Shell shocked! At Pattaya hospital

[tropo]

I took my wife into PIH to see about having a ganglion cyst on her 2nd toe treated or removed.

 

This is about the size of a small pea (1cm in diameter) and doesn't cause a lot of pain:

 

 

The orthopedic surgeon suggested it be removed surgically. He also suggested general anesthetic AND an overnight stay at the hospital.

 

This seems a bit over the top to me. Why put someone to sleep for a small surgical procedure on a toe?  He didn't suggest aspiration as an alternative form of treatment.

 

After a lot of waiting around and an escort to the cashier downstairs to pay our 900 baht consultation fee, we were told (by the cashier) that the operation would set us back ABOUT 100,000 baht. "About" probably means the lowest possible price which would likely be exceeded. It's not a quote and considering the roundness of the number, a very rough estimate at best.

They couldn't give me a price for local anesthetic with no overnight stay, but considering the doctor recommended both we didn't want to wait around to talk to him again.

 

Does anyone have any recommendations about where we could go to have this treated without breaking the bank? Perhaps there may be a doctor that could attempt aspirating it first.

 

 

 

[richard_smith237]

Our son had one on his wrist... 

 

The Doctor (at Samitivej BKK) recommended that as he was so young not to do anything about it and that it would likely disappear (1.5 years later it has disappeared). 

 

The Doctor also recommend not to do surgery as he was so young, small hands, more intricate operation, higher risk of a mistake. 

Additionally, the Doctor also commented as that as we are dealing with a small child a General Anaesthetic would be required rather than local for the sole purpose of ensure our child remained still.

 

We also took advice on aspirating the cyst, but the Doctor advised against that, pointing out that as there is no pain and no associated risk with leaving it there really was no point in doing anything, also pointing out that Aspiration is often only a temporary measure and the cysts returns. 

 

 

Based on all of this my question would be: IF it is confirmed without doubt that this is a (benign) cyst causes no pain or discomfort, its out of sight under the toes, why do anything at all?

 

That said: As cancers can form from cysts, if you cannot be 100% sure that the cyst is benign I'd suggest approaching a public hospital as a minor operation under a local anesthetic is relatively risk free for an adult. 

[tropo]

12 minutes ago, richard_smith237 said:

Our son had one on his wrist... 

 

The Doctor (at Samitivej BKK) recommended that as he was so young not to do anything about it and that it would likely disappear (1.5 years later it has disappeared). 

 

The Doctor also recommend not to do surgery as he was so young, small hands, more intricate operation, higher risk of a mistake. 

Additionally, the Doctor also commented as that as we are dealing with a small child a General Anaesthetic would be required rather than local for the sole purpose of ensure our child remained still.

 

We also took advice on aspirating the cyst, but the Doctor advised against that, pointing out that as there is no pain and no associated risk with leaving it there really was no point in doing anything, also pointing out that Aspiration is often only a temporary measure and the cysts returns. 

 

 

Based on all of this my question would be: IF it is confirmed without doubt that this is a (benign) cyst causes no pain or discomfort, its out of sight under the toes, why do anything at all?

 

That said: As cancers can form from cysts, if you cannot be 100% sure that the cyst is benign I'd suggest approaching a public hospital as a minor operation under a local anesthetic is relatively risk free for an adult. 

Thanks for the info.

 

The surgeon seemed quite certain, upon examining it, that it was benign. It was the consistency of it that lead him to this conclusion, not a biopsy.

 

It causes my wife discomfort when wearing shoes. She likes to wear heels. She's mainly worried about it getting bigger. It has been there for about 5 years. She's a bit of a worrier when it comes to health matters.

[JohnJay]

I find it very patronizing they would suggest general anesthetic for that and think you're just going to OK it, because white people have unlimited money. Man, just visit a hospital in Isaan...

[JohnC]

PM sent 

[NickJ]

This Quack seems to be running on the One born every minute principle. Doesn't seem like your one of them. Get a second estimate at a different hospital.

[Orton Rd]

Neighbor had one off in Bkk at local clinic 6k, he though that was expensive!

[Sheryl]

Obviously, should go elsewhere.

 

Aspiration will relieve the pain.  The disadvantage is that it may well recur (about 50% chance), but that can also sometimes happen even after surgery.

 

If you don't mind some waits and red tape, the least expensive option would be Pattaya Cite Hospital http://pattayacityhospital.go.th/en/aboutus    or Queen Sirikit Naval Hospital in Sattahip.

 

If not, then less expensive private alternatives would be Pattaya Memorial Hospital  https://www.google.com/maps/place/Pattaya+Memorial+Hospital/@12.9357726,100.8868698,15z/data=!4m5!3m4!1s0x0:0xa1147f4d920450e1!8m2!3d12.9357726!4d100.8868698

 

 

or Phyathai Sri Racha hospital    http://www.phyathai-sriracha.com/pytsweb_eng/ 

There is a westerner in their marketing dept named Gavin who can make appointments etc for you - email [email protected]

 

Wherever you go, ask to see a general surgeon. Specifically ask about aspiration if the doctor does not  mention it.  If she opts for surgery, insist it be under a  local block.

