Copd

[banK]

Hi All

I have a friend, who, over the past couple of years has developed this illness or rather it came to the fore with a bacteria in the lungs. Since then he has been in and out of the Khon Kaen Ram hospital, each time for a stay of about a week or so incurring costs of about 100 000 baht each time - its not so much the cost of the room but the medication involved each time.

He was also diagnosed with diabetes when he had a particularly bad episode about a year ago. He then had a problem with his feet getting swollen.

About a month ago he had a problem with his heart shortly after getting home after a few days from the hospital (Khon Kaen Ram). This due to drinking cold water and the shock of it apparently sent the heart into spasms, he was admitted to the local town hospital.

After discharge he traveled to Bangkok to see a specialist about his diabetes - Advice, tablets and insulin brought the diabetes to predictable norms, whereas before the blood sugar levels were all over the place for no particular reason, sometimes within the good range 80 - 130 and others up in the 200s.

As for the swollen feet, a specialist prescribed tablets which got rid of the swelling. Eventually, the swelling came back, the advice then from a different doctor was rest and the swelling will go away, however, it did not.

About 10 days ago he went to see a specialist for his COPD at the Khon Kaen Ram because his breathing was difficult and he suspected he had caught an infection, the specialist was not there but was seen by we presume was a GP. He prescribed a course of antibiotics which were different from the previous ones. After 3 days his breathing was really difficult even though he has an oxygen machine and the inhalers.

He returned to the hospital where they admitted him and was told that the course of antibiotics prescribed by the GP were completely the opposite of what was required -they may have countered the infection but they closed the bronchial tubes , so no wonder about the difficulty of breathing. He was told that at the first sign of an infection he should come to the hospital - it was only 3 days before that he was prescribed these antibiotics by the hospital, so you would think that all was ok and that maybe it takes a day or two for the antibiotics to do their work - as I say because of the difficulty of breathing he returned to the hospital. They have access to his medical files for the past couple of years but this mistake is made.

For the swollen feet they drained the water from them and has improved that.

He has been diagnosed with the infection that he originally had which was a bad one.

After 6 days and a bill of 100 000 baht so far he has lost confidence in the Khon Kaen Ram. 1 - The medical knowledge doesn't seem all it should be (although some specialists know what they are about), but it seems hit or miss on most occasions. 2 - The costs seem to be way above what they should be.

So after the explanation the question is: Is there a good reliable hospital at a reasonable price for the above. I would think, but do not know, that a hospital in Bangkok would fit the bill (so to speak!).

Thanks for your attention and any advice would be gratefully received.

By the way he is a Frenchman so his English is not so good and is 63 years old.

Bank

[Sheryl]

The best hospital in your area is the government hospital affiliated with Khon Kaen (Srinagarind). It is a major regional ans teaching hospital and will have the best specialists to be found in the NE. And needless to say, costs will be much, much lower than at Ram.

The main problem will be language, most of the doctors will have some English but not the nursing and administrative staff. the process of registering and getting to see a specialist can be quite confusing and all the signs, forms etc are in Thai. Try to have a Thai go with him at least the first time. Once he knows the system and has appointments set up it will be easier.

in an emergency it is actually much easier than outpatient care, just present at the ER and usually the patient's condition speaks for itself, especially with something like COPD.

COPD is a chronic disease as of course is diabetes, and lijkely to worsen over time, so it is essential her get under the care of competent specialists,. he should not, ever, go to private doctors or small local hospitals -- wrong treatment is the usual outcome.

this is the hospital's website http://hospital.md.kku.ac.th/ -- all in Thai, unfortunately.

They will probably have a special clinic just for COPD, and also for diabetes.

[FBN]

Underlying congestive heart failure must be ruled out asap. Swelling of feet combined with difficulty in breathing on top of underlying COPD is highly suspicious of heart failure.

This may also account for the blood sugars going out of control. How did they "drain" the water from his feet?

[banK]

Hi FBN The hospital did an ECG and one doctor said his heart was ok. Then along comes the specialist and said that strain on his heart was too much. They drained his feet with injections and tablets.

Hi Sheryl Tks for the info and have passed it on to his Thai wife. She said that they inquired there some time ago and that the waiting list was long and a waiting list for private rooms. However, do you have a telephone number for the Hospital that I could pass on?

Thankyou both for your replies

banK

[Sheryl]

i don't, perhaops some of our readers from Isaan will. I'm sure it is somewhere ion the website I gave you, but i don't read Thai well enough to find it.

[banK]

Hi Sheryl

Yes managed to search website and found number.

Thank you

banK