My Spinal Surgery in Thailand

MEDICAL TREATMENT AT BUMRUNGRAD HOSPITAL IN BANGKOK THAILAND  Dec 5^th thru Dec 18th

Having suffered from back pain off and on for 6 years, I was desperate to find relief.  I took the usual route of cortisone shots that helped a few days and prednisone that also helped temporarily.  Then I tried chiropractic treatment, then acupuncture. I also tried aquatic aerobics and this seemed to be helping, but after Hurricane Wilma it became worse by the day.  Nothing seemed to relieve the sciatic pain running down my leg.  Finely at the advice of my orthopedic friend, now retired, and a dear friend that was an RN, opted not to do what they called a band aid fix with epidural injections, and instead go for surgery. 

Back in May I was in Thailand when stricken with extreme sciatic pain. I was taken to a hospital there.  It was not Bumrungrad, but I was very impressed with the attention, concern, cleanliness, timeliness and general concern they had for me.  After being properly clothed in a hospital gown almost immediately, I entered a room so spotless I would not have hesitated to eat off the floor.  After a short interview, the doctor gave me what I thought was a message but his card says he is an actual MD. This was at least 2 hours.  He then leads me over to a sauna and I am in there another 30 minutes to an hour. He explains that since we were scheduled to fly out in a couple of days they could only try to relieve some of the pain.  He gave me a prescription and was led down stairs to pay the bill.  I was worried, I knew it would be $1000.00 and my insurance would probably not cover any of it.  You really can’t put a dollar figure on your health so I was prepared to pay.  I was shocked; the total bill was US $12.00! 

Although my pain eased up for a week or so it progressively became worse.  I could not stand up more than a couple of minutes without being in excruciating pain.  I started to do research.  I got an MRI and was diagnosed with Lumbar Stenosis of L4 and L5. 

Several years prior to this I was diagnosed with high cholesterol and shortly after that my insurance company pulled out of the state and other insurers wanted to write a policy with this pre existing condition.  I had never used the insurance.  I soon got other insurance but didn’t feel it would cover me if anything very serious happened or I would be out in the cold should anything related to high cholesterol enter the picture.

Like many Americans I am disgusted with medical treatment in the United States, but feel that WE the people have been entirely responsible for the situation we are in.  Every day you see advertising by lawyers advocating mal practice suits.  The drug companies advertising their product encouraging patients to ask their doctors for this or that drug.  Insurers are telling the doctors what they can and can not do.  Courts give huge settlements to patients. Hospitals prefer the doctors to over prescribe insured patients so as to pump up the bill.  Even genetic defects are blamed on doctors. In short good doctors can not practice without extremely high mal practice insurance rates which naturally they must pass on to their patients.  Cost of drugs must include the cost to pay huge settlements.  The list goes on and on.  We the people have created this night mare.  .

A great analogy might be doctors in the US are like a heard of sheep, with naturally a couple of black ones mixed in. A pack of hungry wolves are attacking them at every angle.  When will we realize medicine is not an exact science?  Things can and do go wrong, but huge settlements lead to good doctors leaving their practices.  Wouldn’t it be better to keep our good doctors, and a better method used to police the bad ones?  Mistakes happen, but it would be better to strip the repeat offender of his or her license rather than to punish everyone with almost unaffordable health costs.  We would certainly keep good doctors and eliminate the bad ones.  The way we are doing it now is working just the reverse.

I knew I wanted a doctor that was allowed to practice and not be dictated as to what he could do or not do when it came to my back.

Having remembered my experience in Thailand I did a search on the internet for Spinal Stenosis surgery in Thailand.  Google came up with Bumrungrad Hospital in Bangkok.

I go to their website. I soon realize this was the same hospital featured on 60 minutes a few months back.  I make an inquiry and within 12 hours I receive my first email.  I respond with my diagnosis and symptoms and receive a 2^nd email from Dr Nanthadej Hiranyasthiti.  He wants my MRI.  He does not want to recommend surgery until he actually sees this and me.  I am hurting and having talked to a surgeon here in West Palm and my retired orthopedic friend, I was convinced I needed the surgery.  I get a reply back from the hospital that the complete bill will run around $7500 including a 5 day stay in the hospital with private room and round the clock registered nurses.  This was substantially less than I had been quoted for a one day stay in a hospital in West Palm Beach.    Being a firm believer that you get what you pay for, I was skeptical but remembered my prior experience in Bangkok back in May. 

