Hiatal hernia + 3 fractured vertebrae = pain/fear for life

[sailorjon]

So, it's understood.  there are no guarantees.   I have seen doctors here with a 'good' reputation and still have no diagnosis.   I think  a little research can find hospitals that are accredited and not poorly staffed and ill equipped.  So I don't understand the warnings.  Some of the best equipped hospitals in thailand have left me in the same condition.      The facilities I have been communicating with are those such as this:   http://www.desunhospital.com/index.php.     Does it look shabby, ill equipped, third world risky?    Also, this:  http://www.rubyhospital.com/.   

[perthperson]

Just now, sailorjon said:

The facilities I have been communicating with are those such as this:   http://www.desunhospital.com/index.php.     Does it look shabby, ill equipped, third world risky?    Also, this:  http://www.rubyhospital.com/.   

I have no knowledge of these facilities but you could use the link I provided to determine if they are JCIA accredited.

[sailorjon]

The bottom line, as they say, appears to be that real financial constraints are a reality for me and seem to be ignored or gainsayed as if I have the luxury of choice no matter my budget.  The cold facts are that I, like billions of others, must take risks with my life to get heathcare partly because of bad choices of not having adequate insurance early enough in life and mostly because we face a health care industry more than a health care solution designed to serve people where they are in the reality rather than profits.

[lopburi3]

Do not see JCI accreditation for either of those hospitals.  That would at least insure normal medical and administrative procedures.  But even for a hospital that has international JCI accreditation there can be a huge difference in doctors abilities.  Doctors are not created equal or because they are of any nationality better than others of another nationality.  

12 minutes ago, sailorjon said:

So, it's understood.  there are no guarantees.   I have seen doctors here with a 'good' reputation and still have no diagnosis.   I think  a little research can find hospitals that are accredited and not poorly staffed and ill equipped.  So I don't understand the warnings.  Some of the best equipped hospitals in thailand have left me in the same condition.      The facilities I have been communicating with are those such as this:   http://www.desunhospital.com/index.php.     Does it look shabby, ill equipped, third world risky?    Also, this:  http://www.rubyhospital.com/.   

 

[sailorjon]

That list shows a grand total of 1 hospital in Kolkata with that accreditation.   Is the suggestion that all the others are dangerous?  Come on.  What part of:  I can't afford the places mentioned is hard to understand?

[teddog]

Just now, perthperson said:

I have no knowledge of these facilities but you could use the link I provided to determine if they are JCIA accredited.

Yes I know that hospital in Goa, the state one,just south of Panjim,huge place,the one so 'run down' a pig would be out of place in....one thing that very hospital saved the life of a woman I knew,fed up to back teeth (and expense) of Thailand decided to fly home ,but caught short by illness en route was put there  ,flesh eating disease

[perthperson]

4 minutes ago, sailorjon said:

That list shows a grand total of 1 hospital in Kolkata with that accreditation.   Is the suggestion that all the others are dangerous?  Come on.  What part of:  I can't afford the places mentioned is hard to understand?

JCIA accreditation provides a reliable  assurance that a medical facility meets internationally agreed standards.

 

If you wish to access non accredited facilities then you must determine if the standards offered are acceptable but beware the flash websites ! 

 

Even within a JCIA facility it is also important that any individual doctors education , qualifications and experience are evaluated prior to seeking care.

[teddog]

Just now, perthperson said:

JCIA accreditation provides a reliable  assurance that a medical facility meets internationally agreed standards.

 

If you wish to access non accredited facilities then you must determine if the standards offered are acceptable but beware the flash websites ! 

 

Even within a JCIA facility it is also important that any individual doctors education , qualifications and experience are evaluated prior to seeking care.

5

This also must be true that a set of liars are waiting to pounce.  You will also see   ref India a lot of them are rcof qualified (Edinburgh) blah blah blah, especially India , shines out, seen one here,and hes long dead   JCIA   right, this is why they are touting for business,nobody getting treated ,go get yourself bandaged up

[Sheryl]

You need to select specific doctors not just hospitals. There are poor doctors to be found in even the best hospitals.

