Recommendation for Doctor to treat duodenal ulcer in CM

[RecklessRon]

Can anyone recommend a GOOD doctor who can treat a duodenal ulcer in Chiang Mai?

I need a doctor who will work with ME and my girlfriend. She has all the classic symptoms of a duodenal ulcer and is self-treating with Thai medicine and by avoiding drinking her morning coffee and all coke. Plus she's drinking milk and eating to stop stomach pain (classic). She's also a 'classic' Thai who has little knowledge of science and medicine and so thinks that this is a small problem that she can pretty much ignore and work around. She also has the built in aversion to seeing a doctor for anything and seems to think that if you ignore a problem for long enough it will just go away! Since she's had this problem for years and years it is clear to anyone with a working knowledge of medicine and health that it is well past time for her to see a doctor. I've checked and this can be treated with a combination of antibiotics which may cure her but if they don't she should have surgery to fix it - the sooner the better.

So.... can anyone recommend a doctor who I can work with and will work with BOTH of us to ensure she gets better? (I need to talk to the doctor to tell him all her symptoms and her treatments so he knows - as I'm certain she won't tell him the entire story).

Thanks, eh!

Edited February 26, 2014 by RecklessRon

[Sheryl]

No doctor is going to work with you in the manner you describe except to the extent that your gf asks him to. Patient confidentiality, among other factors.

The symptoms you describe are indeed suggestive of gastritis, not necessarily ulcer (but possible). She needs to be tested for h. pylori and, possibly, to have a gastroscopy.

But how likely is she to consent to this?

If she comes round to seeing a doctor, I suggest either:

Dr. Jaruwat Yossombat at Chiang Mai Ram Hospital

Professor Kannika at Rajavej Hospital

or

Assoc. Prof. Chaiwat at Sripat (CMU Univ - Special Medical Services)

the last would be the less expensive of the 3.

[RecklessRon]

No doctor is going to work with you in the manner you describe except to the extent that your gf asks him to. Patient confidentiality, among other factors.

The symptoms you describe are indeed suggestive of gastritis, not necessarily ulcer (but possible). She needs to be tested for h. pylori and, possibly, to have a gastroscopy.

But how likely is she to consent to this?

If she comes round to seeing a doctor, I suggest either:

Dr. Jaruwat Yossombat at Chiang Mai Ram Hospital

Professor Kannika at Rajavej Hospital

or

Assoc. Prof. Chaiwat at Sripat (CMU Univ - Special Medical Services)

the last would be the less expensive of the 3.

Thanks for the reply - I appreciate it.

As for your questions and concerns:

- Patient confidentiality refers to not disclosing information about the patient to others. I do not believe it has anything to do with not finding out information about your patients from others, especially their friends or relatives. Any doctor who would treat her but would not be interested in hearing from me what her true symptoms and self-treatment are is one I wouldn't want. I get that he couldn't tell me any details about her but if he isn't interested in hearing from me about her then I'd suggest he wasn't a 'good' doctor.

- I didn't list all her symptoms I only mentioned a few. If you google ulcers and go to a reliable site you will find a long list of symptoms for both peptic and duodenal ulcers. She has ALL the symptoms of a duodenal ulcer and has had for years but lately it has been getting worse - much worse.

- I can get her to go to a doctor if I have seen him myself. I could use a checkup and I currently don't have a doctor in CM so it would be useful for me to get to know one. After I've seen him I can set up an appointment for her and get her to go to it. Then it would be up to the doctor to ensure that she gets proper tests and advice. I will go out of my way to ensure she takes any tests and follows any advice that I am aware of. I'm unclear whether it is a breach of confidentiality to disclose if she has a appointment to attend or a test to take - I guess that'll be up to the doctor. I'm from Canada and in Canada I know doctors routinely tell family members, including boyfriends that they live with, to ensure their patients follow their instructions and to make them aware of any future appointments. I suspect she will tell me everything the doctor says as she doesn't like me to be worried and knows that I am very worried about her health, specifically this matter. Plus she is not stupid or a fool, just ignorant and scared. If a doctor tells her she needs to do something, and she trusts that doctor, she will do it.

- Lastly, money isn't anywhere near as important as her receiving proper care and treatment. Would you recommend one of those doctors as better than the others?

[Sheryl]

All 3 are fine. But they are GI specialists, so not suitable for you to see for a general check-up for yourself.

Symptoms of gastritis and ulcer are the same, cannot be differentiated based on symptoms.

I am not clear why you believe she herself would not disclose her "true" symptoms to the doctor, but the doctor discussing her case from others is something the patient would have to agree to. If she is fine with you being present during the doctor visit then no problem. But do not be surprised if the doctor speaks to her in Thai and prefers to hear directly from her as to what she is experiencing.

[RecklessRon]

You ask me why Thais are afraid to go to doctor? Why they don't tell doctor the truth? I have no idea.

I do have a friend who has high blood pressure and takes medication for it daily. She drinks lots of coffee in the day and far too much alcohol every night. She doesn't tell her doctor about either. Why? Ignorance and fear is my best guess. I tell her that her doctor might change the medicine if he knows she is drinking (and smoking). Maybe her blood pressure medicine and caffeine or alcohol are contra-indicated but we'll never know as she cannot be convinced to tell him.

Same friend tells my girlfriend it is okay for her to take antacid to fix problem. I tell them a doctor can test and if she has an ulcer they might be able to fix with two antibiotics so there is no need for her to be afraid. She says antacid works fine (but she takes it several times a week now and in larger quantities...)