Hospital Nightmares

[happyjackthe4th]

You should go to a British hospital , now they really are the pit's , None of the staff can speak English , the nurse' s are extemely rude , and the General hygiene would make a BKK Prison look spotless. I took my wife to a hospital in Isaan ,it was very clean, she got seen to on time, Oh, and the staff spoke her native language.what a difference to the UK ' the worlds leading health authority '

[onethailand]

Did nt want to name the hospital for obvious reasons!! Well done!

Duh.

Along came the ambulance and off to the hospital. not sure of the name, but its on Chang Klan

May I suggest that the next time you don't want to name the hospital, you don't pretend that you don't know?

McCormick is not some backwater hospital or clinic either.

[Pierrot]

As a teenager, I used to practise motocross and was a very frequent visitor to the local hospital, every month or so and usually for a couple of stiches, but I don't remember ever been prescribed antibiotics. But it's not my question. As a kid I had a very bad bike accident and a deep infected wound on my elbow. There was no hospital nearby and I was not about to die, so we had to do my grand mother recipee : bleach and boiling water, as hot as I can take and until the water get cold, repeat 3 times daily. It worked. Later a friend of mine, doctor in the army, confirmed it was an efficient cure for this kind of wound.

Now what I would like to know, in an emergency situation, can we use bleach from the shell of any convenience store? Or are they now so full of other chemicals (???) that it's better to look for more conventional medicine ?

[bsided69]

Did nt want to name the hospital for obvious reasons!! Well done!

Duh.

Along came the ambulance and off to the hospital. not sure of the name, but its on Chang Klan

May I suggest that the next time you don't want to name the hospital, you don't pretend that you don't know?

McCormick is not some backwater hospital or clinic either.

May I suggest that the next time you don't want to name the hospital, you don't pretend that you don't know?

McCormick is not some backwater hospital or clinic either.

I didnt want to name the hospital as it might of been a one off? I have never used this hospital,clinic before this. It was a first time, and bad experience. Rather than trying to diss my post, maybe you could tell me some good experiences you have had said hospital or at other hospitals. As you may have learned? Most of your frequented places( eating, sports, entertainment, etc) are from recomondations. My friend has a very serious break of the collar bone and is now scared about hospital treatment as she has been lucky enough to be healthy up to this point.

Chill out and eat some baked beans. Or maybe go to spicys and watch out for the step?

[bsided69]

As a teenager, I used to practise motocross and was a very frequent visitor to the local hospital, every month or so and usually for a couple of stiches, but I don't remember ever been prescribed antibiotics. But it's not my question. As a kid I had a very bad bike accident and a deep infected wound on my elbow. There was no hospital nearby and I was not about to die, so we had to do my grand mother recipee : bleach and boiling water, as hot as I can take and until the water get cold, repeat 3 times daily. It worked. Later a friend of mine, doctor in the army, confirmed it was an efficient cure for this kind of wound.

Now what I would like to know, in an emergency situation, can we use bleach from the shell of any convenience store? Or are they now so full of other chemicals (???) that it's better to look for more conventional medicine ?

Thanks for that. I actually was starting to beleave that antibiotics were a morning supplement. I cut myself on a broken glass this morning and was going to start on a 2 week course of broad spectrum antibiotics.( NOT!)

Have you tried to buy bleach here though? Its not available. Something to do with bomb makeing I have heard.

You still doing the motocross?

[happyjackthe4th]

As a teenager, I used to practise motocross and was a very frequent visitor to the local hospital, every month or so and usually for a couple of stiches, but I don't remember ever been prescribed antibiotics. But it's not my question. As a kid I had a very bad bike accident and a deep infected wound on my elbow. There was no hospital nearby and I was not about to die, so we had to do my grand mother recipee : bleach and boiling water, as hot as I can take and until the water get cold, repeat 3 times daily. It worked. Later a friend of mine, doctor in the army, confirmed it was an efficient cure for this kind of wound.

Now what I would like to know, in an emergency situation, can we use bleach from the shell of any convenience store? Or are they now so full of other chemicals (???) that it's better to look for more conventional medicine ?

Thanks for that. I actually was starting to beleave that antibiotics were a morning supplement. I cut myself on a broken glass this morning and was going to start on a 2 week course of broad spectrum antibiotics.( NOT!)

Have you tried to buy bleach here though? Its not available. Something to do with bomb makeing I have heard.

