7-20-2004; TOPIC: Healthcare - Part 2

[ATAdmin]

Part 2 - What could Possibly go wrong? When the wheels come off...

So yesterday I got all namby-pamby with you all and told you how lovely healthcare is in Hua Hin. And in general terms to reiterate what I said yesterday it is, but maybe only for farang.

The trouble that I ran into was when my girlfriend recently fell ill. Why the Thais seem to become lazy when it is a Thai that is sick, I have no idea, but it certainly seems to be the case.

Now my girlfriend is 'usually' ill anyway. She always seems to have a lil' something bothering her. As with this last instance she had had a long running cough - which is kind of unusual, as she does not smoke. But then she came down with this migraine headache that the cough compounded because every time she coughed - its seemed horribly painful to her head.

Over a period of two days I took her first, when the problem was milder, to the Hua Hin Hospital. They ran no tests, none - not a single one. Not understanding Thai at a medical level I could offer very little and let her deal with them. Half-hour later we were out the door with an assortment of pills of varying purpose and color. Some were basic antibiotics, there was a mild pain killer - akin to aspirin - and the rest were seemingly vitamins.

The next morning after several rounds medication the problem had not seemed to subside so I thought I should take to another doctor, maybe a 'better' doctor for a second opinion. Now I took her to Hua Hn Polyclinic. Fast and courteous they took her in immediately, more test were run here. Someone took her blood pressure (normal), another nurse thought it prudent to take her temperature (elevated), and not one but two doctors came into to see her and one wielded another diagnostic tool - a stethoscope who listened dutifully to her heart beat (normal) and her respiratory function (labored and congested). They concluded that she was "sick" with a respiratory infection with flu like symptoms. We were given more aspirin and antibiotics and sent on our way.

It was at about this point that I began to wonder why no one had taken a blood sample..? While these lesser diagnostic methods can be good at connecting the dots on a problem, a blood test is a definitive way finding out what is going on. Similarly urine tests and throat cultures can be used. No matter, they were ignored.

I went to work and in the later hours of my day she started calling me every half hours in pain and crying. When I got indeed the poor girl was in tears and was generally no longer functioning; she could not hold down liquids or food and would even throw up medication she would take. She could not take medicine for the pain or the medicine that promised to make her better.

Sao Paulo. Now I am not taking this sitting down anymore. The problem is severe and I am sick of two bit doctors only half diagnosing her. I take her so Sao Paulo get her checked and see the doctor. I explain what she is going through, what we have tried. He asks her some questions in Thai that she is barely able to answer. More diagnostics. I ask him to take a blood test to be sure; not needed he tells me, mai bpen rai. Mai bpen rai my ass! He essentially sided with the earlier diagnosis tried to dispense pills many of which I told him we already had. He added a more powerful painkiller (Tylenol-3 w. codeine), sleeping pills, and probably some other vitamins for good measure. "Drink lots of water," he says. Pffhh! Jackass...

I take her home and as the evening wears on the problem continues to worsen. Finally, properly pissed off I went to local pharmacy before it closed and convinced the chemist there - a previous acquaintance - that I needed a soluble form of morphine that could be take orally. She gave me a fast acting morphine derivative that you can place on your tounge, it dissolves and you can wash away the nasty taste a minute or so later with a bit of water. This at least made her more comfortable. Me, I wasn't very comfortable...



It is about this point that she tells me that she is going to Isaan to be with her family!?! I tell he she is not dying and she doesn't need to go to Isaan! Too late - her brother is halfway from Bangkok in his truck to fetch and take her home. Holy Jesus-Allah-and-Buddha I think. I knew she wasn't dying (I think of course), but I was really wondering why she wanted to go home..? I couldn't leave I had obligation at work the next day but promised to come up the following day.

At this point I am recalling images of Isaan hospitals and doctors. Not very pretty pictures mind you. I had had stitches removed there some time back and that genius of a doctor simply trimmed off the visible portions leaving me to dig them out later with tweezers - they were not the biodegradable sort mind you. So my faith in Issan medicine was not high... I was worried.

