Major surgery concerns

[nokia0077]

Surprisingly, the medical information posted on this site is " Mostly " outdated to the point of being irrelevant, ( at least to me ). I have been in need of some serious medical attention which I am pretty sure will include some sort of surgery. Bad lower back issues causing numbness in the legs, possible Orthoscopic work on my knee and possibly my thumbs. Pretty much your ordinary over 60 trip to the body shop for a major TUNE-UP. My concern is this.. From what research I and my wife have done, there appears to be NO doctors in any of the hospitals here in Udon who do any Orthoscopic surgery. How can that be...at least 4 major hospitals in Udon and ....NOT ONE...can that be.
Also, After suffering a life altering accident some 25 + years ago in which I broke my neck and was lucky to not be a parapalegic, I have suffered cronic pain issues and sleep issues as well. Not to mention a Heart attack at 45 which left me with 2 stents.
What I really need now, after working my way through the THAI medical world, is help from those of you who have had some experience with surgery, pain management etc, and some recommendations as to where I go from here. At this time most of my issues are not life threatening and I would like to do something now before they become so. Any assistance from those of you with previous AND relatively recent experience would be greatly appreciated.

[broon97]

I had major back surgery in BNH hospital in Bangkok. Their spinal unit is second to none. Excellent care and good result.
I was referred to the surgeon there by doctor in AEK Uddon

[Bandung_Dero]

The University Hospital in Khon Kaen (closer to home) has a widely respected neurology department. An ex member of this site, whom I'm sure still monitors it, may well PM you with details (lower back spinal) of his daughters life saving experiences there and who to contact.

[jingjai]

Bumrungrad Hospital:
https://www.bumrungrad.com/thailandhospital

Orthopedics:
https://www.bumrungrad.com/en/orthopedi ... r-thailand

Arthroscopic Meniscus Treatment (Orthopedic Knee Surgery):
https://www.bumrungrad.com/en/orthopedi ... t-thailand

Find a Doctor:
https://www.bumrungrad.com/en/search-fo ... and-doctor

[old timer]

My advice is forget Udon Thani for any major surgery, it isn't worth even thinking about.
Something that was building up with me over the last 10 or more years has been pancreatitis caused by lifestyle. The last quarter of 2014 it came to the crunch, I needed major surgery. Wipple Procedure.
After checking out everywhere in the world I found the finest surgeons who had vast experience in carrying out this surgery at Hyderabad India. I wasn't interested in price even though I had to pay, I just wanted the best because it's a big serious operation.
Anyway, to let you know I had surgeons that go to America and Europe to private hospitals to do this work charging around USD 30,000 for USD 10,000 in India, same surgeons.
So my advice is don't even think about Udon or Thailand or anywhere else for that matter, just do plenty of research, locate the best for your predicament and go for that.

OT...............

[nokia0077]

Just wanted to thank you all for the advice and info so far. Very helpful and informative. I will definitely investigate the web sites and take your advice to heart. Again, thanks

[FrazeeDK]

I've had foot and hand surgeries at BNH in Bangkok. The wife had her gall bladder removed in BNH.. I've used the hospital for various medical procedures from 1997-2011 and found it to be professional with less of a "factory" feel than Bumrungrad which I've used also. Its a smaller hospital that tends to treat people more personally..

[wazza]

Udon Thani Province could be regarded as having Regional Health Care , with not all disciplines of medicine available. You can get angioplasty at the BKK Hospital Udon etc. Certainly an arthroscopy is available, General Surgical and Medical facilities. What it does lack is the intensive disciplines, such as Cardio Thoracic Surgery – By Pass Grafts, Acute Neonatal Care, Burns. Difficult / challenging diagnosis and treatments are not found here. Also many pathology tests cant be done in Udon, eg a simple Hepatits B antibody test cant be done at AEK and sent to BKK with a 2 week turn around.

