A Monday morning experience in the Thai health care system

[kovaltech]

well last week i had a chest infection, i new what it was ive had asthma all my life and many chest infections,

so the wife and i jumped in the truck, drove to our local clinic, the young lady doctor there listened to my chest and breathing, and said chest infection with a cold,

went and got me the medication and cough mixture and dint charge me 1 bht,

thats my experience of the thai medical care i have had from them a few times, allways been very good to me

I find that hard to believe, diagnosis and medication for free??

That must be a very busy clinic?? Can you pls send me doctors name and address pls.

almost any local "hospital" wil do, free if with your lady, 30 bath if on your own...

[Traveling Sailor]

I appreciate the views and experiences related in this topic.

I intend to retire in LOS, and as a diabetic, cardiac patient, etc., this is all near and dear.

Does anybody have experience with the variety of expat insurance programs, and how they work with the Thai health system?

Also, any advice on where to go for medical attention in Ubon Ratchathani?

I had been pondering the whole subject, as I mentioned to a couple of Thai friends that I was going to see my doctor

yesterday, just a periodic check and to get my prescriptions up to date, etc. They both seemed a bit alarmed; "What is wrong?", "You sick?"?"and so on. Preventative or ongoing care seemed to not be part of their expectations.

I found in the course of my two month visit last year that I can walk ok, due to a mile lower elevation than here on the Colorado Plateau, and the abundance of fresh fruit and vegetables also were a great advantage health wise.

I have had a very wide range of experiences with Thai medical treatment. On the bad end, a female doctor at a private clinic telling me that I had an old age problem causing my foot pain, without an examination, which turned out to be a peice of glass in the bottom of my foot. On the good end, a Thai endicronologist at a Bangkok hospital who spent two tours at the San Diego Veterans Hospital. This guy was wonderful. He did tests that most Thai trained doctors have not even heard of and cannot be done in most Thai hospitals. I was recently told by a doctor at a Samui hospital that I had finally moved from Pre-Diabetes to Diabetes because of my fasting blood sugar results. I decided to get a second opinion before starting medication and set up the appointment to coinside with my annual Bangkok treck. This wonderful, US trained doctor was able to determine that, not only did I not have Diabetes, but I didn't even have Pre-Diabetes. I was still suffering from Hypoglycemia, which I had been fighting most of my adult life.

So Bil2054, If you want the name and hospital of this wonderful, knowledgable Diabetes specialist, send me an email and I will be happy to oblige. Cheers!

PS: In September I go back to see this doctor, as he has ordered a CT scan so that he can monitor my heart health. In my experience of over 5 years here, the first doctor who has agreed to do something, anything, extra.

Edited August 19, 2015 by Traveling Sailor

[h90]

I appreciate the views and experiences related in this topic.

I intend to retire in LOS, and as a diabetic, cardiac patient, etc., this is all near and dear.

Does anybody have experience with the variety of expat insurance programs, and how they work with the Thai health system?

Also, any advice on where to go for medical attention in Ubon Ratchathani?

I had been pondering the whole subject, as I mentioned to a couple of Thai friends that I was going to see my doctor

yesterday, just a periodic check and to get my prescriptions up to date, etc. They both seemed a bit alarmed; "What is wrong?", "You sick?"?"and so on. Preventative or ongoing care seemed to not be part of their expectations.

I found in the course of my two month visit last year that I can walk ok, due to a mile lower elevation than here on the Colorado Plateau, and the abundance of fresh fruit and vegetables also were a great advantage health wise.

I have had a very wide range of experiences with Thai medical treatment. On the bad end, a female doctor at a private clinic telling me that I had an old age problem causing my foot pain, without an examination, which turned out to be a peice of glass in the bottom of my foot. On the good end, a Thai endicronologist at a Bangkok hospital who spent two tours at the San Diego Veterans Hospital. This guy was wonderful. He did tests that most Thai trained doctors have not even heard of and cannot be done in most Thai hospitals. I was recently told by a doctor at a Samui hospital that I had finally moved from Pre-Diabetes to Diabetes because of my fasting blood sugar results. I decided to get a second opinion before starting medication and set up the appointment to coinside with my annual Bangkok treck. This wonderful, US trained doctor was able to determine that, not only did I not have Diabetes, but I didn't even have Pre-Diabetes. I was still suffering from Hypoglycemia, which I had been fighting most of my adult life.

So Bil2054, If you want the name and hospital of this wonderful, knowledgable Diabetes specialist, send me an email and I will be happy to oblige. Cheers!

