2nd opinion Hospital - Pattaya

[Jai Yen]

I had my first appointment with Bangkok - Pattaya Hospital, went well but I know they are the most expensive around here.

 

Based on other threads I saw here, it seems like other options may be Pattaya City Hospital, Pattaya Memorial and also Sattahip.

 

Just called Memorial,  they told me to come in at 10pm tomorrow, but didn't even ask my name or anything - also, they have no CT scan capabilities!  X-ray only  - tells me they are kind of bush league.  I need a cat scan

 

Was trying to avoid the drive to Sattahip but that will be my next call. I need 2 operations, my thinking is I can perhaps do both operations for the same price as one at Bangkok- Pattaya, which I know from experience is the most expensive one around {I had one of these Op's there in 2014, had a large private room, not necessary really} 

 

Thanks for any advice  

[scubascuba3]

Jomtien Hospital is good see if they do what you need. Queen Sirikit in Sattahip is good, should be cheapest. Also contact Gavin below, free pickup in Pattaya

 

[Jai Yen]

Thanks!  I have a motorbike and  enjoy riding, but this may be the way to go

 

  FYI  Bkk--Pattaya wants  around 240K for each Op -  I need 2, maybe 3 

 

  But for sure need some place with a CT machine!  

[Jai Yen]

Just called Sattahip  - same  type customer service, never asked for my name or anything, said come in tomorrow at 8 - I said how about ten and they said sure and I said would you like to know my name and they said sure  but didn't write anything down, very odd.

 

And when I mentioned I needed an Xray and a Cat scan they said sure, we can do that - hmmm, very odd, I don't even know if they transferred me to the proper department, I think I still had the front desk  

[Sheryl]

Is the CT you require with or without contrast?

 

What type of surgeries are these?  

 

Cost should not be sole consideration. Won't do you any good to have surgery done badly, or the wrong type of procedure -- both quite possible outcomes  if surgeon not selected with care. Depending on what this is, you might be better advised to come to Bangkok. 

 

While other hospitals may cost less than BPH the diffetence is likely to be fairly small unless you to a government hospital.  At these, wait fof CT is often very long hence my question about contrast. If no contrast media, CT at a  stand alone imaging center eould be an option. 

 

I am frankly puzxled  by refeence to 240k for  "each Op". Rare for a surgery to cost that little at a private hospitsl these days, but again, I have no idea what exactly this is. 

 

BTW Pattaya Memirial, like most hospitals, does have CT.  https://www.pattayamemorial.com/departments/radiology

[scubascuba3]

4 minutes ago, Jai Yen said:

Just called Sattahip  - same  type customer service, never asked for my name or anything, said come in tomorrow at 8 - I said how about ten and they said sure and I said would you like to know my name and they said sure  but didn't write anything down, very odd.

 

And when I mentioned I needed an Xray and a Cat scan they said sure, we can do that - hmmm, very odd, I don't even know if they transferred me to the proper department, I think I still had the front desk  

When you go there, head far right desk to get ticket for dept you want to go, then head there, better if you take a thai speaker otherwise can be a frustrating experience 

[Jai Yen]

1 hour ago, Sheryl said:

Is the CT you require with or without contrast?

 

What type of surgeries are these?  

 

Cost should not be sole consideration. Won't do you any good to have surgery done badly, or the wrong type of procedure -- both quite possible outcomes  if surgeon not selected with care. Depending on what this is, you might be better advised to come to Bangkok. 

 

While other hospitals may cost less than BPH the diffetence is likely to be fairly small unless you to a government hospital.  At these, wait fof CT is often very long hence my question about contrast. If no contrast media, CT at a  stand alone imaging center eould be an option. 

 

I am frankly puzxled  by refeence to 240k for  "each Op". Rare for a surgery to cost that little at a private hospitsl these days, but again, I have no idea what exactly this is. 

 

BTW Pattaya Memirial, like most hospitals, does have CT.  https://www.pattayamemorial.com/departments/radiology

 

 

     I have Kidney stones -  3 surgeries required -  one to first get the biggest one out, then 2  more for  the shockwave therapy I need for each side. I have 20 stones all told, various sizes -  last time I had this done in 2014 at BKK-Pattaya.  They estimated  220-260K for each one now, that is right from their billing office so not sure what you mean. I need around 700K all told if I do it there.

 

Last time, in 2014, I had a HUGE room all to myself - no need for that, I don't mind sharing and it's just one night for each; check in, they do the surgery and monitor overnight,  released the next day.   I had also heard that  some hospitals would work with with the patient to bring down the cost, especially someone paying in cash, which I would be.  

