Just some medical costs

[bunnydrops]

I am in my late 60s and don't even get colds for years at a time. But in the last month I have been hit with the "getting older" stick. So I just want to pass along some of my "cost" experience.

First, out of nowhere, I get a bunch of "eye flooders" in my right eye. Reading on the internet that it might be a sign of something important, I call around to find someone to look at it, It seemed to be a holiday for them since everywhere I called, they were not in. Then Sheryl here on the forum told me to try Bangkok Hospital (Thanks Sheryl). Sure enough the doc was in so I drove the 100km to Korat. Got to see him right away. Took a look, said come back if it gets fussy. cost 600bt. The next day my wife had an appointment at the soldier hospital While I was there I decided to see if I could get a second opinion. Got checked for glaucoma, had the inside of both eyes photographed and had the doc take a look. Cost 50bt.

A week later I wake up with intense pain under my right rib. I go to Ruamphat for ultrasound. They find nothing, give me meds for peptic ulcer. Cost meds ,ultrasound and doc 1900bt.

I go home and have another attack, very painful. Go to St Mary, Get MRI, Gallstones, quoted price of surgery laparoscopically 200,000 bt. I go home to think that one over.

Two days later another, this one brings me to tears after 6 straight hrs of pain. Wife's brother drives me to ER at the soldier hospital at 2 in the morning, given intravenous pain medication and see the doc on duty (English spoken). Cost 700bt including the Tramadol (WOW, do they work!!).

Next day back to the soldier hospital, see the doc, get blood work, another ultrasound, and chest x-ray. Ultrasound finds multiple stones, one 8cm. Quoted price for all that has been done, the laparoscopic surgery and 3 days in hospital, private room 40,000bt. I go in Monday--wish me luck

[FiftyTwo]

Gallbladder doesn't need to be removed unless chronic problem over several years.

Infected GB is dangerous if untreated as the first (and second?) hospital did, intense pain under right rib is a dead give away.

Easily confirmed by competent ultrasound operator, MRI pointless. The pain won't go away without treatment.

Which is why the first two hospital visits solved nothing.

Usual treatment, intravenous anti-biotic and pain killers, saline+glucose drip, for a couple of days.

Doctors in Thailand are very quick to advise removal for some reason.

Can be avoided by diet and lifestyle changes.

Less meat and fatty foods, no fried foods or sugar, regular exercise and weight loss if overweight.

Tramadol available over the counter in any chemist, about 40bht for 10.

You can't have sex within 24hrs if you take Tramadol though.

Good luck if you have the operation.

60% of people with this painful condition, if treated correctly, it never recurs.

Edited October 3, 2013 by FiftyTwo

[bunnydrops]

Oh I forgot the cost of the MRI 10,100bt, Done at the government hospital, 8000 for the government, 2100 to St. Mary

[bunnydrops]

Gallbladder doesn't need to be removed unless chronic problem over years.

Usual treatment, intravenous anti-biotic and pain killers, saline+glucose drip, for a couple of days.

Can be avoided by diet and lifestyle changes.

Less meat and fatty foods, no fried foods or sugar, regular exercise and weight loss if overweight.

Doctors are very quick to advise removal for some reason.

Tramadol available over the counter in any chemist, about 40bht for 10.

You can't have sex within 24hrs if you take Tramadol though.

Good luck if you have the operation.

I have been having an attack almost everyday for over two weeks, each lasting from 6 to 10 hours. Without the Tramadol the pain is at the point I would just rather die. I'm not over weight, don't eat much meat. Believe me, I would rather not be cut into.

[Sceptict11]

"You can't have sex within 24hrs if you take Tramadol though."

Why?

[FiftyTwo]

I have been having an attack almost everyday for over two weeks, each lasting from 6 to 10 hours. Without the Tramadol the pain is at the point I would just rather die. I'm not over weight, don't eat much meat. Believe me, I would rather not be cut into.

I understand, but you haven't been treated yet, as far as I can see.

The pain of a gallbladder infection this severe doesn't go away without a strong course of anti-biotic in a hospital bed for a couple a days. You should have been in a hospital bed on drugs within 6 hours of the first attack.

Correct treatment would have likely cured it right away, but not always.

