Hospital-ing in Thailand

Hospital-ing in Thailand is the art of getting yourself treated at a hospital here.

I am middle-aged. I have been fortunate to have avoided serious congenital or chronic illness during my life which has required infrequent visits to the hospital. However, I have in recent years been ‘breaking down’ more than usual. I would like to share my experiences at hospitals that I have visited in Thailand.

It starts with Education

First things first, and I hate to write things like this, but it is necessary. The higher education systems around the world are NOT equal. Students who graduate from prestigious institutions in Europe or America receive a far more comprehensive education than those in Southeast Asia. This is a fact, unfortunate as it is to say out loud. Westerners are taught to question everything, who, what, when, where, why, and how? Question your elders, offer solutions and think outside the box.

Eastern education is more rigid, follow the rules, do not ask questions question, and whatever you do, you do not question your elders. That is taboo, and just not done. This mindset can be overcome to some degree, but underneath it all it is still there.

I realize that education is simply the beginning and experience achieved through the practice of medicine is what counts. But then again, the medical journals, conferences, technology, pharmaceuticals, etc. available in the West give those practitioners an edge. The surgeon who did my father’s total knee replacement actually was a half engineer in that he had built his own specialty jigs and calibration instruments to ‘computer fit’ the implants and check the range of motion, etc. 6-8 patients a day, total hip replacements in 30 minutes, total knee replacements in 45 minutes. It is harder to find that in Asia, sorry.

I should also mention this extends to other parts of the Thai educational system. I dated a girl once who had a “computer science” degree, and an MBA to boot. When I realized she knew absolutely nothing about computer science, I checked her transcripts to see that she had failed every single class she took. Somehow, she still received a degree. Scary, but true.

First Case

My first major trip to the hospital here was due to a massage injury that occurred back in 2018. I was on vacation in the provinces and had the upper crossed-back syndrome crap every officer worker gets. 12 hours a day behind a computer with poor posture, I had upper back issues, to say the least. Lower back problems as well from years of working in the field carrying 200-400 lb. objects. When I landed in Thailand, I thought I was in heaven, finally, I could get ‘therapy’ for my back via massage at the incredible price of 250-350 THB a pop. I kept going more and more frequently, but it wasn’t really helping. Eventually, on this said vacation, I had a man give the massage and apply quite a bit of pressure with his elbow, to my back, well, he caused an injury.

Initially whatever he did caused me to have instant nausea and want to throw up. I felt chills, lightheadedness, and a sense of impending doom I had never felt before in my life. I knew something was seriously wrong, and I told him to stop and got the hell out of that massage parlor.

Went back to the room and started noticing the area went numb. When I took a shower, I could feel the radius around the area where the water was hitting as numb. I laid in bed for quite a while and decided (I guessed) it was a herniated disc of some sort (pinched nerve) in my upper back and shouldn’t worry about it.

I continued my vacation in discomfort until I returned to Bangkok, where I wanted to see a medical professional.

I went to the largest private hospital in Bangkok, and being an idiot, solicited the services of an orthopedic surgeon. Now, after the fact, I know orthopedic surgeons are what other doctors call “carpenters”. They use nails and screws and wire to fix catastrophic back injuries. They are NOT neurosurgeons. I had an MRI, and the results came back, the Doctor sat me down and told me the bad news, scrolling through slices from the MRI scan showing me the massive white spot in my spinal cord around T2-T3. “I’m so sorry,” he said, “I’m not sure why you aren’t paralyzed, this is very serious”.

The radiologist had also pointed out some bleeding that occurred around the dura mater (wrapping of the spinal cord) in the MRI notes. All in all, bad news from him. He said, not sure what we can do, but it looks very bad, gave me a neck brace, and sent me home. I then spent the following 2 weeks in bed depressed, thinking my life was over as I was now on the precipice of being confined to a wheelchair for the rest of my life.

Second Opinions

I finally got the resolve to face the problem head-on. Let’s find a solution I thought, I’m not quite sure I understand all this MRI stuff, but I want to know more. I had another Dr look at the results from another hospital, he said the same thing. Damage to the spinal cord, T2-T3, looks bad. I went back to the USA and sought out the head of the neurosurgery department at Houston Methodist and brought the MRI CD. He looked at the results and said “Hmm.. yeah there’s something there, but, you don’t have any issues walking or neuropathy and so forth, right?” I said, no, and he replied, “Well, then don’t worry about it.” Pretty cryptic at best.

