelihood of success which in turn relates to availability of a good donor match. Unless there is a matched sibling able to donate,  this will be an issue.

 

Anyway please indicate which location works better for you and  I will suggest a doctor who can assess her and advise more specifically. 

[DrJack54]

@Sheryl you never fail to amaze.

What a treasure ASEAN Now has. 

[delgarcon]

Thanks for your reply Sheryl. We live in Koh Phangan, so Bangkok would probably make sense. As you have suggested, We need to see a specialist,  who can advise us of the best way forward. The doctor at Surat Thani hospital, apart from the blood transfusions has given us folic acid and vitamin pills and told us to come back in 3 months (15  Jan) There are several problems that I can see for myself, the girl is very anemic and pale, even jaundiced and her spleen is obviously enlarged which is making it difficult for her to pee, although it doesnt hurt her.

[Sheryl]

https://www.samitivejhospitals.com/doctor/detail/suradej-hongeng

 

Is an excellent choice if you can afford private care. Even if you cannot, might be useful to consult him.

 

Otherwise for government hospital, Ramathibodhi is good choice (and where Prof. Suradej is on faculty). 

 

If you want to try to first contact Prof. Suradej his email is listed here  https://www.rama.mahidol.ac.th/en/aboutus/administrative-team

(He is very busy so no guarantee he'll reply but no harm in trying)

 

Sounds like the girl may need a splenectmy, which should be free under the govt scheme. 

 

Do not feel that you must wait for the next appointment at Surat Thani... . that is for routine follow up.  Can return now citing the difficulties you mentioned. Follow up appointment dates are meant as "when to come back if no problem before then" but this is often not well communicsted. With government hospitals it is often necessary to keep coming back before a patient finally gets admitted (which  she msy need to be). 

[georgegeorgia]

48 minutes ago, Sheryl said:

https://www.samitivejhospitals.com/doctor/detail/suradej-hongeng

 

Is an excellent choice if you can afford private care. Even if you cannot, might be useful to consult him.

 

Otherwise for government hospital, Ramathibodhi is good choice (and where Prof. Suradej is on faculty). 

 

If you want to try to first contact Prof. Suradej his email is listed here  https://www.rama.mahidol.ac.th/en/aboutus/administrative-team

(He is very busy so no guarantee he'll reply but no harm in trying)

 

Sounds like the girl may need a splenectmy, which should be free under the govt scheme. 

 

Do not feel that you must wait for the next appointment at Surat Thani... . that is for routine follow up.  Can return now citing the difficulties you mentioned. Follow up appointment dates are meant as "when to come back if no problem before then" but this is often not well communicsted. With government hospitals it is often necessary to keep coming back before a patient finally gets admitted (which  she msy need to be). 

Thankyou for your service 

[Tropicalevo]

11 hours ago, delgarcon said:

Thanks for your reply Sheryl. We live in Koh Phangan, so Bangkok would probably make sense. As you have suggested, We need to see a specialist,  who can advise us of the best way forward. The doctor at Surat Thani hospital, apart from the blood transfusions has given us folic acid and vitamin pills and told us to come back in 3 months (15  Jan) There are several problems that I can see for myself, the girl is very anemic and pale, even jaundiced and her spleen is obviously enlarged which is making it difficult for her to pee, although it doesnt hurt her.

Wishing you all good luck in  your quest. 

[Sheryl]

@delgarconyou might also try https://www.saintlouis.or.th/doctor/dr.photsawee-khemaphiphat/dbafe795-29e5-493a-ab2d-8bcc8ed1af42

 

As St Louis is a nonprofit and has some sort of fund for indigent Thai patients which might possibly help. I don't really know how the fund works but I've seen the office for it when there. 

[delgarcon]

Thanks Sheryl, Ill let you know how we progress