PS: In September I go back to see this doctor, as he has ordered a CT scan so that he can monitor my heart health. In my experience of over 5 years here, the first doctor who has agreed to do something, anything, extra.

The glass in the foot story is amazing...

[Sheryl]

I have had a very wide range of experiences with Thai medical treatment. On the bad end, a female doctor at a private clinic telling me that I had an old age problem causing my foot pain, without an examination, which turned out to be a peice of glass in the bottom of my foot. On the good end, a Thai endicronologist at a Bangkok hospital who spent two tours at the San Diego Veterans Hospital. This guy was wonderful. He did tests that most Thai trained doctors have not even heard of and cannot be done in most Thai hospitals. I was recently told by a doctor at a Samui hospital that I had finally moved from Pre-Diabetes to Diabetes because of my fasting blood sugar results. I decided to get a second opinion before starting medication and set up the appointment to coinside with my annual Bangkok treck. This wonderful, US trained doctor was able to determine that, not only did I not have Diabetes, but I didn't even have Pre-Diabetes. I was still suffering from Hypoglycemia, which I had been fighting most of my adult life.

So Bil2054, If you want the name and hospital of this wonderful, knowledgable Diabetes specialist, send me an email and I will be happy to oblige. Cheers!

PS: In September I go back to see this doctor, as he has ordered a CT scan so that he can monitor my heart health. In my experience of over 5 years here, the first doctor who has agreed to do something, anything, extra.

Would you please give the name of the endocrinologist as we get frequent requests to recommend a diabetes specialist. There is no problem with naming individual doctors in a positive context. Thanks!

[Sheryl]

.... Fortunately for me, I was able to find an experienced lawyer, who has since lodged a civil claim against the hospital and doctor, as a well as a criminal charge against the doctor for a wrongful act (medical negligence) a few days prior to the 12 month expiry.

For obvious reasons I have not mentioned the names of the hospitals or medico's involved but the second and third hospitals provided excellent treatment, despite the second hospital not being able to diagnose what had caused the post op complications. The initial hospital and third hospital are both well known, the first being a private establishment, thethird a large government hospital. The care given at the latter was just as good, if not better, than the private establishment, with the costs being one fifth of those charged at the private hospital. So now, besides having had two additional operations, I now have to go through a legal battle, which will take god knows how long, and even then there is no guarantee that I will be compensated but I do have the guarantee that my eyesight cannot be returned to normal and will have the use of just one eye for the rest of my life.

Very sorry to hear about your problems. Indeed wise not to name the hospitals or doctors involved (all the more so given legal action is in progress). But I would greatly appreciate it if you would name the lawyer, either here or in a PM to me. There are not many experienced in handling medical malpractice cases in Thailand and I would like to be able in future to refer TV members in need of such help. Thanks.

[Si Thea01]

.... Fortunately for me, I was able to find an experienced lawyer, who has since lodged a civil claim against the hospital and doctor, as a well as a criminal charge against the doctor for a wrongful act (medical negligence) a few days prior to the 12 month expiry.

For obvious reasons I have not mentioned the names of the hospitals or medico's involved but the second and third hospitals provided excellent treatment, despite the second hospital not being able to diagnose what had caused the post op complications. The initial hospital and third hospital are both well known, the first being a private establishment, thethird a large government hospital. The care given at the latter was just as good, if not better, than the private establishment, with the costs being one fifth of those charged at the private hospital. So now, besides having had two additional operations, I now have to go through a legal battle, which will take god knows how long, and even then there is no guarantee that I will be compensated but I do have the guarantee that my eyesight cannot be returned to normal and will have the use of just one eye for the rest of my life.

Very sorry to hear about your problems. Indeed wise not to name the hospitals or doctors involved (all the more so given legal action is in progress). But I would greatly appreciate it if you would name the lawyer, either here or in a PM to me. There are not many experienced in handling medical malpractice cases in Thailand and I would like to be able in future to refer TV members in need of such help. Thanks.

Thanks, I'll pm you.

[Issangeorge]

I have had very good treatment in Khon Kaen private hospitals. The doctors were very good. I suffer with chest problems, 3 times in 3 yrs I had Pheumonia I had drips with antibiotics. The only thing I said to the nursing staff was do not come to take my temp or blood pressure after 10pm come back at 8am in the morning. They are instructed to do these tests every 4 hrs or so at a nice charge.

