Thai medical pratices.

It is hard to comment on your experience with the insertion of the inhalator as we weren't there and don't know how urgent the need or the prescribed procedures for that hospital.  I try not to jump on the bandwagon of condemning something without firsthand knowledge.

My only experience with doctors in Thailand over the last forty years has been one broken leg with a plate and eleven screws, more recently a crown on one tooth and a couple of physicals which my wife insisted we get over our twenty years together.  All of that turned out very good.

For everything else I developed a good working relationship with a pharmacist and self-treated with drugs bought over the counter.  That was all pre-internet so I was unable to Google the information I needed but everything has worked out fine.  I guess I have always focused on prevention over cure by staying healthy and out of harms way.  I have also never had any form of medical insurance and at 63 it is perhaps a little to late to change that.

In no way am I condemning The medical practices of Thailand. What I do condemn is this old concept that the "Thai Way" is the only and right way of practicing something, even if existing practices and documented research prove otherwise. I did say that the Thai government realizes this point and allows a legal remedy for this by allowing the letter of legal medical instruction for appropriate procedures.. This procedure of forcing a procedure is not isolated to me and Thai history demonstrates that. I even heard a child crying in the hall because he was being subordinated to a Thai Way of medical procedure, rather then taking a more a compassionate approach.

As a whole I am not condemning the Thai medical profession. I think it is great and I and many others have benefited from such services. But as a Farang there are differences. Westerners adhore pain and Western doctors accommodate the patient. But there are some old concepts, that are even accepted by young doctors today, that no longer have a place in medicine. These concepts come from at least the 19th century and further back. What I am saying is that all Farangs be fully informed as to any medical procedure prior to the administration of that procedure, or have your advocate (wife, lawyer or whatever) to provide the MD's with the appropriate medical instructions. This can easily be done by having the letter included in your medical file.

Again I say that Thai medical practices are normally excellent, and comply with J.C.I. accreditation. But no patient needs to be subordinated to outdated 19th century medical practices. (at one time "blood letting"  was an acceptable medical practice, which is now know to be completely wrong and a was of time.)

My real intent is that the Farang be able to give informed consent to any and all medical procedures, not simply given the expression of "it's the Thai way", even if the Thai way is the normal procedure. I was in one of the best Fang hospitals in Chiang  Mai, with full accreditation for international standards and yet the six attending physicians chose a practice from the 19 Century, not one that was for the best interests of the patient. My only hope here is that no other Farang is ever again subordinated to the pain, suffering, and indignation of a medical procedure that could case more harm then good. (To think that at one time a lobotomy was considered  a beneficial medical procedure, o to find out in less then a decade the procedure was completely useless.)

I have a huge (or is it hugely) respect and appreciation for Thailand and the medical profession. But like in any country in the world a person has to know when to say NO.

Bill is quite right.
Thank you, Bill, for the warning about intubation. It is very hard to believe that all Thai doctors must spend time in the USA because intubation there is always done under some kind of sedation. (And the choice of tube circumference size is obviously crucial). Tying a patient down to cram a tube down their throat is barbaric and totally unnecessary.
So, Bill, thanks so much for the heads up. We will each definitely get a letter of medical instruction. (My son is a Harvard trained Anesthesiologist -  and he was totally shocked to hear the Thai intubation practice).
   For VILLAGEFARANG: you have been very, very lucky so far. And 63 is no age!
     My husband of 4 years is strong as an ox, was raised on a working farm, and never needed to see a doctor his whole life. He didnt even get his Medicare card at age 65. But when he was 69, they discovered advanced colorectal cancer!  STAGE 4!!! How about THAT?!  If he hadnt been pestered into having a colonoscopy, he never would have known he had cancer!!!
     He was only saved by the special clinical trial he was in. He had no health coverage at all, because he "never was sick". Idiot. 
     So, It cost him (us) $19,000 per shot to go thru radiation and chemo treatments!!!
    So......."Mr Healthy" almost died a terrible and painful death because he thought getting older couldn't possibly bring any health problems!  WRONG!!!! That's when problems just start! 
       My eagle-eyed husband never needed glasses. He is 74 and now uses reading glasses, AND at the last eye exam 6 months ago he was told he had the start of wet macular degeneration!  To save that eye from total blindness, he must get an injection in that eye monthly. And he had no symptoms for that, either!!
To top it off, he now has Atrial Fibrillation - for which he takes pills. This started two years ago. A bit if heart palpitations, he thought, was normal. But it's NOT!!!
My husband is 6'3, 190 lbs, trim, fit, attractive, a natty dresser, exercises with a trainer (who keeps track of his pulse rate) and we eat healthy, ride our bikes, go for power walks. So it's not like he drinks, smokes, is overweight or a couch potato.
     His friend, a successful NY lawyer, tall and fit, started to lose his energy, out of the blue, at age 70. He went to his GP but the doc didnt find anything. A few months later, he went to another doc because he was so terribly fatigued. No other symptom.  Diagnosis: pancreatic cancer.  He died exactly 6 months later.
So - just because you didn't need health insurance before, doesnt mean you shouldnt consider getting some for a couple hundred bucks a month - for in case.  Getting older brings no joys.

