Medical Check-up

[NguuMuu]

I am looking at getting a complete medical check up at Vibhavadi hospital.

Q1. Of the plans below, what would be best (health-wise and value-wise) for a seemingly healthy 27 year old female that has never had a full physical before?

Q2. Is there anything useful here for a 27 year old male that has had a full check up in America 6 months ago?

Q3. Do the prices seem reasonable?

Note that should you choose a cheaper package you can add individual items at the end.

Vibhavadi Packages (from http://www.vibhavadi.com/en/events_detail.php?id=21):

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PROGRAM VP1

1. Physical Examination

2. Dental Examination

3. Laboratory Test

3.1 Complete Blood Count

3.2 Fasting Blood Sugar

3.3 BUN

3.4 Creatinine

3.5 Uric Acid

3.6 SGOT,SGPT,Alkaline Phosphatase Bilirubin, Direct Bilirubin, Total Protein,Albumin,Globulin

3.7 Cholesterol, Triglyceride,HDL,LDL

3.8 AFP/CEA

3.9 PSA

3.10 Urine Examination

3.11 Stool Examination/Occult Blood

4. Thin Prep Pap Test

5.Chest X – ray

6. EKG

7.Ultrasound Whole Abdomen

8.Mammogram both breast

9.Medical Report Book

10. Complimentary

M. 7,300 Baht 215 US Dollars F. 9,800 Baht 288 US Dollars

PROGRAM VP2

1. Physical Examination

2. Eye Examination

3. Dental Examination

4. Laboratory Test

4.1 Complete Blood Count

4.2 Fasting Blood Sugar

4.3 BUN

4.4 Creatinine

4.5 Uric Acid

4.6 SGOT

4.7 SGPT

4.8 Cholesterol, Triglyceride,HDL,LDL

4.9 PSA

4.10 Urine Examination

4.11 Stool Examination/Occult Blood

5. Thin Prep Pap Test

6.Chest X – ray

7. EKG

8.Medical Report Book

9. Complimentary

M. 3,200 Baht 94 US Dollars F. 3,700 Baht 109 US Dollars

PROGRAM VP3

1. Physical Examination

2. Eye Examination

3. Dental Examination

4. Laboratory Test

4.1 Complete Blood Count

4.2 Fasting Blood Sugar

4.3 Creatinine

4.4 Uric Acid

4.5 SGOT

4.6 SGPT

4.7 Cholesterol, Triglyceride,HDL,LDL

4.8 Urine Examination

5.Chest X – ray

6.Medical Report Book

M. 1,900 Baht 56 US Dollars F. 1,900 Baht 56 US Dollars

PROGRAM VP4

1. Physical Examination

2.Eye Examination

3. Dental Examination

4. Laboratory Test

4.1 Complete Blood Count

4.2 Fasting Blood Sugar

4.3 Creatinine

4.4 SGPT

4.5 Urine Examination

5.Chest X – ray

6.Medical Report Book

M. 1,300 Baht 38 US Dollars F. 1,300 Baht 38 US Dollars

2Note Prices up to currency rate SPECIAL PROMOTION FOR ADDITONAL EXAMINATIONS FOR THOSE WHO SELECT PROGRAMS VP1-VP.5

1. ABO (Free)

2. RH 120 Baht

3. Hepatitis B (HBs Ag,HBs Ab, HBc ab) 720 Baht

4. Anti – HAV 480 Baht

5. Anti – HCA 480 Baht

6. Anti – HIV (AIDS test) 480 Baht

7. Thyroid Function Test (TSH, FT3, FT4) 960 Baht

8. Liver/Intestine CA (AFP, CEA) 760 Baht

9. Prostate CA (PSA) 540 Baht

10. Bone Strenght (Bone Densitometer) 1,950 Baht

11. Mammogram both breast 2,050 Baht

12. Thin Prep Pap Test 1,200 Baht

13. Exercise Stress Test 3,000 Baht

14. Barium Enema 3,000 Baht

15. Upper GI 1,800 Baht

16. Ultrasound Upper Abdomen 1,800 Baht

17. Ultrasound Lower Abdinen 1,800 Baht

[think_too_mut]

M. 7,300 Baht 215 US Dollars F. 9,800 Baht 288 US Dollars

That program at Bumrungrad would be 13-14,000B. I did it 3 times.