Flew up to Isaan and was met by the family at the airport who took me straight to the hospital. Again, not pretty. The sick are sleeping in the halls with their families, children walk around playfully in areas where people are deathly sick and possibly contagious. It is later evening but it is still humid and hot, I can hear some one's mother, sister or wife weeping softly in the adjacent room. I had already decided that if the hospital was not up to snuff that she would be leaving with me the following day for Bangkok's Buhmigrand International Hospital, pricey yes, but I didn't care.

Somehow she had garnered a private room which was good because her ample family needed it to set up mats for sleeping and eating, I swear they probably making plans to bring in a BBQ to cook for her. I love how Thais set up shop where ever they go...

She was much more comfortable than when I saw her last and this at least was a relief. We talked for a while and seemed better. I asked what the doctor had said, she thought for a moment, pointed at herself in general and said, "He say sick inside." 'Well, yeah...' I thought and resigned myself for waiting to see the doctor the next day. She tried to make me happy by showing on her arm that they had taken blood. That did make me happy. I sat next to her on the bed and light stroked her back. At one point she winced in pain. I asked her what was wrong and she said that the doctor had, "Put needle, take water," pointing to the spot on her spine. Holy shit, they had done a spinal tap - I was impressed.

The next day I waited impatiently for the doctor. When I finally became pissy and asked her where he was my girlfriend said, "Him, walk-walk-walk-walk..." She smiled - so did I.

I went into the nurses station and sat down and asked a nurse what was wrong with my lady. She tested my Thai - I failed. She tried her English - she failed. She then grabbed a pieice of paper and after about a minute of careful writing she slid it across her desk to me. It had only one word, "MENEGITIS" in all caps. Aw, crap that's not good. The doctor enters the nursing station and the nurse goes, "Oh, Doctor!" and passes me off to him. This guy looked like he was 19! It was a Thai version of Doogie Houser!! He then tells in great English with only a slight accent that:

"Your girlfriend has meningitis yes. We began by taking a blood sample, which indicated that she had an infection. We later attributed that to pneumonia - which she has had for some time. That is why she coughs a lot. Still we did not know why she had headaches so yesterday I order a spinal tap. That indicated that she had meningitis. She is on a strong anti-bacterial and anti-fungal antibiotic regimen and should be fine in about two weeks."

Holy-f%#@&in'-crap! I stood there in shock and disbelief, not because my girlfriend was sick, but in awe of this young genius. I shook his hand and he was on his way. I returned happily and confidently to my girlfriend know she would be okay soon. I was at ease.

It turns out that young doctors in Thailand are sent to do their "residency" in rural and poor areas on government salary for the first few years. After that time they are recruited by or apply for better jobs in Bangkok or where they want to work - they are then replaced with a new young doctor. What a great freaking system! Insuring that the most impoverished areas have doctors that are up to date on medicine and techniques. Just when you think everything is backwards in Thailand - something like this comes along and warms your heart.

Anyway, back to Hua Hin. Hua Hin is by no way an poor area so it does not get these young Einstein doctors. Instead we have mostly to old sods who are working towards retirement. Sometimes their skills can be out of date; sometimes they can just be lazy - so beware. Her diagnosis if it had not been treated, could have been deadly.

I went to the Hua Hin Polyclinic a few days ago for a routine ailment on my own. I saw one of the doctors that had treated my lady. He remembered her and me. He asked how she was doing. I told that she was fine. "Good, medicine work, see?" "No actually, she went to a hospital in Isaan by her home, where they figured out she had meningitis and pneumonia, they cured her." I said to him.

"Oh," he said, "Not so good."

[magobligin]

Waiting with bated breath for the next episodes. The health related articles contained humour, romance and not a little cynicism and they were a real eye-opener on available local healthcare facilities.

