Appendix

[prakhonchai nick]

I took my wife to the hospital recently, as she was suffering stomach pains, in the area of the appendix. I went in with her to see the Doctor, and told him I thought she may have appendicitis.

He looked through her records, saw that she had given birth twice with caesarean section, and suggested that it was highly likely that the appendix was automatically removed at that time. He said he would check. However some half hour later my wife was shown into another Doctor, who made no comment on its possible previous removal, but said she did not have appendicitis.

Having now spoken with various locals, most confirm that removal of the appendix when giving birth by caesarean section is quite normal.

I wonder how this can be possible. Whilst I understand the appendix has no useful purpose, and it clearly makes sense (and saves money) to remove it when the stomach is open, I am more than annoyed that this procedure is carried out without any pre-consultation, or authority being given.

I would be interested to hear the views of anybody else who has been similarly operated upon.

[tim armstrong]

I took my wife to the hospital recently, as she was suffering stomach pains, in the area of the appendix. I went in with her to see the Doctor, and told him I thought she may have appendicitis.

He looked through her records, saw that she had given birth twice with caesarean section, and suggested that it was highly likely that the appendix was automatically removed at that time. He said he would check. However some half hour later my wife was shown into another Doctor, who made no comment on its possible previous removal, but said she did not have appendicitis.

Having now spoken with various locals, most confirm that removal of the appendix when giving birth by caesarean section is quite normal.

I wonder how this can be possible. Whilst I understand the appendix has no useful purpose, and it clearly makes sense (and saves money) to remove it when the stomach is open, I am more than annoyed that this procedure is carried out without any pre-consultation, or authority being given.

I would be interested to hear the views of anybody else who has been similarly operated upon.

It sounds a bit strange to me. I can only suggest that there may be some risk of infection by leaving it in. But agree -your wife should be informed. But also this is Thailand and mutual discussion of treatment options for anything between Thai doctor and Thai patient is a rare event. Maybe Sheryl can shed some light.

[bdenner]

A friends TW had her appendix removed at a major private hospital in Udon Thani during an operation on her bowls, the doctor saying he thought he was doing the right thing as the incissions were so close too it.

TiT I guess! - If it happened in the Western world the doctor and hospital would have had their <deleted> sued off em.

[Bagwan]

What is wrong with taking responsibility for one's own body? I have been forced to ruffle a few doctor's feathers by reminding them that I meeting with them on a consultative basis. I expect them to pay full attention to what I am saying to them, to seek clarification if they are not 100% sure what it is that I have said, or have made omissions, and to let me know what they think ails me and what they suggest is a suitable treatment. I believe in the power of the mind and knowing what is wrong with you is very often helpful in effecting a cure. The body usually cures itself, medications merely assist in the process. If, in the course of a consultation I am not satisfied with what I see, hear or feel, I thank the doctor for their time and pay the fee and then seek a second opinion - without mentioning recent history. Doctors bury their mistakes (and medical records mysteriously disappear) so don't even try suing one for negligence, in Thailand at least. Many hold that the most important thing to them is their health. Why put it at risk?

After complaining of aches in my lower abdomen one doctor told me, without investigation, that I was having too much sex and told me to stop masturbating! I laughed and told him that this was Pattaya and that he needed to get out more; furthermore I had been very happily married for 7 years. After consulting a GU specialist and undergoing tests I was told that I had BPH (Benign Prostatic Hyperplasia), a common ailment for men of my age. The first doctor told me, after a review of the results of a blood analysis, that my blood sugar was a little high. That will be the beer he said. I reminded him that I had told him that I was on a strict diet to lose 7 or 8 kilos and that all alcohol had been off my menu for the past three months. Another doctor told my wife that he wanted to suspend her antiviral treatments for six months (she is HIV positive). Sheer bloody madness according to the specialist whom we consulted for a second opinion who took the trouble, in our presence, to telephone the original doctor and roundly castigate him. Furthermore he changed her medication since that which she had been taking was now attacking her body rather that keeping the virus in check.

My experience has been that many male junior doctors are, to use a hackneyed phrase, pissed with power and arrogance. For minor ailments now I prefer seeing a female doctor, who I find, are both more careful and caring. For anything of a more consequential nature I prefer to use a doctor with experience of working in the First World. Bumrungrad gives the facility to provide an online check of the professional experience of the doctors that they employ and feel it would be no bad thing if other hospitals followed suit.

This post is not intended to come across as a rant although if it does, then so be it. I counsel care and watchfulness rather than treating doctors as minor Gods and nodding away like a toy dog in the back window of an Austin Allegro. A cursory search of this forum will show that many others share my disquiet regarding the effectiveness and provision of medical services in LoS.

[prakhonchai nick]

This post is not intended to come across as a rant although if it does, then so be it. rovision of medical services in LoS.

A rant indeed in my view, but nevertheless some very valid points, although quite irrelevant to the topic.

[FBN]

Appendicectomy is not usually performed at caesarians but commonly when hysterectomies are done. (western medicine, I do not have any reference for local Thai practices).

This should be included in the consent form and the patient is informed.

The rationale behind this is to remove a portential cause or reason for another laparotomy. Each time the abdomen is opened, it may lead to adhesions which may lead to bowel obstruction (another surgical emergency) later in life.