Hemodialysis

[ericl]

Hello !

I am a french citizen and I am looking for a hospital in Mae Sai which provides hemodialysis with a catheter. Do you know one please ? And how can I contact them ?

Thank you !

[sunnyjim5]

Haemodialysis is unlikely to be available in other than in major hospitals.

Are you currently in Thailand ?

[Sheryl]

You won't find this in Mae Sai. Would have to go into Chiang Rai. Chiang Rai Prachanukroh Hospital is a large regional hospital and can certainly do it. Would have to go in person during government working hours, arriving very early in the morning (the earlier the better - people start queuing by 7 AM or earlier), register first and then explain that you need the dialysis clinic. Might take the better part of a day to see a specialist and get scheduled. Be sure to have all medical records with you.

[ericl]

@sunnyjim5 : No, it is for my mother et she plans to go to Thailand (she speaks Thai, she has familly in Mae Sai).

@Sheryl : Thank you for your answer. And what about Kasemrad Hospital ? Do you know it ? Is it better than Chiang Rai Prachanukroh Hospital ?

[Sheryl]

It is not better - but it IS about 5 times as expensive. They can do it, though. And while no better in terms of quality, it would be quicker/easier to schedule. So if she is only going to need one or two sessions and can afford it, you might think of this route. The only thing I am not sure of is how often their kidney specialist is available, best to call the hospital and check - he will almost certainly also work at the government hospital and might have quite limited hours. While the dialysis itself can be done by nursing staff, she has to see a doctor initially to set it up.

If your mother has Thai citizenship, she can get treatment for free through the universal health care system. She will have to first go to the hospital which covers the place where she is listed in a tabian ban (house registration book). If that is Mae Sai, it is a small community hospital and will refer her to Chiang Rai Prachanukroh, but she needs to still go there first to get the referral letter as without that she would have to pay (still at a rate much less than Kasemrod though).

[ericl]

Oh I see, thank you very much for these information.

I made inquiries with some hospitals and here, and they answered me (including you ^^) that I have to schedule a meeting with a specialist. But as my mother has to have dialysis 3 times per week, it is quite short to shedule a meeting at the hospital before the sessions (since we live in France). I don't know if you understand what I mean, sorry for my english.

Is it possible to do all the administrative process online, By the Internet, including the sending of medical records, the devis cost estimate from the hospital etc .. ?

Edited January 3, 2016 by ericl

[Sheryl]

I understand what you mean. But you definitely cannot make these arrangements ahead of time for the government hospital. It might be possible with Kasemrod but I wouldn't guarantee it. However,once she has seen the doctor the hemodialysis can proceed quite quickly. If it is a morning appointment could be the same day, otherwise the following one. Services are quick at private hospitals, it is one of their main advantages.

I think the best thing to do is (1) call Kasemrod and find out what days the kidney specialist is there and make an appointment for the earliest time slot; also verify with them that the can do hemodialysis any day of the week once she has been seen and doctor has ordered it (I think so but make sure); (2) schedule her trip such that she arrives in Chiang Rai either the day of her appointment or the day before, no more than that; and (3) make sure she has a dialysis session immediately before she leaves, i.e. the day before (or the day of departure if it is a night time flight). These measures will hopefully insure that not more than 3 days elapse between sessions.

You don't mention how long she will be here but unless it is a very quick visit I suggest she also go through the process to arrange to get it at the government hospital, because it is going to be very costly at Kasemrod. Once she starts at the government hospital can then stop at Kasemrod, i.e. use it just for the first few sessions while she is getting through the process at the government hospital.

Her family members will likely be able to help her through the government hospital process, they should be familiar with the system.

She should also bring a letter from her doctor in France with her giving her history, most recent lab results and usual order for hemodialysis. The letter needs to be in English, no one here can read French. However most doctors can read English, even if they don't speak it well.

When you talk with the hospital (or when she does -- may be easier for her to do it in Thai) be sure to find out what the dialysis will cost as she'll need to have enough money with her or a credit card with sufficiently high limit. Remember that in addition to the dialysis fee there will be lab test costs. Doctor visits may be about 1,000 baht each time and they may charge her for a visit at each session since the doctor needs to review lab results etc.