These are found at Sirikarin Hospital in Khon Kaen, which is the teaching hospital attached to the KKU. It has a dedicated Cardio Throacic Unit called the Queen Sirikat ? Cardiac Centre. Detailed Neuro Surgery, Neonatal all there. It is a public hospital so expect long waiting times for some appointments and then dedicate a day to be there. No doubt some appointments can be seen easier. Word of Advice, Udon residents ( Thai ) cant just turn up there, as they need a referral from Udon Public System, unless in an emergency etc. Good Clinical disciplines , well trained medical and nursing staff in the acute units. Like all Thai public health care systems , Expats are required to pay. No idea how that Health Card system introduced a few years ago, works in KK Province for those few expats that did sign up for it.

Bangkok then covers all of the above and even more, as far as standards are concerned. 1 1 Nursing in private facilities, English is spoken to a higher level in the private care facilities. The best Thai Hospital for the public system is Chula , based in Siam and has the Thai Red Cross Nursing Uni attached to it as well as the Thai Red Cross Blood Bank. The founding patron is the mother of HRH. English language is well spoke here as it’s a requirement of their training programme. Consultants who graduate from here are at the top of the Thai System.

The other reason why you wont get all your required skill sets in Udon, is there is little or no demand. Its based on clinical presentations and the medical and nursing skills sets required to perform and then post op care. The Privates are not going to fund expensive surgical instruments, fit out an OR just for 5 patients per year. The cost blows through the roof, and guess who pays. The other issue is the clinical competence of the Surgical team and their competency accreditation that the Thai Medical Council reviews.

Before anyone confirms any surgery ask the following questions to the Surgeon
• Have you completed this procedure before ?
• If so when ?
• Do you have a surgical list at another hospital in Udon. Goes back to the dedicated OR / Theatre having all the correct equipment. The hospital you are at will want you to have the procedure done with them, but Hospital No 2 , actually has better facilities for this.
• Do the Nursing staff have the correct Post Op qualifications for any detailed procedure, a Nurse is not always qualified in Surgical Post Op Care, bought in on OT due to sick leave of the only specialised nurse who was going to look after you.
• Has the Surgeon or Hospital experienced any complications or adverse issues associated with that procedure .
The private hospitals are a business and as such may perhaps tell you they can accommodate all your medical / surgical requirements, then you find out later after your admission, ahh, well we have to do it this way etc…

A good example of what MIGHT happen.
You have ischaemic chest pain , and ECG on arrival confirms you have a myocardial infarct. Heart Attack. Your admitted in Hospital A, you ask the Cardiologist, can I get an angioplasty ( surgical intervention of the clot blocking your coronary artery ) He says, well actually having these medications know as “ Clot Busters “ is just as good . Why, well Hospital A, doesn’t do angioplasty, so they don’t wish to loose a 10 day ICU admission to a competitor.

LAST piece of advice, choose your Anaesthetist well, these are the Clinicians who actually keep you alive for the procedure, interview them also, patients should have an Anaesthetic examination before admission ( not day of procedure ) The older you are the younger and experienced the anaesthetist should be.

[parrot]

It's easy to say you'll go to Bangkok, Khonkaen, or another country for a major operation......but if the SHTF, you might be at the mercy of Udon's rescue services to get you to the nearest hospital.
Although AEK has advertised for years its air-evac service, I've never known anyone who's had an opportunity to use it.

I received an email a few days ago of an American who went to Bangkok Hosputal in Udon with major heart problems and was air evacd to Bangkok along with his wife to accompany him. I'm hoping he'll post updates on UM for others to read. In his initial report he said he was highly satisfied with the services provided.

[wazza]

Parrott in 2000 I asked AEK about this and the HLZ wasnt licenced to operate.

ASEAN seminar in KK years ago. I assisted in writing emergency response plans from the then Sofitel.

They bought in an old Thai Military Huey. Airframe 1967 !! And they wanted to use this from Sofitel to the KK Trauma centre. 2 min max.

So i inspected the HLX there. And again not licenced at the time. No fire team. Lights. Drains etc...

We conducted training scenarios with the medical teams and all agreed..close the roads off from Sofitel to the Trauma Centre. Police are used to doing that already onstandby for this.

The chopper didnt even have restraints for the stretcher. Thai ambulances dont have enough portable O2 to support a Medevac ....

