Inguinal hernia cost experience and recovery?

[sapson]

Has anyone had recent experience of a inguinal hernia repair operation here in thailand.

 

Costs etc at private or public hospital, realistic  recovery time etc. where why how etc , how long before you could work again? climb stairs etc? or drive a motorbike?

 

Probably the mesh repair with local anaesetic  is the best option as I think Laproscopic is very expensive,

 

Any recent information ALL areas appreciated and if anyone has had this done in Khon Kaen area that would be incredibly useful bonus info.

 

Also any medical buffs could perhaps have an opinion,

 

Can anything else cause a bulge that can be mistaken for a inguinal hernia, guess if it retracts at night laying down and comes out partially during the day and the cough reflex is their its sadly conclusive or not? think I am clutching at straws here!!

 

Also how long if not in great pain and can poop ok can you wait for the operation to be done.? what are the realistic delay risks?

 

Last thought are you safe to travel if required as in visa trips or  to Bangkok or a ,12 hour flight back to the Uk if required?

 

Thanks guys for any input, greatly appreciated!! 

[cheeryble]

Can't tell you the cost here but can say I had it done in Brighton UK by the dear old NHS.

Four of us were done one after the other as a batch using general anaesthetic and mesh (about 15 years ago).

It was an absolute model of efficiency all done and out same day.....four of us arrive lunchtime in a ward to ourselves, get bed, prep, wait a little while with a book, get wheeled in, get done, wake up and spend a while in bed. Get picked up late afternoon and go home.

As I understand there are muscle layers which repairing fibres grow across, and movement especially early morning, tears these little fibres and damned sore.....and time is needed for recovery.

Never had a problem since.

All I'm saying is if you're Brit and can get it on the NHS don't hesitate......and here in LOS it shouldn't be too expensive if they can do so quickly and no hospital stay.

Good Luck

 

 

 

[sapson]

8 minutes ago, cheeryble said:

Can't tell you the cost here but can say I had it done in Brighton UK by the dear old NHS.

Four of us were done one after the other as a batch using general anaesthetic and mesh (about 15 years ago).

It was an absolute model of efficiency all done and out same day.....four of us arrive lunchtime in a ward to ourselves, get bed, prep, wait a little while with a book, get wheeled in, get done, wake up and spend a while in bed. Get picked up late afternoon and go home.

As I understand there are muscle layers which repairing fibres grow across, and movement especially early morning, tears these little fibres and damned sore.....and time is needed for recovery.

Never had a problem since.

All I'm saying is if you're Brit and can get it on the NHS don't hesitate......and here in LOS it shouldn't be too expensive if they can do so quickly and no hospital stay.

Good Luck

 

 

 

Small  small world......

 

About 20 years ok I had a mesh repair inguinal hernia on the right side ,,,,,,,,,,,,,,,same procedure as you anaesthetic out same day.

Guess where that was done! yes on the NHS......... Brighton UK.............. but if I remember rightly I was on a years waiting list at the time, however I had no idea I had a hernia just a routine docs visit picked it up and I was totally fine during the years wait.

 

BUT ... now twenty years older, in late fifties and 20kgs lighter in body weight, the bulge is sadly large and very very obvious to feel and see except in the morning when waking up first standing it retracted, but then with movement its back out.

 

Brighton twenty years ago.............the memories!

 

.........................................................................................

 

 

Question for the medics when they arrive..............will twenty minutes walking a day etc ,help pull in  or cause further damage?

[cheeryble]

HAHA small world in fact I waited a very short time.

Fact is the NHS is very cheap compared to other countries and for non-urgent treatment there is sometimes......just sometimes......delay.

It's a trade off which I think's a good balance......imagine being under the cloud of worry and overtime the onerous cost of healthcare must bring in the US (unless you're a Congressman of course). British people don't even know what co-pays and deductibles are......thank God.

If you need anything really serious you'll be seen to in a trice, and the government bargains very very hard indeed to keep pharmaceutical costs down.

[Sheryl]

Many, many TV members have had hernia repairs done here, please do a search for those threads. (google" Hernia + site:thaivsia.com).

 

Assuming the hernia is not incarcerated (i.e. you can easily push it back in, though of course it pops back out) this is an elective procedure and there is no immediate rush, nor any contraindication to flying. The reason for repairing a reducible hernia is that the risks of the surgery (in an otherwise healthy person) are much less than the risk it may one day strangulate, which leads to peritonitis and a medical emergency. Most hernias won't, but it is serious if they do, and statistically it is safer to repair it provided the patient is in reasonably good health with no special operative risk factors. My nepohew has had one for about 10 years now and I keep nagging him to have it seen to but I don't lose sleep worrying about him. In other words, yes it is prudent to have it treated but no, it is not in any way an emergency and no reason not to go back to UK to have it done if you are still eligible under NHS there - but as it is an elective procedure, expect to be wait-listed for the actual op.