You still doing the motocross?

now my nan always had the cure , ' sit down and have a nice cup of tea '

[bsided69]

As a teenager, I used to practise motocross and was a very frequent visitor to the local hospital, every month or so and usually for a couple of stiches, but I don't remember ever been prescribed antibiotics. But it's not my question. As a kid I had a very bad bike accident and a deep infected wound on my elbow. There was no hospital nearby and I was not about to die, so we had to do my grand mother recipee : bleach and boiling water, as hot as I can take and until the water get cold, repeat 3 times daily. It worked. Later a friend of mine, doctor in the army, confirmed it was an efficient cure for this kind of wound.

Now what I would like to know, in an emergency situation, can we use bleach from the shell of any convenience store? Or are they now so full of other chemicals (???) that it's better to look for more conventional medicine ?

Thanks for that. I actually was starting to beleave that antibiotics were a morning supplement. I cut myself on a broken glass this morning and was going to start on a 2 week course of broad spectrum antibiotics.( NOT!)

Have you tried to buy bleach here though? Its not available. Something to do with bomb makeing I have heard.

You still doing the motocross?

now my nan always had the cure , ' sit down and have a nice cup of tea '

PG tips? one lump ot two?

[happyjackthe4th]

PG Tips one lump or two? - quote east end nan - " they dont know what the bloody ell there talking about them doctor's - now where's me fags ?

[gunnyd]

Sounds like we need to call in Gordon Ramsey so he can tell everyone to F@@k off and grow a pair of bullocks.

As for having a broken collar bone, your friend really does need go to the hospital and have it set. Otherwise there can be permanent deformity that will effect the range of motion of the entire shoulder and arm. Also if it is let go too long it will start to heal and will have to be re-broken and set to fix it.

GunnyD

edit: bad grammar

Edited February 22, 2008 by gunnyd

[mr_hippo]

Sounds like we need to call in Gordon Ramsey so he can tell everyone to F@@k off and grow a pair of bullocks.

As for having a broken collar bone, your friend really does need to hospital and have it set. Otherwise there can be permanent deformity that will effect the range of motion of the entire shoulder and arm. Also if it is let go too long it will start to heal and will have to be re-broken and set to fix it.

GunnyD

Can you tell me how to set a broken collar bone?

[gunnyd]

When I broke mine a large male nurse held me around the hips, then the doctor and a resident proceeded to first pull my shoulders back and then they manually reduced it (shoved it back in place). Then they immediately put a brace in the shape of a figure 8 that held my shoulders in place and crossed in the back. After that they took a post reduction film to make sure it was properly aligned. Makes me shudder thinking of how painful that was. I was stuck in that brace for 6 weeks. Brutal. But it had to be done. After I got hit by a car my left shoulder hurt and I couldn't lift my arm. The ER doc knew what it was broken before the x-rays came back because he could feel where the fracture was AHHHHHHH!!!! It hurt like the devil. F.Y.I. this was in an ER at Luke Air Force Base in the USA

Not that I need to give credentials but, I am a Registered Nurse (retired due to disability) who worked for 15 years including orthopedics...

GunnyD

Edited February 22, 2008 by gunnyd

[mr_hippo]

Did you read my earlier posts on the subject?

[gunnyd]

Yes as a matter of fact I did. Sometimes people need to hear from more than one source. And I felt like posting

[Pierrot]

You still doing the motocross?

+ 20 years + 20 Kgs = no more motocross, unfortunately.

Btw, thanks everybody for replying my question regarding the use of bleach as disinfectant.

If one day you are in the ER and you hear nurse mr_hippo and nurse gunnyd arguing, you know for sure that you're going to die before anybody pay attention to you !!

[mr_hippo]

If one day you are in the ER and you hear nurse mr_hippo and nurse gunnyd arguing, you know for sure that you're going to die before anybody pay attention to you !!

I am not aware of any argument between us.

[gunnyd]

If one day you are in the ER and you hear nurse mr_hippo and nurse gunnyd arguing, you know for sure that you're going to die before anybody pay attention to you !!

I am not aware of any argument between us.

Nope, I guess humor and sarcasm is lost on some people.

No we'll be coming for you in latex gloves with a Foley catheter kit. Not to mention a HUGE syringe

And did I mention the doctor ordered a RECTAL exam???? mr_hippo Cover me I'm going IN!

[mr_hippo]

And did I mention the doctor ordered a RECTAL exam???? mr_hippo Cover me I'm going IN!

I'll help but then you will have to help me - I have been asked to do some research on the effects of Tazers/Tasers on unsuspecting people!

[gunnyd]

As long as I get a taser too, I can think of few people i'd like to sneak up on with one.

[bsided69]

Obviously you work in a hospital. Antibiotics for minor grazes no worse than a carpet burn is dangerous. They are given far to frequently in this country and very soon will start to become inafective against the serious infections that they are suppose to fight.