On my prescription the do gave me a breather puffer, one from Sweden it was 2,500 a go. I refused this at the medication desk and said I have this at home. From the previouse time I went and bought one from the outside pharmacy and I go 3 for 2,100 at 70 Baht each. Other stuff you can get from the pharmacy is more than 50% less than the hospital. But the treatment always cured me.

I know at Khon Kaen Ram mist of the doctors also work at the University Hospital.

[Traveling Sailor]

I have had a very wide range of experiences with Thai medical treatment. On the bad end, a female doctor at a private clinic telling me that I had an old age problem causing my foot pain, without an examination, which turned out to be a peice of glass in the bottom of my foot. On the good end, a Thai endicronologist at a Bangkok hospital who spent two tours at the San Diego Veterans Hospital. This guy was wonderful. He did tests that most Thai trained doctors have not even heard of and cannot be done in most Thai hospitals. I was recently told by a doctor at a Samui hospital that I had finally moved from Pre-Diabetes to Diabetes because of my fasting blood sugar results. I decided to get a second opinion before starting medication and set up the appointment to coinside with my annual Bangkok treck. This wonderful, US trained doctor was able to determine that, not only did I not have Diabetes, but I didn't even have Pre-Diabetes. I was still suffering from Hypoglycemia, which I had been fighting most of my adult life.

So Bil2054, If you want the name and hospital of this wonderful, knowledgable Diabetes specialist, send me an email and I will be happy to oblige. Cheers!

PS: In September I go back to see this doctor, as he has ordered a CT scan so that he can monitor my heart health. In my experience of over 5 years here, the first doctor who has agreed to do something, anything, extra.

Would you please give the name of the endocrinologist as we get frequent requests to recommend a diabetes specialist. There is no problem with naming individual doctors in a positive context. Thanks!

Yes, happily. His name is Dr. Sithiphol Chinnapongse and he works in the Endocrinology and Diabetes Center at Bangkok Hospital. Very knowledgable with great "bedside manner". His focus is listed as: Diabetes, Thyroid, Insulin Pump, Lipid, Calcium & Osteoporosis.

[Traveling Sailor]

I appreciate the views and experiences related in this topic.

I intend to retire in LOS, and as a diabetic, cardiac patient, etc., this is all near and dear.

Does anybody have experience with the variety of expat insurance programs, and how they work with the Thai health system?

Also, any advice on where to go for medical attention in Ubon Ratchathani?

I had been pondering the whole subject, as I mentioned to a couple of Thai friends that I was going to see my doctor

yesterday, just a periodic check and to get my prescriptions up to date, etc. They both seemed a bit alarmed; "What is wrong?", "You sick?"?"and so on. Preventative or ongoing care seemed to not be part of their expectations.

I found in the course of my two month visit last year that I can walk ok, due to a mile lower elevation than here on the Colorado Plateau, and the abundance of fresh fruit and vegetables also were a great advantage health wise.

I have had a very wide range of experiences with Thai medical treatment. On the bad end, a female doctor at a private clinic telling me that I had an old age problem causing my foot pain, without an examination, which turned out to be a peice of glass in the bottom of my foot. On the good end, a Thai endicronologist at a Bangkok hospital who spent two tours at the San Diego Veterans Hospital. This guy was wonderful. He did tests that most Thai trained doctors have not even heard of and cannot be done in most Thai hospitals. I was recently told by a doctor at a Samui hospital that I had finally moved from Pre-Diabetes to Diabetes because of my fasting blood sugar results. I decided to get a second opinion before starting medication and set up the appointment to coinside with my annual Bangkok treck. This wonderful, US trained doctor was able to determine that, not only did I not have Diabetes, but I didn't even have Pre-Diabetes. I was still suffering from Hypoglycemia, which I had been fighting most of my adult life.

So Bil2054, If you want the name and hospital of this wonderful, knowledgable Diabetes specialist, send me an email and I will be happy to oblige. Cheers!

PS: In September I go back to see this doctor, as he has ordered a CT scan so that he can monitor my heart health. In my experience of over 5 years here, the first doctor who has agreed to do something, anything, extra.

The glass in the foot story is amazing...