 

Once repaired and after the healing is complete there is no limit on physical activity.  Surgeon's advice should be sought and followod regarding physical activity in say the first 6 months post op however.

 

Repair can be done laparascopically (most expensive option but quickest recovery) or open, and open approach can be under general or spinal anesthesia. Usually general in a private hospitals here but govt hospitals seem to favor spinal.

 

P.S. And yes, OP what you describe is almost certainly a hernia.

[sapson]

1 hour ago, Sheryl said:

Many, many TV members have had hernia repairs done here, please do a search for those threads. (google" Hernia + site:thaivsia.com).

 

Assuming the hernia is not incarcerated (i.e. you can easily push it back in, though of course it pops back out) this is an elective procedure and there is no immediate rush, nor any contraindication to flying. The reason for repairing a reducible hernia is that the risks of the surgery (in an otherwise healthy person) are much less than the risk it may one day strangulate, which leads to peritonitis and a medical emergency. Most hernias won't, but it is serious if they do, and statistically it is safer to repair it provided the patient is in reasonably good health with no special operative risk factors. My nepohew has had one for about 10 years now and I keep nagging him to have it seen to but I don't lose sleep worrying about him. In other words, yes it is prudent to have it treated but no, it is not in any way an emergency and no reason not to go back to UK to have it done if you are still eligible under NHS there - but as it is an elective procedure, expect to be wait-listed for the actual op.

 

Once repaired and after the healing is complete there is no limit on physical activity.  Surgeon's advice should be sought and followod regarding physical activity in say the first 6 months post op however.

 

Repair can be done laparascopically (most expensive option but quickest recovery) or open, and open approach can be under general or spinal anesthesia. Usually general in a private hospitals here but govt hospitals seem to favor spinal.

 

P.S. And yes, OP what you describe is almost certainly a hernia.

Thanks for the info,any idea on costs,cant find information that is up to date ,would be fantastic if someone has recent experience In Khon kaen area or Issan or Bangkok

[cheeryble]

Check if it's on the list of Bumrungrad standard prices and deduct ?% (half to two thirds?) if you are in a local hospital 

 

Sound right Sheryl?

[Sheryl]

In a government hospital probably around 20,000 give or take. (For open procedure -- double if lapatoscopic and that will be available only in the larger hospitals).

 

Private hospital around 100k open, 200k laparascopic.

 

In Issan area Khon Kaeun Univ hospital is the best and has an after hours clinic which will help avoid the crowds and reduce the waits for not much more cost.

 

 

 

 

 

 

[sapson]

38 minutes ago, Sheryl said:

In a government hospital probably around 20,000 give or take. (For open procedure -- double if lapatoscopic and that will be available only in the larger hospitals).

 

Private hospital around 100k open, 200k laparascopic.

 

In Issan area Khon Kaeun Univ hospital is the best and has an after hours clinic which will help avoid the crowds and reduce the waits for not much more cost.

 

 

 

 

 

 

Thanks Sheryl,

                             That would be Sinagrind hospital I guess, after hours would be from what time in the day do you think?

 

During the day its like a crowd scene from a Ghandi movie.

 

Is their in general a special name for the after hours clinic ? 

 

Maybe I should co post this in the Issan forum, was hoping for someone with recent experience with the operation locally or anywhere in Thailand..............

 

[Sheryl]

Yes, Srinagarind. Probably starts around 4. Ask about the clinic "nawk wela".

 

 

[sapson]

1 hour ago, Sheryl said:

Yes, Srinagarind. Probably starts around 4. Ask about the clinic "nawk wela".

 

 

Sheryl I presume  nawk wela means night time? you certainly know your stuff! thanks

 

Seems almost certainly its a hernia, but once this week , on first stand up in the morning it was flatter than the other side and without a cough reaction..............I was delighted! but then it comes out again after an hour and a cough reflex returns.

 

I guess a doctor fumbling around will confirm it and maybe abdominal ultra sound could confirm it and dismiss any other possibilities if it was an infected or impacted intestine that could be treated with drugs I think.

 

Was walking 5ks a night  and light exercise, only a couple of months ago and fit as a fiddle until I strained a neck and back muscle so cant understand why a sudden hernia.

 

Do you think park circuit walking again maybe only 30 minutes a day could actually help it retract or would it aggravate it further..............maybe my previous walking regime and abdominal exercises was actually keeping it under control and now when I have stopped due to the strained back ..........it appears??? questions questions?

 

Tried the search you suggested but nothing recent.............unless I have overlooked something.