Carpet burn and a graze from a road accident are entirely different things - you obviously haven't a clue. I'd like to know someone who caught tetanus from carpet burn... and you seem to know a whole lot about "far too frequently" for someone who has been here 6 years and can't even remember the name of the hospital (probably McCormick).

You should have insisted on an x-ray if you were present and heard her complain many times in front of the doctor. X-ray does not need a Thai translation.

Maybe you should consider purchasing medical insurance that includes evacuation to a first world country if you are so afraid of medical care here in Thailand.

The hospital in Question was Not McCormicks!!!!

[ProThaiExpat]

I was quite surprised to learn that the national average for hospital contracted staph infections in Great Britain is over 30% these days. I bet it is not that high in good Thai hospitals.

My four operations last year in Thailand went fine with no infections, but then again the doctor ordered prophylactic antibiotics in hospital and for a week after discharge. I have heard the mantra about too many antibiotics being ordered around the world and the fears of antibiotic resistant strains for 40 years. Not impressed.

Those who care for their own health rarely are caused to use antibiotics with any frequency. A "phised" lady is in no condition to insure she gets proper medical care, her responsibility. I know there are many users of medical services in Thailand who are extremely passive when it comes to being responsible for getting good medical care, but become very agressive when they don't get it and start the complaining.

I blame the complaining individual when he doesn't get the care he feels he deserves. When I was lying on the gurney in the emergency room with a comminuted and displaced femoral fracture at Ram Hospital and in considerable discomfort, I still interviewed the doctor who came in to take over my treatment. Fortunately he spoke good English, was Thai board certified in Orthopedics and taught the subject at CMU Medical School. He had extensive foreign training and I satisfied myself of his qualifications before allowing him to even order the xrays.

From then on, he was warned I was going to question everything he did and he acted accordingly, often joking in a slightly defensive way, "are you going to sue me?" Sure, this didn't keep 'know nothing nurse assistants" from trying to treat me without even knowing which leg was injured.

I even managed my own "transfers" from gurney to bed, to operating room table etc. as it was very painful and I could accomplish it with less discomfort than well meaning but unknowing hospital staff.

I questioned every pill, injection and service rendered and if I didn't fully understand what it was and why it was being given and ordered by whom, it didn't happen until I did. I consider this assumption of responsibility for my own care a must. As a result, my complaints about care received is more to express incredulity rather than complaints about what I allowed to happen to me.

Of course, if delivered to the emergency room in a coma, little can be done about your care until you awaken, but such cases are rare. Being responsible for my own health care includes not riding motorcycles, by the way. Being disabled with a leg injury, that is a daily risk on a motorcycle, for over a year, did not cause me to be any more aware. Seeing the aftermath of motorcycle accidents for years in the West did not cure me of the desire to ride one, only the motivation to act on it. By the way, most motorcycle accidents are caused by the drivers of automobiles, IMHO.

Thais are great at telling you something is not possible just to avoid having to do it, so don't take no for an answer until your sure of the facts. A daily detailed hospital bill is certainly in order if requested, but that didn't stop one staffer from telling me it wasn't possible, until I got a supervisor involved and three hours later, the impossible became reality.

All of the foregoing is done politely and firmly and with an sureness of purpose that belies any belief that you can be persuaded otherwise. With the internet, one can check on almost any medical issue and can educate yourself to a point that you can ensure you get the proper treatment. I even have the doctor order extra blood tests to make sure I have a full panel due to meds I take on a regular basis that are unrelated to a femur fracture, but could affect healing, such as low potassium from diuretics for blood pressure control, etc.

I have noticed that many Thai doctors are modeled after the 30 year old U.S. model of clinician that looked at you like you are a specimen and have no clue what bedside manner means. Just a bigger challenge to turn such a doctor around and get them to give your the proper medical service or change doctors. Usually, the doctor will change of their own volition.

Years ago, I drew a Chinese physician at a U.S. HMO clinic who asked me in the middle of a digital prostate exam if I minded that a woman doctor was performing the procedure.

My answer was, "I don't mind you being a woman, I just mind you taking so XXXXXX long". She replied that her fingers were short so she had to take more time to be thorough.

On leaving the exam room and passing the nursing desk I refered to the examing Chinese doctor as "short fingers Wu", a nickname that caught on and sure enough, I was transferred to a male doctor for the balance of my treatment at that facility for a number of years.

Edited February 26, 2008 by ProThaiExpat

[bsided69]

Obviously you work in a hospital. Antibiotics for minor grazes no worse than a carpet burn is dangerous. They are given far to frequently in this country and very soon will start to become inafective against the serious infections that they are suppose to fight.