I do further research.  Dr. Nanthadej is highly qualified, Not only board certified, but fellowships  : Spine Surgery, Chicago and Member of North American Spine Society as well as numerous Thai accreditations.  Most of the doctors at Bumrungrad have trained and practiced throughout the US and Europe.  I do further research on Bumrungrad.  Google searching I try to find anything negative about Bumrungrad.  I come up with “O negative blood is in short supply but the hospital has donors on call as a back up”.  (I am not O negative).  I can find nothing else.  It is the undisputed number one hospital in Asia, and one of the few hospitals in the world that are internationally accredited. 

I am hurting, and purchase airline tickets before receiving Dr. Nanthadej’s reply.  I am determined to get treatment at Bumrungrad.  Shortly after I get an appointment date Hurricane Gamma  threatens and I feel I just can not leave Florida at this time.  I explain in an email about another hurricane threat.  I tell Dr. Nanthadej we have already gone thru the English alphabet, and into the Greek alphabet, and then say we should probably use the Thai alphabet since it has 44 characters.  (I hope this man has a sense of humor!)  Hurricane Gamma fizzles out and armed with another appointment we fly to Bangkok.  The hospital is within walking distance of the area we stay in when we conduct our botanical tours.  I am very comfortable as I know the area well. 

On the flight from Taipei to Bangkok we meet 2 Americans that live in Chiang Mai, a city several hundred miles north of Bangkok, and that were just returning from New Orleans where they had lived for many years.  I strike up a conversation and ask them if they had ever heard of Bumrungrad.  Not only had they heard about it but she had had gall bladder surgery there as well as a few nicks and tucks and he had several procedures also.  We find out she is a doctor.  They assure me I have come to the best hospital in the world. They would never think of ever going anywhere else.  I am certainly becoming more comfortable with my decision.

We arrive 2 days early.  We check out the hospital.  Wow! I am impressed.  We see a steady stream of high end cars coming in and out of the hospital directed by 8 policemen.  International patients are throughout the facility.  A McDonalds , Au Bon Pain,  Starbucks and several other restaurants are on the 2^nd floor visible from the immaculate lobby.  Could this really be a hospital?  It is more like a 5 star hotel

 I sign in, as I had already pre registered.  This takes all of 3 minutes.  They put a bar-coded band around my arm with my name, patient number date of birth etc.

My appointment with Dr. Nanthadej is at 10:40.  On the dot I am led to his office.  We discuss my problem and he explains the procedure.  I like him immediately.  He says he enjoyed my humor in the emails.  He was interested to find out how I had heard of Bumrungrad and I explain.  In my research the Staph infection rate in US hospitals was not acceptable to me. I had been told that in some cases it was as high as 27%.  Dr. Nanthadej says that total infection rate for all types of infections at Bumrungrad was less than .007% and he felt the orthopedic section was even less than that. He explains to me some other risks with the procedure however.   I was convinced I needed to have a fusion.  He explained that he really does not think that in my case I need this even though it is several thousand dollars more that I am willing to spend.  I tell him that I am a very active person but that I am only a nurseryman, he is the doctor and I will respect his decision. We agree that he is to make the final decision on the operating table.

He sets up my operation in two days and prepares me for pre op tests immediately.  I am led to another Doctor by the name of Wiwat and I wait about 2 minutes.  I like this man too.  He interviews and examines me and writes out several other steps.

I get led to blood testing.  This time the wait is less than a minute.  My veins are hard to find and most everyone has to stick me several times.  Not so, first time she hits the vein.  She draws blood.  Then she shows me the labels with my name and patient number on it.  Is this your name she asks, and then proceeds to place the labels on the blood samples. I see there is no chance for mistaken blood.

 Blood clotting test was next and I just get into another chair in the same office and this test is done.  I dread needles but this was all practically painless.  From here I am led to X-ray and I have to wait a full 2 minutes, then EKG was practically instantaneous.  Boy does this hospital have its act together.  I become even more impressed.  I am told the doctor will call me about the results and am led to the in patients admission where I choose a room, and sign some forms.  She tells me I must pay for the work done today. 

The payment office is just behind registration.  A big computer monitor board is above and displays your patient number.  You sit in comfortable chairs with a table of refreshments while you are awaiting your turn. There are about 16 stations. My number comes up in less than 3 minutes.  The bill was slightly under $100.  This alone would have taken many trips and several weeks to happen in the US.  Dr. Wiwat calls on my cell phone and all is a go for the surgery. 