[ericl]

She doesn't have an axact idea about the longer of her stay, but no more than one week I think. Maybe one week in Bangkok, one in Chiang Mai and one in Mae sai (or only 2 weeks in all).

Anyway, I thank you for your advice. I most likely come back to you when I will have more information and other questions to ask you !

[sunnyjim5]

She doesn't have an axact idea about the longer of her stay, but no more than one week I think. Maybe one week in Bangkok, one in Chiang Mai and one in Mae sai (or only 2 weeks in all).

Anyway, I thank you for your advice. I most likely come back to you when I will have more information and other questions to ask you !

Which means Dialysis will have to be arranged in more than one place place if the lady need treatment 3x week.

This will prove very difficult to arrange via Government hospitals. Private care may be the only (expensive) option.

[ericl]

Yes I think I would choose Bangkok Hospital because they have an hospital in Bangkok and Chiang Mai (except if you advise me against this hospital). It could be easier to choose one same group regarding administrative process. Then for Chiang Rai I would choose another.

[Sheryl]

If she is going to be first in Bangkok then CR, indeed Bangkok Hospital is best choice and Bangkok Hospital in Bkk is far easier to deal with by phone/email than their upcountry branches.

Complete this form http://www.bangkokhospital.com/index.php/en/refer-patient and they should get in touch with you. Under "treatment given" put "has received hemodiaylsis three times a week for the past (time period). " Under "reason for referral" put "need to arrange for outpatient hemodialysis three times a week for a two-three week period while visiting Thailand. Will first be in Bangkok and then in Chiang Rai" (no need to mention Mae Sai as it is in Chiang Rai province, and the hospital is only in CR town).

Given the short time periods in any one location indeed I don't think care at a government hospital will be feasible.

It is going to be necessary to firmly fix her itinerary in advance in order to ensure uninterrupted care. The hospital will need to know the dates and length of time in both Bangkok and Chiang Rai.

She can have doctor consultation in Bkk and stay under that doctor's care, they can send the orders for dialysis to the CR Hospital for her. You don't mention it but I would assume she will return to Bkk before leaving?

[ericl]

Ok I will talk to her about what you said. Yes, she would return to Bangkok before leaving.

Let's assume she wants to stay a few days at BKK, then Chiang Mai, then Chiang Rai (to go to Mae Sai), and she has 3 sessions per week like in France. Here, she has a session on tuesday, thursday, and saturday. So she has 2 free days on sunday and monday.

Don't you think it would be better to stay one week in each cities in order to move to the next city sunday for example ?

[Sheryl]

I think it will be very hard to maintain her scheduled sessions if she moves about more frequently than once a week. And you will have to time her departure etc with the schedule.

What would make sense would be something like this:

Depart either Saturday evening (after dialysis) or Sunday

See doctor in Bkk either Sunday or Monday to get the hemodialysis orded, labs done etc

Dialysis in Bangkok Tuesday, Thursday and Saturday. Arrange to have orders sent on to Kasemrod hospital for the following week(s).

travel to Chiang Rai on Sunday. Hemodialysis in Chiang Rai Tuesday, Thursday and Saturday - times 2 weeks if she wants to stay that long. For treatment purposes makes no difference if she is in CR or Mae Sai as in Mae Sai she still has to come to Chiang Rai town for treatment. But note that it is over an hours drive - maybe an hour and a half - from Mae Sai to Chinag Rai town. So her family would have to be able to drive her to and fro. It might be better if she stayed in Chiang Rai altogether and had them come visit her there, perhaps making just a 2 day trip back to Mae Sai (say Saturday evening after dialysis and return by Monday evening) if she really wants to see the town.

Then again return to Bangkok on a Sunday or Monday with dialysis on a Tuesday and plane on departure flight either Tuesday after dialysis or Wednesday so that she can resume by Thursday in France.

Does she have a good understanding of her condition and the importance of keeping to the dialysis schedule? Unless you will accompany her that is important point. You cannot count on her family in Thailand understanding just how important it is - Thais tend not to have very sophisticated understanding of medical matters.

[ericl]

Yes she does, but sometimes she is fed up lol.

Ok I have to see with her if she can stay 3 weeks. Meanwhile, I have an oncle in BKK who is going to inquire with hospitals about price, process, etc.

Thank you a lot and I keep you informed.