Ah Yes! Another story: A female friend of mine was, and still is, getting severe headaches in the left rear quadrent of her skull. After going to a couple of hospitals and clinics in Nakhon si Thammarat provence, I decided to take her to a well known international hospital in Phuket. We arrived about one pm and were sent to the neurology department. After a nurse took vitals and statement, we were seen by a youngish neurologest who asked more questions. To make a long story short, after 1 1/2 days, an MRI, a visit to a heart doctor and an ear-nose-throat doctor, and parting with about 30,000 baht, there was no problem determined and no medicine provided. A complete waste of time and money. The doctor, having only rote learned Thai schooling, was clueless when confronted with something unusual. By the time I walked out of that "international" hospital, I was livid. Back home, I checked the "find a doctor" page on the hospital's website and found there wasn't a single doctor in the neurology department who had any training outside of Thailand.

[Sheryl]

I have had a very wide range of experiences with Thai medical treatment. On the bad end, a female doctor at a private clinic telling me that I had an old age problem causing my foot pain, without an examination, which turned out to be a peice of glass in the bottom of my foot. On the good end, a Thai endicronologist at a Bangkok hospital who spent two tours at the San Diego Veterans Hospital. This guy was wonderful. He did tests that most Thai trained doctors have not even heard of and cannot be done in most Thai hospitals. I was recently told by a doctor at a Samui hospital that I had finally moved from Pre-Diabetes to Diabetes because of my fasting blood sugar results. I decided to get a second opinion before starting medication and set up the appointment to coinside with my annual Bangkok treck. This wonderful, US trained doctor was able to determine that, not only did I not have Diabetes, but I didn't even have Pre-Diabetes. I was still suffering from Hypoglycemia, which I had been fighting most of my adult life.

So Bil2054, If you want the name and hospital of this wonderful, knowledgable Diabetes specialist, send me an email and I will be happy to oblige. Cheers!

PS: In September I go back to see this doctor, as he has ordered a CT scan so that he can monitor my heart health. In my experience of over 5 years here, the first doctor who has agreed to do something, anything, extra.

Would you please give the name of the endocrinologist as we get frequent requests to recommend a diabetes specialist. There is no problem with naming individual doctors in a positive context. Thanks!

Yes, happily. His name is Dr. Sithiphol Chinnapongse and he works in the Endocrinology and Diabetes Center at Bangkok Hospital. Very knowledgable with great "bedside manner". His focus is listed as: Diabetes, Thyroid, Insulin Pump, Lipid, Calcium & Osteoporosis.

Very good to know. Thanks.

[Sheryl]

Ah Yes! Another story: A female friend of mine was, and still is, getting severe headaches in the left rear quadrent of her skull. After going to a couple of hospitals and clinics in Nakhon si Thammarat provence, I decided to take her to a well known international hospital in Phuket. We arrived about one pm and were sent to the neurology department. After a nurse took vitals and statement, we were seen by a youngish neurologest who asked more questions. To make a long story short, after 1 1/2 days, an MRI, a visit to a heart doctor and an ear-nose-throat doctor, and parting with about 30,000 baht, there was no problem determined and no medicine provided. A complete waste of time and money. The doctor, having only rote learned Thai schooling, was clueless when confronted with something unusual. By the time I walked out of that "international" hospital, I was livid. Back home, I checked the "find a doctor" page on the hospital's website and found there wasn't a single doctor in the neurology department who had any training outside of Thailand.

You will almost never find western trained doctors at "international" hospitals in the provinces. The level of expertise available is in no way comparable to their Bangkok branch. It is not easy to attract top specialists and the like to areas outside of Bangkok and lacking a medical school.

However I would have to disagree that the workup done was a "complete waste of time and money". With a problem such as described, the objective is to rule out (1) potentially life threatening causes such as brain tumor or aneurysm and (2) headache secondary to other conditions (e.g. sinusitis) that need and respond to treatment.

Sounds like that was done . Negative findings are still findings and important ones at that. As to "no medicine provided", would you really have wanted them to give paracetemol or NSAIDs at hospital pharmacy prices when readily available at a fraction of that? Because that would be what was indicated. Quite possible they told her this and verified she already has the meds, as anyone suffering chronic headaches likely would.

BTW has she tried back and neck massage? And does she tend to carry a purse strap on her left shoulder?

[thailand49]

When I started to read the post, after the first sentence I knew it had to be a experience from a Private Hospital. The story is much I have experience many times at BPH, in general, makes you wonder if they are taught any bedside manners. Maybe they are insecure about there English? sure that has something to do with it. To be honest many of the male Doctors seem to have this problem.

Many of these Doctors are not Internationally trained, majority of the International Hospital false advertise like no one is going to check? If a credential is hung it is generally a short week seminar in the U.S.

