Shoulder Surgery

[Moouan]

Had anyone had experience of arthroscopic shoulder surgery at either Vejithani Hospital or Bangkok China Town Hospital. If so how was it and can you recommend a surgeon. No comments about Bumrungrad or Bangkok Hospital as my insurance company do not want to pay their high costs.

Thank you

[Sheryl]

It is going to depend on the surgeon, not the hospital.

At Vejthani this appears to be the only ortho specifically specializing in shoulder http://www.vejthani.com/doctors_detail.php?DoctorCode=91850

I have no idea about Bangkok Chinatown Hospital

The top shoulder specialist in Thailand, Dr. Mason Porramtikul, while mostly at Bumrungrad also has privileges at Phyathai 1 Hospital which generally costs a little less than Vejthani. Are you sure your insurance will only cover Vejthani and Bkk China town (seems very odd) ? http://www.phyathai.com/doctorsearchdetail/63872/PYT1/en

[Moouan]

They will cover other hospitals these are just the ones they suggested.

I wanted Bangkok Hospital because they fixed my other shoulder 6 years ago and are now FIFA approved, which I assume means they are one of the best!.

Will check Phyathai.

Thanks for the input.

Why is Dr Mason considered the best?

Edited June 29, 2015 by Moouan

[Torrens54]

There is an Excellent one in Chiang Mai, so if you don't find what you need in BKK, give me a yell and I'll message you with his contact details.

Edited June 29, 2015 by Torrens54

[andvari26]

I would like the contact details for the C Mai surgeon, I have need of someone good for a shoulder op fairly soon.

Cheers

[kuma]

I would like the contact details for the C Mai surgeon, I have need of someone good for a shoulder op fairly soon.

Cheers

I also have been diagnosed via MRI with a detached and torn ligament in my shoulder, part of the rotator cuff I guess.

Today I find out insurance will cover roughly 47k thb, and hospital wants me to pay an additional 300k thb!

Seems crazy to me, would like to hear of others experience and comments on whether the surgery is necessary, perhaps there are other ways to manage thru it?

I am still very active and bicycle to work daily and on the weekends so I want to get back to as good a state as possible but think this hospital is very expensive....and my insurance really is junk, so comments or suggestions on other hospitals to consider would be great. In my case I went to Samitivej.

Cheers

[Sheryl]

I also have been diagnosed via MRI with a detached and torn ligament in my shoulder, part of the rotator cuff I guess.

Today I find out insurance will cover roughly 47k thb, and hospital wants me to pay an additional 300k thb!

Seems crazy to me, would like to hear of others experience and comments on whether the surgery is necessary, perhaps there are other ways to manage thru it?

I am still very active and bicycle to work daily and on the weekends so I want to get back to as good a state as possible but think this hospital is very expensive....and my insurance really is junk, so comments or suggestions on other hospitals to consider would be great. In my case I went to Samitivej.

Cheers

See if you can get an appointment with this doctor at Phyathai Hospital http://www.phyathai.com/doctorsearchdetail/63872/PYT1/en

He is more readily contacted at Bumrungrad but surgery there will be as expensive as at Samitivej whereas Phyathai will be less (though still nowhere near as low as your insurance coverage).

Dr. Mason is IMO the best shoulder specialist in Thailand. Even if it turns out that you need surgery and can't afford surgery at Phyathai either (in which case you will have to think of going to a government hospital) , he is worth consulting for advice as to whether surgery can be avoided and if not, what type of surgical procedure is indicated.

I believe Dr. Mason is also at Vajira Hospital, a Government Hospital. You might ask him whether it is feasible to be admitted as his private patient there, would certainly save a great deal of money if so (though still probably in excess of your insurance...the only way to not exceed that would be to go through the public channel of a public hospital, in which case you cannot pick your doctor and much of the surgery will be done by residents in training, albeit under supervision).

Are you sure 47K is the total amount the insurance will pay or is it just the surgical fee? Read your policy closely. Usually there is a maximum amount for surgical fee and then separately amounts for the room, medications, anesthesia etc etc. Likely the amount the hospital is quoting is the total bill. If your insurance will truly only cover a total of 47K inclusive of surgical fee, anesthesia, room, medications etc etc then indeed it is a worthless policy. For future reference, if you want the option of using private hospitals you need a 5 million baht per episode cover.

[kuma]

Thanks for the great reply Sheryl.

I am going to indeed go back to my company ( a major multi national, making the poor insurance even more shocking) and the insurance company to understand this and get better coverage.

As back up I will get ready to go see Dr Mason, I actually am going to get my MRI and maybe get a second opinion.

Cheers for the great response.