I returned to Thailand and visited the orthopedic surgeon again to get a second MRI and review the results with him. When I was going into the hospital, I ran into my doctor in the elevator. He shook his head at me and said, “I’m so sorry. It looks bad.” Again, I felt sick to my stomach but pressed on. I went to his office and demanded that he EXPLAIN to me what looked so bad, what this “lesion” identified by the radiologist meant, and what my prognosis was.

Details, I’m a scientist, you’re a scientist (sort of), explain to me in technical terms exactly what this means. He struggled at best. I believe he didn’t even really know what he was looking at. I happen to be sort of an expert in MRI physics by the way. I use the technology in my line of work for different purposes, but I know all about T1/T2, echo spacing, etc., and have a pretty good idea of how Lamor frequency changes are used for slicing in MRI volumes. In any case, he couldn’t answer anything and after enough pestering and embarrassment, he decided to call his “neurosurgeon friend” down to the office.

Neurosurgically Speaking

The neurosurgeon quickly took over his computer, started scrolling the mouse wheel, and changing settings in the viewer used to display the data. I’m not sure exactly what he was doing, but I think it was related to the contrast and filtering of the image. He told my physician that he had “not been looking at the data right”, turned the monitor to show me, and said, “There’s nothing to worry about” and walked out. What a fucking ride, thank you Fun Rungrad. To this day, by the way, I am still completely functional. If there was indeed a lesion in my spinal cord, it could have happened from the massage. It could have happened from a 20-foot fall off a roof on my back years ago. It could have happened from a car accident I was in. I’m thankful that I’m OK and still able to live a normal life.

So, in reality, this story had a happy ending, a long and involved happy ending, but ok nonetheless.

Second Case

My second experience at the house of Fun Rungrad was after COVID-19 struck Thailand. Once thriving food courts were shut down and when they did reopen had a fraction of customers that they did in the past. ¼” plastic PVC pipe and saran wrap everywhere. People were scared. I was stupid enough to eat dinner at a food court without realizing that the food was probably recycled and since things had abruptly “restarted” since the COVID lockdowns, hygiene and overall operations were probably still rusty at best.

I came down with some sort of stomach parasite/bacteria/who knows. Fever, chills, sickness. Food poisoning, I thought, except it wasn’t. After the initial illness, the symptoms turned into nausea (all the time) and the inability to really digest food.

I suffered from this for weeks and went to see a gastroenterologist at Bummy Grad. He said let’s do a stool culture, did a little blood work (at my request), and came back with some weirdo antibiotics that I can’t even remember the name of. I looked them up online and found out they were once used in the USA back in the 1970s but were banned.

I took the pills, and nothing changed. I went back in again, with gastrointestinal distress. I asked if it could be a gallbladder problem or a pancreas problem. I didn’t know what was going on, but I did not feel right at all and was miserable. This had been months now. He tapped around my abdomen and listened with a stethoscope. Nothing wrong he said, you’re fine. I had to argue my case, he wasn’t liking it. I could see it in his face,

“Who the hell does this farang think he is, coming in here, and asking medical questions to, of all people, a prestigious gastroenterologist SPECIALIST such as myself, and then, disagreeing with my diagnosis?” How dare a patient say they don’t feel well when the doctor says you’re fine.

Annomyous

I had to argue with him to do more testing, we checked for H. Pylori, and ulcers and did more blood work. Lots of stool testing. I was a pro after a while having sent so many samples in. By the way, for those that are interested, chopsticks are your best friend. The easiest way to deal with it.

Nothing coming back. After about 3 months of torture and being told there was nothing wrong with me every time I visited (was in there at least 8 times I bet), finally I fell ill with another fever and chills. This fever hit around 102-103 deg F and I was sick for a weekend. I believe, what happened was that this bacteria or parasite that was in my system (more likely bacteria) got into my bloodstream and caused an infection that my body finally abruptly responded to. In any case, after that weekend I got better and have been since. Thanks for properly diagnosing that one Bumrungrad—that’s 0/2.

