Medical Tourism - Advice Needed

[unclebilly]

My 74 year old father is in Thailand. He goes once per year and has dental and minor medical work done. He has been to the RAMM (sp?) hospital in Chang Mai in the past.

Before he left, he struggled for 6 months with inflammation and was prescribed 50 mg/day Prednazone which totally screwed with his body. He has been coming off of this and was put onto something else by a rheumatoid arthritis doctor. For the first time, his CRP is down to 0.3 which is acceptable. It was around 230 at its peak. He also had issues with one of his eyes from the Prednazone.

Before he left last week, he was cleared to go by his family doctor (and old washed up veterinarian), the RA specialist, and his eye doctor.

He is in Bangkok now and has been to the Bumrungrad hospital for a full check up. They did a thorough nerve assessment and want to do carpal tunnel surgery on his arm (he had the other one done about 8 years ago). They also told him he might not have rheumatoid arthritis (telling him what he wants to hear like any good businessman would do - the doctors at Bumrungrad are on commission).

The cost is $6130 Canadian which he wants us to loan him for this procedure.

He is totally confident in the hospital. The alternative is he comes back to Canada at the end of his holiday and IF his doctor thinks he needs this surgery, he gets on a 6-12 month wait list.

His only symptom is a slight loss of feeling in his 'pinky' finger, there is no muscle loss or appreciable strength loss yet.

What is the downside to having this done? Do they normally put you under for this procedure?

I am worried about 2 things:

1. Bumrungrad appears to have got caught harvesting organs from patients (there is a famous case of an american 23 year old who was allegedly killed for his organs). Being 74 years old, I cant imagine my dad's organs being of much use.

2. Infection. What are the odds of potentially lethal infection?

What are your thoughts? I don't think I can talk him out of this.

[cairns]

If it helps I was in a Thailand hospital and could not believe how good they were and how they could do it for so little cost. I don't think I've been to an American hospital that good. My doctor was a late middle aged Japanese woman and a consummate professional. With respect to infections they took far more precautions than I've seen at my local hospital.

[David]

I'll ask my wife, she's from Bangkok. If she doesn't have any first hand experience with the hospital, I'm sure her family has.

[motion]

Good luck to your dad!

I had my teeth cleaned in Bangkok a few months ago and couldn't believe how crappy the office was and how violent the experience was. I totally dug it

[1990C4S]

If you think your local hospital doesn't have MSRA you're probably ill-informed.

All hospitals have infection risks. Get in and get our as fast as possible.

[David]

My wife called her brother in Bangkok. He said the organ selling was only a rumor but the hospital is one of the best and most expensive. They specialize in treating foreign patients.

[GH85Carrera]

OK, honest question and I am not trying to PARF this this thread. You are in Canada. I thought they had universal health care in Canada. Why not get it done in Canada?

I have heard the wait for some operations is a bit long in Canada but personalty I can't fathom going to Thailand for an operation. That is just me.

[unclebilly]

Originally Posted by GH85Carrera

OK, honest question and I am not trying to PARF this this thread. You are in Canada. I thought they had universal health care in Canada. Why not get it done in Canada?

I have heard the wait for some operations is a bit long in Canada but personalty I can't fathom going to Thailand for an operation. That is just me.

That's the part that bothers me about this. His DR at home has never told him he needs this surgery on this arm. The DR there did a neurological test of some sort and came up with this. He has lost some feeling in his pinky finger, that is his only symptom.

The alternative is waiting until he gets home in April, seeing his doctor and getting on a wait list (I'm guessing 6-12 months) for a surgery he may not need. This option is free.

Oh but my dad is a know-it-all and wont listen to reason.

[1990C4S]

Originally Posted by unclebilly

Oh but my dad is a know-it-all and wont listen to reason.

Get him join in here, we need more guys like that on PARF.

Seriously, it seems like something that could wait for a second opinion at home.

