Medical care in Thailand

[akentryan]

On November 23 I took my Thai wife to the Bangkok Hospital Pattaya Clinic Section with high blood pressure (150/105) for a few days and a persistent cough. X-rays revealed a problem with spots on the lungs that could be Miliary TB or cancer. The clinic doctor said "this is very serious" and if its TB "you have won the lottery." Referred to a pulmonary doctor who ordered a CT scan of the chest on November 24. The doctor in Imaging reviewed the film and noted that a golf ball sized growth in one lung is probably Primary Lung Cancer which means he does not think it metastisized from a cancer somewhere else.The respiratory doctor at BHP said 75/25 cancer vs TB. My wife wanted a second opinion so she took the films to the Government Respiratory Hospital in Bangkok where the pulmonary doctor is the guru of all pulmonary doctors in Thailand. He recommended that she see a doctor at Bumrumgrad Hospital and have a needle biopsy. Having a past history with BH I know it is very expensive plus the logistics of BKK vs Pattaya posed a problem. In short, we came back to BHP. The pulmonary doctor there had originally wanted to do a bronchoscopic procedure to get a tissue sample but admiited the chances of hitting the tumor were very slim. BHP does not have a doctor that can do a needle biopsy. A doctor from Rama Hospital in BKK comes down every Saturday and does the procedure. He could not come the next Saturday, but could come the week after (December 27, two weeks wait). On December 24 my wife was admitted to the Intensive Care Unit as BHP with dizziness and shortness of breathe. They told me the enzyme markers indicated she had a heart attack. The cardiologist was absolutely 100% certain that she had artery blockage(s) and would require an angioplasty procedure to determine the extent of the problem. If only one or two blockages he could put in stents at that time. If a wider problem would require by-pass surgery. In the meantime, he had given my wife 4 plavix tablets and an aspirin which means the needle biopsy must be postponed until January 3. They were doing absolutely nothing for her at BHP except they ran another CT scan which told them nothing and they were taking daily chest x-rays which told them nothing. On December 25 the cardio doctor snuck in a angioplasty knowing that if he found a blockage he could not do anything about it and would have to repeat the procedure at a later date. In any event, there were no blockages in the arteries. I have also been advised by another cardiologist that a person that has had a severe coughing problem over an extended period of time will have bruised muscles that will emit enzymes like those that a stressed heart muscle will emit. I sincerely doubt that my wife, who has no past history of heart or blood pressure problems, had a heart attack. There is now zero concern at BHP about her "heart problem" and it is no longer a factor in her treatment. The three night stay at BHP cost 148,000 baht and I do not know a damned thing definite about her lung problem plus she still has high blood pressure. They have her on a blood pressure medicine but tell me it will "take a few days to stabilize." The doctors cannot understand why I am upset that after one month and 170,000 baht we are still in the dark, They moved my wife from the ICU to a ward where they had planned to keep her until about January 12 which allows for the tissue sample to be sent to BKK for analysis. That's another 14 days at 25,000 baht a day and we are still no more knowledgeable than before. The only thing they were doing for her was keeping her on oxygen because the level in the blood was in the 80s without oxygen. They did not want to release her. I bought an oxygen condenser at a cost of 29,000 baht and pulled her out of the hospital and brought her home. The savings over the next 14 days will be approximately 320,000 baht. She will not miss the daily x-rays (note that the doctor hides around the corner when they do the x-rays). Plus, she is a helluva lot more comfortable at home where she can eat whatever she wants whenever she wants.Check the bill the next time you are in BHP. Two pills (combined cost 15 baht) that could be taken orally were administered by injection (cost 2,200 baht). Two boxes of gloves (50 pairs each) every day. the daily x-rays which accomplish nothing. The doctor sticking his head in the door (1,200 baht a one-minute visit). 700 baht breakfasts, a second CT scan that revealed nothing new, an angioplasty that accomplished nothing, and the cost goes on and on. If I had left her in the hospital we would have passed the 500,000 baht mark before ever finding out what is wrong and getting to the treatment phase.

