A Good Endocrinologist In Bangkok?+Is It Possible To Get Records Sent Over From The Uk?

[bobtailkitten]

Hi all

So i'm not sure if this has been asked before but here goes...

Like the title says I am looking for a decent endocrinologist in Bangkok, one that will actually listen and try to help me solve my problem.

I have a Prolactinoma and I think it needs treatment/medication. The docs in the UK said my prolactin levels were not high enough for medication at the time, but from what I have read and heard from others it is way above normal and I wished I had seeked a second opinion at the time.

It is affecting my health and I am getting run down a lot, aswell as difficulty to lose weight,I eat healthy and run/exercise 4 days a week twice a day).

I am going to get a blood test to check and see if I am anaemic as I have a lot of side effects of that too...pale, run down/lethargic, hair falling out, feeling itchy, headaches, mouth ulcers and stys constantly. But I am also going to check the hormone levels for my prolactin.

I know from tests in the UK I have a Prolactinoma as I have had an MRI scan before. The problem is when you go to the doctors here they seem to want to go through all the same procedures although I can happily tell them I have this issue,(maybe they don't believe and they need proof I don't know). I can't afford to pay for the MRI which I think is around 15thou bhat or justify paying for it. As it is a pre-existing condition my insurance will not cover it.

Because of my situation/reponsibilties here I cannot simply return home and wait around on the NHS to see specialists etc. So anyway my question is has anyone had any records sent over from the UK? will the NHS do this? surely it is my right to the records due to the data protection act? or am I being completely ignorant and stupid here?

I don't mind to pay for a good specialist here, I just can't see why I should pay for and go through unneccesary tests which have already been done.

I really appreciate any help/comments and experiences.

Thanks

[jrtmedic]

Your problem is one of convincing (from a distance) the UK authorities of who you are !

If you are well known to your GP or a UK based endocrinologist they may be prepared to release your documentation against say a copy of your passport data page accompanied by your NHS /Hospital number. There may be a fee associated with retrieving/copying/posting your records.

As you know your condition is rare and associated with a benign growth of the pituitary gland.

The symptoms you describe are not commonly associated with a Prolactinoma.

You could however seek to have a "health screen" here and ask for your prolactine level and thyroid function to be undertaken in addition to the usual full blood count etc.

If your prolactin levels are indeed outside normal limits it may be difficult to avoid another MRI Scan. As you will know in the UK serial MRIs are undertaken to monitor the size of the pituitary growth and also to monitor the effect of treatment.

Treatment is available for Prolactinoma in the form of medication and in very rare instances surgery may be indicated.

Medication is however, not without side effects and I would be surprised if you found an endocrinologist of repute who would be prepared to treat you "blind" without the benefit of a full and current set of investigations including an MRI.

I do of course wish you well and hope my long (sorry!) response is of assistance.

Others maybe able to guide you toward an appropriate specialist.

Edited June 8, 2013 by jrtmedic

[Sheryl]

Suggested specialists:

http://www.bumrungrad.com/doctors/Sarat-Sunthornyothin

http://www.bumrungrad.com/doctors/Sathit-Vannasaeng

If you do need a repeat MRI (and unless the last one was recent and you get a copy, you probably will), don't get it at Bumrungrad, go to:

http://www.mrithailand.com/e_index.html

Will be less expensive. In your case would likely need contrast to be used, but ask the doctor.

You do have an absolute right to your medical records the problem will be the logistics of getting them given that you are unable to appear in person with ID to collect them. Since a repeat MRI will be needed in any case if it has been some time since the last one, you might do just as well to go ahead and get it unless last MRI is pretty recent.

As jrtmedic said, some of the smptoms you complain of are not likely to be related to your prolactinoma so a thorough physical check up would be a good idea.

[bobtailkitten]

Hi

Thanks for your helpful responses.

I know that weight gain can sometimes be an issue with a prolactinoma but not sure of other side effects. I have tried to read up on it but some of the information is contradictory and I am not sure what is correct.

I was going to go to Bumrungrad as a friend of mine said they are good with checking blood etc but I will have a look at the other link in a moment, did you go to the other hospital? It has been some time since I had my MRI i'd imagine maybe 3 or 4 years! so I expect they would ask me to repeat from what you are saying.

I have had these issues in the UK but they seem to be magnified out here and I also think I am missing some vital things from my diet as I am living on the thai diet of rice, chicken/pork and fried veg eeek.

What does a 'health screening' involve? and the costs of one?

Thank you

[bobtailkitten]

Sorry, also what do you mean by contrast on the MRI scan? and would another hospital be happy for me to do the MRI scan somewhere else? I know they would push for me to get it done with them. Also any experiences with Yanhee hospital? does anyone know if it is any good as it is the closest one to me that is reputable as far as I am aware...I am in salaya near nakhom pathom

[Sheryl]

The "other hospital" is just an imaging place, not a hospital. You can save several thousand baht (maybe 5-6K) by going there for MRI rather than having it done at Bumrungrad if you don't mind the extra trip.

As it has been years since your MRI you are going to have to repeat it regardless so maybe not worth hassling with the NHS over this. Just tell the doctor your history and then get the repeat MRI as well as prolactin level;. You might be able to get the prolactin level first before seeing the doctor as part of a check-up package.

Look art the websites of the various hospitals (Bumrungrad, BNH, Bangkok Hospiyal, Samitivej, St Louis, Phyathai, Vejthani etc), they all list check up packages and prices. The prolactin won't be part of any package but can be added on.

How extensive a check up package you should get will depend on your age, family history, gender etc. All of them would include a full blood count, fasting blood sugar,liver enzymes, and usually creatnine (kidney function). Sometimes the most basic does not include triglycerides and HDL/LDL cholesterol which you do need if you are middle aged or older or if you have any history of elevated lipids.

Regardless, in addition to adding on prolactin, add on a thyroid panel given your specific complaints. Make it a full panel i.e. TSH, T3, T4 not just TSH.

I would also suggest you start taking a good Vitamin supplement. Mouth ulcers can be due to certain B vitamin deficiencies (or even lack of Vit C). And try to eat better. Fresh fruit and lots of veggies.