[Moses]

Only his pinky finger is numb? Doesn't sound like carpal tunnel syndrome. With carpal tunnel, the first nerve compressed is generally the radial nerve which affects the opposite side of the hand. Thumb, pointer and index fingers.

[Moses]

[DanielDudley]

Sometimes my dad disappointed me when I was a child, but he would often tell me it was for his own good.

Sounds like you might be in a similar situation now with your dad, primarily because you are holding the purse strings, and you are probably not made of money.

Can you tell your dad you aren't sure it stacks up ? Because in here in the US, we usually get second and third opinions before we go forward.

[red-beard]

Originally Posted by motion

Good luck to your dad!

I had my teeth cleaned in Bangkok a few months ago and couldn't believe how crappy the office was and how violent the experience was. I totally dug it

Is that what they're calling it now?

[red-beard]

Originally Posted by Moses

Only his pinky finger is numb? Doesn't sound like carpal tunnel syndrome. With carpal tunnel, the first nerve compressed is generally the radial nerve which affects the opposite side of the hand. Thumb, pointer and index fingers.

In long distance cycling, the hand numbness is usually actually a neck issue, and it affects the pinky finger first. My father has this issue and it was a nerve compression issue in the neck.

[Evans, Marv]

What James said. In the '90s I had a bad coughing spell. During one episode, the left side, shoulder blade area of my back started paining really badly all of a sudden. In a fairly short time it developed into a numbing pain across the top, back of my left shoulder, down the triceps area, through my elbow joint, down the back of my fore arm, through the left side of my palm, and my little finger & the one next to it. For a couple of years or more it persisted severely. I couldn't stretch my left arm out to the steering wheel, because that movement initiated severe nerve pain. The doctor told me it was most likely a pinched nerve caused by an arthritic condition in my neck where the nerve exited that area. It persisted for years, & pain killers didn't help at all. Over the years it slowly subsided, most likely because the nerve(s) adapted or my mind developed a defense to the pain. I can still feel it at times in the background.

[pavulon]

What surgery is being proposed?

[aigel]

You certainly wouldn't cut me open for a numb pinky, no matter what country I was in. This sounds like something to watch develop and address without rush - so perfect for the Canadian schedule.

While I am not an MD, I second the pinky being numb coming from the neck most likely. I have had this on the bicycle and also laying wrong in bed for too long. Stretch the neck out - good to go.

A lot of small stuff like this will start going wrong as you age. If you go have surgery for each of them, you'll be cut open every couple months. There are old folks out there that seem to pursue this path - it certainly isn't my plan. Benefits need to outweigh the risk of surgery by a large margin, before i'd go under the knife.

G

[scottmandue]

I had carpel tunnel surgery done about two years ago:

First as Dr. Moses say it was from thumb across all fingertips, not even sure I had a problem with my pinkey. (think of the feeling when you sleep wrong on your arm and your hand falls asleep, but 24/7).
They diagnosed me by attaching my fingers with sensors to a computer the zapping my arm in different places, low voltage - not painful but not fun either (thou motion might dig it ).
Although they gave me a green light I was not thrilled with the idea of surgery so put it off for a year... it gradually started getting worse so I asked for the surgery... the test had timed out so I had to retest (oh goodie! This is they type of test where the tech is apologizing to you while testing).

That to say IMHO there is no rush to get the surgery done.

They knocked me out for the surgery, but then I'm a big puss and they gave me that option so I took it.

I had no problem with infection, matter of fact took the ace bandage off at night (but left the gauze and tape bandage on for the full two weeks until they took out the stitches).

That infuriate my wife because:
She had the same surgery earlier and hers got infected and they had to go back in TWICE to clean her wound.
And she always follows the Dr.s instructions to the T.

Aside from that, stitches out and back to work in two weeks but more like a year to get full strength back to your hand (still have a little ache in the wrist but worth it to have the feeling back in my fingertips).

Insurance paid for it here in the USofA