[Issangeorge]

Go to a government hospital, never go to a rip off private hospital, except for perhaps diagnostic equipment that a government hospital might not have. ฿25,000 a day, that's highway robbery.

[Sheryl]

Government hospitals (inckuding military hospitals, which will treat civilians and foreigners) are definitely the least expensive option but waits can be long, communications difficult for non-Thai speakers, and due to high patient loads little is given to patients by way of explanation.

Bumrungrad, while at the top end price-wise in Bangkok, is still usually less expensive than BPH.

It is a real mistake to choose to be treated in Pattaya over Bangkok for anything really serious or complex. It costs more and with a few isolated exceptions, the physicians are much less qualified in terms of having had specialty training abroad, for example.

The best government hospitals are also in Bangkok and many levels above those in Chonburi, though the latter is OK for common problems.

In Bangkok, one has an array of choices. Listing from least expensive to most:

tertiary govt and military hospitals

govt hospitals with an after hours private channel (only some have it - notably Siriraj and Chulalongkorn)

non-profit private hospitals

mid-sized private hospitals mostly utilized by Thais

larger private hospitals aiming at the international market

Many of the same doctors work at these places.

It is also essential to specifically chose your doctor rather than leaving it to the hospital to decide (if using a private hospital...not possible at govt ones except those that have a "private" channel)

OP, if I read your post correctly you still have not arrived at a clear diagnosis or commenced treatment for what may be a very serious condition. A shame the biopsy was not done in Bkk as results would be available much more quickly (and not have cost more than BPH, probably less).

As soon as you do get the results of the biopsy, please post here and I will recommend a specific specialist (who will almost surely be in Bangkok, but not necessarily at an expensive hospital).

[TerryLH]

OP, I hope your wife gets the correct diagnosis and treatment soon.

"...an angioplasty that accomplished nothing"

You found out there aren't any blockages. I'd put that in the 'pro' column.

"...and due to high patient loads little is given to patients by way of explanation"

If you ask, you can most often get an explanation, at least in my experiences. Many Thai's just don't ask.

"It is also essential to specifically chose your doctor rather than leaving it to the hospital to decide (if using a private hospital...not possible at govt ones except those that have a "private" channel)'

If you know the name of the doctor you want to see, and go on a day they are actually there, you can request to see a specif doctor. That's been true for me here in KKC at the two largest government hospitals.

Another way is to see the doctor you want at their private clinic (only works if they have a private clinic, obviously) and arrange to see them at the government hospital they work at.

[Robby nz]

I am a fan of military hospitals because of the excellent care I have received there over the years, Particularly at Pramoncutklau in BKK, I have also heard good things from others about other military hospitals.

Military specialist doctors go to other military hospitals (as well as public and private) when needed, there are military hospitals in your area which would be worth a try, from the list of Thai hospitals on Wiki :

Queen Sirikit Naval Hospital Royal Thai Navy Public Military Chonburi 240

The 240 refers to beds.

Also

Abhakara Kiartivongse Hospital Royal Thai Navy Public Military Chonburi 300

[akentryan]

The doctor from BKK that was supposed to come to BHP on the 3rd and do the needle biopsy can't make it. I will never set foot in BHP again. We have an appointment at Bumrumgrad on the 2nd and if my wife's blood is OK, the biopsy on the 3rd and a discharge on the 5th. Three nights at 8,400 baht per which includes food and nurses but probably with a lot of extras to come. The cost of the procedure is from 20,000 to 35,000 depending on what I do not know. My wife weighs 45 kilos so it can't mean a longer needle! If you want anybody to look at the tissue the lab fee is separate. The Bumrumgrad ambulance will pick my wife up at our house and take her to the hospital for 8,500 which is a bargain as it includes oxygen. After 36 days we may be getting a diagnosis. Yippee