Update 8th January 2017:
Because my Thai is poor I begin to realise certain facts much later as my Thai improves. My wife has just informed me that during the conversation with the hospital matron (she who must be obeyed) my wife revealed that we were married and showed her ID as proof. Suddenly the black clouds lifted. The matron confirmed that a husband of a Thai lady can benefit from state hospital visits up to 3 times. This is why the matron said we had already paid sufficient money into the system and asked that we simply pay an additional 2,000 baht. I must stress that I was extremely grateful to the doctors and nursing staff for helping me recover. The doctor who suggested that I should pay 30,000 baht was probably fed up with foreigners taking advantage of Thai hospitality by not having the funds or insurance to pay for hospital treatment. Apparently it does happen but I do not yet know the scale of this problem. He is entitled to his opinion of course and I have no problem with that. It's just that I was at a very vulnerable point when he mentioned it! All his actions and the actions of the nursing staff were otherwise professional, caring, effective and exemplary, bless them all.
Day 1. I woke up feeling a little dizzy at 5am. I got up and proceeded to the toilet but had to get quickly to my knees en route because I thought I was about to pass out. Seconds later I realised I had blacked out because I woke up staring at the floor where my head had hit it. I had a cut on my forehead to prove it. I immediately felt I was going to throw up and placed my head over the toilet. I retched but only a small amount came out, but it was blood. As I got up, I immediately threw up again into the bath. This time there was a lot of blood. I got up and went to the bedroom to alert my Thai wife. I got as far as the bedroom door and had to quickly drop to my knees again as the dizziness returned. This time I was in shock and was vomiting blood at one end and emitting faeces at the other. I had no control of my body during this time.
After cleaning me and the floor, my wife called the landlord who lives nearby to get me to the local hospital. Once there they placed a tube in my nose which dropped into my stomach. They then were able to clean out my stomach which still contained blood. This went on for a while and because the bleeding did not stop, I was transferred to the larger district hospital by ambulance. Once there a drip was placed in my arm. I was monitored on a trolley for a while and was admitted to a ward about an hour later.
I speak some Thai and it seemed that the staff assumed my condition was alcohol related. So there I was in a Thai ward, bed number 12. Nurses came and went taking my blood pressure and temperature. Subsequently a doctor appeared and after studying my notes he pronounced that my condition was alcohol related. The condition could be controlled and a stay in hospital of several days was necessary. He calmly pronounced that because I was not Thai, the cost of the special drug I needed would be 30,000 Thai baht, and that other expenses relating to my stay would need to be paid. I asked him how many days and he said he couldn't be sure so I asked him for an estimate of the overall likely costs I would incur, but he said he was a doctor, and it was not his job to know the prices of everything.
I decided to check out. As I began to get up and move out, he asked me to sign a form. I was in no mood to do so. I got inside the lift and suddenly my symptoms returned. I vomited copious amounts of blood into a bowl my wife had brought with her to the hospital and stumbled out of the lift and fell to my knees, still vomiting. The doctor appeared again, insisting that I could not leave until I signed the form. I politely declined. Moments later I was back in bed 12, which I now considered was my personal prison. There now existed a stand off. No nurses or doctor approached my bed for about 30 minutes. My wife suddenly had had enough and decided that I would sign the necessary forms and that I would stay in the hospital in accordance with the doctor's wishes. Suddenly several nurses and the doctor appeared. I signed all the forms and my treatment resumed. I asked the doctor what was the name of the wonder drug which would cost 30,000 and he pointed to the word Moduloc which had been written on the drip bottle.
There now proceeded the normal ward routine, with staff shifts coming and going and nurses randomly appearing at my bedside to attend to drips, my blood pressure and temperature and replacing the bag which was attached to my nose, which contained blood still emanating from my stomach. Gradually night descended. It was extremely hot in the ward so my wife gave me many bed baths which were a huge relief. I told her to go home for a rest but she refused.
As the night shift nurses were replaced by the day nurses, I heard my name being called and my wife soon returned with the bill for the first day – it came to 13,575 Thai baht. We had already paid the local hospital bill of 2,143 Thai baht the day before so 15,718 altogether. The doctor appeared by my bedside and said he wanted to arrange an endoscopy (a camera which passes down the neck and into the stomach). He explained that if there was any bleeding the endoscopy would be able to solve the problem because the doctor could clip blood vessels or stop the bleeding by injection. I readily agreed. I asked him how much it would cost and again he gave a non committal reply. I tried hard to get him to commit to a figure for the remaining time I needed to be at the hospital. I explained that we didn't have much money left in my wallet because we had arrived with about 20,000 baht but the bills for the first day needed to be paid out of that. I asked him if I could go to an ATM in or near the hospital to withdraw more funds. Strangely he said he could not permit that to happen. This may well have been for medical reasons, but I got a sense that lack of trust might have something to do with his decision. I remonstrated with him that this was not sensible, because how otherwise could I pay the bills if I cannot get to an ATM. A hopeless “Catch 22”.
There then followed a distinct slowing down of attention by the nursing staff. I sensed it but said nothing but eventually my wife mentioned it to me. She decided to pay the 13,575 without further delay by going to the payment office. She returned and handed the receipt to the ward nurses. Almost immediately there was a change and my wife whispered to me how quickly the level of care had improved. A new doctor arrived – a lady. I asked her whether I should continue with my heart disease medication, because I had not taken it for 2 days. She said that my blood pressure was normal, probably because of the loss of blood, so there was no need to take the hypertension tablets.
She asked what other tablets I took so I told her that one tablet was for cholesterol control and also daily aspirin. She became a little animated and asked if I had been taking the aspirin tablets during my time at the hospital, but quickly calmed when I said it would be unwise to do so when I was losing blood. She then stated that the bleeding was possibly directly connected to the aspirin so this was the first time that alcohol had not been mentioned as the root cause of my condition.
