Medical question. I need a doctor for my 89 year old mom

[NCC1701A]

I need to get a doctor for my mom so we can get the medication she has been already prescribed in the USA for her in Thailand. Anybody know a good doctor in Bangkok that speaks English?

Here is what she needs.

Morphine Sulfate 15 mg.

Oxycodone 5 mg

Gabapentin 300 mg

Omeprazole 20 mg

Lisinopril 10 mg

Hydroxyzine HCL 25 mg

Ropinirole .25 mg

Ondansetizon 4 mg

Klor-com

Potassium Chloride

Oxybutynin 5 mg

Loperamide 2mg

Furosemide 20 mg

[harrry]

I think you will get a better answer if you post this in the Health Forum.

Sheryl there knows the full accurate information on all of them Some of which I know are available and some only in a hosptal and I think a couple not.

[NCC1701A]

yes, maybe the mods can move me over there...

[CharlieH]

I would pm Sheryl, a mine of information and always helpful.

[Sheryl]

Other than the first two drugs, all of these are available in Thailand without prescription (though you will need a large pharmacy to find some of them). Note that Klor-Con is potassium chloride so I think listed twice in error. In addition, while you can get all these meds, unless she will be going back home soon and under the care of a usual physician there, it would be wise to have her under medical supervision. Her potassium levels need to be checked periodically, for one thing.

Oxycodone is not available in Thailand. Morphine can only be gotten fro ma hospital pharmacy and Thai doctors are notoriously reluctant to prescribe it. (From the dosage I suspect it is a sustained release form of morphine. This is available here in 10 and 30mg dose, brand name MST Continus). So her pain regimen is going to have to be modified somewhat.

If she is going to be long term in Thailand then I suggest trying Dr. Nick Walters at Mission Hospital, he is an American doctor licensed in Thailand, specialty Family Medicine, and would be a good choice for her overall management. http://www.mission-hospital.org/index.php/en/component/sobipro/?task=search.results&sid=54

If she is just visiting and only needs a med refill then a pharmacy for all but the pain killers and a consultation with a pain management specialist, I have had good feedback on http://www.bangkokhospital.com/index.php?p=doctor_profile&DrID=960. Hopefully she has medical records with her certifying to her condition and need for morphine? If not try to get them as it may otherwise be a difficult.

[Thongkorn]

Most good doctors speak English in most Hospitals,

[NCC1701A]

Other than the first two drugs, all of these are available in Thailand without prescription (though you will need a large pharmacy to find some of them). Note that Klor-Con is potassium chloride so I think listed twice in error. In addition, while you can get all these meds, unless she will be going back home soon and under the care of a usual physician there, it would be wise to have her under medical supervision. Her potassium levels need to be checked periodically, for one thing.

Oxycodone is not available in Thailand. Morphine can only be gotten fro ma hospital pharmacy and Thai doctors are notoriously reluctant to prescribe it. (From the dosage I suspect it is a sustained release form of morphine. This is available here in 10 and 30mg dose, brand name MST Continus). So her pain regimen is going to have to be modified somewhat.

If she is going to be long term in Thailand then I suggest trying Dr. Nick Walters at Mission Hospital, he is an American doctor licensed in Thailand, specialty Family Medicine, and would be a good choice for her overall management. http://www.mission-hospital.org/index.php/en/component/sobipro/?task=search.results&sid=54

If she is just visiting and only needs a med refill then a pharmacy for all but the pain killers and a consultation with a pain management specialist, I have had good feedback on http://www.bangkokhospital.com/index.php?p=doctor_profile&DrID=960. Hopefully she has medical records with her certifying to her condition and need for morphine? If not try to get them as it may otherwise be a difficult.

Thank you so much Sheryl, this is great information.

[NancyL]

Oh my goodness, the OP also asked in another thread about how to arrange flights for his Mom from the west coast of the U.S. given that she uses oxygen.

I know it's none of my business, but given that I've assisted others who may be in the same situation as the OP's mom here in Thailand I really wonder if it's good idea to bring her here at this stage. Pain management in Thailand is at least one generation behind the U.S. and it's very difficult to access good pain management here without already having a good relationship with a primary care physician.

In the post asking about airline options, the OP said he found a placement for his mom in an assisted living facility. Given her meds, it seems more likely that she should be in a nursing home. I hope the OP has reviewed her medical needs with the care facility and has a back-up nursing care facility at the ready.

[Sheryl]

I did not realize she was not already in Thailand.