Paintergirl;

It sounds like you could use a trip to Thailand, for medication.

I met a couple from Hawaii. They fly to Thailand for medical things, whatever they are. They told me that their saving actually pays for their trips to Thailand.

Just sharing

No worries. Coming there in Nov. and then again to retire

You said you wanted comment but you seemed very unhappy that I didn't take your account of things as absolute proof that the Thai Way is somehow antiquated, lacking compassion or that you were subordinated to the pain, suffering and indignation of a medical procedure that caused more harm than good.  Your lecture about blood letting and lobotomy seemed a bit over the top to me. 

I understand Americans are very litigious and want everything in writing but I am not convinced that what you suggest would make much difference to someone who finds themselves in an emergency room as you did.  If one is unfortunate enough to find oneself on a table in an ER there probably won't be much time or inclination to sit around discussing medical practices, appropriate medical instructions and trying to convince the person you are depending on to save your life how to do their job.

Sure you have every right to search for a doctor who agrees with you or to seek a second opinion when contemplating elective surgery or even to say no to recommended treatment.  In an emergency I am not sure anyone wants to be pulling the farang card and making demands.

As for Paintergal, I guess you are free to call people “idiot” if they don't conform to what you consider appropriate behavior but I think everyone has the right to choose their own path and not be forced to do things they do not wish to do.  I could be wrong but I figure we all die and I am more concerned with living too long rather than trying to cling to life at any cost.  That is a personal thing based on family experience and not something I try to force on others.

Two people care enough about others to offer helpful advice from their own experiences. 
This happens in other fora, such as commentaries re: visas, or insurance, for examples. 
Up to you to use this info for your benefit or not.
Being prepared is a good thing - but if you don't want that, that's fine.

I have many responses for you but I will not elaborate on them at this time. My medication is kicking in and it's time for me to go to bed.

Before I do so I will make one point.

I have a home in the dry climate of the Arizona dessert.  That is in contrast to the humid climate of Thailand. That in itself means that I could live a longer life in a dry climate, with my COPD. But that creates a conflict. The goodness and feelings about living in Thailand are very important to me. Living in Arizona with an unhappy life style is not something I want to look forward to.

To put it the way that I think you understand it - I am willing to live a shorter life and be happy, then to live a longer life and not be happy.

One afterthought of your analysis of my commentary could be that you are over analyzing my commentary.

I posted a message to alert Farangs, even if it only affects 1% of the population. I can assure you that even if it is only 1% of the population those affected are very affected. But I also gave an option for people not to subordinate themselves to my indignation.

Off the top of my head you might be splitting to many hairs to finely and looking at unsatisfactory results.

My med's are kicking in - good bye.

For someone with a chronic condition like COPD, or emphysema, who may well expect regular return visits to a nearby hospital, your advice to set something up in advance of need does make sense.  I did not associate ER with reoccurring visits and envisioned road accidents which are common here but I do know a couple of guys with your condition and they do on occasion need the ER so I now better understand what you were trying to say.

I have been told that the chances of having any kind of accident are 20 times greater in Thailand then that of living in the US. Walking the side walks in Chiang Mai could support that statement, because how uneven they are. I readily can see unsafe habits on a daily basis.  But I have no hard data to support this 20 times statement.

But such a statement about accidents brings up the idea - it's not a matter of if but when an accident will happen.