 

 

[Jai Yen]

1 hour ago, scubascuba3 said:

When you go there, head far right desk to get ticket for dept you want to go, then head there, better if you take a thai speaker otherwise can be a frustrating experience 

 

 

 My Thai friend was hesitant to even call - because she was so worried she'd have a hard time translating what they tell me into English!

 

I found even at BKK-Pattaya their translation skills are minimal,  but  we are visitors to this country so thankful for their trying and my lack of compatant Thai means  frustrating translations at times. 

[Jai Yen]

1 hour ago, Sheryl said:

Is the CT you require with or without contrast?

 

What type of surgeries are these?  

 

Cost should not be sole consideration. Won't do you any good to have surgery done badly, or the wrong type of procedure -- both quite possible outcomes  if surgeon not selected with care. Depending on what this is, you might be better advised to come to Bangkok. 

 

While other hospitals may cost less than BPH the diffetence is likely to be fairly small unless you to a government hospital.  At these, wait fof CT is often very long hence my question about contrast. If no contrast media, CT at a  stand alone imaging center eould be an option. 

 

I am frankly puzxled  by refeence to 240k for  "each Op". Rare for a surgery to cost that little at a private hospitsl these days, but again, I have no idea what exactly this is. 

 

BTW Pattaya Memirial, like most hospitals, does have CT.  https://www.pattayamemorial.com/departments/radiology

 

 

Memorial Hospital here called me  back, said they could do what I need done with an Ultrasound and X-rays;  the CT scan would be more thorough,  so if these 2  don't show enough of what they need I will have to look at getting a CT scan. 

[Sheryl]

1 minute ago, Jai Yen said:

 

 

     I have Kidney stones -  3 surgeries required -  one to first get the biggest one out, then 2  more for  the shockwave therapy I need for each side. I have 20 stones all told, various sizes -  last time I had this done in 2014 at BKK-Pattaya.  They estimated  220-260K for each one now, that is right from their billing office so not sure what you mean. I need around 700K all told if I do it there.

 

Last time, in 2014, I had a HUGE room all to myself - no need for that, I don't mind sharing and it's just one night for each; check in, they do the surgery and monitor overnight,  released the next day.   I had also heard that  some hospitals would work with with the patient to bring down the cost, especially someone paying in cash, which I would be.  

 

 

Lithotripsy (shockwave therapy to break up stones) is not surgery. It is a non-invasive procedure.  In fact sometimes done as a day procedure without overnight stay.

 

While any large hospital will have CT, not all can do lithotripsy as this requires specialized equipment and expertise. Note that lithotripsy is not always successful, and skill of the doctor is paramount, not just in doing it but in deciding if it makes sense to do in the first place. Given how many stones you have, might or might not.

 

I am not sure why CT needed, usually stones can be visualized by ultrasound (and sounds like they already have been)??

 

If they are going to have to operate to remove a stone that is too large for lithotripsy (a point you should perhaps get another opinion on before proceeding) via what I assume will be either Percutaneous Nephrolithotomy  or Uteroscopy (laparoscopic approach through the urethra)  I don't see why they would not remove the other stones  at same time?  In fact, if at least one stone is too large to remove otherwise, might make most sense to just go for a single operative procedure to remove all of them, the procedures just described can be done at same time on both kidneys....and might give the best chance of success. 

 

The whole thing as you describe it, does not seem to make sense.  I think you need another opinion on treatment plan altogether.

As for lithotripsy costs, 99k here https://phyathai2international.com/programs-and-promotions/Extracorporeal+Shock+Wave+Lithotripsy+(ESWL)/695/en

However, the  cost would likley be more for large number of stones.

 

I strongly suggest you come to Bangkok (bringing CD of ultrasounds and all other medical records with you) and consult this senior doctor at Siriraj

 

https://www.siphhospital.com/en/medical-services/doctor-biography?id=249

 

As there is a good chance you can be treated with a single procedure or surgery at a far lower cost. The treatment plan you describe seems odd to say the least.

 

Most private hospitals  in Thailand offer only private rooms, but with a range to choose from, which  you select at time of admission or reservation. Unless you opt for one of the most costly VIP rooms, the room cost will be a very small factor in the total cost -- even though you may feel the room is unnecessarily  nice or large.

 

 

 

[Sheryl]

21 minutes ago, Jai Yen said:

 

 

Memorial Hospital here called me  back, said they could do what I need done with an Ultrasound and X-rays;  the CT scan would be more thorough,  so if these 2  don't show enough of what they need I will have to look at getting a CT scan. 

would not be usual to need a CT for this. See my previous post. 