Carpet burn and a graze from a road accident are entirely different things - you obviously haven't a clue. I'd like to know someone who caught tetanus from carpet burn... and you seem to know a whole lot about "far too frequently" for someone who has been here 6 years and can't even remember the name of the hospital (probably McCormick).

You should have insisted on an x-ray if you were present and heard her complain many times in front of the doctor. X-ray does not need a Thai translation.

Maybe you should consider purchasing medical insurance that includes evacuation to a first world country if you are so afraid of medical care here in Thailand.

Where did McCormick come from? I am sure I said it was On Chang Klan. Never said anyone could get tetanus from carpet burn. How the hel_l do you know how deep the grazes went? I had assumed the X-ray had already been done before I got there. I have great medical insurance thanks. My first experience of a medical emergency and it was a Fecin farce. So only natural to be concerned?

[IMA_FARANG]

I would serioiusly reconsider having any unnesacery medical treatment in Thailand. Having been here for 6 years on and off I know of very few postive experiences. There are some great Doctors, but many of the younger junior doctors and nurses are a joke, and these are the people that will be looking after you once youve had your Op.

A friend of mine fell off her bike on Thursday ( pished as a fart). Along came the ambulance and off to the hospital. not sure of the name, but its on Chang Klan . I went to see her in the A an E department. She had some minor grazes no bigger than a 10 baht coin on her elbow and head. She had quite obviously hit her head tho, and was complaining of a pain in her shoulder. The clown, oops sorry Doctor put some Iodine on her grazes and sent me to the pharmacy to pay the bill and pick up some meds. So quess what they give her? ?????? Yes you got it, antibiotics and paracetamol. Ok pain killers, but why antibiotics????? Well this isnt the meat of the tale. When I got back to her she was being helped up and into a wheel chair. She winced with pain and again said her shoulder hurt. She pulled back the top of her T-shirt revealing another minor graze that hadnt been spotted. I had not been there for the first hour that she had arrived, but assumed ( ha, assumed in Thailand) they had removed her top at some point to examine her propaly. I should of questioned this but I forgot how to speak Thai.( im an idiot who speaks very little Thai) So we Take her home are told to keep an eye on her and watch out for any fainting spells and vomiting.

In the morning she wakes up with a thumping head and severe pain in her shoulder. Back to the hospital she goes. (I was not there) The Doctor this time had obviously attended doctors school, as he sent her for X-rays. Well would you Adam and Eve it? Broken Collar bone. Now how the Bloody hel_l does the doctor on the night shift miss this one????? Because I suggest, he is a Muppet with little or no Knowledge of medical treatment. These are the people that will be giving you aftercare. The people that will not question a senior Doctors methods even if they can see that there is quite obviously something not right.

I have many more storys like this, but will save them for another time.

ps I love Thailand and want to spend the rest of my life here and die of natural causes.

I've had good experiences and bad experiences with hospitals in Thailand.

One bad experience was when my Thai girlfriend fell down a starway and broke her wrist. She was taken to a hospital in BKK (I was not there at the time, so I don't know which one) They supposedly set her broken wrist and put a cast on it. The next day her hand was the size of a ballon, and dark blue in color. She went back to the hospital, and it was found that the original emergency room doctor had blocked the artery bringing blood to her hand partially when he put the cast on too tight. The doctor that redid the cast told her that if she hadn't come in, it could have lost her hand from the low blood flow.

However, my son had an accident on his bicycle and tore up his knee. The doctor that treated him did an excellant job. And, yes, he did get antibiotics for any possible infection (he had some gravel in his knee from the accident). He only got antibiotics after he was given a jab test to see if he was allergic to the antibiotics they intended to give him. They cleaned his wound carefully and gave him clear instructions on how to wash the wound (they gave him the antibiotic wash to use) and how to change the bandage himself.

So I guess it is just luck of the draw what doctor you get and how it goes.

[ProThaiExpat]

"So I guess it is just luck of the draw what doctor you get and how it goes."

That statement may be "spot on", what do you guys think of this scenario??

Fell off ladder onto concrete floor and fractured my left femur, compound and comminuted. Ambulance from RAM not available, it was in Hang Dong bringing in a heart attack patient who died on the way, so government hospital ambulance took me to the ER.

After a while, night duty Ortho showed up and after xray, opined broken femur and surgery was in order. Got blood from BKK and operation occurred the next night. Fracture was reduced, plate installed and off to room where I couldn't deal with the food and the staff rarely knew what leg was broken when they moved me. I got pretty good at transfers, wouldn't let know nothings help.

