Isan Major Hostpitals? Udon Thani/Kon Kaen? - Kidney Specialists?

[saanya]

My wife has been suffering a kidney condition, and staying at the local hospital where we live for 12 days on an IV just seems to be profiting the local hospital and not fixing her condition.

The general doctor has little to offer, obviously.

I would like to take her to one of the major cities either Udon or Kon Kaen, and get her an MRI, as well as on track with the proper medical treatment.

She will likely lose a kidney, but it's better than losing her life over it.

Any serious recommendations are truly appreciated.

Note and Warning: This post is serious, comments offering debate or foolish wisdom won't be appreciated, nor will jaded criticisms of the medical care here.

We know where we are, we know where we live.  We know what to expect.

With that, any advice or insight you have have could help save us and perhaps someone else some heartache and lost days and nights.

-saanya

Edited July 3, 2010 by saanya

[jazzbo]

I would call Khon Kaen Ram and ask for their Renal Clinic hours to start: 0-4333-3800

[KhunBENQ]

I would call Khon Kaen Ram and ask for their Renal Clinic hours to start: 0-4333-3800

Sounds like good advice. Some good reports to find about Khon Kaen Ram. Sri Nakharin seems second best at most.

Adress of KK Ram is 193 Srichan Road

http://www.khonkaenram.com/EN/index.html

[TerryLH]

Actually, Srinakarin Hospital is the regional hospital and usually accepted as being very good.

It's a teaching hospital associated with KKU.

Many of the specialists work part time at Ram and other private hospitals because their real gig is at Srinakarin.

If you look at the ICU's or surgery rooms of any of the private hospitals in KK, and compare them with either Srinakarin or Khon Kaen Hospital,

it's like day and night with the two government hospitals coming out on top.

I've used all three for different reasons, and would use them again.

for a major problem though, I'd head for Srinakarin.

[gregb]

If your wife is Thai, go to Srinakarin. As a general rule, any hospital associated with a university is going to be your best bet for quality of care and number of eyes studying her condition. As Terry explains above, teaching hospitals in Thailand truly are some of the best. Some are better than others of course. If you wanted to head all the way to Bangkok I would say Siriraj or Chulalongkorn would be excellent choices.

The reason you might want to choose Ram instead is if your wife needs care by an English speaking staff, or you wish to have a little more Western "feel" when you visit. Thai government hospitals cater to Thais. If you want to ask hundreds of questions and have everything about her care explained to you in English then it may be worth considering Ram instead. Most doctors at Srinakarin will speak some English, but not the staff. That is one thing you can not get at the government hospitals.

But as has been mentioned before, most doctors split their time between both hospitals and their own private clinics. So I would not worry too much about the competency of the doctor, but only the resources of the hospital he has available to him while performing his duty.

[citizen33]

but only the resources of the hospital he has available to him while performing his duty.

...Which are very much better at Srinakarin.

[saanya]

This is what I was hoping for, and what I think the real value of a resource like Thaivisa is.

Thanks a lot for the advice gregb, TerryLH, citizen33, khunBENQ, jazzbo.

It's good to hear because it gibes with exactly what my wife said, but was slightly lost in translation.

The info regarding the nature of each hospital is especially valuable, I'm a former combat medic myself, and it's exactly the stuff I was looking to find out.

She mentioned Sri Nakharin, and I had her read what you all wrote, so now we have a much better plan.

I am lucky she's as educated as she is, it's allowed for us to plan what do to in an effective manner.

Thanks again, I'll report here the specific information about the depts and perhaps names & numbers where relevant.

-saanya

[TerryLH]

"The reason you might want to choose Ram instead is if your wife needs care by an English speaking staff, or you wish to have a little more Western "feel" when you visit"

That might be true in Bangkok, but it's certainly not at KK Ram.

As mentioned, doctors usually can communicate in English, to varying degrees.

The same does not hold true for nurses or other staff, at least not as a general rule.

KK Ram used to have a foreigner on staff to liason with foreign patients.

I know that guy left, and I don't know if they have replaced him.

Good luck to your wife whichever way you decide to go.

[wales01]

Srinakarind is the right place for her, if you talking about nephrectomy.

You can even get the MRI done at the MRI center in KK.

Good Luck to you wife.

[saanya]

Is there a name for the MRI Center? I'd like to contact them as well in sort of prep for our visit.

I would also like to search out temporary housing just in case we end up having to stay for an extended time.

I think based on what's been written, and my wife's opinion, Srinakarind would be a first stop.

I have studied Thai for a long time as well and even though medical terms are hard to understand, I have enough vocabulary to work through it.

Anything beats the options we have in Nong Khai, which are limited to a large extent.

This all appears to have started with her taking medication for migraines, which did damage to one of her kidneys.

We made the mistake of her taking an Ibuprofin a few days ago and that hurt her for hours, and prompted an in depth discussion to make a plan to go to Kon Kaen and take care of this.

[jazzbo]

Srinagarind is of course an excellent facility; it also can have the ambiance of MoChit bus terminal during SongKran...