These private hospitals have quotas to meet that is why they are not willing to let go of test etc.. they want to monopoly the case. their interest is not really with your care but with the profit of the hospital.

From my experience, and it has been voiced by even Government officials the disparity of service and cost between public and private. The private medical system is only for the haves, if you think you can use it and then ask for a itemized statements etc... don't bother to go.

If you have something simple and common you are in good hands but if they have to dig and dig for the problem I personally have serious doubts and would pray I can get better get on a airplane and go home to a local County hospital than allow a Thai private hospital soak and treat me like a guinea pig.

[mogandave]

I use private hospitals 90% of the time and never have any trouble getting itemized bills.

I expect them to make money, if they don't they go out of business, and I'd have to go to the government hospitals.

I always seem to get good care.

[lopburi3]

As said detailed receipt is available anywhere (but most do not understand itemized as a word so say detailed).

Doctors get paid a fee by patient - in most cases doctors do not have financial interest in hospital and are free to change there location if they feel another is better for them or patients. Hospital staff and stock holders are those being paid by tests/drugs/stays.

Thailand has been regarded as a medical treatment center in the region since well before my first visit 47 years ago and facilities are still considered to be of good international standards.

Having foreign medical qualifications is a positive reference but not something that is required to be a good doctor. But better understanding of patients language makes for an easier route to finding the problem so those with time in English speaking countries are likely to be a good choice for those speaking English better than Thai. So yes, digging may be easier done in your home country.

[Sheryl]

....Many of these Doctors are not Internationally trained, majority of the International Hospital false advertise like no one is going to check? If a credential is hung it is generally a short week seminar in the U.S.

There are many internationally trained (and I mean really trained, not short seminars and the like) doctors in international hospitals in Bangkok. Including some truly outstanding, internationally renowned ones. (They are often also at the government teaching hospitals, but in a senior supervisory capacity there with most care delivered by interns and residents under them).

It is the provincial branches of "interntaional" hospitals which have very few internationally trained doctors.

In the provinces, it is usually better to go to a large government hospital.

In Bangkok, if you understand how best to use the two systems, it is possible to get good care at either a private or a public hospital, and it comes down to time and conveniences vs. cost. (For people for whom time is money, public hospitals are may be actually more expensive for outpatient things).

[thailand49]

Sheryl,

Thank you for your perspective.it is refreshing because here in Pattaya from my experience I have real doubts. It seems to be all about show and tell and money for these private hospitals. I've seen the prices raise to unbelievable levels and even told to my face after being quoted by mistake a price for Thai, " that is Thai price ".

I'm always interested and willing to learn. Do you have any recommendations of University Teaching Hospitals as you mentioned, and do you have a example of how to make better use of the two systems? I basically would like to do visits and research for I know my personal storm will be coming?

Thanks

[mogandave]

Seems a lot of the international hospitals have pricing on their websites.

Why not check before you go?

[chubby]

i'm curious, which family of drugs might be better to pay a premium and get at the hospital (assumign hospitals never had countefeit meds)

and/or would big name pharmacys outside the hospital be unlikely to sell any counterfeit drugs, eg antibiotics ?

[chubby]

sort of curious why you had surgery 'the same day' for this type of problem?

Signs and symptoms[edit]

Nasal polyps are usually classified into antrochoanal polyps and ethmoidal polyps. Antrochoanal polyps arise from the maxillary sinuses and are the much less common,^[3] ethmoidal polyps arise from the ethmoidal sinuses.^[4]

Symptoms of polyps include nasal congestion, sinusitis, anosmia (loss of smell), and secondary infection leading to headache. They may be removed by surgery, but are found to recur in about 70% of cases. Sinus surgery requires a great amount of precision as this involves risk of damage to orbit matter.^[5]

Here's my experience. Diagnosed with nasal polyps, went to a large private hopsital, checked out and agreed to do operation the same night. Told them I had insurance coverage but wanted me to guarantee payment if not covered by insurer. I agreed and was given an estimate of between B150k to B200k, which not knowing costs, seemed reasonable. They then asked for B100k deposit, told I'd give B20k, as by this time they had determined insurer would meet certain costs. Later found out this was $100k. The costs charged ended up being B153k, which turned out to be B53k over what the insurer paid. I was also advised that the fees charged were B53k over what two other hospitals would charge. My mistake for not getting another quote.