Seven days after "oosing" into a bag, Doctor decided to go back in and see why very long surgical incision kept bleeding. After second operation, he must have done some cautery and wound packing, oozing diminshed and was discharged three days later.

Follow up appointments every three months, on each was told no union of femur bones. At 8 months, Doctor decided to do bone graft. It was done 9 months post break. Took bone from hip. A few weeks later, plate broke when I returned to almost full weight bearing, I had been doing before the graft surgery, against doctor's orders.

New operation a month later, late November with two bags of bone graft material and new plate installed.

Released from care and full weight bearing granted last night, 13 months after accident but only 3 months after 4th surgery for plate replacement.

Question: Was the doctor not doing his job to make me wait for 8 months before declaring a non-union and deciding to do bone graft? Was the doctor wrong in his initial surgery by not getting all the "bleeders" and thus requiring a second operation a week later? Was the delay in declaring the non-union a cause of the plate breaking due to patient not being "patient" regarding weight bearing? Was the doctor wrong in not using the two extra bags of graft material during the first bone graft procedure?

The answers to the above questions may well be in the realm of a glass being half full or half empty, depending on how you look at things.

In defense of the Doctor, he is extremely well qualified and teaches the subject at CMU. He is extremely skillful in his surgical techniques. I was an unusual heavy bleeder and once the doctor learned this, after the first surgery, he reduced hospital recovery time to only three days for the 3rd and 4th surgeries by his surgical skill. The wait for declaring a non-union and doing a bone graft was in the exercise of caution and desire to spare the patient an additional surgery in the event I was a slow healer. No knowing if the first bone graft would have taken, the patient, in violation of weight bearing restrictions, broke his plate and additional surgery was required. Thus the doctor was just taking advantage of the exisiting situation to put in more bone graft material.

So what's your take on my medical care at Ram?

[Sheryl]

(Femur) Fracture was reduced, plate installed ...Seven days after "oosing" into a bag, Doctor decided to go back in and see why very long surgical incision kept bleeding. After second operation, he must have done some cautery and wound packing, oozing diminshed and was discharged three days later.

Follow up appointments every three months, on each was told no union of femur bones. At 8 months, Doctor decided to do bone graft. It was done 9 months post break. Took bone from hip. A few weeks later, plate broke when I returned to almost full weight bearing, I had been doing before the graft surgery, against doctor's orders.

New operation a month later, late November with two bags of bone graft material and new plate installed.

Released from care and full weight bearing granted last night, 13 months after accident but only 3 months after 4th surgery for plate replacement.

Question:

Was the doctor not doing his job to make me wait for 8 months before declaring a non-union and deciding to do bone graft?

No. Normal healing time is 3-6 months and a few people (especially smokers) take a bit longer. A bone graft is no small procedure. The doctor took a sensible conservative approach and did the bone graft only when it was clear you had not healed within a reasonable period of time.

Was the doctor wrong in his initial surgery by not getting all the "bleeders" and thus requiring a second operation a week later?

If he had missed any bleeders of significant size you would have had a lot more than "oozing". Very tiny bleeders would normally clot off in less than 7 days. Not sure what was going on or even if bleeding as opposed to pus collection was the problem. Anyhow, nothing in what you say indicates a signifciant surgical error. With small oozing, waiting it out first and then re-opening if it does not stop on its own is appropriate.

Was the delay in declaring the non-union a cause of the plate breaking due to patient not being "patient" regarding weight bearing? I don't really understand the question. But for sure, bearing weight before you were supposed to was a very bad idea and contributed to break of the plate and delayed healing. With any fracture, instructions about weight bearing and use of the affected bone should be followed to the letter.

Was the doctor wrong in not using the two extra bags of graft material during the first bone graft procedure? I can't tell from the information provided whether or not the amount of bone used at the first graft was standard and appropriate. .. but for sure, the graft was done with the expectation that the patient would comply with instructions about weight bearing. It is essential to avoid weight bearing after a bone graft, even if you were able to bear weight before the graft. If the doctor did nto fully explain that, he should have. If he did and you didn't listen...you should have! Would quite ;likely have prevented need for the second graft.

In short, nwhile I obviously can't assure all was done well, not having been there or even seen the operative notes, nothing you say suggests otherwise. Sounds like a combination of bad luck/poor healing and unnecessary complications due to poor patient compliance.

All that said, what does ring some potential alarm bells in my mind is the poor healing aspect. The question being, why? If you are a smoker, that would account for it. Obesity might also. If you are not a smoker, not obese, otherwise healthy, I'd suggest you get a thorough check-up to rule out any underlying problem which migth have contributed to the poor healing.