1 time i did it at Pattaya Bangkok Hospital and, instead of 90 minutes it takes at Bumrungrad for everything, it took 6 hours. There were periods when nobody came to me for 2 hours. Looks like other hospitals are trying to copy Bumrungrad with "me too" offer with 1 doctor.

That may be the only drawback, I think any hospital can do the tests.

It's just how efficient and well oiled the process is.

[Sheryl]

At your age and healthy, unless there are issues of concern due to family history (such as cancer of the breast, uterus, ovaries) then I would go with the VP4 package (cheapest one) and add on a thin prep, ask the doctor who does the thin prep to do a manual breast exam. If possible schedule the check-up soon after the end of a menstrual period as that is best time for breast exam. Total cost will be only 2,500.

If there is a family history of concern then re-post or email me with that info and I'll advise further.

If you have had in the past or may have in the future any exposure to high risk sexual partners, intravenous drugs or occupational exposure to blood, then I would recommend the number 3 add on (Hepatitis B panel) because it 720 baht it will tell you if you would benefit from the comparatively costly Hep B vaccine. Likewise if any of those factors present in your past you might want to consider add-on#6 (HIV test) if you have not had one recently.

For the young male, if he is as far as he knows completely healthy and has no family history of special concern then same recommendation as above but minus the thin prep and breast exam.

If he has any health complaints or worrisome family history, would need to know the details before advising further.

[Thanyaburi Mac]

At your age and healthy, unless there are issues of concern due to family history (such as cancer of the breast, uterus, ovaries) then I would go with the VP4 package (cheapest one) and add on a thin prep, ask the doctor who does the thin prep to do a manual breast exam. If possible schedule the check-up soon after the end of a menstrual period as that is best time for breast exam. Total cost will be only 2,500.

If there is a family history of concern then re-post or email me with that info and I'll advise further.

If you have had in the past or may have in the future any exposure to high risk sexual partners, intravenous drugs or occupational exposure to blood, then I would recommend the number 3 add on (Hepatitis B panel) because it 720 baht it will tell you if you would benefit from the comparatively costly Hep B vaccine. Likewise if any of those factors present in your past you might want to consider add-on#6 (HIV test) if you have not had one recently.

For the young male, if he is as far as he knows completely healthy and has no family history of special concern then same recommendation as above but minus the thin prep and breast exam.

If he has any health complaints or worrisome family history, would need to know the details before advising further.

Me?  Male, a tad over 60, I did the VP1, baht 7,500, last May.  The ultrascan, which I'd never had before, IDed gall stones

that I had out in June, same place, Vibhavadi General.  The regular exam doesn't include the DRE (finger wave) for guys but you can request it, for free.   Ugh, but probably necessary.

My wife, Thai, age 45, did the VP1 for gals.  Came out fine.

Total time, under two hours.  Not the same doc, shuttle from department to department.  10 days later get a report in the mail.

Mac

[Tammi]

M. 7,300 Baht 215 US Dollars F. 9,800 Baht 288 US Dollars

That program at Bumrungrad would be 13-14,000B. I did it 3 times.

1 time i did it at Pattaya Bangkok Hospital and, instead of 90 minutes it takes at Bumrungrad for everything, it took 6 hours. There were periods when nobody came to me for 2 hours. Looks like other hospitals are trying to copy Bumrungrad with "me too" offer with 1 doctor.

That may be the only drawback, I think any hospital can do the tests.

It's just how efficient and well oiled the process is.

And perhaps how good the doctor is at reading results. I know someone who was diagnosed with constipation by a gastoenterologist after a 3 day series of x-rays. Person had stage IV cancer. Another person showed a low normal haemocrit that was not questioned by doctor doing health check. Another doctor later said (but with hindsight, of course) that she would have questioned it. Again patient had cancer. Another patient had a left kidney op, then got right side extreme pain. Urologist said it was referred pain. Patient had ruptured appendix. He lived because another surgeon had more sense. You pays your money and hopes for the best. And that applies anywhere in the world.

Edited October 25, 2007 by Tammi

[Sheryl]

Exactly, Tammi. I have only actually been satisfied with the thoroughness of the review of the test results at Samitivej, especially with Dr. Anchanee. Bummers does the tests just fine but I find their analysis of the results very cursory and have known them to miss significant problems several times and fail to relate lab results to the individual patient's history, etc. They seem to be in the business of telling everyone thet are fine without really thinking through the test results. People leave very impressed with the efficiency of the testing procedsure and happy to be assured all is well...but in a few cases this latter wasn't true and this false sense of assurance can be deadly. Having all those tests doesn't do anything for you unless a comopetent and conmscientious doctor takes the time to really look carefully at the results in an individualized manner.