[NanLaew]

42 minutes ago, Jai Yen said:

 

 

 My Thai friend was hesitant to even call - because she was so worried she'd have a hard time translating what they tell me into English!

 

I found even at BKK-Pattaya their translation skills are minimal,  but  we are visitors to this country so thankful for their trying and my lack of compatant Thai means  frustrating translations at times. 

 

There are translation apps on smartphones that have been around for years. I used them four years ago while training with a bunch of Japanese in Laem Chabang and they worked well. With AI, they're even better these days.

[Sheryl]

P.S. Who told you that you have 20 kidney stones, that is pretty much unheard of. Or was that a typo?

 

And how large is the largest stone?

 

[Jai Yen]

21 minutes ago, Sheryl said:

P.S. Who told you that you have 20 kidney stones, that is pretty much unheard of. Or was that a typo?

 

And how large is the largest stone?

 

no, that's what I have lol 10 on each side - I will just scan in my results and show you here, I don't mind

 

I will also scan in their estimate, you can see it's around 250K for each side;  still unsure if they can get the largest [1.2CM] and do one shockwave at the same time, Doctor "Jimmy" was not clear on that, said he'd know better once I was in  the Op room  -  yes, I get that it's non-invasive, I call them surgery  because I will be knocked out and spending an overnight, same as I did last time.

 

  scanning these in now, stand by  

 

 

[Jai Yen]

  This shows their costs and the number of stones I have; ten on each side -  wasn't making anything up

 

They got 6600 for an Ultrasound, X-ray and Consultation - 

Dr. Jimmy said 2 procedures for sure, but maybe 3 - after they get the largest one out, which they say is stuck, I still need shockwave lithotripsy on both sides. 

 

Maybe you can make sense of these, somehow I added  20 stones since I last saw them ten years ago

 

 

 

 

 

 

 

 

 

[Jai Yen]

Thank you for your  advice by the way, much appreciated 

[Jai Yen]

2 hours ago, Sheryl said:

P.S. Who told you that you have 20 kidney stones, that is pretty much unheard of. Or was that a typo?

 

And how large is the largest stone?

 

   The chief Urologist at BKK_Pattaya told me that -  10 on each side

 

  Largest one is  1.1cm,  this was last month so may be 1.2  by now  

[Sheryl]

1.1 is  actually not too large. Large enough to not pass on its own, but well within the size that lithotripsy might be able to break up.

 

Sounds like many, perhaps even most, of the other stones are small enough to pass on your own (i.e. without needing to be btoken up by shock wave first),  has conservative management been tried (e.g. hydration plus pain meds and an alpha blocker?)

 

I do not see any indication on the estimate to suggest that there would need to be  multiple admissions at that price, are you sure that is the plan? I cannot understand why it would be.  Of course if the litho does not work, might have to then have surgery, that is always a possibility (not a certainty. A back up plan if the litho does not work).

 

The larger issue is why so much stone formation.  Do you maintain adequate hydration?  Do you have an enlarged prostate causing urinary retention? Have you been evaluated for parathyroid issue?

 

I continue to urge you to go to Bangkok and consult the recommended doctor for a comprehensive treatment plan. Bring a CD with the Xrays and ultrasound images on it. 

 

 

 

 

 

 

[Lorry]

Agree with @Sheryl

Seems OP thoroughly misunderstood the whole treatment plan.

I cannot imagine it is 3x ESWL fir 3x 250,000

In Pattaya, the only place (except BPH) one could go with this problem is Memorial Hospital,  but I would rather go to Bangkok. 

And really check for underlying problems.

[norsurin]

8 hours ago, Jai Yen said:

 

 

 My Thai friend was hesitant to even call - because she was so worried she'd have a hard time translating what they tell me into English!

 

I found even at BKK-Pattaya their translation skills are minimal,  but  we are visitors to this country so thankful for their trying and my lack of compatant Thai means  frustrating translations at times. 

Not about surgery but about dentist in kap choeng Hospital in surin.I had toothake so i went there.

Lucky that i speak thai well.The dentist asked me alot before working on my teeth.Where im from..how long time i been in Thailand..where i learn to speak thai..where i live.. where I work..my salary..if im married...where i was at a dentist last time etc etc..She took out my teeth and it only cost me 220 baht because i had a card issued by the hospital.Before i left the dentist asked my number and i gave it..but she never called me.Another time at this hospital i went there because i felt dizzy the whole day They wanted me to stay over the night and i did.The funny part was that a nurse checked me in the middle of the night even put her hands over my balls.I don't understand why but i have a clue why she did that.