[Sheryl]

If the insurance was from an international company there is no way it covers only 47K and might have been a communication problem between hospital and insurer, perhaps confusing total cover with the surgical fee alone. But if a Thai ocmpany unlikley there was miscommunication as the Thai hospitals and they communicate all the time.

If the policy is from a local insurer, many of them do indeed offer really low end policies that are effectively worthless.

However by law, if you are employed here in Thailand, you have to be enrolled in the Thai Social Security system in which case you are eligible for free care at the hospital you are registered at (one is initially just assigned to you). When you talk to your company ask specifically if you are covered by Social Security. AFAIK other than private schools, inclusion in the SS scheme is mandatory and companies are not allowed to opt out, regardless of whether they also offer a private insurance policy. You may want to call the SS Office as well to follow up on this if it turns out your employer was not making SS deductions and paying SS contributions on you.

[kuma]

So yes I work locally for one of the worlds largest companies, but they use local insurer for coverage and indeed the coverage in this case is useless.

Interesting, I did need another procedure, related to spondylitis in my back and that was to be fully covered, at 500k+, but now they will not cover this. I did not do the back surgery, opted for wait loss and exercise and all good so far, but my shoulder is in need of repair now,,but they are not covering.

Tried to get Dr Mason at PYT1 today and they said no such Dr works there. I mentioned that he is on their website.....they had no reply to that. Maybe I have to drop in in person. Almost feel like they prefer to point foreigners to bumrungrad instead.

So now the search is on for a competent and decent priced surgeon. It may turn out that they all charge the same......

Thanks for all the replies

[Sheryl]

At phyathai did you go througj the intl office? Email [email protected]

He is listed on the site as by dpecial appt only i.e. he does not routinely come in. So if you just call the hospital they won't see him on the schedule.

Can easily see him at Bumrungrad but surgery there if indicated would cost about the same as samitivej.

I am not sure what your company does is legal. To mu undetstanding except for private schools enrollment of employees under Social Security is mandatory. If a company wants to offer a private policy in addition they csn but it does not remove the SS requirement.

Suggest you contact the Soc Security office. Even if not able to help with the current problem it migjt help in future.

Are there SS deductions from your paycheck?

[kuma]

Hey Sheryl

Sorry yes we do have SS, just not sure what type of surgeon I would get from an experience standpoint from the public hospital I am registered at (forget the name)

And yes just spent another twenty minutes on the phone in Thai with PTY1 and they insist he is not there anymore.

Apparently he is at a teaching hospital, washira (sp?) and at Bgrad. I made an appt there to get his opinion anyway and see what the quote is from them

[Sheryl]

Its Vajira. Don't know though if there is any way to be admitted there as his private patient. Som government hospitals have a system that allows this (essentially a two track system one public one quasi private) and some do not.

What government hospital are you registered at? As SS will cover full costs.

[kuma]

Hi

I believe it is Thetarin on Rama 4, near the Tesco. I will confirm at work tomorrow.

In the meantime I have read up on a Dr named K Bura Sintupakorn, at Suranaree hospital in Nakhon Ratchasima. He was trained at U of Western Ontario, which works for me as it is a good Canadian School.

Have seen a few good comments on him but info not easy to find.

I would of course like to get full coverage, but I would only contemplate if the surgeon seemed up to the job. My intent is to get good value, not always the case that most $$ is best.

I do have an apt with Dr Mason as well, see what his opinion is

Thanks again for all your assistance, appreciate it.

[Sheryl]

S0unds like a good plan. If he advising surgery could also ask his opinion of Dr. Bura Sintupakorn.. and while you are at it ask if he can recommend any of the ortho surgeons at Theptarin Hospital if that turns out to be where you are registered (it is nto, BTW, a government hospital. It is private). I am dubious as it is not much known for ortho (best known for diabetes management) and its ortho department is quite small, but no harm in asking.

[kuma]

Excellent idea, did not even think of that but for sure will quiz him now, thanks for that.

Really disappointed with the insurance, need to look at topping it up on my own I guess.

[kuma]

Well so I did see Dr Mason.

In the end I did not feel comfortable asking about the other Dr or alternatives, so let it go and will continue my own research.

I can see why he is highly regarded, seemed very well spoken and professional. He nailed the problems I am having and had comprehensive set of suggestions to tackle them.

Interestingly he mentioned more than once that surgery is not the only option, that non surgical options could be considered. I will look further into that, but have had pain in this shoulder for so long I think now I should try to get it repaired. I had the cortisone years ago and it worked I suppose, but now that I have tear, figure better to reattach - comments on that welcomed from those who have been thru it. Will the muscle not shrink and atrophy if not reattached?

I will go to Suranaree in NR to see Dr Bura, but it will be another week, which seems hard to bear but guess I should and then compare.