Yes going to an ER can be rattling. In my case I had my Thai friend who would be, and was, my advocate. She is also an upper tier administer at the Ram Hospital, the hospital that I use for any of my needs. (That became helpful a few times.) I can assure you that when I return I will hand deliver at least three copies to the hospital, one of which will be in my Ram file. I will also provide a copy for my friend, when she needs to be my advocate again. For me, this Thai procedure will not happen a second time.

The point of this posting is for those who live or want live in Thailand. Be warned and prepared when it comes to medical procedures in Thailand. One suggestion, given to me, is to get a primary care physician, PCP, set up who knows you and your wants and needs. Considering Thailand, this cost is next to nothing, with huge benefits in the future.

As the Thai's say - Up To You.

I agree with you when it comes to people with serious pre-existing conditions which require regular hospital visits.  It is a little bit harder for a healthy person with no history to prepare for that bolt from the blue.  I suppose it is not uncommon for an individual to take their very specific life experience and generalize it to everyone.  I see that a lot in Thailand, where people have a bad experience with a Thai and suddenly all Thais are terrible.  Each person needs to evaluate his or her specific needs and not let headline catching statistics influence their fear level too much.

I rode a big bike around northern Thailand for a few years and constantly heard my accident prone friends say it wasn't a matter of “if”, it was a matter of “when” but that “when” never happened to me because my attitude toward riding was very different from theirs.  Accident statistics in Thailand are based on Thais doing things which are inherently unsafe and don't necessarily translate to everyone.  If you don't drive too fast, in the rain, in the dark, drunk, on a flimsy scooter, talking on your phone, with no helmet or safety gear and with more than one person on the bike, then you probably fall well outside of  the statistical bracket one reads about for road carnage.  That said, foreigners often have a hard time adjusting to this new environment or bring bad habits with them when they come here which get them into trouble.

Personally I think it is helpful to think of coming to Thailand like you would stepping onto an airplane.  Once you are on the plane you have no control over the pilot, the airplane or the weather.  You can try to select a reputable airline and good weather but you have far less control than if you simply stay home.  Thailand is different and takes some getting used to.

So, yes, if you have health needs it is probably a good idea to do your homework and make sure to source medications and hospitals before you need them.

Just to clarify, I am not saying anyone is wrong, I am simply continuing the conversation and giving my own personal opinions and insights.  As Bill says, what you think or do is “up to you.”

Without a colonoscopy, my husband (whom I had not met yet) would have surely died of colorectal cancer.
He did not fear or suspect anything. He hadnt been sick a day in his life.
He is quite thankful this test saved his life. But because he had no insurance, each treatment cost $19,000. US.
I lived in Thailand 4 years and enjoyed each day. Thats why returning will be what I do. He is looking forward to it all. With insurance.

I would like to follow through with through with a personal comment. I don't believe that I even blamed all Thai's for anything. I will say that there are some individual practices that are very antiquated. Since 2010 the Thai medical profession is learning that some of the old traditional Thai ways can be counterproductive to the patient - Thai or Farang. Thailand, as I have seen and lived it for the past 17 months is working very hard to make Thailand a good place for both Thai's and any Farangs. But progress takes time.

Another comment; at our age and increasing age things change. I'm not criticizing anything you have to say, but age takes it's toll. Recently I was providing some advice about hearing, one of my areas (even if it is limited). I was writing about the hairs inside the inner ear that activate the hearing process. Some of those hairs are damaged to specific frequencies that are specific to certain activities. The action specifically is shooting guns. The damage to hearing is frequency specific and associated specifically to which ever ear is close to the firing of the gun. But that leaves out another process that is inevitable. It's called the ageing process. I imagine that I have the mind of a 30 something year old. My 69 year old body tells me otherwise (no matter which beautify Thai girl will say otherwise). I remember a man that I met who at a particular time was 91. He was alert, physically fit, and swam everyday. Then he turned 92 and something in his body clock changed. He died about a year later. He was not unhappy and he knew it was time him to pass on to the lord.


Again, best wishes for all and let us not have any foolish arguments.

Bill

I didn't mean to imply you blamed all Thais for anything, just that you perhaps did not get specific enough when making your initial claims.  You seemed to generalize after what I view as a rather specific complaint.  Given your circumstances I think your plan of action makes perfect sense but I am not convinced it is necessary or practical as a general guideline.

I don't see this as an argument, foolish or otherwise.  We are for the most part expressing opinions without resorting to name calling.