I am given pre surgery instructions and told to be at the hospital by 9 in the morning.  We are on time.  I pay for the estimate of $7500 in advance.  I am led to my private room.  It is huge complete with a nice bathroom, refrigerator, safe , state of the art electric bed, a sofa big enough for someone to sleep on , chairs, TV, DVD player, telephone, and closet and cabinet space, as well as an private outdoor balcony with a beautiful view of downtown Bangkok.  I ask about internet access.  They bring me a converter and connection.  This room costs approximately 70.00 per day with meals and round the clock nursing staff all of which are RN’s.

At about noon I am given an IV.  At about 1 they come in and tell me that surgery has been delayed for an hour or two.  At about 3:30 I am taken to pre op and Dr. Nanthadej greets me and apologizes for the delay.  He explains he had 2 emergencies.  I answer back that if he is too tired I will wait until tomorrow.  He says no that it actually limbered up his fingers.  We both laugh.  Shortly thereafter I meet the anesthesiologist Dr  Sunantha   .She asks about prior surgeries and any allergic reactions.  She reassures me, and tells me what to expect after the surgery.  I immediately like her too.  I am wheeled into the operating room.  It looks ultra modern and I’m pretty sure it was equipped with a huge laminar flow.  This is a sophisticated filtering system that is capable of filtering out the smallest bacteria in the air.   Dr. Sunantha asks if I am ready to go to sleep.  I do not remember answering.

Several hours later I wake up and think I have dosed off.  To my surprise the operation was over.  I immediately feel that my leg pain is gone.  I barely feel the incision.  I call home and tell everyone I am OK. I am wide awake.  I am so happy it is all over. 

Throughout the night the nurses checked in on me.  I have little or no pain.  Everything is administered thru the IV portal.  I even think the anesthesia was administered this way, but I do not remember.  I sleep the whole night and they never awaken me.  I remember when my dad had cancer they would wake him every 15 minutes with an injection etc.  He was miserable, and exhausted simply from lack of sleep.

The next day I am cared for like I am a king or president.  They were particularly vigilant of any change in temperature or blood pressure.  I knew they were going to be on top of any possible infection.   Both doctor Nanthadej and Wiwat come in to check on me.  They reassure me that everything is fine. Dr. Nanthadej explains that he opted not to do the fusion and that I would be getting a refund.  We joke and I tell him I plan to buy some stock in Bumrungrad and to make a little bit of profit. He laughs.

The food selection is unbelievable.  There are four choices including Oriental, Western, Japanese and Chef’s choice.  I have found them all to be delicious, but if you don’t like it you can always call room service for a huge selection of meals served downstairs from the many restaurants.   Gee should I have room service bring me the Rock Lobster salad with fresh tomatoes and cumbers with Balsamic vinegar, or should I just accept one of menu choices that just happened to be thinly sliced tuna with mashed potatoes in a red wine sauce.  McDonalds has a restaurant on the second floor of the hospital, and also delivers to your room. “McBumrungrad McDelivery”

Customer service comes in and asks me if there is anything they can do to make my stay more pleasant.  I tell her that I am at a loss for words for how pleased I am.  Phenomenal, remarkable, fantastic, do not portray my happiness.  I can barely withhold the tears.  I am out of pain after suffering severely for 8 months and off and on for over 6 years.  She knows I sell plants and wants to know if I would like to be moved to the garden floor with an outside balcony garden.  My outside balcony only overlooks downtown Bangkok.

The next day Dr Nanthadej again visits me and checks the incision.  He gets me up to walk.  I have a bit of tingling in my leg but he says this will go away in time and to take it easy.  He says I will be ready to be released the following day and he can see the almost disappointment in my eyes.  He says I can stay for as long as I wish. (After all a private room with meals included is only US $70.00 a day.  I feel great and will surely be able to lift small buildings in another day.  As it turns out I do stay an extra day but one day short of the estimated 5 days.  I think Dr. Nanthadej sees that I could be too anxious and impatient to heal and possibly orders a reduction in pain medicine.  I have not so good a day, but more importantly I learn this is actually going to take some time as they had explained.

I get on the internet and book the Bumrungrad Hospitality Suites for the remainder of the stay.    They almost immediately call me with a reservation but apologize for not having accommodations for several nights but will be glad to get me reservations at hotels within walking distance of the hospital. 