You will end up undiagnosrd in India too if you continue the pattern of refusing recommended consultations etc. Your situation is complex and doctors are not magicians. Guaranteed there will be points where they have to ask you to consult a different type of specialist or have a specific test. If you refuse you will get no further than you did here.

[jpinx]

6 hours ago, sailorjon said:

The bottom line, as they say, appears to be that real financial constraints are a reality for me and seem to be ignored or gainsayed as if I have the luxury of choice no matter my budget.  The cold facts are that I, like billions of others, must take risks with my life to get heathcare partly because of bad choices of not having adequate insurance early enough in life and mostly because we face a health care industry more than a health care solution designed to serve people where they are in the reality rather than profits.

Good to see you face the reality now.  Assessing the quality of healthcare is a black art when you're on a severely limited budget.  You're skirting the fringes of what's good healthcare within your budget, and that forces you into considering the marginal facilities, treatments and professionals.  

 

In my own case I laid a lot of faith on getting my local helper to do the talking and negotiating and this most certainly kept my bills down to something I could manage financially.  It also avoided a lot of the mis-translations that can happen, such as Sheryl pointed out about "gas in the abdomen" when it almost certainly means "gas in your intestines".  It also allows the marginal questions to be asked of a professional. Self-applied colonic irrigation was a good example - where my helper asked the doctor about that and got a non-commital reply that strongly indicated that he wanted to do that himself and the hospitals finances, but could not find a reasonable medical excuse to stop me doing it myself.  Obviously correctly pointed out by Sheryl  and Perthperson, there has to be a large amount of commonsense applied regarding pressure and volume, but it worked very well for me.  I restricted the flow to the bumgun with a clamp and applied the nozzle very gingerly, all the time feeling what is happening inside carefully for any hint of sharp pain.  I don't recommend it - I tell you what I did and let you decide for yourself. 

 

I'll repeat -- I am a patient - not a doctor. 

 

 

[sailorjon]

Again, nonfactual misstatements.  I am not refusing treatments.  Some I cannot afford any longer in BKK if the insurance will not pay.  Pacific Cross is investigating whether they will pay for pulmonary tests and Angiogram.   I have also asked Samitive to submit the recommendation to Pacific Cross for a colonoscopy + biopsy or x-ray with contrast or barium enema.   However, I don't know how procedure can be done if I am not 'cleaned out' first and all the treatments recommended that I HAVE FOLLOWED, laxative after laxitive have not done that job.     I don't have time or money to waste on recommendations from anyone that will not lead to a diagnosis and treatment but rather seems geared to another reality that I don't live in where the patient has unlimited funds and time to perform as many tests as possible to rule out everything first.  I"ve gone to SPECIFIC DOCTORS you recommended with the same results. The pulmonary doctor at st. louis has been out of the country and he will be back next week so I haven't been able to see him yet.

 

 

 

[sailorjon]

5 minutes ago, jpinx said:

Good to see you face the reality now.  Assessing the quality of healthcare is a black art when you're on a severely limited budget.  You're skirting the fringes of what's good healthcare within your budget, and that forces you into considering the marginal facilities, treatments and professionals.  

 

In my own case I laid a lot of faith on getting my local helper to do the talking and negotiating and this most certainly kept my bills down to something I could manage financially.  It also avoided a lot of the mis-translations that can happen, such as Sheryl pointed out about "gas in the abdomen" when it almost certainly means "gas in your intestines".  It also allows the marginal questions to be asked of a professional. Self-applied colonic irrigation was a good example - where my helper asked the doctor about that and got a non-commital reply that strongly indicated that he wanted to do that himself and the hospitals finances, but could not find a reasonable medical excuse to stop me doing it myself.  Obviously correctly pointed out by Sheryl  and Perthperson, there has to be a large amount of commonsense applied regarding pressure and volume, but it worked very well for me.  I restricted the flow to the bumgun with a clamp and applied the nozzle very gingerly, all the time feeling what is happening inside carefully for any hint of sharp pain.  I don't recommend it - I tell you what I did and let you decide for yourself. 

 

I'll repeat -- I am a patient - not a doctor. 

 

 

I have been facing the reality from the beginning.  