If she is in the US, I too strongly advise against bringing her to Thailand as she will not get adequate pain management and comfort measures here. Palliative care is more than 50 years behind the times. Add to that the culture shock and disorientation of being in a foreign environment and this is not at all in her interests.

[Sceptict11]

+1

Additionally ......................

All airlines will require that an elderly person who is oxygen dependent is certified, according to individual airline rules, as being "fit to fly".

The cost of meeting the airlines demands, which may include accompanying flight trained medical staff, and the purchase of "adequate" space , may prove to be VERY expensive.

The OP would be well advised to reconsider.

[harrry]

+1

Additionally ......................

All airlines will require that an elderly person who is oxygen dependent is certified, according to individual airline rules, as being "fit to fly".

The cost of meeting the airlines demands, which may include accompanying flight trained medical staff, and the purchase of "adequate" space , may prove to be VERY expensive.

The OP would be well advised to reconsider.

Actually not now true. New rules in the US prevent an airline flying under a US flight number or from or to a US airport stopping a person flying for medical reasons. The assesment of whether the person is fit to fly or not has been returned to the person flying. In regard to oxygen use they do require a prescription giving the quantityes required.

Other countries do not have the same rule and the some of Sceptic11's comments do apply.

If they deem an attendant is required they can require you to provide one but they cannot charge for him or her.

Though US Airlines are not the best at this having just been fined several million dollars for breaching this I will put the link from their site.

http://www.usairways.com/en-US/Resources/_downloads/traveltools/ACAA_14_CFR_part_382.pdf

Personally I feel that comming here is a lot of change for a person but that is a decision for them to make.

Edited January 23, 2014 by harrry

[Sceptict11]

+1

Additionally ......................

All airlines will require that an elderly person who is oxygen dependent is certified, according to individual airline rules, as being "fit to fly".

The cost of meeting the airlines demands, which may include accompanying flight trained medical staff, and the purchase of "adequate" space , may prove to be VERY expensive.

The OP would be well advised to reconsider.

Actually not now true. New rules in the US prevent an airline flying under a US flight number or from or to a US airport stopping a person flying for medical reasons. The assesment of whether the person is fit to fly or not has been returned to the person flying. In regard to oxygen use they do require a prescription giving the quantityes required.

Other countries do not have the same rule and the some of Sceptic11's comments do apply.

If they deem an attendant is required they can require you to provide one but they cannot charge for him or her.

Though US Airlines are not the best at this having just been fined several million dollars for breaching this I will put the link from their site.

http://www.usairways.com/en-US/Resources/_downloads/traveltools/ACAA_14_CFR_part_382.pdf

Personally I feel that comming here is a lot of change for a person but that is a decision for them to make.

I am not familiar with the USA's requirements in this respect, however I believe this is still current !

http://www.aa.com/i18n/agency/Travel_Experience/Accept_pax_misc_medical.jsp

[harrry]

+1

Additionally ......................

All airlines will require that an elderly person who is oxygen dependent is certified, according to individual airline rules, as being "fit to fly".

The cost of meeting the airlines demands, which may include accompanying flight trained medical staff, and the purchase of "adequate" space , may prove to be VERY expensive.

The OP would be well advised to reconsider.

Actually not now true. New rules in the US prevent an airline flying under a US flight number or from or to a US airport stopping a person flying for medical reasons. The assesment of whether the person is fit to fly or not has been returned to the person flying. In regard to oxygen use they do require a prescription giving the quantityes required.

Other countries do not have the same rule and the some of Sceptic11's comments do apply.

If they deem an attendant is required they can require you to provide one but they cannot charge for him or her.

Though US Airlines are not the best at this having just been fined several million dollars for breaching this I will put the link from their site.

http://www.usairways.com/en-US/Resources/_downloads/traveltools/ACAA_14_CFR_part_382.pdf

Personally I feel that comming here is a lot of change for a person but that is a decision for them to make.

I am not familiar with the USA's requirements in this respect, however I believe this is still current !

http://www.aa.com/i18n/agency/Travel_Experience/Accept_pax_misc_medical.jsp

Yes that is a good summary and you will note it does not require a medical clearance except for certain contageous diseases.

I will add that this applies to the US airlines and codes. It does not apply to most other countries.

Edited January 23, 2014 by harrry

[Sceptict11]

+1

Additionally ......................

All airlines will require that an elderly person who is oxygen dependent is certified, according to individual airline rules, as being "fit to fly".