Dismissal day:  Dietician comes in and asks how I found their services.  Are they kidding?   Customer service wants to know if I had any suggestions on how to improve.

 Dr. Nanthadej again visits me, and writes out prescriptions for my recovery.  All the nurses, much of the staff, meal servers and even the cleaning crew, have come to say good bye.  I get tears in my eyes.  And then they do too.

They send me down to the 9^th floor for final payment.  I am surprised to get a sizable refund with total costs including doctors, operating room medical supplies, prescriptions including  that used during my recovery, private room, meals,  nurses, anesthesia , X-ray , telephone and internet service which I used a lot, for the 4 day stay is $4631.  I am elated.  Surely this can not be right. 

Sure enough, I go back up to my room to move out, and the nurses inform me there was a slight error and that I needed to go back to the 9^th floor.  I get there and the cashier is all apologetic; he made a $19.85 error in the hospital’s favor and needs to refund this back to my credit card!

One of the staff meets me with my suitcases, and takes me to the Bumrungrad Hospitality Suites, a service the hospital supplies to patients and their families to stay during their Bumrungrad visit.   I feel like I know them by now as we have made reservations thru the internet, as well as talking by phone   Check in was fast and efficient.  The facility is no more than a block from the hospital and an easy walk for me now. 

The rooms here are even nicer than the hospital’s with beautiful bathrooms and a showers and tubs you almost have to have instruction to operate.  Now this is getting pretty close to heaven.   The kitchenette has dishes and microwave with Washer and dryer and even dishwasher in the two and three bedroom apartments.   The rooms are so spotlessly clean and polished you better not walk around in you stockings as the floor could be slippery this way.   I guess they take extra precautions for cleanliness here to keep down the ever present threat of infections. 

Some of the apartments even have adjacent connecting apartments.  I took many photographs of this facility and will have a CD  PowerPoint presentation by the time this is published.  I never got to use the pool on the top floor. 

/My first day as an out patient I decide to get some trays made to whiten my teeth.  Actually, I wanted to see if other departments were as efficient, and wonderful as the Orthopedic.  And yes, it was an absolute pleasure.  I will have my trays in 2 days. 

That evening I go to the Emergency center as instructed by Dr. Nanthadej to have my bandage changed.  I walk into the center and greeted with a person that led me straight to a whole line of beds.  I never stopped walking in the process.  They asked what I needed and I showed them my paper from Dr. Nanthadej and they immediately changed my bandage.  I told the nurse or she may have been a doctor, that I would see them tomorrow.  She gave me a computer generated bill and I walked up to the counter at emergency to pay the 274 baht.  I jokingly said would you take 275.  Anyway that amounts to $6.88.

The following day I have become very comfortable with Bumrungrad and go to make an appointment for another problem.  They say we can make an appointment for you tomorrow or you can go standby today.  I decide to “go standby”.  Exactly 23 minutes later I am in the doctor’s office.  He prescribes an ultrasound.  I am led to that department and wait another 4 minutes.  After the ultrasound I am told to go back to the doctor.  The reception says what is referred to as Tinglish here, “Oh Mr. Pearson take one hour to read Ultrasound, you go have fun for one hour.  I love it.  I go to the lobby for lunch and return an hour later.  My ultrasound is ready and the doctor explains what is going on and that it is not cancerous but to check it annually or if it becomes painful.  Charge for all this is $62.90.

Bumrungrad compared to other hospitals is like comparing Cirque du Soleil with a summersault or Disneyworld to a merry-go-round.

Unless I am in an emergency situation and can not make the flight to Bangkok, will be the only way I will ever seek hospital medical treatment in the states, if the current medical crisis continues.   I will crawl back to Bumrungrad if I have to.  It is a world class state-of-the-art facility, staffed with the most sincere and caring, compassionate people on earth.  There is not one thing I can suggest to them to improve upon what they have there.  (Except that it sure would have been nice to have a diet coke on ice immediately after the surgery)  I told one of my doctors this and he said all you had to do was ask!

They provide translators for other languages, but I found English to be no problem.

It is very convenient to get around as it is very close to the Nana Sky Train station with free shuttle service from there to the hospital every 20 minutes during the day.

I can not sing enough praises about this facility  

AARP did an article with me on medical tourism  check this out    https://vimeo.com/106496720

Bruce Pearson