[jts-khorat]

8 hours ago, Jai Yen said:

no, that's what I have lol 10 on each side - I will just scan in my results and show you here, I don't mind

 

I will also scan in their estimate, you can see it's around 250K for each side;  still unsure if they can get the largest [1.2CM] and do one shockwave at the same time, Doctor "Jimmy" was not clear on that, said he'd know better once I was in  the Op room  -  yes, I get that it's non-invasive, I call them surgery  because I will be knocked out and spending an overnight, same as I did last time.

 

  scanning these in now, stand by  

 

As Sheryl has already said, this is not really a very large stone.

 

I had one of slightly larger size, it was broken up by lithotripsy and I had to stay stationary at the hospital for two days to pass the first broken up fragments and to see in a follow-up that the break-up was successful. Actually the most painful action in the whole process was the pulling of the catheter. The whole procedure was done in Germany though.

[jts-khorat]

2 hours ago, norsurin said:

Before i left the dentist asked my number and i gave it..but she never called me.Another time at this hospital i went there because i felt dizzy the whole day They wanted me to stay over the night and i did.The funny part was that a nurse checked me in the middle of the night even put her hands over my balls.I don't understand why but i have a clue why she did that.

 

Where is the confused emoji?! Bring it back!!

[actonion]

16 hours ago, Jai Yen said:

 

 

 My Thai friend was hesitant to even call - because she was so worried she'd have a hard time translating what they tell me into English!

 

I found even at BKK-Pattaya their translation skills are minimal,  but  we are visitors to this country so thankful for their trying and my lack of compatant Thai means  frustrating translations at times. 

As Bangkok Pattaya  boast that they are an International hospital their  English language should be better than it is, and in my experience the Nurse's medical  skills need to be a lot better too

[Jai Yen]

I agree 100%, although as I said earlier this is THEIR country and for me to not know Thai is my issue, not theirs.

 

With that said, I swear I asked the nurses that work with Dr. Jimmy, is this for all three operations? 'yes'  - do I need 2 or 3 procedures? 'Yes' -  is this  the total cost for all 3?  'yes' -    essentially, nowhere.   The billing office wasn't much better.  The Doc  spoke  great english,  but he just shook his head like he couldn't believe it when I said there was no pain, and that I needed the procedures  done right away.

 

Thankfully still no pain, but I have a dutch friend who has one large stone slip into his urethra and said the pain was beyond belief 

[Jai Yen]

10 hours ago, Sheryl said:

1.1 is  actually not too large. Large enough to not pass on its own, but well within the size that lithotripsy might be able to break up.

 

Sounds like many, perhaps even most, of the other stones are small enough to pass on your own (i.e. without needing to be btoken up by shock wave first),  has conservative management been tried (e.g. hydration plus pain meds and an alpha blocker?)

 

I do not see any indication on the estimate to suggest that there would need to be  multiple admissions at that price, are you sure that is the plan? I cannot understand why it would be.  Of course if the litho does not work, might have to then have durgery, that is always a possibility (not a certainty. A back up plan if the litho does not work).

 

The larger issue is why so much stone formation.  Do you maintain adequate hydration?  Do you have an enlarged prostate causing urinary retention? Have you been evsauated for parathyroid issue?

 

I continue to urge you to go to Bangkok and consult the recommrnded doctor for a comprehendive treatment plan. Bring a CD with the Xrays and ultrasound images on it. 

 

 

 

 

 

 

 

why so much stone formation, who knows -  20 certainly isn't normal. Only around 9% of people from both sexes get Kidney stones, could be because not enough water but that seems crazy; I work out several times a week and drink copious amounts of water all day, have for years.  No booze at all, no beer,  some salt, soda and energy drinks but no more than the average human does.  I could go to BKK,  you mentioned Siriraj and I used to live not far from there - but you also sent a link to another hospital with the 99K  lithotripsy,  which one would you think could treat this  better.  Thankfully no pain at all, but waiting too long would change that of course

[Sheryl]

1 hour ago, Jai Yen said:

 

why so much stone formation, who knows -  20 certainly isn't normal. Only around 9% of people from both sexes get Kidney stones, could be because not enough water but that seems crazy; I work out several times a week and drink copious amounts of water all day, have for years.  No booze at all, no beer,  some salt, soda and energy drinks but no more than the average human does.  I could go to BKK,  you mentioned Siriraj and I used to live not far from there - but you also sent a link to another hospital with the 99K  lithotripsy,  which one would you think could treat this  better.  Thankfully no pain at all, but waiting too long would change that of course

Go to Siriraj and see the recommended doctor there.