So what's your take on my medical care at Ram?

[Prakanong]

I have had very mixed results in Thai hospitals. I have visited them as a patient and professionally for work.

On one hand some of the most highly rated of our sites in asia are in Thailand.

Then I had a similar experience to the OP when I was run over. The Dr at Bumrungrad did not even see the large hole in my leg and was too busy playing solitaire on windows to care.

The only advice I can give it to be lucky enough to have contacts but thats not an option for everyone.

They do like their 240 SGD bottles of wine when its one our expenses though

[Captain Chaos]

I would serioiusly reconsider having any unnesacery medical treatment in Thailand. Having been here for 6 years on and off I know of very few postive experiences. There are some great Doctors, but many of the younger junior doctors and nurses are a joke, and these are the people that will be looking after you once youve had your Op.

A friend of mine fell off her bike on Thursday ( pished as a fart). Along came the ambulance and off to the hospital. not sure of the name, but its on Chang Klan . I went to see her in the A an E department. She had some minor grazes no bigger than a 10 baht coin on her elbow and head. She had quite obviously hit her head tho, and was complaining of a pain in her shoulder. The clown, oops sorry Doctor put some Iodine on her grazes and sent me to the pharmacy to pay the bill and pick up some meds. So quess what they give her? ?????? Yes you got it, antibiotics and paracetamol. Ok pain killers, but why antibiotics????? Well this isnt the meat of the tale. When I got back to her she was being helped up and into a wheel chair. She winced with pain and again said her shoulder hurt. She pulled back the top of her T-shirt revealing another minor graze that hadnt been spotted. I had not been there for the first hour that she had arrived, but assumed ( ha, assumed in Thailand) they had removed her top at some point to examine her propaly. I should of questioned this but I forgot how to speak Thai.( im an idiot who speaks very little Thai) So we Take her home are told to keep an eye on her and watch out for any fainting spells and vomiting.

In the morning she wakes up with a thumping head and severe pain in her shoulder. Back to the hospital she goes. (I was not there) The Doctor this time had obviously attended doctors school, as he sent her for X-rays. Well would you Adam and Eve it? Broken Collar bone. Now how the Bloody hel_l does the doctor on the night shift miss this one????? Because I suggest, he is a Muppet with little or no Knowledge of medical treatment. These are the people that will be giving you aftercare. The people that will not question a senior Doctors methods even if they can see that there is quite obviously something not right.

I have many more storys like this, but will save them for another time.

ps I love Thailand and want to spend the rest of my life here and die of natural causes.

Don't worry - this is not limited to A&E departments in Thailand - I came off my beloved Kawasaki ZX-6R in 1996 (whilst sober I may add) and the young doctor who treated me at High Wycombe General missed the fact that I had fractured my shoulder blade and couldn't lift my arm over shoulder height. Unfortunately, sh*t happens - everywhere.

I've had some great medical care in Thailand - I've also had some very average care. My dad had a minor complaint whilst we were in Samui a few years back and got some very efficient, cost-effective care from a clinic in Chaweng.

Medical care is one where you have to find a doctor that you are comfortable with in my opinion... regrettably this may not always be an option in A&E of course ...

But overall, I don't find the average standard of medical care in Thailand to be any worse than the UK, that's for sure...

Edit: seeing Prak's post, one place I do not recommend is Bumrungrad - just too many patients going through and not enough time taken to consider properly each one's case - it's not "bad" but it is "average" - that is just my experience and others may have a different take of course

Edited March 3, 2008 by Captain Chaos

[Tammi]

I was quite surprised to learn that the national average for hospital contracted staph infections in Great Britain is over 30% these days. I bet it is not that high in good Thai hospitals.

My four operations last year in Thailand went fine with no infections, but then again the doctor ordered prophylactic antibiotics in hospital and for a week after discharge. I have heard the mantra about too many antibiotics being ordered around the world and the fears of antibiotic resistant strains for 40 years. Not impressed.

Those who care for their own health rarely are caused to use antibiotics with any frequency. A "phised" lady is in no condition to insure she gets proper medical care, her responsibility. I know there are many users of medical services in Thailand who are extremely passive when it comes to being responsible for getting good medical care, but become very agressive when they don't get it and start the complaining.

I blame the complaining individual when he doesn't get the care he feels he deserves. When I was lying on the gurney in the emergency room with a comminuted and displaced femoral fracture at Ram Hospital and in considerable discomfort, I still interviewed the doctor who came in to take over my treatment. Fortunately he spoke good English, was Thai board certified in Orthopedics and taught the subject at CMU Medical School. He had extensive foreign training and I satisfied myself of his qualifications before allowing him to even order the xrays.