The quoted cost at Bumrungrad with Dr Mason lines right up with Samitivej, no surprise there again did not push if he works elsewhere but have tried calling other places to no avail so will leave it at that.

So for now that is it til go to NR next week.

[Sheryl]

2 other leads to look intio:

Dr. Somsak Kuptniratsaikul| is a Professor at Chulalongkorn (government teaching hospital) trained in US and UK and has published in international journals on the subject.

Dr. Kitiphong Kongrukgreatiyos likewise at Chula, trained in Australia, published.

don't have any feedback on either of these but qualifications look encouraging

Both have private hours at BNH Hospital which will be just as expensive as Samitivej and Bumrungrad, but it is possible you could also access one or the other of them through Chulalongkhorn's after hrs clinic - a quasi-private arrangement in the evenings for those willing to pay a little more to chose their doctor and have a fixed appointment . If so then being admitted to Chula as his private patient might be an option and would cost significantly less than the private hospitals.

Unfortunately the only way to find this out is to go down there in person. 13 th floor from about 4 PM onward and ask the nurses.

[kuma]

2 other leads to look intio:

Dr. Somsak Kuptniratsaikul| is a Professor at Chulalongkorn (government teaching hospital) trained in US and UK and has published in international journals on the subject.

Dr. Kitiphong Kongrukgreatiyos likewise at Chula, trained in Australia, published.

don't have any feedback on either of these but qualifications look encouraging

Both have private hours at BNH Hospital which will be just as expensive as Samitivej and Bumrungrad, but it is possible you could also access one or the other of them through Chulalongkhorn's after hrs clinic - a quasi-private arrangement in the evenings for those willing to pay a little more to chose their doctor and have a fixed appointment . If so then being admitted to Chula as his private patient might be an option and would cost significantly less than the private hospitals.

Unfortunately the only way to find this out is to go down there in person. 13 th floor from about 4 PM onward and ask the nurses.

Sheryl

That's a great heads up thanks. I will look them up and maybe pop by tomorrow after 16:00 and see them, very close to work so easy.

Cheers for that, really appreciate it!

[kuma]

Good day Sheryl

So I am not currently registered at a Government hospital. They are getting me set up and gave me this list to choose from, saying I can pick any two - wondering if you have thoughts on any of them, in general or specifically with respect to the rotator cuff issue:

Kasemrad Hospital Bangkae

Kasemrad Hospital Prachachuen

Paolo Memorial Hospital

Petcharavej Hospital

Kluaynamthai Hospital

Nawamin 9 Hospital

Bangmod Hospital

B Care Medical Center

Yanhee Hospital

Sikarin Hospital

Hua Chiew Hospital

Lerd Sin Hospital

Klang Hospital

Police General Hospital

I will go to Chula later today after 16:00

Cheers

[Sheryl]

Police hospital. By far the highest level of care/range of services.

[kuma]

Police hospital. By far the highest level of care/range of services.

Thanks Sheryl, that's what my cursory investigation said this AM as well, so good to know you feel same.

I will register myself there.

Alisara Arirachakaran

Tana Wande

Viroj Larbpaiboonpong

These are some of the names I am finding listed as ortho surgeons, any look familiar to you?

[Sheryl]

Dr, Viroj is well known and also at several private hospitals including Bumrungrad but I think he specializes in hips. The other two have published but in regard to knees, does not look like any of the three specialize in shoulder issues.

Actually purely for ortho, Lerdsin is probably the better choice as it is very well known for that, it is its strong suit. But the Police Hospital is a better choice all round in terms of the range of things it can manage and the level of care it can provide.

[kuma]

Dr, Viroj is well known and also at several private hospitals including Bumrungrad but I think he specializes in hips. The other two have published but in regard to knees, does not look like any of the three specialize in shoulder issues.

Actually purely for ortho, Lerdsin is probably the better choice as it is very well known for that, it is its strong suit. But the Police Hospital is a better choice all round in terms of the range of things it can manage and the level of care it can provide.

Hi

So made it to floor 13 today. Thought it would be a snoozy post in the corner but wow the floor was packed with people. They registered me and I have an appt on Oct 2.

Interesting you mention Lerdsin, some at work said the same. I get to pick two so will make that my other choice.

I still plan to go to Korat next week as well. Your point is well taken on knee doctors not being always good with shoulders, I have seen many references to same so looking for someone who does shoulder work often.

The pain has significantly subsided as I use the arm less so it makes waiting easier, so I hope the wait and the looking culminates in a good surge in and a more affordable price. Never considered supplemental insurance thinking my work policy would be fine but now have learned all the locals have extra insurance, they fully expect the work policy to be inadequate, whereas income from where you expect it to be all you need.