[tonybuxton]

The Sao Paulo is the worst Hospital I have ever been in during my 45 years in Thailand. I arrived there in great pain from food poisoning and went into the emergancy ward.
I asked for a pain killing injection but was told that there were no doctors presently at the the hospital that could authorise this. I would have to await until one arrived. Four different staff members tried to take blood samples. None of them could get the needle in a vien. Finally the fifth, a uniformed nurse tried and failed. Frustrated she pushed the needle with no syringe into my arm and sueezed out some blood into a test tube. She got my blood all over her hand. None of these five were wearing surgical gloves.
They gave me a private room which they told me would cost Bt4,900 a day.
Finally a proper doctor arrived. Unsmiling gave me a quick lookover and left.
They got a woman from the pathology lab to give me an intraveneous drip and some pain killer. She had no problem getting a needle into my vien.
The very young staff were obviously untrained in any way and poorly educted. The food was dreadful. The staff unsmiling. Bad service.
On the second day when the doctor came. I said I felt better and he told me I could leave the next morning. The nurse came and tried to give me another bag of saline just as I was waiting ready for the doctor to OK me to leave. I refused, already bloated by four bottles of the stuff.
After waiting an hour for my bill, which they spent trying to "pad" it up as much as possible. I went downstairs to the cahier asking why it took so long.
When I got the bill I was shocked by the amount of unheard of extra charges like "inpatients outgoing care fees" nursing fees. "inpatients incoming care fees" and very heavy medicine charges.
Nursing fees at Bt1,600 per day is ridiculous. The staff were not even nurses. I saw only one uniformed nurse.
I got a reduction on the room rate when I told them I was not a tourist and had no insurance. Even then it was higher than a first class hospital in Bangkok.
This hospital a complete money making rip-off. I could name 10 hospitals in Chiangmai whose costs are less than half and services and facilities first class. San Paulo is obviously not qualified for any serious medical complications and a much better hospital in Bangkok would be half the cost. Bangkok General Hopital is as good as Bamrungrod and much cheaper

[lomuamart]

Unfortunately, we don't have much choice here. It's either San Paulo or the public Hua Hin hospital - and I certainly wouldn't recommend the latter. I had a serious leg injury earlier this year and was initially treated at HH Hospital. After a three hour operation, I woke up the next day in a corridor. No beds anywhere. They were cleaning/slopping up around me, it was unbearably hot and no fans - my wife eventually went home to get one and after an hour the staff moved me to an electrical socket where they could plug it in. All this is not mentioning the mosquitoes and flies. Some sludge was served up for lunch that would have been more at home in Bang Kwang.
I got myself transferred to SP where I stayed for the next 10 days. It's the second time I've been admitted there. It's not perfect and certainly dosn't have too good a reputation, but they've taken care of me both times and overall, I've not got too many bad words to say.
Still, it is a question of available choice, as I said. Certainly, hospitals in BKK would be preferrable and there are good ones in Petchaburi, an hour away. Sometimes, however, time is of the essence and there's no chance to initially get to these.

[suzannejames]

I got myself transferred to SP where I stayed for the next 10 days. It's the second time I've been admitted there. It's not perfect and certainly dosn't have too good a reputation, but they've taken care of me both times and overall, I've not got too many bad words to say.
Still, it is a question of available choice, as I said. Certainly, hospitals in BKK would be preferrable and there are good ones in Petchaburi, an hour away. Sometimes, however, time is of the essence and there's no chance to initially get to these.

In Petchaburi, which hospitals there would you recommend?

It's good information that you're providing regarding HH medical care. If there's ever a time hospital care is needed, I'll be thankful for having this knowledge well in advance of treatment or hospitalization.

[sezanu]

When your a tourist Sao Paolo is good.

Been there a couple of times with my kids, first time we was hospitalized
for a week.
The service was good,nurses was ok and my daughter liked them.
If anything happens next time I'm inHH,and need attention of a doctor
I'll use the doctors at SP.



Hopefully I want be need ing any medical care.

[JD]

Other San Paulo Horror Stories Here.

http://www.ha.or.th/Cgi-Bin/list.pl?topic=83

Needed a blood test when I visited the Hua Hin Polyclinic on Petchkasem about a month ago. The so called "Nurse" drew blood from my arm, I think she thought she was pumping up a bike tyre, never will I go there again.