 

Thanks so much for your input, were you? or are you a medical professional! 

[Sheryl]

Nawk wela means "outside of (normal) times" i.e. after hours

 

It is not infected or incarcerated, you would be quite ill if it were and also unable to push it back in. What you are describing is a regular, garden variety inguinal hernia. They occur because there is an opening in part of the abdominal wall in males that normally closes at birth but in some cases doesn't, or does so incompletely, leaving a weak spot where the intestines can pop through and sooner or later they do. Sometimes there is a clear precipitating event and other times not, but in all cases there was weakness in the abdominal wall to start with.

 

Exercise will not fix this. No harm in walking etc.  and moist exercise is also OK  but best avoid abdominal crunches and very heavy lifting.

[banK]

I had mine done in the Bangkok Khon Kaen Hospital last September. I had open surgery under a general anesthetic. I had a mesh repair. 

 

I was in hospital for about 3 or 4 days.

 

Total cost around 200,000 Baht.

 

banK

[cheeryble]

I had mine done in the Bangkok Khon Kaen Hospital last September. I had open surgery under a general anesthetic. I had a mesh repair. 
 
I was in hospital for about 3 or 4 days.
 
Total cost around 200,000 Baht.
 
banK

Scary price for a self insured person like myself.
Same as I paid.....all in....... at Bumrungrad for a highly enlarged thyroid to have the left side removed.


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[sapson]

1 hour ago, banK said:

I had mine done in the Bangkok Khon Kaen Hospital last September. I had open surgery under a general anesthetic. I had a mesh repair. 

 

I was in hospital for about 3 or 4 days.

 

Total cost around 200,000 Baht.

 

banK

Wow thats vey high for khon kaen , a general anesthetic and 3/4 day stay, they sure know how to charge, if you dont mind me asking what age bracket are you in, maybe if late fifties like myself they are more cautious and expensive.

 

Nice service though had a full health check their two years ago for 10k baht which they still do as a promotion price.

 

Would have put that as a Bumrungrad price for Laproscopic,

 

But up to date info which is what I wanted so thanks very much for the input!

 

What was your recovery time as in able to drive a car or motorbike and walk freely?

[banK]

28 minutes ago, sapson said:

Wow thats vey high for khon kaen , a general anesthetic and 3/4 day stay, they sure know how to charge, if you dont mind me asking what age bracket are you in, maybe if late fifties like myself they are more cautious and expensive.

 

Nice service though had a full health check their two years ago for 10k baht which they still do as a promotion price.

 

Would have put that as a Bumrungrad price for Laproscopic,

 

But up to date info which is what I wanted so thanks very much for the input!

 

What was your recovery time as in able to drive a car or motorbike and walk freely?

Yes does seem rather high - they also initially said that I would be icu for one day and the full stay would be for a week.

Both myself and insurer queried the length of time - There was an issue of a previous operation for an AAA 7 months before, they cut down the same scar 20cm and inserted the mesh there. There was also a bit of a problem with my hyper thyroid numbers at the time, the operation had to be put off till they stabilised it.

 

Reading back over my post sounds like I'm falling apart!! I'm fine!! 

 

I actually drove home myself after discharge (30km)., and within a few days I was into my routine of walking on the treadmill for 30mins/day.

 

banK

[banK]

Am 68

 

banK

[cheeryble]

I know it's shutting the stable door after the horse is out but for patients with just about anything wrong with them you might take a look at this page 

 

 http://www.nhs.uk/Conditions/Pages/hub.aspx

 

(I use it to advertise the brilliant NHS website which guess what....saves them money)

Just follow through to the part of the body you need.

it points out that same day or next day discharge is normal for inguinal hernia, and only 10% will have a repeat event.

[sapson]

12 hours ago, banK said:

Am 68

 

banK

Thanks for the info banK , all very good in terms of your recovery driving home etc! but wow that 200k is way out of my league as a self insured at the moment!

[Sheryl]

If you can't afford 200K you are not "self-insured", you are uninsured, and dangerously so.

 

To be "self-insured" in any meaningful way in Thailand you would need to have at least 2-3 million baht set aside and the ability to replenish it if needed, as that is what a true medical emergency will easily set you back here.

 

The hernia is not  really a problem -- ,you can get it done in a government hospital, open approach, for a very reasonable amount. Or, you could have it done back in the UK laparoscopically for the price of the air ticket if you are still covered under NHS (may not be if you have been overseas long).

 

But you need to get insurance in case of something more serious happening - illness, accident etc.

[lopburi3]

On 3/30/2017 at 2:21 PM, cheeryble said:

Check if it's on the list of Bumrungrad standard prices and deduct ?% (half to two thirds?) if you are in a local hospital 

 

Sound right Sheryl?