[jpinx]

24 minutes ago, sailorjon said:

I have been facing the reality from the beginning.  

I know that -- and you know that too -- but the forum is not a comfortable place to have to lay it all out like this.  Everyone has different experience, so all the advice you get is different and sorting through it is a royal pita. The only thing I'd press you on is to get a local helper to do the talking and other legwork for you because that really made a huge difference to me.  Getting a good relationship with each doctor across a cultural and language barrier is difficult, but it is vital.

[NancyL]

1 hour ago, sailorjon said:

Again, nonfactual misstatements.  I am not refusing treatments.  Some I cannot afford any longer in BKK if the insurance will not pay.  Pacific Cross is investigating whether they will pay for pulmonary tests and Angiogram.   I have also asked Samitive to submit the recommendation to Pacific Cross for a colonoscopy + biopsy or x-ray with contrast or barium enema.   However, I don't know how procedure can be done if I am not 'cleaned out' first and all the treatments recommended that I HAVE FOLLOWED, laxative after laxitive have not done that job.     I don't have time or money to waste on recommendations from anyone that will not lead to a diagnosis and treatment but rather seems geared to another reality that I don't live in where the patient has unlimited funds and time to perform as many tests as possible to rule out everything first.  I"ve gone to SPECIFIC DOCTORS you recommended with the same results. The pulmonary doctor at st. louis has been out of the country and he will be back next week so I haven't been able to see him yet.

 

 

 

I find it difficult to believe that "laxative after laxative" have failed to do the job.  I've had several lower GI procedures in the U.S. where the doctor said the results were "inconclusive" because I wasn't adequately cleaned even though I'd followed their recommended procedure.  I brought this up when I was scheduled for a colonoscopy in Thailand, saying I didn't want to pay for another procedure only to have "inconclusive" results even though I follow instructions to the letter.  He reviewed the CD-rom from a previous procedure and said there were some small, hard pieces of feces remaining in pockets in the colon that could be masking problems.

 

So, the Thai doctor had me eat nothing but clear liquids like broth, soft drinks and fruit and vegetable for five days, and then two days of doing the standard prep, not just one.  The standard prep uses very strong laxatives like magnesium citrate or bisacodyl where you're flushing your system with large amounts of water.  I spent two days within steps of the toilet.

 

After that, the colonoscopy in Thailand went very well.  The view of the colon in the CD-rom showed a nice, clean healthy organ.  I've never been so proud of an internal organ.  It was good to finally have the presence of mind of a good colonoscopy rather than paying good money for one that yielded "inconclusive" results.

 

Sailorjon, you should review your concerns with the GI doctor.  That you don't want to pay for a GI procedure if you can't get yourself cleaned out.  What is their "Plan B" for someone who has chronic constipation problems to ensure they really are clean before they start the procedure?    You may have to basically give up eating for five days (or maybe more) and perhaps to be hospitalized while they get you clean.  I do know people who have heart problems and other medical concerns that are put in the hospital for close monitoring while they prepare for something like a colonoscopy.

 

 

 

 

[sailorjon]

4 hours ago, jpinx said:

I know that -- and you know that too -- but the forum is not a comfortable place to have to lay it all out like this.  Everyone has different experience, so all the advice you get is different and sorting through it is a royal pita. The only thing I'd press you on is to get a local helper to do the talking and other legwork for you because that really made a huge difference to me.  Getting a good relationship with each doctor across a cultural and language barrier is difficult, but it is vital.

Yes, thanks.  I will try again. The samative experience is instructive to me in the sense that,  even though I feel I am being cheated with the inflated prices, the doctor was competent with very good English and the first one who recognized the reality of financial matters and that offered a choice of treatments for the next step.   So, I am doing what I can to be able to stay with that.  I'm thinking of calling and appealing, for what it's worth to one of the top hospital managers or the leader to reconsider the pricing giving examples that he is hitting me with top of the mark 'medical tourist' pricing which is not my profile.  The other charges were fair,  800 for doctor vs 1500 vejathani and hospital charge only 200bt.  The meds were overpriced but we expect that, I should try to use outside pharmacies.  They did charge 490 bt for a plastic finger sleeve for the digital exam which probably cost 10cents to make. 