[saanya]

well, we went to Kon Kaen Ram, and initially were impressed, the staff took us in quickly and had her in an ultrasound room within the hour. after urine, blood tests, and ultrasound, she was admitted, we paid for a single room, and were also impressed by the level of service.

But, it seems like the General doctor really could not make any headway, and was sort of obtuse as to our insistence on getting a specialist.

We reinterated that was the purpose of our visit in the first place, and some of this difficulty I can chalk up to my wife's insistence that it's OK to just show up places without an appointment, as when she called Kon Kaen Ram they assured her she could just show up.

My instinct says that put us into a normal triage, where really, we could have skipped soe of it, and moved on to a specialist.

Unfortunately, the specialist actually is based out of Sri Nakharin. And missed his first stop with us, causing us to stay another day.

When we voiced irritation at being made to just wait under no guarantee the fellow would show up, he spontaneously appeared, and gave a very short exam.

We had a CT scan done of the area affected as well, her right side lower abdomen, as well as the left.

They said everything "seemed normal" even though the english language readout on the CT scan said it "revealed a lesion perhaps due to a __(drained/damaged?)__vein. I asked that we get copies of all the paperwork and my wife said that would be impossible, but I think it's normal to get such paperwork, or copies of it, to be able to bring it around throughout the course of the diagnostic phase.

They kept acting like nothing really was wrong, but she's been in severe pain, and had other doctors swear up and down she has a kidney condition, and not that it's affecting her bladder and urinary tract.

We finally got an appointment with the Urologist to run some kind of scope into her urinary tract to see more what might be amiss, as well as another appointment for her to drink some barium and have her colon scanned.

She's got blood in her urine now, which was never there.

The two issues she has seem related, she always knew she had a kidney issue for the last 5 years, but now a new issue over the last year crept up, a persistent pain in her side, right above her pelvis.

When you look at medical drawings, this is right where the urinary tract passes by under the affected kidney. But she says you can feel the swelling and perhaps even something more.

Could this be colon cancer forming? We want to rule it out, thus the barium drink/scan, I don't know if it's an Xray or what kind of scan.

My feeling though is that the doctors appear pretty clueless and almost in denial. This is what makes me think cancer.

I'm not sure why, but they seem to really deny anything is out of the ordinary, they said her left kidney was the one that was swollen, even though it's her right side kidney and abdomen where all the pain is. When asked to explain this, they could not.

She says if we go to Sri Nakharin we will be made to wait endlessly because it's a govt facility. I don't care about waiting, I care about a solution.

I actually got irritated at one point and asked if this being a private hospital (Kon Kaen Ram) meant we had access to just about any specialist or procedure without having to wait long, and the staff all seemed to catch on, and looked at the doctor knowingly. Basically, the culture that pervades govt work doesn't fly well at a private venue. You could see in their eyes that these nurses knew the ins and outs of why these doctors from Sri Nakharin coming into Kon Kaen Ram operate the way they do. They (the doctors) expect a typical Thai to be used to being told to wait, that every-thing's OK, and just to take some pills.

And, if the patient insists something really is wrong, all that's prescribed is some IV treatment for a few nights and some more meds. After a while the patient will get sick of laying around and go home, basically undiagnosed as to the real issue, with zero paperwork.

Back home I can almost predict what would happen. They'd request the records from the other past facilities and doctors, see the history of kidney issues, and recommend appropriate treatments.

Is it wise to simply switch over to Sri Nakharin and find someone who won't just say "everything seems ok"? How could a woman who's had a 7 year history of a problem basically be told "nothing seems wrong"? We spent 32,000 baht.

The general practitioner seemed to wear the same clothes everyday without changing, and it seemed like we really had to get on his case for the 5 minutes a day he'd show up that we were serious about seeing a specialist. Was he just holding onto commission or something? He couldn't even read the CT scan paperwork in English and contradicted it saying something was "abnormal" by saying "it's ok, that's normal, no problem".

I wouldn't normally write this much, but after 3 days in a relative fog with them, we fell it's reayy just the couple MD's we saw that seemed to be lacking, the facility and service itself were top notch. When we requested the CT scan, they had her in and out of there in an hour, and had it scheduled two hours after we requested it.

I really like their service model, but could it be that the few MD's who work there have not the vision or depth of expertise to really get my wife past the preliminary triage phase toward some level of in depth diagnosis and treatment?

It almost seems like we should skip Sri Nakharin and try Bangkok or even exit the country, or at least start tapping the social network of other patients in country who can elaborate on their experiences and what to do.

We will pay the taxi fare to go back in two weeks, first to KK Ram for the urology exam, and then perhaps consider a visit to Sri Nakharin.

My wife has agreed from now on to not follow her Thai instinct to not schedule things, agreed we should research, contact by phone in advance, and make and keep appointments, from here on out.

Our failed trip this last time to uncover the problem may well have to do with the system itself not being equipped for rapid response to such issues. 3 days and 2 nights might have seemed like a lot to us, but to them that might have been barely enough time. ok, time to stop writing, thanks for any advice. Time to research how we can get copies of her records form the last visit, I need to at least make a list of the tsts done so far and get a copy of the CT scan that told of the lesion.