[buksida]

In Petchaburi, which hospitals there would you recommend?

Petcharat hospital on Petchkasem Road, very professional (ie they know what they're doing), always several doctors on duty.

[billseymour]

Just to reinforce buksida's response, we live in Phetchaburi, and have direct personal experience of both the large private hospitals -- Phetcharat and MeuangPhet Thonburi.

As you drive north from HH, the first hospital you encounter is MeuangPhet Thonburi, and Phetcharat is about one mile further north (the second set of traffic signals). Both are on the east side of Highway 4.

We believe Phetcharat is a perfectly satisfactory hospital for uncomplicated (i.e. easy to diagnose) medical conditions, and is substantially superior to the Thonburi group subsidiary. The latter should not really be considered unless you are very price-sensitive.

But for any serious (non-emergency) condition, you should not use provincial hospitals -- go to Bangkok. My wife suffers from a complex health condition and is treated at Bumrungrad in Bangkok, as fine a hospital as I have found anywhere in my experience (and I have direct personal experience of what are reckoned to be the premier private hospitals on the west coast of the US). 40% of Bumrungrad's patients are foreigners, many of whom make the trip to Bangkok only for medical treatment.

If you have health insurance, the better plans will cover treatment at Bumrungrad.

[suzannejames]

Thank you very much for the two posts above.

I'll file the information for reference, while hoping there won't be need for it.

[bill]

Iwas living in hh when my wife's sister's 2 kids took sick. Her husband is Swiss and money is no problem. She went to hospital on main road going north. About 5 kl up on side of road going to sea and back 1\2 block is the hospital. The kids were there about 10 days and getting much sicker. She was worried they might die. This service was costing her, a Thai mind you, 8,000 bath a day. I was there alot and escaped lunatics could have done no worse. She found , from her Thai friends who had money, that there was a dr. in pacmanpran, 30 kl south ot hh, who had an excellent reputation. we went there twice a day and in 2 days the kids started improving. In 5 days they were cured. This dr. works at the army base. He also dlivered our child. The Dr. also cured my wife's Dad who i thought was going kick the bucket. He's damn good. Remember you have to have a car to get there.Maybe a baht bus goes there but you'll be dead before you get there. If you want his address contact me and i will give you my wife's phone number.

[lomuamart]

Bill,
Sounds like your describing HH hospital or even Thonburi, which would have been a while ago now as it's closed.
HH hosp does its best, but it's the public hosp for town. I've never seen it anything but bursting at the seams with patients. As often as not, the unlucky ones are on gurneys in corridors. Not pleasant to even walk around let alone be admitted.
I'd forgotten about the one on the military base at Pranburi. Yes, that does have a good reputation and will admit/treat members of the general public.

[Jaime]

It was at about this point that I began to wonder why no one had taken a blood sample..? While these lesser diagnostic methods can be good at connecting the dots on a problem, a blood test is a definitive way finding out what is going on. Similarly urine tests and throat cultures can be used. No matter, they were ignored.

Going back to the original post - and I do not have a medical background - but this story seems similar to ones here in the UK, where children have become seriously ill or died after misdiagnosis of meningitis. To be fair, I seriously doubt if a blood test would have been likely as the first course of action if I went to my local surgery with the same ailments as ATA's gf, who I hope is now recovered.

[egeefay]

Here is some heartening information I got from several other people on another forum regarding a new world class hospital coming to Hua Hin.

[ Link removed as this site does not allow links to us and has banned at least 2 of our moderators we respond in kind ]ADMIN

[Limey711]

I don't know if I chose a good day to visit the Poly Clinic, but my self and my grand daughter, both had an ear infection and we attended the Poly Clinic, when we were last in Hua Hin, the nurse's were superb and the doctor also.

When we move over there later this year and any member of my family is feeling poorly, then the Poly Clinic will be my first port of call.