[northernphil]

I think it will be very hard to maintain her scheduled sessions if she moves about more frequently than once a week. And you will have to time her departure etc with the schedule.

What would make sense would be something like this:

Depart either Saturday evening (after dialysis) or Sunday

See doctor in Bkk either Sunday or Monday to get the hemodialysis orded, labs done etc

Dialysis in Bangkok Tuesday, Thursday and Saturday. Arrange to have orders sent on to Kasemrod hospital for the following week(s).

travel to Chiang Rai on Sunday. Hemodialysis in Chiang Rai Tuesday, Thursday and Saturday - times 2 weeks if she wants to stay that long. For treatment purposes makes no difference if she is in CR or Mae Sai as in Mae Sai she still has to come to Chiang Rai town for treatment. But note that it is over an hours drive - maybe an hour and a half - from Mae Sai to Chinag Rai town. So her family would have to be able to drive her to and fro. It might be better if she stayed in Chiang Rai altogether and had them come visit her there, perhaps making just a 2 day trip back to Mae Sai (say Saturday evening after dialysis and return by Monday evening) if she really wants to see the town.

Then again return to Bangkok on a Sunday or Monday with dialysis on a Tuesday and plane on departure flight either Tuesday after dialysis or Wednesday so that she can resume by Thursday in France.

Does she have a good understanding of her condition and the importance of keeping to the dialysis schedule? Unless you will accompany her that is important point. You cannot count on her family in Thailand understanding just how important it is - Thais tend not to have very sophisticated understanding of medical matters.

Hey , Sheryl , Not sure where to find info on TV despite posting over the past year over 1000 posts. For the past week I have been getting nose bleeds . A week ago Saturday I had a little drip for 1 minute. I went to the pub a week ago last Monday and I had a bleed for 10 mins. Now maybe one a day for just a minute. I have been on Cardiprin for about 5 years , are these the problem or something else.

[Sheryl]

You urgently need to see a doctor, and in the meantime hold off on the cardiprin, which is contraindicated when there is bleeding. Problem may be hypertension, excess anticoagulation, combination of both or something else.

In future please start a separate topic rather than tacking onto a thread with unrelated topic.

[ericl]

Sheryl,

Without considering the prices of the hemodialysis sessions and the fact that Bangkok Hospital has a hospital in Chiang Mai (which would make easier the administrative process), do you know which hospital in Bangkok would be the best for hemodialysis please ?

[sunnyjim5]

Sheryl,

Without considering the prices of the hemodialysis sessions and the fact that Bangkok Hospital has a hospital in Chiang Mai (which would make easier the administrative process), do you know which hospital in Bangkok would be the best for hemodialysis please ?

I doubt there is a "best" hospital for haemodialysis but there may be variations in cost.

If your mother wants to visit a number of different places and needs 3x week dialysis then you should select a service which eases the "administration" Attempting to arrange dialysis, at a distance , from multiple providers, will prove to be very complex.

Just my opinion.

[ericl]

Sheryl,

Without considering the prices of the hemodialysis sessions and the fact that Bangkok Hospital has a hospital in Chiang Mai (which would make easier the administrative process), do you know which hospital in Bangkok would be the best for hemodialysis please ?

I doubt there is a "best" hospital for haemodialysis but there may be variations in cost.

If your mother wants to visit a number of different places and needs 3x week dialysis then you should select a service which eases the "administration" Attempting to arrange dialysis, at a distance , from multiple providers, will prove to be very complex.

Just my opinion.

Yes I see, I think you are right. I asked this question because I saw that Bangkok Hospital is a little far from my parent's points of interest (family in Bangkok, etc).

[Sheryl]

Agree. Any hospital which provides dialysis will be able to administer it adequately. But do need to consider the qualifications of the doctor who will oversee her care.

For what you need I think the only hope is to stay within the same hospital system/chain and under the care of the same doctor. Even then it will not be easy to ensure uninterupted care as she travels from one part of the country to another.

It is going to be very hard to arrange all this and I really think the medical care needs to be the focal point around which everything else is planned (choice of hotel etc). Surely family members will understand and accomodate her special needs. One cannot expect an older woman with renal failure on dialysis to be as mobile as someone in normal health. If they really care about seeing her, they will come to whetever she is.