The third Case is the Charm – or how I nearly lost my eyesight

Medical problem #3 involved my eyes in Pattaya. COVID was running rampant around the city, everyone had red swollen eyes. The hospital said it’s “viral conjunctivitis”, which they would not be incorrect in saying. The virus is either an adenovirus or COVID as the latest sub-omicron variant strains are causing conjunctivitis as a major symptom.

Furthermore, have a look at peer-reviewed ophthalmology journals from August-Oct 2023 and you’ll find a number of articles written about absolutely SOARING cases of conjunctivitis reported throughout south and southeast Asia, to the extent that they have never seen before, ever. Hospitals are slammed with patients.

In Pattaya, every pharmacy I went to was sold out of every type of eye-related accessory or therapeutic. Eye patches, drops, you name it, all sold out. Now you’re telling me, an adenovirus popped up with this virulency and slammed a few billion people? Or it’s COVID, something that’s already incredibly contagious, but we don’t want to say the word “COVID” because it could impact tourism.

I went to Bangkok Pattaya Hospital, otherwise known as Rong Payaban Krungthep Pattaya. I saw a nice young female ophthalmologist who quickly examined my eyes and said I had conjunctivitis. Was it viral? Not sure, looks viral though. Gave me some drops (Tobradex) and sent me home. Should clear up in a week she said.

What happened next is arguably one of the worst illnesses that I’ve ever had. My eyes got worse, much worse; my left eyelid was swollen to the likeness of Rocky Balboa. My eyes HURT. The left eye then turned red. My vision in my left eye was very blurry, I couldn’t see to work. I couldn’t stand the pain, I couldn’t sleep. Nonstop, 24/7 misery like I’ve never experienced. Not a few days, but weeks. After 2 weeks, I went back to Bangkok Hospital and saw my next ophthalmologist, who was an exceptional piece of work.

Let me paint the scene, here sat a doctor who clearly didn’t want to be working on a Saturday afternoon. He was wearing a $500 Burberry checked shirt and upon his desk sat a designer Louis Vuitton bag, so small as to be useless to any purpose other than storing condoms, but LV nonetheless (hey look at me, I’m rich AND have style). His hair was done up with gel and a “there’s something of a “Mary” curl in the front. He sat down and looked at my eyes.

At this point, I was in pretty severe pain and very concerned, as I have never had any problems with my eyes in my life. This was bad and I expressed my concerns to him. He said “This isn’t bad. I have patients that are way worse. 10% of cases result in cornea problems. Keep using the drops, it will clear up in a week, it is viral conjunctivitis.”

I said, “It’s not getting any better, and it’s already been 2 weeks, is there anything else you can do, test, or prescribe?”, he became very agitated with me. He kept saying, “Just go home, use the drops”, repeating it over and over. He basically ran me out of his office and was not happy.

So, I went home and waited yet another 3-4 days in pain and misery where the infection spread to my right eye and at this point, I’m screwed. I work in front of a computer every day as a contractor at a daily rate and I was barely able to function. If I can’t work, I don’t get paid, no ‘sick days’ for me. Desperate for answers, I finally felt that I could see well enough I drove to Bangkok and booked an appointment at Samitivej Sukhumvit with an ophthalmologist.

Samitivej Salvation

The doctor at Samitivej was another young lady, I saw her and she examined my eyes. This time, however, it was a MUCH more thorough examination than what took place in Pattaya (which was just looking at the eye with a lens in white light). They used several machines, applied UV dyes or something to my eyes used different lenses to image everything. She said, you have lesions and may have damage to your corneas, I don’t know much about this so I will refer you to a cornea specialist. I thanked her and returned the next day to see the specialist. Great I thought, now I’m going to be blind.

The cornea specialist spent about 20 seconds looking at me and made a correct diagnosis. She said I had “membrane” buildup due to the infection, peeling back my gyoza-shaped bright red eyelid and showing me the crap in there with a camera that was projected onto a TV monitor on the wall. She said it had to be removed, as it was causing most of the discomfort/pain and scratching to the cornea. She diagnosed me with viral conjunctivitis and said it was likely an adenovirus.

She then numbed my eyes and within a few minutes, had removed the membrane. I immediately felt better. She also put me on several different drops and medications, including an antibiotic drop to treat the (additional) bacterial infection that was in my eye that was not diagnosed by BKK hospital, along with some pretty good steroid drops (nothing like this was provided in Pattaya, only Tobradex—which is not a steroid, she said throw the Tobradex away, it’s useless). With the inflammation going down and the membrane removed, I had a chance of healing.