Anyway, that aside, I was operated on the same night, woke up the next day and looked like I had done 20 rounds with Mohammad Ali. Complained to ENT specialist about extreme headaches and eye pain and later was taken down and had nose packing removed. Pain stopped within 10 minutes. Was then checked by eye specialist who told me they had instructed specialist to remove packing as it had been packed too tightly. I also complained about pain in eyes and the eye specialist checked and gave me medication but made no mention of any other problem. The ENT specialist wanted to discharge me on the Saturday but I asked to stay another day as I was concerned abut my eyes. Stayed another day and was discharged and returned home the same day. My head during the night and next morning swelled like a football and later the following evening I went to local clinic and was rushed from there to the ER of the local hospital with post op complications.

Admitted and remained there for 3 days and was advised that they did not know what was causing the problem and advised to go to a larger hospital. This happened and after being discharged I was taken to a major government hospital, where, after an examination I was admitted and remained for two weeks. Here it was determined that I had suffered major trauma to the intraocular muscles in one eye, which cause me to have double vision and would require further surgery in an attempt to rectify the problem. I was also told that it was highly likely that the damage occurred during the nasal operation.

As a result I informed the ENT doctor, who after speaking with doctors at this hospital, although not admitting to causing the problem, undertook to meet some extra costs that had been incurred and also indicated that this had never happened before in respect of his competing similar operations. Over the next 1o months I had two operations which, unfortunately, did not rectify the problem caused to my eye and now I have to wear a patch over the damaged eye as if I don't I become disorientated and lose my balance when walking. I was also told that the damage occasioned was a complication that could occur, along with a number of others. I was initially told that complications that could arise was excessive bleeding and infections but never told about what could occur to my eye, as had I, I would never have undergone the surgery.

I later did a search of the internet and found out that although the surgery could cause this particular complication, it was rare. Seeing I wasn't told, it may well be that they doctor didn't know either. I later returned to the hospital and obtained a copy of my medical records, where it was discovered that following my initial operation, the eye specialist had examined my eyes the next morning and had recorded that muscle damaged had been occasioned to my right eye. Yet no one ever told me of this and I only found out about this after I was admitted to the third hospital.

So now I am stuck with ruined eyesight, cannot drive, have trouble getting around and my wife has to take time off work to take me to the last hospital for regular examinations. Since this I have had a meeting with the medical board of the initial hospital, in relation to compensation but they have tried to stretch out the time it takes them to do their investigation so as to run the time over 12 months, which is the time factor that I have to sue. Fortunately for me, I was able to find an experienced lawyer, who has since lodged a civil claim against the hospital and doctor, as a well as a criminal charge against the doctor for a wrongful act (medical negligence) a few days prior to the 12 month expiry.

For obvious reasons I have not mentioned the names of the hospitals or medico's involved but the second and third hospitals provided excellent treatment, despite the second hospital not being able to diagnose what had caused the post op complications. The initial hospital and third hospital are both well known, the first being a private establishment, thethird a large government hospital. The care given at the latter was just as good, if not better, than the private establishment, with the costs being one fifth of those charged at the private hospital. So now, besides having had two additional operations, I now have to go through a legal battle, which will take god knows how long, and even then there is no guarantee that I will be compensated but I do have the guarantee that my eyesight cannot be returned to normal and will have the use of just one eye for the rest of my life.

[Si Thea01]

sort of curious why you had surgery 'the same day' for this type of problem?

Signs and symptoms[edit]

Nasal polyps are usually classified into antrochoanal polyps and ethmoidal polyps. Antrochoanal polyps arise from the maxillary sinuses and are the much less common,^[3] ethmoidal polyps arise from the ethmoidal sinuses.^[4]

Symptoms of polyps include nasal congestion, sinusitis, anosmia (loss of smell), and secondary infection leading to headache. They may be removed by surgery, but are found to recur in about 70% of cases. Sinus surgery requires a great amount of precision as this involves risk of damage to orbit matter.^[5]

Here's my experience. Diagnosed with nasal polyps, went to a large private hopsital, checked out and agreed to do operation the same night. Told them I had insurance coverage but wanted me to guarantee payment if not covered by insurer. I agreed and was given an estimate of between B150k to B200k, which not knowing costs, seemed reasonable. They then asked for B100k deposit, told I'd give B20k, as by this time they had determined insurer would meet certain costs. Later found out this was $100k. The costs charged ended up being B153k, which turned out to be B53k over what the insurer paid. I was also advised that the fees charged were B53k over what two other hospitals would charge. My mistake for not getting another quote.