From then on, he was warned I was going to question everything he did and he acted accordingly, often joking in a slightly defensive way, "are you going to sue me?" Sure, this didn't keep 'know nothing nurse assistants" from trying to treat me without even knowing which leg was injured.

I even managed my own "transfers" from gurney to bed, to operating room table etc. as it was very painful and I could accomplish it with less discomfort than well meaning but unknowing hospital staff.

I questioned every pill, injection and service rendered and if I didn't fully understand what it was and why it was being given and ordered by whom, it didn't happen until I did. I consider this assumption of responsibility for my own care a must. As a result, my complaints about care received is more to express incredulity rather than complaints about what I allowed to happen to me.

Of course, if delivered to the emergency room in a coma, little can be done about your care until you awaken, but such cases are rare. Being responsible for my own health care includes not riding motorcycles, by the way. Being disabled with a leg injury, that is a daily risk on a motorcycle, for over a year, did not cause me to be any more aware. Seeing the aftermath of motorcycle accidents for years in the West did not cure me of the desire to ride one, only the motivation to act on it. By the way, most motorcycle accidents are caused by the drivers of automobiles, IMHO.

Thais are great at telling you something is not possible just to avoid having to do it, so don't take no for an answer until your sure of the facts. A daily detailed hospital bill is certainly in order if requested, but that didn't stop one staffer from telling me it wasn't possible, until I got a supervisor involved and three hours later, the impossible became reality.

All of the foregoing is done politely and firmly and with an sureness of purpose that belies any belief that you can be persuaded otherwise. With the internet, one can check on almost any medical issue and can educate yourself to a point that you can ensure you get the proper treatment. I even have the doctor order extra blood tests to make sure I have a full panel due to meds I take on a regular basis that are unrelated to a femur fracture, but could affect healing, such as low potassium from diuretics for blood pressure control, etc.

I have noticed that many Thai doctors are modeled after the 30 year old U.S. model of clinician that looked at you like you are a specimen and have no clue what bedside manner means. Just a bigger challenge to turn such a doctor around and get them to give your the proper medical service or change doctors. Usually, the doctor will change of their own volition.

Years ago, I drew a Chinese physician at a U.S. HMO clinic who asked me in the middle of a digital prostate exam if I minded that a woman doctor was performing the procedure.

My answer was, "I don't mind you being a woman, I just mind you taking so XXXXXX long". She replied that her fingers were short so she had to take more time to be thorough.

On leaving the exam room and passing the nursing desk I refered to the examing Chinese doctor as "short fingers Wu", a nickname that caught on and sure enough, I was transferred to a male doctor for the balance of my treatment at that facility for a number of years.

A good post - but maybe I just think so because you sound a lot like me. Two things came to mind while reading your post: 1. I always get daily detailed accounting and question whatever I don't understand - I have saved thousands of baht by doing so. 2. My partner had an op, surgeon came to tell me that nurses said he was bleeding too much post-op and needed blood transfusion. I said no way until I had seen the dressings and the operation site. Surgeon went away and came back to tell me nurses were talking nonsense. But all this checking is hard to do for the average non-medical person!

[Sheryl]

Addendum - for ProThaiExpat:

Forgot to agg one other major cause of poor bone healing: steroids. If you have been on any in past few years, could explain it. So can certain other medications...and a number of medical conditions.

[ProThaiExpat]

Well put Sheryl. Second guessing an experience is very much like doing the same just after taking an exam, rarely productive.

The startling contrast between the non-union over 8 months and the 3 month post last surgery to full weight bearing is probably what you are pointing to. What was it about the first healing period and the last one that was so different.

Most web pages say failure to heal in long bone fractures is because of poor blood supply to the fracture site. I at first felt that the second operation to stop the bleed or ooze may have hindered the formation of blood clots so important to the initial healing of the bone. But then again, the fracture was not a clean brake and the doctor ended up putting a pin in near the femoral head so I suspect the comminuted nature of the fracture put quite a strain on the blood supply and I am not spring chicken to say the least. Age is a very big factor but with a three month healing period the last time, right on the norm, I just can't come up with any major factor that was different except the second surgery to stop the bleed except for the fact that there was a bone graft from surgery number three and two bags of bone graft material in surgery number four (plate replacement) that was the big difference in my mind. Of course the doctor didn't respond when I suggested in the future that stuffing fractures in oldsters with allograft material might be a safeguard against non-unions but I haven't seen any literature to support this approach. Certainly, an earlier call on the non-union, on hindsight, may have been in order but those calls are more art than science.