This problem started sometime in late September, around the 25^th or so. It is now Nov 10^th, and my eyes are still not fully recovered. My left eye still hurts, and the vision is still a bit blurry and has not returned to normal. Thanks, BKK Pattaya for helping me out, had Somchai SpunkHair spent an extra few seconds giving a fuck about his patients and knew anything about his field of expertise, like, hey, that guy’s eyelid looks really fucked up, maybe I should look under it? I could have been spared weeks of pain/torture and perhaps today my eyes would be back to 100%.

In Summary

From all of this, I offer the following bits of advice for medical care in Thailand:

• I have never had so many “chronic” illnesses in my life, as I have had here in Thailand. Problems do not seem to resolve and go on far longer than necessary. This is partly because of a lack of proper diagnosis and treatment and maybe partly because of my Western upbringing and lack of exposure to some of these diseases earlier in life.
• I have had MUCH better luck overall with female doctors. They appear to be more empathetic, knowledgeable and have a better disposition all around. I would request a woman. I had another internal medicine Doctor at Bumrungrad help with an issue I was having, she actually took out some paper and started doing differential diagnosis, brainstorming, etc. THIS is what I expect, not a holier than thou attitude and unquestionable authority that I’ve received from the men.
• Just because someone is wearing a white coat with a sign on the door that says “Dr.” and might even say, “PhD”, doesn’t mean they are good at what they do, especially in Thailand. Not all education paths and practical experiences are equal. Take control of your own diagnosis, push them if they are uncomfortable, and keep pushing until you get answers. If you have a doctor that’s not cooperating, find a different one, as you aren’t going to make any headway by beating on the same stubborn shithead. It’s unfortunate, as a layperson, that you have to do someone else’s job for them, but this is life. Research and educate them, if necessary.
• I have had the best luck in my personal experience with Samitivej Sukhumvit. The doctors there seem to be the best trained and I have had the best results overall. In general, I would say that medical care in Bangkok is going to be far superior to anywhere else in Thailand. If you have health issues, get to Bangkok and get treated there.
• If you have a doctor who dismisses you or acts arrogant/agitated (i.e., Somchai SemenTop), I would not hesitate to request another doctor on the spot. You are paying money for this, and it sets you back in time/illness to have to make repeat visits to the hospital.
• The hospitals will usually refer you when you call to a specialist depending on what they think your problem is. In the case of my back issue, I was referred to an “orthopedic surgeon”. I thought of course, that this was appropriate, but I’m not a doctor. The hospital and I both made a mistake in seeking treatment from the WRONG person. I should have seen a neurosurgeon from the beginning. Make sure you see the right doctor to begin with for the symptoms you are experiencing.
• I’ve also had other health problems in Thailand too long to discuss in this article. I have seen other doctors, mostly surgeons (one even a highly regarded Emeritus professor in his field) that have all turned out to be very one-trick pony. When you’re a hammer, all you see are nails. They have misdiagnosed or offered treatment paths that were very invasive or made no sense because they saw everything through the lens of their own discipline. If you see a colorectal surgeon for a hang nail, he’s going to recommend a lateral sphincterotomy because that’s his trick.
• Lab testing in Thailand can be done cheaply at certain laboratories outside of more expensive Flagship Hospitals. If you are doing this on your own, with no insurance, it might be best to obtain results through the cheaper third-party labs and then bring said results to consult with the physician.
• Healthcare is a business in Thailand, do not forget this–“Medical tourism”. Some of the bigger hospitals spend a lot of money on advertising. You’ll see they are “#1”, but they are making this claim themselves. I’m not certain how to tell you where to review physicians and hospitals but be wary and skeptical.

At the end of the day, it is true that the most important thing in life is health, not wealth. Without health you have nothing, and when you lose it, you would pay any sum of money to have it back. As such, you in some part, are responsible for your own health. Choose your hospital and physician wisely.

Note: The cases related in this article are true to the best of my knowledge, and are reported accurately. There are many other stories of exceptional treatment at the hospitals mentioned in this article. Each hospital, and doctor, should be reviewed by yourself to determine what is best for you.