severe abdominal pain on saturday afternoon, around asoke .....

[chubby]

hello,

friend of mine, is coming to see me complaining of severe abdominal pain, apparently was admitted to hospital for overnight last week. not sure yet if it is female or GI problem.

would you advise (sheryl) something like a GI or OBGYN ?

are there saturday /sunday office hours for these kind of doctors?

.......looks like bumrungrad has some https://www.bumrungrad.com/en/search-for-a-thailand-doctor

apparently she doesn't have her government ID, or wants to not go back to a government hospital,

.......any advice on a private hospital doesn't have to be Bumrumgrad, but something efficient in quality and time around Asok/lower sukhumwit ; and/or particular MDs, I'll run a search in the forum

so, any advice on how and where to book an appointment vs. the ER / ED ; emergency room ; which i'm guessing might be a long wait ........ etc

thanks

Edited February 13, 2016 by chubby

[JHolmesJr]

First round of defense should be to take some charcoal pills to absorb any toxins that may have been ingested.

Theres a medicine you get in any boots or pharmacy…its a sachet containing a clay like powered that you mix in water and chug down…works a treat…the name I'll update when it comes to me, but it is a white packet with blue lettering.

[sunnyjim5]

You should arrange for your friend to see a General Practitioner then, if she needs specialist advice, the GP can point her in the right direction.

[chubby]

actually the pain is Right upper quadrant, seems to be some palpable induration or tightness

is with walking ; apparently had some 'bacteria' in the gut last week ; something prescribed unknown

question is whether to wait or see an MD i guess

Edited February 13, 2016 by chubby

[lopburi3]

GP is not a normal step in Thailand - you go to whatever doctor you have a relationship with and they will refer you to specialists - if you have none admitting nurse crew will suggest or you make the choice. There are very few GP in the Thai medical system - and most would be found in small clinic practice rather than in hospital settings.

[chubby]

maybe internal medicine then 1st

[sunnyjim5]

GP is not a normal step in Thailand - you go to whatever doctor you have a relationship with and they will refer you to specialists - if you have none admitting nurse crew will suggest or you make the choice. There are very few GP in the Thai medical system - and most would be found in small clinic practice rather than in hospital settings.

The OP mentioned the Bumrugrade

A quick search reveals a number of GP's who are available at the hospital

The link leads to the details of one!

https://www.bumrungrad.com/doctors/Watcharaphong-Saechere

[lopburi3]

Most people do not go to one of the most expensive medical facilities to visit a GP - but there are a few available as they have an active emergency room facility. But most people in Thailand will spend there life without a visit to a GP.

[chubby]

i'm wondering if should skip the internal med, and just see GI doc, if it may be gallbladder, pancreatitis quadrants, though i guess those should not be palable , have hardness in upper right quadrant.....

[Sheryl]

RUQ pain does not sound Ob-Gyn.

GI specialist if the pain persists (if it passes then personally I'd just shrug it off).

Private care is quite expensive if scans are hospital admission needed. I would really suggest she return to the government hospital where she is registered, especially since they already have records relevant to this admission.

If determined to see a private doctor, for GI I suggest either Dr. Varocha or Prof. Rungsun at Bangkok Hospital. A consultation without meds or scans will run about 1,500 baht. But admission would be very, very costly, if indicated she should go to the government hospital.

Should try to identify whether there is any relationship between the pain and food: does it occur after eating, especially after eating fatty foods? (suggestive of GB)

[chubby]

ya, bit complicated by my lack of knowledge of what she is eligible for, and/or wants, which seems to change, called hospital gluaynamthai yesterday, as she wanted to go there, not bumrumgrad(which speaks english), GNT told me come before 800pm and can go to OPD for 800baht to see an MD, got there a 1900, and no one person spoke english, and they wanted 3000 up front or something, as eventually it seems the OPD was already closed, so I guess that was upfront for the ED, not exactly sure, as I had to speak Thai...

<br>

She seems to have her ID card, does she need some other card to get government hospital care besides just a ID card?