Anyway, that aside, I was operated on the same night, woke up the next day and looked like I had done 20 rounds with Mohammad Ali. Complained to ENT specialist about extreme headaches and eye pain and later was taken down and had nose packing removed. Pain stopped within 10 minutes. Was then checked by eye specialist who told me they had instructed specialist to remove packing as it had been packed too tightly. I also complained about pain in eyes and the eye specialist checked and gave me medication but made no mention of any other problem. The ENT specialist wanted to discharge me on the Saturday but I asked to stay another day as I was concerned abut my eyes. Stayed another day and was discharged and returned home the same day. My head during the night and next morning swelled like a football and later the following evening I went to local clinic and was rushed from there to the ER of the local hospital with post op complications.

Admitted and remained there for 3 days and was advised that they did not know what was causing the problem and advised to go to a larger hospital. This happened and after being discharged I was taken to a major government hospital, where, after an examination I was admitted and remained for two weeks. Here it was determined that I had suffered major trauma to the intraocular muscles in one eye, which cause me to have double vision and would require further surgery in an attempt to rectify the problem. I was also told that it was highly likely that the damage occurred during the nasal operation.

As a result I informed the ENT doctor, who after speaking with doctors at this hospital, although not admitting to causing the problem, undertook to meet some extra costs that had been incurred and also indicated that this had never happened before in respect of his competing similar operations. Over the next 1o months I had two operations which, unfortunately, did not rectify the problem caused to my eye and now I have to wear a patch over the damaged eye as if I don't I become disorientated and lose my balance when walking. I was also told that the damage occasioned was a complication that could occur, along with a number of others. I was initially told that complications that could arise was excessive bleeding and infections but never told about what could occur to my eye, as had I, I would never have undergone the surgery.

I later did a search of the internet and found out that although the surgery could cause this particular complication, it was rare. Seeing I wasn't told, it may well be that they doctor didn't know either. I later returned to the hospital and obtained a copy of my medical records, where it was discovered that following my initial operation, the eye specialist had examined my eyes the next morning and had recorded that muscle damaged had been occasioned to my right eye. Yet no one ever told me of this and I only found out about this after I was admitted to the third hospital.

So now I am stuck with ruined eyesight, cannot drive, have trouble getting around and my wife has to take time off work to take me to the last hospital for regular examinations. Since this I have had a meeting with the medical board of the initial hospital, in relation to compensation but they have tried to stretch out the time it takes them to do their investigation so as to run the time over 12 months, which is the time factor that I have to sue. Fortunately for me, I was able to find an experienced lawyer, who has since lodged a civil claim against the hospital and doctor, as a well as a criminal charge against the doctor for a wrongful act (medical negligence) a few days prior to the 12 month expiry.

For obvious reasons I have not mentioned the names of the hospitals or medico's involved but the second and third hospitals provided excellent treatment, despite the second hospital not being able to diagnose what had caused the post op complications. The initial hospital and third hospital are both well known, the first being a private establishment, thethird a large government hospital. The care given at the latter was just as good, if not better, than the private establishment, with the costs being one fifth of those charged at the private hospital. So now, besides having had two additional operations, I now have to go through a legal battle, which will take god knows how long, and even then there is no guarantee that I will be compensated but I do have the guarantee that my eyesight cannot be returned to normal and will have the use of just one eye for the rest of my life.

The polyps were so large that they completely blocked the nasal passages, and breathing through the nose was not possible. According to their records, I was also suffering from chronic sinusitis, so why the same day, I cannot tell you, so your curiosity will have to wait. The doctor was the one who, after all his examinations, indicated he could operate that night so, unfortunately, putting my faith in him, I agreed, so maybe when we get to the mediation process, he will be able to answer why he elected to do it the same day. However, given what my insurer has since informed me, it may well be that the hospital did not want to lose a patient and the greed factor set in. Just have to wait and see.

[piersbeckett]

in my home country, a doctor can diagnose a urinary problem and give the right medication for it

you don't go to a specialist for everything & nothing

you go see your "house" doctor first and when needed, he will tell you to go see a specialist in the hospital

my home doctor also takes blood or piss or stool and send it to the lab

when I have a cut in my let's say finger, do I go see the normal doctor or a bone pr platisc surgeon ?

Obviously for a simple cut, one sees a GP (or any other available doctor).

But this is Thailand, not your home country, and (1) medical care is very specialized/siloed; (2) quality of GPs is generally not very good, though there are exceptions; (3) many things that in the west would be considered normal to be handled by a GP are viewed as the sole province of specialists here; and (4) there tends to be a feeling that it is a "loss of face" to refer patients elsewhere with the result that it is not done when it should be in many cases, to the patient's detriment.