By now you probably have a necrotic gallbladder and removal is their only choice.

http://health.nytimes.com/health/guides/disease/acute-cholecystitis-gallstones/prognosis.html

"If antibiotics are administered immediately, the infection clears up in 75% of patients. If cholangitis does not improve, the infection may spread and become life-threatening. Either surgery or a procedure known as endoscopic sphincterotomy is required to open and drain the ducts."

Edited October 3, 2013 by FiftyTwo

[Sceptict11]

bunnydrops The treatment you have recieved and that which is planned is fine ! No need for concern.

Sad how often scaremongering posts are made. I guess as a result of ignorance and the over use of Google.

The pain associated with Bilary Colic rarely requires hospitalization and does not require a "strong course of anti-biotic" (whatever that means).

The vast majority of patients will recover from a bout of bilary colic with the help of analgesia +/- an anti-spasmodic.

Repeated episodes of bilary colic are best treated by elective cholestectomy.

Some rare cases (which are relatively easy to identify) will require urgent surgery. Ultrsound +/- CT or MRI scanning are both useful tools for identifying these cases

To suggest someone is walking about with necrotic gall bladder is of course barking nonsense !

[Sceptict11]

Whoops !

Apologies

For cholestectomy please read Cholecystectomy

[FiftyTwo]

The pain associated with Bilary Colic rarely requires hospitalization and does not require a "strong course of anti-biotic" (whatever that means).

The vast majority of patients will recover from a bout of bilary colic with the help of analgesia +/- an anti-spasmodic.

Repeated episodes of bilary colic are best treated by elective cholestectomy.

Some rare cases (which are relatively easy to identify) will require urgent surgery. Ultrsound +/- CT or MRI scanning are both useful tools for identifying these cases

To suggest someone is walking about with necrotic gall bladder is of course barking nonsense !

Severe pain every day for two weeks sounds slightly more serious than a 'bout of bilary colic'.

Repeated episodes, are usually considered repeated over years, not repeated over days.

If it 'rarely requires hospitalisation', maybe you can tell us why the OP has been booked into hospital?

Edited October 3, 2013 by FiftyTwo

[Sceptict11]

The pain associated with Bilary Colic rarely requires hospitalization and does not require a "strong course of anti-biotic" (whatever that means).

The vast majority of patients will recover from a bout of bilary colic with the help of analgesia +/- an anti-spasmodic.

Repeated episodes of bilary colic are best treated by elective cholestectomy.

Some rare cases (which are relatively easy to identify) will require urgent surgery. Ultrsound +/- CT or MRI scanning are both useful tools for identifying these cases

To suggest someone is walking about with necrotic gall bladder is of course barking nonsense !

Severe pain every day for two weeks sounds slightly more serious than a 'bout of bilary colic'.

Repeated episodes, are usually considered repeated over years, not repeated over days.

If it 'rarely requires hospitalisation', maybe you can tell us why the OP has been booked into hospital?

If you read the OP's post ....................

"Quoted price for all that has been done, the laparoscopic surgery and 3 days in hospital, private room 40,000bt. I go in Monday--wish me luck "

He actually does tell us why !

[Sheryl]

There are circumstances under which hospitalization and surgery are indicated for acute cholecysitits (inflammation of the gallbladder). We hardly know enough about OP's case to be second-guessing his doctors. So how about we all just wish him well?

The quality of care in military hospitals is usually quite good so you ought to be in good hands. Take care.

[bunnydrops]

Thanks all for your replies.

My intent for this post was to show some of the costs here in Thailand. Back in the states I had to pay $500 (15000bt) a month with a $2500 (75,000bt ) deductible. Being healthy for many years, I had no idea of the costs here in Thailand. I see many my age questioning about getting insurance. I thought giving some examples of cost out of pocket for fellow farang may be of some help.

[Sheryl]

Bear in mind that the costs you mention are in conjunction with a simple outpatient consultation and now a very routine surgical procedure.

In catastrophic situations (e.g. heart attack, stroke, massive trauma from an accident - multiple major specialized surgeries, long ICU stay etc) costs even at government hospitals will easily exceed a million baht. That's why insurance is important.

I just renewed my own policy and believe me, I wouldn't have bothered (and it would not have made financial sense) if I believed all I was ever going to need would be common general surgery. But none of us have the assurrance. Any one of us could be the victim of a major accident, or have a stroke, heart attack etc and these are very different matters.