Will update after I get the next appt done, was thinking of going to Sririraj but maybe instead I will go to Lerdsin

Cheers

[WorriedNoodle]

>Had anyone had experience of arthroscopic shoulder surgery

My experience of arthroscopic shoulder surgery was the doctor at one Bangkok expat hospital telling me I needed the surgery after an MRI he did and it would cost 10kUSD. I walked out as I didn't have insurance for it and it seemed pricey. I then went to Bumrungrad with the previous MRI scan results, which I couldn't make sense of, and they told I just needed physiotherapy. This lasted about a month every day and cost me 2000USD and then I went home to do it myself. After about 3 months I stopped my own exercises and 12 months I couldn't tell anything has been wrong with my shoulder and its been fine ever since.

[kuma]

Great comment thanks. My shoulder has actually got better, but that means I can lift it to parallel with the floor. Have read a bit about physio but have a full thickness tear so not sure that is an option. But continue to research, and visiting surgeons for multiple opinions. Cheers

[kuma]

Dr, Viroj is well known and also at several private hospitals including Bumrungrad but I think he specializes in hips. The other two have published but in regard to knees, does not look like any of the three specialize in shoulder issues.

Actually purely for ortho, Lerdsin is probably the better choice as it is very well known for that, it is its strong suit. But the Police Hospital is a better choice all round in terms of the range of things it can manage and the level of care it can provide.

Good day

So in the end I had surgery, and went to Nakhon Ratchisima for it. It was done last Tuesday. In addition to the detached tendon they found I had a SLAP lesion as well so did that repair the same time.

Wondering if the board here knows of any good physiology outfits in Bkk that know about post op shoulder surgery physio. I have been given a few exercises from my doctor and can go back there each week to see their physio but if there is a bkk based place that I can use then that might be a better option.

The shoulder feels quite good, except when sleeping, which is a real problem. I guess will not know how successful the whole procedure was till after physio but I was happy with the Dr, the facilities and the service. Not to mention the cost, which was quite reasonable.

Also I am looking online for links to video or documents on post op rehab but not finding much. If anyone has any links they would be appreciated.

[oncearugge]

Dr, Viroj is well known and also at several private hospitals including Bumrungrad but I think he specializes in hips. The other two have published but in regard to knees, does not look like any of the three specialize in shoulder issues.

Actually purely for ortho, Lerdsin is probably the better choice as it is very well known for that, it is its strong suit. But the Police Hospital is a better choice all round in terms of the range of things it can manage and the level of care it can provide.

Good day

So in the end I had surgery, and went to Nakhon Ratchisima for it. It was done last Tuesday. In addition to the detached tendon they found I had a SLAP lesion as well so did that repair the same time.

Wondering if the board here knows of any good physiology outfits in Bkk that know about post op shoulder surgery physio. I have been given a few exercises from my doctor and can go back there each week to see their physio but if there is a bkk based place that I can use then that might be a better option.

The shoulder feels quite good, except when sleeping, which is a real problem. I guess will not know how successful the whole procedure was till after physio but I was happy with the Dr, the facilities and the service. Not to mention the cost, which was quite reasonable.

Also I am looking online for links to video or documents on post op rehab but not finding much. If anyone has any links they would be appreciated.

You may find this to be of assistance.

http://www.orthoontheweb.com/pdfs/Shoulder_Arthroscopy_Postop_Inst.pdf

[Sheryl]

All of the major hospitals have physiotherapy departments.

Can't say I have been overly impressed with any of them though.

As I recall you had social security, so would suggest taking the doctor's letter with you to whatever hospital you are registered at and see how that goes.

[konying]

I had one in Bangkok Hospital Bangkok,

Will not comment on doctors, just give you some advice about surgery itself

Firstly, i strongly recommend you tell surgeon you like to have novocane injection into the nerve.(not instead of general but on top of it, injection goes just in the front, neck area. I was scared and asked to do it when i was asleep,)

This numbs your nerves and no pain for 3 days after the surgery, also no need for morphine, next morning you can eat and function as normal,

2. Remind surgeon to make sure he cleans all the debris,its common sense, yet mine forgotten, i lost 40% movement,

3. Make sure to start physio and even if you have high pain tolerance as i do, tell them hurt and fake it, because they do not seem to understand, just because you not screaming, it does not mean they can stretch your arm limitless in the first days.

4. Recovery does take a long time, despite what docs will tell you, 6-12 months

5. Not sure if its only me or common, but now 8 years later, i feel the pain during rainy seasons and cold weather.

6. You may need cordizone shots on yearly basis for the rest of your life.

Little humor: Do not pick surgeon who has sexy nurses, its a ploy to get you in, you wake up in ward with heavy, well seasoned nurses and never see the sexy ones

Edited November 1, 2015 by konying