Overall, I really can't fault what happened to me and when you hear or read about so many bad results with hospital borne infections, surgical infections of the bone, etc. I consider myself fortunate to have come out of it so well considering I have only myself to blame for being careless on the ladder that started it all. My first broken bone so was not forewarned. A pediatric orthopedist once told me that you only have to get kids bones in the same room to get a good result and that just deteriorates as once gets older. In addition to smoking and drinking, which I do not do, the other major risk factor in long bone fractures is age.

[Sakeopete]

I was quite surprised to learn that the national average for hospital contracted staph infections in Great Britain is over 30% these days. I bet it is not that high in good Thai hospitals.

My four operations last year in Thailand went fine with no infections, but then again the doctor ordered prophylactic antibiotics in hospital and for a week after discharge. I have heard the mantra about too many antibiotics being ordered around the world and the fears of antibiotic resistant strains for 40 years. Not impressed.

Those who care for their own health rarely are caused to use antibiotics with any frequency. A "phised" lady is in no condition to insure she gets proper medical care, her responsibility. I know there are many users of medical services in Thailand who are extremely passive when it comes to being responsible for getting good medical care, but become very agressive when they don't get it and start the complaining.

I blame the complaining individual when he doesn't get the care he feels he deserves. When I was lying on the gurney in the emergency room with a comminuted and displaced femoral fracture at Ram Hospital and in considerable discomfort, I still interviewed the doctor who came in to take over my treatment. Fortunately he spoke good English, was Thai board certified in Orthopedics and taught the subject at CMU Medical School. He had extensive foreign training and I satisfied myself of his qualifications before allowing him to even order the xrays.

From then on, he was warned I was going to question everything he did and he acted accordingly, often joking in a slightly defensive way, "are you going to sue me?" Sure, this didn't keep 'know nothing nurse assistants" from trying to treat me without even knowing which leg was injured.

I even managed my own "transfers" from gurney to bed, to operating room table etc. as it was very painful and I could accomplish it with less discomfort than well meaning but unknowing hospital staff.

I questioned every pill, injection and service rendered and if I didn't fully understand what it was and why it was being given and ordered by whom, it didn't happen until I did. I consider this assumption of responsibility for my own care a must. As a result, my complaints about care received is more to express incredulity rather than complaints about what I allowed to happen to me.

Of course, if delivered to the emergency room in a coma, little can be done about your care until you awaken, but such cases are rare. Being responsible for my own health care includes not riding motorcycles, by the way. Being disabled with a leg injury, that is a daily risk on a motorcycle, for over a year, did not cause me to be any more aware. Seeing the aftermath of motorcycle accidents for years in the West did not cure me of the desire to ride one, only the motivation to act on it. By the way, most motorcycle accidents are caused by the drivers of automobiles, IMHO.

Thais are great at telling you something is not possible just to avoid having to do it, so don't take no for an answer until your sure of the facts. A daily detailed hospital bill is certainly in order if requested, but that didn't stop one staffer from telling me it wasn't possible, until I got a supervisor involved and three hours later, the impossible became reality.

All of the foregoing is done politely and firmly and with an sureness of purpose that belies any belief that you can be persuaded otherwise. With the internet, one can check on almost any medical issue and can educate yourself to a point that you can ensure you get the proper treatment. I even have the doctor order extra blood tests to make sure I have a full panel due to meds I take on a regular basis that are unrelated to a femur fracture, but could affect healing, such as low potassium from diuretics for blood pressure control, etc.

I have noticed that many Thai doctors are modeled after the 30 year old U.S. model of clinician that looked at you like you are a specimen and have no clue what bedside manner means. Just a bigger challenge to turn such a doctor around and get them to give your the proper medical service or change doctors. Usually, the doctor will change of their own volition.

Years ago, I drew a Chinese physician at a U.S. HMO clinic who asked me in the middle of a digital prostate exam if I minded that a woman doctor was performing the procedure.

My answer was, "I don't mind you being a woman, I just mind you taking so XXXXXX long". She replied that her fingers were short so she had to take more time to be thorough.

On leaving the exam room and passing the nursing desk I refered to the examing Chinese doctor as "short fingers Wu", a nickname that caught on and sure enough, I was transferred to a male doctor for the balance of my treatment at that facility for a number of years.

How would you know what infection rates are in Thailand, cover up (save face) is the norm in Thailand and most of SEA. Its easy to criticize the west because problems are actually disclosed and not hidden for the most part. Do you honestly think that deaths due to malpractice or infections are reported? Only rarely does that happen when a financial agreement isn't reached with the next of kin. That sometimes works for the middle class but you can bet the rural poor are showed the door.