So I understand the only Medevac AEK ever received by Rotary Wing was an Army General flow in using military machines.

So ask AEK where is the bird. Who owns it..who is approved to use it. Who owns the response plan and who authorises its use. Is their HLX licenced under Thai Airports or whoever....

BkK hospital might have a fixed wing plane they cross charter for regional medevacs ????

ISOS based in Singapore have aircraft.

To my knowledge there are no regional rotary or fixed wing aircraft available for Medevacs. Military excluded.

[svensk1]

To my knowledge there are no regional rotary or fixed wing aircraft available for Medevacs. Military excluded.

Bangkok Hospital Group has fixed wing jets , short range and long range helicopters based in Bangkok. For the medivac Patient Parrot spoke about, flight time was 50 minutes each way. The Patient is recovering well and hopes to return to Udon next week.
Bangkok Hospital Udon does do Cardiothorasic surgery ( bypass and even heart valve replacement), has done neurosurgery, and in extreme cases, has the ability to transfer the Patient to one of the 41 Hospitals and clinics in the Hospital Group, where a specialist in that field is based. Or if preferable, can have the specialist flown to Udon Thani. Many Patients prefer to be near their family and loved ones when they undergo surgery. Some folks can not afford to pay the higher prices associated with Hospitals in Bangkok.
The key is to investigate your own ailment thoroughly, research facilities and personally meet and interview your prospective Physicians, and make the decision based on your judgement, not on what a stranger on a blog might say. Some people spend more time and effort researching where to buy a new car than they do on finding appropriate medical care. Isn't it funny that we might take the advice from someone we don't know about something as important as major surgery, when we could consult with a Specialist Physician in Udon Thani for about 800 baht. If you don't like that Doctor, ask them to refer you to another expert. In most cases you will find them to be courteous and helpful.

[wazza]

Swensk1

Best wishes to to your friend / colleague etc,

The chopper they used is this one
http://www.bangkokhelicopter.co.th/service.aspx?TID=SKY ICU

Its a BK 117 , I have flown heaps of Medevacs in these and are capable of providing quality flights.

Their promo says that Paramedics are flying, so experienced crew to also perhaps. Not just throw a Doctor who is excited on it etc.

The biggest key that patients and the medical system needs to know and understand , is you must take your patient to the definitive care centre ASAP, the more regional clinics, hospitals etc, the more delays , as these all play and stay, ordering stupid tests and care is poor. Neurosurgeons have 4 hours to "Crack "a head from time of injury .

BKK Udon and Neuro , It that elective or Emergency surgery ?? , I have seen their Cardio Thoracic Ward .....

Be interested in where their chopper landed in Udon, airport ??

[svensk1]

The neuro was elective, only in the aspect that the Patient was losing sight in one eye slowly. They used to have a full time Neurosurgeon, and now part-time when they need one. The medivac flight landed at Udon Thani Airport and the Patient was transported by ground ambulance to the airport, along with the medical team. One Doctor , one nurse, and 2 EMTs.
I have been in Hospitals all across America, and I can say in comparison, the private hospitals in Thailand provide better care. In the USA., the nurses are often overworked, and under-appreciated, resulting in grouchy service. There are exceptions to every generalization, but I have been treated in Private Hospitals in Pattaya, in Ubon Ratchathani, and all 3 private Hospitals in Udon Thani. The nurses are generally pleasant and helpful. The Doctors in America are constantly more concerned with the cost and application of their mal-practice insurance, and less on the Doctor-Patient relationship. I think "ordering stupid tests" was invented in the USA to prevent being sued at a later date for not investigation every possible diagnosis regardless of how remote. Most of the Doctors I have met in Thailand are primarily concerned with the Patient's recovery and wellness. They are dedicated, hard working healers, and I am proud to have known quite a few. Bangkok Medical Center and Bumrungrad Hospital are world class Hospitals. If I have any illness or injury, I would much prefer to be treated in Thailand than in most of the Hospitals in the USA. In short, the health care workers here still care.