I am trying to give advice specific to the reality of how it is in Thailand. Which differs from how it is in western countries in many, many ways.

BTW even in the west, urinary problems are frequently referred to specialists. Depends obviously on the nature of the problem.

Well said - how do you keep your 'cool' !?

[Traveling Sailor]

Ah Yes! Another story: A female friend of mine was, and still is, getting severe headaches in the left rear quadrent of her skull. After going to a couple of hospitals and clinics in Nakhon si Thammarat provence, I decided to take her to a well known international hospital in Phuket. We arrived about one pm and were sent to the neurology department. After a nurse took vitals and statement, we were seen by a youngish neurologest who asked more questions. To make a long story short, after 1 1/2 days, an MRI, a visit to a heart doctor and an ear-nose-throat doctor, and parting with about 30,000 baht, there was no problem determined and no medicine provided. A complete waste of time and money. The doctor, having only rote learned Thai schooling, was clueless when confronted with something unusual. By the time I walked out of that "international" hospital, I was livid. Back home, I checked the "find a doctor" page on the hospital's website and found there wasn't a single doctor in the neurology department who had any training outside of Thailand.

You will almost never find western trained doctors at "international" hospitals in the provinces. The level of expertise available is in no way comparable to their Bangkok branch. It is not easy to attract top specialists and the like to areas outside of Bangkok and lacking a medical school.

However I would have to disagree that the workup done was a "complete waste of time and money". With a problem such as described, the objective is to rule out (1) potentially life threatening causes such as brain tumor or aneurysm and (2) headache secondary to other conditions (e.g. sinusitis) that need and respond to treatment.

Sounds like that was done . Negative findings are still findings and important ones at that. As to "no medicine provided", would you really have wanted them to give paracetemol or NSAIDs at hospital pharmacy prices when readily available at a fraction of that? Because that would be what was indicated. Quite possible they told her this and verified she already has the meds, as anyone suffering chronic headaches likely would.

BTW has she tried back and neck massage? And does she tend to carry a purse strap on her left shoulder?

Thank you for your knowledgable response. And yes, I agree with your first paragraph, as I am finding out the same thing, at least in the southern provences. I just checked out the new Krabi "international" hospital and not only are there no internationally trained doctors, there are very few "seasoned" Thai doctors. Not a place I would recommend or go to.

Yes, the MRI did rule out several things, and it did show that sometime in the past, a mild stroke had happened. I guess that the fact that the doctor kept moving away from the problem at hand (pain and a swelling in the left-rear quadrent, with pain shooting down the left side of the brain stem to the left shoulder), to other "perhaps" causes, symptoms, etc., irked me. It seemed like she was out of her depth, didn't have a clue as to what it might be and was doing everything to "save face". The doctor's English was quite good and I tried to make sure that everything was said to me as well as to my friend. My experience has been that most Thai people tend to believe whatever they are told if the teller is supposed to be an expert at something.

In answer to your drug question, no, I would not have wanted to purchase medicine at the hospital. Under the circumstances, even if medicine had been prescribed, I would not have allowed it to be taken. I have seen too many cases of clueless or programmed doctors prescribing bad or inappropreate medicine. Any medicine that a doctor prescribes to me is researched by me before I take it. And that goes for doctors in America as well. :-)

I doubt, although I do not know for sure, that she has tried massage. She almost never carries a shoulder bag. :-)

[Sheryl]

If the MRI indicated a past stroke then together with these unexplained headaches, she really does need to continue to pursue a medical workup. With a really good well trained neurologist which from the sound of it, she has yet to be treated by.

Which in turn may require a trip to Bangkok or Songkhla (Prince of Songkhla Univ Hospital).

But first try the the Nakorn Sri Thammasart Regional Hospital (government hospital in the provincial town). It will have a neurologist being a regional center that receives referrals from multiple provinces. It is also affiliated with a medical school so will have supervising professors. The quality of care in regional government hospitals is good though amenities nil and waits/red tape long.

Bring along copies of all scans done to date. If she can manage to get an official letter of referral out of one of the hospitals that has already treated her it will facilitate getting straight to the neurology dept, otherwise have to run a gauntlet of medical students and internists before getting to specialist.

If she is Thai and can get a letter of referral from the hospital where she is registered the care will be free. Otherwise, have to pay but a fraction of what private hospitals charge.