Do not believe that 'real cost' service is still offered - at least I could not find it when I recently checked there website..

[Sheryl]

Yes, it seems to have vanished now. A pity.

[cheeryble]

A shame ......it was genuine and no nonsense.
In fact I was estimated at 300k baht and ended up paying 200k.
Becoming friends with the doc may have helped :)


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[sapson]

On 3/31/2017 at 4:23 PM, Sheryl said:

If you can't afford 200K you are not "self-insured", you are uninsured, and dangerously so.

 

To be "self-insured" in any meaningful way in Thailand you would need to have at least 2-3 million baht set aside and the ability to replenish it if needed, as that is what a true medical emergency will easily set you back here.

 

The hernia is not  really a problem -- ,you can get it done in a government hospital, open approach, for a very reasonable amount. Or, you could have it done back in the UK laparoscopically for the price of the air ticket if you are still covered under NHS (may not be if you have been overseas long).

 

But you need to get insurance in case of something more serious happening - illness, accident etc.

Some very interesting and concerning points.

 

You may well know or good for the visa section?

 

If this problem were to worsen which I think it is, or one other very concerning problem and you were advised surgery within a week etc,

 

Could you go to local immigration armed with a doctors confirmation letter of your condition confirming unfit to travel and extend a standard visa already extended for  another 30 days or much longer if better, to avoid an overstay and to allow for op scheduling and recovery period on medical grounds..................or do you need to arrive in an ambulance at immigration for this service..............is their any leniency?

[Sheryl]

You need to have a doctor's letter certifying you are unable to travel. Which would be rather undermined by your walking in the door.

 

They also often request photographs of the patient in their hospital bed.

 

Elective surgery won't do it.

[sapson]

14 hours ago, Sheryl said:

You need to have a doctor's letter certifying you are unable to travel. Which would be rather undermined by your walking in the door.

 

They also often request photographs of the patient in their hospital bed.

 

Elective surgery won't do it.

Thanks for that so if I am admitted in hospital, or a  confirmed by a doctor unfit to travel you could send someone with a doctors letter and you passport and fee to get the extension.?

[Sheryl]

Yes but the evidence will need to be substantial. They will want a letter from a hospital, not just a doctor, and photos etc. A hernia repair will not do the trick.

[phetphet]

Besides the laparoscopy method, and mesh method, where a triangular piece of mesh is used, you should be aware that there is also another method where a "shuttlecock" shaped piece of mesh is inserted into the hernia, then a mesh patch over the top.

 

Google "hernia + shuttlecock method"

 

I chose this method in the UK. A double hernia. Both sides done at the same time. The doctor told me it had a far greater success rate against failure or recurrence, and that if it ever failed, he would redo it for free.

 

He explained that over the coming twelve months the body would produce fibroblasts? that would envelop the shuttlecock shaped mesh, which would then act like steel reinforcement in concrete.

 

Spent one night in hospital, then went home. Not painful, but could not do anything strenuous for three to four weeks. Told not to lift anything heavier than 2kg. After the first week, I was out and about, albeit walking slowly and gingerly. Things improved rapidly.

 

IMPORTANT..

I was warned that general anaesthetic causes severe dehydration, and could cause constipation, (and this proved to be true).

Keep well hydrated, and also keep some  medicine to loosen your bowels handy. believe me, you don't want constipation when you have stitches.

I cannot remember the name of the medicine the doctor recommended to me, but it worked.

 

HTH

[sapson]

On 4/2/2017 at 3:16 PM, Sheryl said:

Yes but the evidence will need to be substantial. They will want a letter from a hospital, not just a doctor, and photos etc. A hernia repair will not do the trick.

Thanks for all your input, I did manage to do a visa trip to Vientiane even though concerned so at least bought myself some time,

 

Do you think it is safe to delay the operation for six months or so, was offered a job, but this would involve a lot of time standing.4/5 hours a day............is this viable medically or totally stupid to even contemplate risking it.?

 

 

[Sheryl]

As explained before, this is elective surgery. The only reason for doing it is that on balance, for an otherwise healthy person, the risk of it strangulating are higher than the risk associated with the surgery. (This equation is reversed for the very elderly and people with health conditions placing them at unusual risk for surgery).

 

To give you an idea, the annual risk of strangulation is about 1-2%. Risk of it in a 6 month period would be half that. So odds are 99-99.5% you will  be fine delaying the surgery. You should do it eventually (unless you have helath condition that makes you a poor operative risk) but there is no rush. Some people wait years before getting around to it, and if you had it done back home on the NHS you'd likely be made to wait 6 months or more.

 

In addition, your new job should provide you with insurance through the Thai  Social Security system, unless it is a private school.  This will pay the cost of the surgery in full.