[sailorjon]

2 hours ago, NancyL said:

I find it difficult to believe that "laxative after laxative" have failed to do the job.  I've had several lower GI procedures in the U.S. where the doctor said the results were "inconclusive" because I wasn't adequately cleaned even though I'd followed their recommended procedure.  I brought this up when I was scheduled for a colonoscopy in Thailand, saying I didn't want to pay for another procedure only to have "inconclusive" results even though I follow instructions to the letter.  He reviewed the CD-rom from a previous procedure and said there were some small, hard pieces of feces remaining in pockets in the colon that could be masking problems.

 

So, the Thai doctor had me eat nothing but clear liquids like broth, soft drinks and fruit and vegetable for five days, and then two days of doing the standard prep, not just one.  The standard prep uses very strong laxatives like magnesium citrate or bisacodyl where you're flushing your system with large amounts of water.  I spent two days within steps of the toilet.

 

After that, the colonoscopy in Thailand went very well.  The view of the colon in the CD-rom showed a nice, clean healthy organ.  I've never been so proud of an internal organ.  It was good to finally have the presence of mind of a good colonoscopy rather than paying good money for one that yielded "inconclusive" results.

 

Sailorjon, you should review your concerns with the GI doctor.  That you don't want to pay for a GI procedure if you can't get yourself cleaned out.  What is their "Plan B" for someone who has chronic constipation problems to ensure they really are clean before they start the procedure?    You may have to basically give up eating for five days (or maybe more) and perhaps to be hospitalized while they get you clean.  I do know people who have heart problems and other medical concerns that are put in the hospital for close monitoring while they prepare for something like a colonoscopy.

 

 

 

 

Thanks, that sounds reasonable.  It is true about the laxitives, it's literally been months on them.  There is obviously another problem bloating me and blocking me.  Could be the gas, or blockage who knows that's why I want to check.   The plan B I think is the barium enema.   Perhaps that first will clean out better and the other solutions you've mentioned then, colonoscopy.  I feel the colonoscopy would be good also to check for polyps, colorectal cancer etc.  I have seen magnesium nitrate mentioned as a powerful clean out med pre surgery.  Perhaps, I should get that.  Not eating is not a problem,  As I tried to explain to one G.I. who said eat 5 small meals a day, I can eat one small bowl of soup and be 'full' with a packed stomach and unmoving digestive track for the next 24 hours practically.   Noboday seems to get that.   This is not just constipation I think.

[lopburi3]

I hope you mean Magnesium Citrate.  But I suspect that is what caused me to faint in hospital (and from tales of other patients many others) so be very careful if you use this.  

[teddog]

1 hour ago, sailorjon said:

Thanks, that sounds reasonable.  It is true about the laxitives, it's literally been months on them.  There is obviously another problem bloating me and blocking me.  Could be the gas, or blockage who knows that's why I want to check.   The plan B I think is the barium enema.   Perhaps that first will clean out better and the other solutions you've mentioned then, colonoscopy.  I feel the colonoscopy would be good also to check for polyps, colorectal cancer etc.  I have seen magnesium nitrate mentioned as a powerful clean out med pre surgery.  Perhaps, I should get that.  Not eating is not a problem,  As I tried to explain to one G.I. who said eat 5 small meals a day, I can eat one small bowl of soup and be 'full' with a packed stomach and unmoving digestive track for the next 24 hours practically.   Noboday seems to get that.   This is not just constipation I think.

Perhaps so Sailor,    if that is the case it takes your situation  to a whole new level, and rapid departure from Thailand must be on the cards .  Waiting for decisions being made cannot be easy, and if it is cancer, well the decision is taken out of your hands, got to seek other alternatives rapidly, before worsening conditions prevail, as long as you can still travel and not bed bound,do not want to be stuck here in Thailand looking at end of life,got to be better in the States,even tho nobody is there for you   All the Best Sailor

[sailorjon]

wow.  I just don't know how to make myself clear I guess.  I have monthly income to support myself here just fine but not in the states.  Got it?  The minute I land I need to find new apartment, and then have security money for the apartment and, again, I lived in the bay area, very expensive for one room with nothing in it. And I have to do this while still suffering shortness of breath and all the rest.  Am I still speaking English here???  Are you just having a laugh, Teddog?  How would that be better than here?  I'm exhausted just trying to explain my situation which should be so simple understand.  