<br>

My initial suggestion was to go back to where the apparent 1st admission happened, but not sure if she is open to that, will try again..thanks<br>

..........apparently now, she is saying, she went to some hospital in Ramkhamhaeng and "was moved" to Bumrumgrad, and that she can't go to a government hospital in Bangkok, because she is a resident of Fang Town in Chiang Mai, and can only get Government care at that location ; does that sound right? ; so it's just as well to go to a private hospital as it won't be cheaper to go to a government hospital in bangkok ,

..........addendum 2: apparently she is only allowed to go to some small clinic in Lad Prao, but thinks it is a bad clinic ........ sigh

Can Thai people get any coverage to go to private hospitals from their standard government insurance, OR must they have purchased private insurance to go to any and all private hospitals.

I know medicalese, but am clueless on how the Thai system works basically, that and language barriers, makes it hard to navigate health care here, so in the past I just default, for my own care to Bumrumgrad...

I'm not thinking its strickly URQ now, but maybe Right sided, though, doesn't seem to be appendix area at all ; i imagine some CT or such will be required for a proper workup ....all she can explain is last week it was "bacteria" ; and possibly was given antibiotics .......

Edited February 14, 2016 by chubby

[chubby]

looks like both

Dr. Varocha or Prof. Rungsun at Bangkok Hospital.

are internal medicine, though they are in a GI clinic ?

.......Dr V. only takes tues, thurs, sat , so made an appt for Tues 1000, though, not sure can wait that long, or should wait that long. Prof. R apparently is only on-call and takes no "OPD" appointments at all ..

........could one be seen by a GI MD on sunday at say Bumrumgrad, and be admitted into a less expensive hospital , if the Bumrumgrad MD had "privelidges" at > 1 hospital, or does that happen in Thailand ?

....... do appreciate the referral ideas though

PS: the pain apparently is not any better or worse, and/or possibly a bit worse, i can't explain "if you eat fatty foods does it increase/or did it increase the pain" ...so thats a dead end, eating very little, but had appetite, but no food last night, is regular with BM apparently for whatever intake has happened, afebrile yesterday, haven't checked today yet

Edited February 14, 2016 by chubby

[chubby]

friend of mine, is suggested Bangkok Christian as a less expensive starting point for Sunday ER /ED visit. ; though Bumrumgrad has GI OPD appointments on Sundays, and Bangkok Christian only has GI on call apparently.

my friend also says there should be no reason a Chiang Mai person can't go to a government hospital, unless they haven't paid their ?30Baht/month for the Thailand insurance ; not sure what the lad prao clinic thing is; maybe that is the/a weekend government designated OPD clinic

.....update now: is there is some blood in the Urine. so, maybe atypical pain location for a UTI, but possibly less concerning there is some symptom of note other than diffuse abdominal pain ; i guess a ER workup maybe still a good thing to do, rather than just starting UTI antibiotics again .....

[Sheryl]

Dr. Rungsun and Dr. Varocha are both GI specialists. All GI specilaists are also internists and it will always also say internal medicine, ditto all the other medical specialties.

A government hospital even if paying out of pocket will cost vastly less than the least expensive private hospital by a factor of 5 fold.

She is registered at the government hospital where she is listed in a tabian ban and needs only to present her tabian ban the first time she goes and then nothing thereafter.

She can get any necessary emergency care at any government hospital if she is far from the hospital where she is registered but for non-emergency care indeed has to go back there.

I strongly advise you to stay out of this, you are IMO being used and the tab could well come to over a million baht, even over 3 million if surgery is involved.

[MaeJoMTB]

Gall bladder infection or appendicitis.

A 48hr delay in treatment for either of these can result in severe complications or death.

Best to see a doctor within hours of the pain.

Edited February 14, 2016 by MaeJoMTB

[Sheryl]

With the blood in the urine, UTI or kidney/bladder stones also a possibility.

Either way she should use the government system as she undoubtedly would if the OP wasn't showing an inclination to bankroll her.

[chubby]

live and learn, this is someone i've known for a few years, asking for help. not from bkk, nor knowing the health care system. but, we decided to go to BKK Christian, which indeed was reasonable.

though, i'm not above "being used" ; not quite that simple, as i usually do I probably did a "TMI" here .......but god bless you, as they say at BCH ......