The cost of meeting the airlines demands, which may include accompanying flight trained medical staff, and the purchase of "adequate" space , may prove to be VERY expensive.

The OP would be well advised to reconsider.

Actually not now true. New rules in the US prevent an airline flying under a US flight number or from or to a US airport stopping a person flying for medical reasons. The assesment of whether the person is fit to fly or not has been returned to the person flying. In regard to oxygen use they do require a prescription giving the quantityes required.

Other countries do not have the same rule and the some of Sceptic11's comments do apply.

If they deem an attendant is required they can require you to provide one but they cannot charge for him or her.

Though US Airlines are not the best at this having just been fined several million dollars for breaching this I will put the link from their site.

http://www.usairways.com/en-US/Resources/_downloads/traveltools/ACAA_14_CFR_part_382.pdf

Personally I feel that comming here is a lot of change for a person but that is a decision for them to make.

I am not familiar with the USA's requirements in this respect, however I believe this is still current !

http://www.aa.com/i18n/agency/Travel_Experience/Accept_pax_misc_medical.jsp

Yes that is a good summary and you will note it does not require a medical clearance except for certain contageous diseases.

I will add that this applies to the US airlines and codes. It does not apply to most other countries.

Taken at random from the list !

"Fractures And Broken Bones

Passengers may travel within three days of injury with a doctor's statement advising they are stable for air travel."

Edited January 23, 2014 by Sceptict11

[harrry]

Though US Airlines are not the best at this having just been fined several million dollars for breaching this I will put the link from their site.

http://www.usairways.com/en-US/Resources/_downloads/traveltools/ACAA_14_CFR_part_382.pdf

Personally I feel that comming here is a lot of change for a person but that is a decision for them to make.

I am not familiar with the USA's requirements in this respect, however I believe this is still current !

http://www.aa.com/i18n/agency/Travel_Experience/Accept_pax_misc_medical.jsp

Yes that is a good summary and you will note it does not require a medical clearance except for certain contageous diseases.

I will add that this applies to the US airlines and codes. It does not apply to most other countries.

Taken at random from the list !

"Fractures And Broken Bones

Passengers may travel within three days of injury with a doctor's statement advising they are stable for air travel."

Has the person in question had a broken bone within 3 days of the date of travel or is she pregnant and expecting to deliver within 30 days?

Is the person suffering from one of the few contageous diseases on the list.

other than that is there anywhere it says she cannot fly without a certificate.

I refer you to the actual rules I posted.

[Sceptict11]

Just for information here are the BA "rules" which are adhered to by many airlines.

http://www.britishairways.com/en-gb/information/special-assistance/medical-conditions

And the WHO guidlines

http://whqlibdoc.who.int/publications/2005/9241580364_chap2.pdf

Note !

Failure to consult the airline about "fitness to fly" requirements may result in a refusal to board an individual.

Edited January 23, 2014 by Sceptict11

[harrry]

Just for information here are the BA "rules" which are adhered to by many airlines.

http://www.britishairways.com/en-gb/information/special-assistance/medical-conditions

And the WHO guidlines

http://whqlibdoc.who.int/publications/2005/9241580364_chap2.pdf

Note !

Failure to consult the airline about "fitness to fly" requirements may result in a refusal to board an individual.

Yes.

That is correct outside the uS

However for flights to the US the rules I gave apply.

In this case we were talking about someone coming from the US.

[harrry]

This is an important issue. It is one that often seems to come up with Medical or Disabilities issues. Who has the right to make a decision for the person becuause they think it is in their best interest.

Under the old system people with disabilities etc were forced to stay at home. They are now wncouraged to reach out into the world around them. It is now considerred that a person with a disabiliy or medical condition has exactly the same rights as anyone else and must be allowed to do the same as anyone else is unless there is very very strong evidence to the contarary. The US has determined that allowing people with medical conditions which do not affect others to make their own decision on whether to fly or not is the right way. They have considered that in "trying to cover their backsides" the airlines were placing unreasonable restrictions on the right of the person to fly. As a condition of their licences airlines do not have the right to refuse carriage for most things and the law expressly forbids them in this respect.

Disability laws vary throughout the word but in this respect the US is ahead at the moment.

[Langsuan Man]

Getting her here is just the beginning of multiple problems. First is going to be to pay for medical care for an 89 year old. Medicare is not going to cover her in Thailand and unless she has very good private medical insurance the cost burden is going to be substantial

Listen to Sheryl in post # 9, this is a bad idea and one has to wonder if the OP is considering this for his mothers benefit or for his ?