No idea about Vipawadee. But as a general rule of thumb, wherever you go, insist o n a thorough discussion of and investigation into any abnormal results (you'll get a copy of all the test results and usually the normal range is shown and/or abnormalities highlighted); if not satisfied then take the test results to someone else.

[NguuMuu]

Thanks for the advice so far!

add on a thin prep, ask the doctor who does the thin prep to do a manual breast exam.

Should I expect the doctor to give the manual breast exam for free? I'm assuming this only takes a minute or two, right?

Also, is there a significant difference between the manual exam and machine exam? Would it be worth the extra cost for the machine test at this age?

Total time, under two hours. Not the same doc, shuttle from department to department. 10 days later get a report in the mail.

Did you just show up or make the appointment in advance? It looks like they've raised the prices a bit since your visit.

Edited October 26, 2007 by NguuMuu

[Sheryl]

Yes, breast exam is normal part of a gyn exam and no additional charge. Actually the doctor should automatically do it, as well as ask if you do monthly checks and teach you how if necessary. In reality tho, in Thailand they either don't do it or ask if you'd like them too. So speak up and request it...and if you don't already know how and are interested, ask the doctor to show you how to do monthly self-checks. (you can request a female OB-Gyn if it would make you more comfortable, usually no problem).

At your age and provided (1) there is no family history of breast cancer, (2) you have no unusual symptoms (lumps, nipple discharge etc) and (3) nothing unusual is detected on the manual exam, then a mammogram (Xray of the breast tissue) is not considered necessary. Screening by mammogram is advisable starting at around age 40. There are different opinions about the frequency with which it should be done between 40-50 years of age, some experts recommending yearly and some every 2-3 years; most agree that it should be yearly from age 50 onward. Of course if there is a family history of breast cancer or any symptoms (either found accidentally or in the course of a manual exam) that's another matter.

In more hospitals there is no need top make an appointment for a check-up but do not eat or drink anything from midnight the night before and come in the morning. They need to draw the blood before you eat.

[NguuMuu]

Well, I did end up getting a check-up at Viphavadee this past weekend so here's an update on this topic.

Well, I showed up about 9 in the morning, found the counter and requested VP3 (I figured the cost was small enough I could get a few extra blood tests). Of course, as is so typical in Thailand, the website packages were quite different than what they actual provide. On the plus side, the price of VP3 was only 1400 baht (and the thin prep add-on only 900). On the down side there was no eye test included in this package and that was something I actually was hoping for. They really hurried us through...there was no chance for us to request add-ons or realize that the VP3 did not include an eye test anymore until it was too late. We did manage to get through to somebody to finally add on the thin prep, but never did get that eye test.

Now this is what I found to be the bad part: the physical exam. The physical exam consisted of putting the stethascope at about 5 places on my chest for 2 seconds each, pushing around on my stomach, and a 2 second glance in my mouth. Thats all. Nothing like I experience from my western doctor. No checking reflexes, looking at my eyes, in my ears, no deep breathes using the stethescope, no asking questions about lifestyle (doctors english was fine). Basically, I wouldn't call it a physical exam at all.

Everything else was OK. Taking blood, chest x-ray, dental, and thin prep (for the gf).

At the end the doctor did briefly review the results with me. Seems everything's fine except for my cholesteral, which is actually down 20 from last time, and some high wbc counts...he thinks I was just fighting off an infection of some kind. It was a very cursory discussion and I'm still awaiting my official results via mail. He wasn't very interested and I doubt it would be a worthwhile discussion had there been any serious problems.

Finished by 11 and a lot cheaper than I anticipated. Also got a 40 baht lunch voucher with the deal.

Overall I would have to say that I'm glad I did it, and everything was fine except the physical. At least I will have some x-rays and blod work done. Now I'll just wait until I'm back in the US for another physical.

[ThaivisaInsurance]

A point to remember before taking any checks or tests and that’s to be sure you have medical insurance. It’s no good having a check and be told there is a problem as this can be classified as a pre-existing condition for when you do take out insurance.