[sailorjon]

Now, let's get out our calculators class.  I've said I have about 50k baht left in savings to spend, subtract the plane ticket to usa, and securing place to live, and what does that leave for medical care etc.   Wow.  

[sailorjon]

et tu dogte?

[sailorjon]

Truly bizarre advice.  Some weeks walking to the 711 and back is all I can do and you suggest relocation to usa to begin again.  What's wrong with this picture...?  And what is so far out about going to India for treatment?  I've done a lot more reading and I should have done it long ago.  What's the difference.. a two hour plane ride, checkin to hotel and taxi to hospital with great reputation at a fraction of the cost?  I have spent a whole day in some hospitals here only to charged double for services hat didn't address the problem.   Has the world gone mad?  Am I the last sane person here... it's possible I'm exhausted, miserably uncomfortable and in need of some relief but I seem to be making sense and rational choices given my circumstances and financial condition.  

[sailorjon]

Ayaahhhh.  Now my feet and legs are starting to swell with pitted edema again.   Dr Taworn had told me I could stop taking the Lasix since the edema had gone.    I guess I better start it again.

[NancyL]

Have you actually taken magnesium citrate, Sailorjon?    At one point you confused the name with "magnesium nitrate", which is used in agriculture, printing and the chemical industry.  If you'd actually consumed magnesium citrate, you'd probably remember, because it's like drinking a bottle of 7-up.  This should have gotten some action going.

 

 

[NancyL]

Sailorjon, are you over age 65?  If so, perhaps you should return to the U.S. and let Medicare sort out your problems.  You still have enough left for a plane ticket.

 

[sailorjon]

No, Nancy I haven't taken it.  I wrote the name down incorrectly.  It was Magnesium Citrate I saw referenced on a medical forum by someone describing the medication that was given pre-surgery.  Which made me wonder, how about that for me?  Perhaps I just need this powerful cleaner and the laxative treatments I have been prescribed are too weak and everyday.

[sailorjon]

Ok, I"m 60.  And I am respectfully requesting everyone who wants to participate on this thread to not ask me again to return the usa.   If you do, I will request you to not comment to me again.  Thank you.

[sailorjon]

I didn't appreciate your earlier comment implying I cannot manage my situation and perhaps am senile or demented and, again, proferred the useless suggestion to return the usa as if that would make all things right.  I detect the stench of people in comfortable positions who don't understand what happens when you lose your pension, health care, are not competitive and then have the misfortune to live in the usa.  Please keep this advice to yourself.  I have been perfectly capable of managing my life.  This is a difficult situation and I have run into many bad experiences with the doctors and hospitals any way you look at it.   Odd you could read about my experiences with the medical community here and see no fault there but blame me as incompetent.    I am not the only one this has happened to.  Read the google reviews for almost any hospital here and you will see many horror stories.

[sailorjon]

I guess you are uninformed about what the new health care bill is threatening to do for the people.  Citizens in my age bracket are penalized the most, pre-existing condition clauses reapply, most real health care is curtailed or denied, and medicare is being decimated to provide a huge tax break for the richest and most well off.    That's america.  I would rather take my chances with India. 

[sailorjon]

Honestly, I've had enough.  I don't have energy to fight with hospitals not to cheat me, doctors to TRY to understand my needs and do their job competently,  insurance companies to honor their contract and pay for services and now defend myself against some of you who have turned against me, suggesting I refuse treatments irrationally or am not being swindled but am just a complainer or that shortness of breath attacks are not acute and are 'subjective',  or I'm lying about laxatives  not working,  or 'maybe' I have back pain, or life will be good if I just go to the usa.   Enough.  Let's just stop.  Not helpful.  Do the kind thing and if you have nothing helpful to add and don't care to respect my decisions, just fade away please.  Thank you.  I have enough to deal with.