 

In a government hospital, aspiration should cost under 1,000 baht, surgery probably under 10,000 (using local anesthetic). At the private hospitals mentioend, about 3 times that.

[tropo]

Thank you Sheryl.... you have given us a lot of great options, and hope.

 

May I ask you what you mean by "red tape" at Pattaya City Hospital? Waiting will be no problem.

[Sheryl]

Forms and registration process. Not really all rhat bad at smaller hospitals but usually all in Thai. It is possible Pattaya hosp has some signs etc in English, I don't know.

[tropo]

Thanks, Sheryl. We may try Memorial first, just to have it aspirated and see how that goes. She is already registered there.

[simon43]

In my twenties, I had a ganglion on the back of my hand that I'd had for years.

 

One day, a neighbour who was also a nurse told me that it was easy to get rid of it.  She took my hand and pressed very hard onto the ganglion for a few seconds until it 'exploded' and dispersed under the skin  The sensation of the explosion almost made me faint!

 

OP - I'm not recommending this course of action for your wife :)

[tropo]

4 minutes ago, simon43 said:

In my twenties, I had a ganglion on the back of my hand that I'd had for years.

 

One day, a neighbour who was also a nurse told me that it was easy to get rid of it.  She took my hand and pressed very hard onto the ganglion for a few seconds until it 'exploded' and dispersed under the skin  The sensation of the explosion almost made me faint!

 

OP - I'm not recommending this course of action for your wife :)

LOL> I've seen YouTube videos of people smashing them with books. Some recommend using bibles. I see them dispersing too. That won't work for my wife as it is not very hard and you can't reach it with a book without whacking the rest of the toes at the same time.

 

 

 

[cooked]

13 minutes ago, tropo said:

LOL> I've seen YouTube videos of people smashing them with books. Some recommend using bibles. I see them dispersing too. That won't work for my wife as it is not very hard and you can't reach it with a book without whacking the rest of the toes at the same time.

 

 

 

The term 'Bible ganglion' exists. I did this myself after years of having one on the back of my wrist, It went away and didn't come back.

[tropo]

7 hours ago, Sheryl said:

Forms and registration process. Not really all rhat bad at smaller hospitals but usually all in Thai. It is possible Pattaya hosp has some signs etc in English, I don't know.

We had it aspirated by a doctor at Pattaya Memorial Hospital today. Including medicine (488) the total bill was 2572. We were happy with the surgeon. He went out of his way to explain everything in detail. He explained that if it returns quickly we should have it removed.

[chickenslegs]

How can we trust private hospitals here when a medical professional advises a 100,000 Baht operation, with risky general anesthetic, for a condition that only required a simple 2,500 Baht procedure.

 

Rhetorical question, of course.

[Gary A]

I had one on the top of my wrist for years. I did nothing to it and discovered it was suddenly gone. It too was about the size of a pea and caused no pain. I used to wobble it back and forth and it finally just disappeared.

[tropo]

22 minutes ago, chickenslegs said:

How can we trust private hospitals here when a medical professional advises a 100,000 Baht operation, with risky general anesthetic, for a condition that only required a simple 2,500 Baht procedure.

 

Rhetorical question, of course.

When you ask the doctor they say to go and ask the cashier. They pretend they have no idea.

[tropo]

*deleted* (double post)

[JohnJay]

2 hours ago, chickenslegs said:

How can we trust private hospitals here when a medical professional advises a 100,000 Baht operation, with risky general anesthetic, for a condition that only required a simple 2,500 Baht procedure.

 

Rhetorical question, of course.

They are doing a disservice to the medical industry of Thailand. I find it incredibly patronizing they thought OP would OK a general anesthetic operation for that, it's like they think white people are very stupid and just have tons of money - and this is someone with 2 medical degrees. What a disgrace.

[Ace of Pop]

I had one on the top of my wrist for years. I did nothing to it and discovered it was suddenly gone. It too was about the size of a pea and caused no pain. I used to wobble it back and forth and it finally just disappeared.

Funny that, I had just the same.untill I showed it too my best mate who wacked it so hard with a Coke Bottle I nearly thumped Him. After a day it was gone. Not Hi Tec but it worked.?


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[Sheryl]

When you ask the doctor they say to go and ask the cashier. They pretend they have no idea.

Actually they usually do not know total cost. They know only their own fee, not the other hospital charges.

But in this specific instance, while the doctor would not have known exactly the other charges, he certainly knew that he was turning a simple outpatient procedure into an inpatient admission under general anesthesia and hence was being unethical.

It is not the case BTW that behavior like this is consistant within a hospital. Many TV members have used this same hospital with different results. Conversely I once encountered the same thing st St. Louis Hosp in Bkk, a non profit where such things are not usually encountered. Just happened upon a bad apple. Same department, same procedure, different doctor and no problem.