 

You need a complete treatment plan as well as investigations into underlying causes. 

 

The other link was just to give an idea of normal lithotripsy costs, but of course these prices assume not many stones. However I do not really  see why the small stones (which is most of them) would need lithotripsy.

[Jai Yen]

1 hour ago, Sheryl said:

Go to Siriraj and see the recommended doctor there.

 

You need a complete treatment plan as well as investigations into underlying causes. 

 

The other link was just to give an idea of normal lithotripsy costs, but of course these prices assume not many stones. However I do not really  see why the small stones (which is most of them) would need lithotripsy.

 

   OK,  just back  from BKK-Pattaya, spoke to my Doc there,  here's  the official deal from him;

 

I need 3 procedures -  the ESWL is up to me, 'elective' at whenever I want it. Each side is  220-250K baht

He  says I need Holium  Laser treatment to break up the largest stone, as he's concerned it will block the urethra soon.

That procedure is also in the 220-250K range and he says he can NOT do the lithotripsy for that side at the same time - totally different procedure.

 

He says the largest one *needs* to come out, but that's assuming I am in pain - I am not, if it had dropped into the urinary tract it seems the URSL is necessary.  Attached description of the first procedure. 

 

Renting a car and heading to Siriraj next week,  see what they say.  Thanks a lot for your advice  -  it's crazy to think the price in Pattaya would be  around 140% more for the same procedure.  Billing told me when I had the ESWL in  2012 it cost me 90K baht - I get inflation, but 240K from 90k?    Nothing else around here has risen so dramatically in 13 years.  They want a  190K deposit before starting.  

 

 

[Sheryl]

55 minutes ago, Jai Yen said:

 

   OK,  just back  from BKK-Pattaya, spoke to my Doc there,  here's  the official deal from him;

 

I need 3 procedures -  the ESWL is up to me, 'elective' at whenever I want it. Each side is  220-250K baht

He  says I need Holium  Laser treatment to break up the largest stone, as he's concerned it will block the urethra soon.

That procedure is also in the 220-250K range and he says he can NOT do the lithotripsy for that side at the same time - totally different procedure.

 

He says the largest one *needs* to come out, but that's assuming I am in pain - I am not, if it had dropped into the urinary tract it seems the URSL is necessary.  Attached description of the first procedure. 

 

Renting a car and heading to Siriraj next week,  see what they say.  Thanks a lot for your advice  -  it's crazy to think the price in Pattaya would be  around 140% more for the same procedure.  Billing told me when I had the ESWL in  2012 it cost me 90K baht - I get inflation, but 240K from 90k?    Nothing else around here has risen so dramatically in 13 years.  They want a  190K deposit before starting.  

 

 

 

 

Still making no sense at all and not consistent with the doctor's  written recommendation.  No way are there THREE procedures envisioned. Per what he had written, he is proposing to do a ureteroscopy (URSL) on the left, presumably because it is suspected that there is a stone in the ureter; while lithotripsy could be tried instead, ureteroscopy is somewhat more successful when stones are lodged in the ureter. This is not the largest stone, you have same size on the right, but the issue is that it is lodged in the ureter and there are signs that it may be partially obstructing flow of urine from the left kidney.

 

In the course of the URSL they can also remove any other, smaller, stones encountered on that side. Would not normally also do ESWL after that on the same side, the decision tree is ESWL vs URSL not both. And there is no mention in what he wrote of an ESWL on the left afterwards. Rather,  he writes of  elective  ESWL later on the right side where there are apparently also at least 1 1.0 cm stone as well as some smaller ones.  So 2 procedures, not 3 and only one essential. 

 

Do you have appointment with Prof. Ekkarin set up at SIPH?  When you see him, ask:

 

1- does he concur that URSL is the best approach for the stone  on the left? 

2 - if so, could a bilateral URSL be done at same time (i.e. both sides) to also remove the stones on the right?  (That might be the most efficient and least expensive approach. )

 

Understand that ESWL only breaks stones up into smaller stones, it does not dissolve them, so only worth doing for largish stones. Generally, stones 0.4 cm in size or less will easily pass on their own, and stones .4 - . 7 may also pass but with more difficulty. So the "20 stones" seen on your ultrasound are not really the issue (and indeed, many of them may already have since passed, I don't know the date of that US). It is the 1.0 cm stone that may be lodged in the left ureter, and a few stones sized .6 - 1.0 cm on the right, that are the issue.