[Tracechain]

I went in last Friday, 10 Apr to Bangkok Hospital Udon for removal of right kidney the following day. Came home yesterday, 14 April. Surgeon was Dr. Saifon, Urologist who works at the gov't hospital in NBLP. I liked her attitude and confidence and since I am now sitting here at home, she did not disappoint. I found the whole experience to be professional and under the circumstances, don't have any major complaints. Of course it has only been a few days, ask me again in a few months. Total bill was 150,000 baht.

[Pooclover]

I went in last Friday, 10 Apr to Bangkok Hospital Udon for removal of right kidney the following day. Came home yesterday, 14 April. Surgeon was Dr. Saifon, Urologist who works at the gov't hospital in NBLP. I liked her attitude and confidence and since I am now sitting here at home, she did not disappoint. I found the whole experience to be professional and under the circumstances, don't have any major complaints. Of course it has only been a few days, ask me again in a few months. Total bill was 150,000 baht.

On finding out that you doctor of choice was based at the government hospital in Nong-Bua-Lompu I would have went there for the surgery… It would have been less than half the cost you paid… plus she would have been round to check on you on a daily routine… Certainly I would use her for any follow ups.

Good luck with the recovery

[wazza]

Pooclover

It might be cheaper but a small public hospital is flat out.

BKK Udon would have had a higher ratio of nurses to patients on their surgical ward. Something that has its advantages during those first 24 hours etc.

Private hospitals are more personalised. Some people pay for that experience. Its also what Private Health Insurance is for. Each to their own I suppose.

[Pooclover]

Pooclover

It might be cheaper but a small public hospital is flat out.

BKK Udon would have had a higher ratio of nurses to patients on their surgical ward. Something that has its advantages during those first 24 hours etc.

Private hospitals are more personalised. Some people pay for that experience. Its also what Private Health Insurance is for. Each to their own I suppose.

What is also advantageous is having the specialist on site rather than a one hour drive away…

[wazza]

There are always other medical staff there for the first review or concern over anyside effect. A phone call sorts that out etc.

If and not normally required , that the patient is required to be returned to surgery . Then its not just the Surgeon you have to find. But the Anaethetist. Nursing staff for Theatre as well..so I would say that hour is also burnt up getting all the players around the table literally.

BKK Hospital last time i asked didnt have 24/7 staff for OR. But did have oncall staff.

In cases in the rural hospitals if complications do arise they tend to transfer to the tertiary referring facilities rather than holding etc. ( thats Khon Kaen region anyway ) especially after hours.

[Tracechain]

I went in last Friday, 10 Apr to Bangkok Hospital Udon for removal of right kidney the following day. Came home yesterday, 14 April. Surgeon was Dr. Saifon, Urologist who works at the gov't hospital in NBLP. I liked her attitude and confidence and since I am now sitting here at home, she did not disappoint. I found the whole experience to be professional and under the circumstances, don't have any major complaints. Of course it has only been a few days, ask me again in a few months. Total bill was 150,000 baht.

On finding out that you doctor of choice was based at the government hospital in Nong-Bua-Lompu I would have went there for the surgery… It would have been less than half the cost you paid… plus she would have been round to check on you on a daily routine… Certainly I would use her for any follow ups.

Good luck with the recovery

Sure, it would have been cheaper. Matter of fact she suggested it as one course of action which I thought was interesting since it would probably mean less money for her. We live about half way to NBLP so it would have been just as easy to go there, but decided that Udon hospital offered more in the way of personal convenience plus additional concerns which I needed some help with. For dressing and wound cleaning, I go to the local aid station out here in the village which either has a nurse or real doc. Cost is 50 baht.

[parrot]

I visited a friend from the UK who was in NBLP Hospital last year with cancer. He was in the open ward area of the hospital.
My two visits were frightening.....family members sleeping on the floor of the open ward, trash on the floor, hacking and sneezing by visitors, including children, poor ventilation, outdated bedside equipment, and nurses who spoke not a word of English. At one point the hospital told the man's wife to take him home to die, saying there was nothing else they could do.
She transferred him to KK where he died a month later.
NBLP private room care may be better.......but I'll take my chances on one of the private hospitals in town.