Some time later the male doctor returned. He said the endoscopy would take place later that day and sure enough it did. He said that if the endoscopy went well then I could look forward to returning home shortly afterwards. The procedure entailed me swallowing a dreadful substance sprayed into my mouth 3 times. The endoscope was then inserted into my mouth and I was told to swallow. Moments later the doctor said I had gastric enteritis and that I must never drink alcohol again for the rest of my life. He told me the bleeding had now stopped. Happily the tube inserted into my nose and stomach was no longer required and that was a huge relief. I returned to bed 12 hoping that I might return home the same day, but it was not to be. To my surprise a group A blood drip was placed in my arm soon after returning to my bed.
Later I felt the need to go to the toilet but this time it was not the easy bottle version. I proceeded to get up in order to go to the toilet, but a nurse informed my wife that this was not possible. The dreadful bed pan thing was handed to her. The curtains only shielded me on 3 sides because there was no curtain at the back of the bed. Normally this would be a solid wall, but my wall had a glass panel in it enabling all and sundry to have a perfect view of me. The front curtain needed to be held shut by my wife because the ties were not present, so she was unable to assist me at all, because the moment she stopped holding the curtains together the overhead ceiling fan blew the curtains apart enabling the whole ward to see my every move. My wife placed bed clothes to shut off the view at the back of the bed and then the fun began. I had 2 drips in me and they were in different arms and on different sides of the bed. My task was to place my buttocks squarely on the bed pan and to then wipe my bum clean. Normally this would be a walk in the park because I had been potty trained several years before, but this was a whole new thing. I managed it but it took a long time and I was exhausted. To make matters worse, the man in the bed beside me had about ten visitors arrive just before this ghastly exercise started. I kid you not.
The dirty deed was done. There was a lot of blood in my excrement and the smell was just awful. And I do mean awful. We heard the comments of the people visiting the bed beside mine and they were not polite. They were saying that the foreigner's excrement smelt dreadful and so he probably had AIDS, and why didn't he use the toilet like everybody else. My wife defended me stoutly, bless her, but it upset her. I vowed not to repeat this process again. (Note: The comments by the Thais aimed at the English foreigner about HIV/Aids are laughable - in excess of 500,000 people have HIV/Aids in Thailand (source: Unicef) and in excess of 107,000 in the UK (source: Public Health England) which is a ratio of nearly 5:1)
As the evening wore on I sensed that my drips had stopped working efficiently. I assumed this might be because of the strain placed upon the entry point to my arms during the bed pan exercise. After several attempts by the nurses I was still not convinced that the drips were working properly, and finally asked that the entry points to my arms be replaced. My wife and I were surprised at the rudeness and blunt comments of the nurses as this process went on.
Later I felt the need to go to the toilet again but this time I decided that I would not use the bed pan. I asked for the drips to be removed so that I could walk to the toilet. It is possible to walk to the toilet and take the drips with you and many Thais had done this during the day with the aid of the nurses, but my drips were connected to machines which were plugged into the wall which controlled the flow of the drips into my arms. The nurse refused and her comments were very impolite so I told her that I wanted to check out immediately. I asked that my drips be removed and shortly they were, allowing me to walk freely to the toilet.
About an hour later my wife and I were still sitting on bed 12 discussing our options when a lady in a white uniform appeared– she was the hospital matron. She ushered us to an office so that we could speak in private. She soon got to grips with all our problems. She spoke to the male doctor by telephone and asked him to speak with me. He said my release would most likely be the next day once he had a chance to examine the endoscopy results and that he would speak with me again the following morning. Following this she made her pronouncements and they were as follows:
1. She said that we had already paid sufficient money for treatment because it was in keeping with what Thais would pay for a similar condition. She stated that the remaining treatment would cost a further 2,000 Thai baht.
2. She stated that her nurses work long hours and sometimes can be blunt, that they are decent people, but not perfect.
3. I could walk to the toilet when I needed to. Normally she said that patients should avoid too much movement in my condition, but she would sanction this on this occasion. My wife later explained to me that patients can go into shock at any time during treatment, and if this was to happen on the way to or in the toilet, it would pose extreme problems for the emergency crash team.
4. My treatment was still ongoing and I should remain in hospital until the doctor released me, though she thought this might possibly be the next day.
As we returned to bed 12, she was talking to a Thai patient and asked him if he would mind swapping beds with me because his bed was right next to the toilet. We declined this kind offer. She asked me if I wanted “Valium” to ease my stress and to help me sleep, but I again declined. Sleep soon overcame us.
My wife and I had slept well. She had not left my side and tiredness had completely overwhelmed her. She was rolled in a ball at the end of my bed. I thought I was beginning to feel better, though still weak. My heart suddenly started beating faster so I woke my wife and she called for assistance. The nurse explained, as she was attaching ECG electrodes to my body, that my loss of blood deprived my body of oxygen, so my heart was beating faster to compensate. She asked another nurse to set up oxygen for me and after about 30 minutes my heart slowed. The male doctor appeared and told me that the endoscopy went well and that he would release me today. He advised me to wait another few hours because I needed a further blood transfusion. I shook him by the hand and thanked him for his skill and efforts. I also apologised for being a difficult patient. He just smiled. About 4 hours later, following the blood transfusion, my wife settled the final bill and we were on our way home. An out patient appointment was made for me to attend the hospital on the 8th September for a final check up. Meantime I was handed tablets to take daily at home. The whole cost of the treatment I received at both hospitals amounted to 17,718 Thai baht.
I forgot to mention that when I was panicking on the first day, I had contacted my landlord and landlady. They are local celebrities because he is a highly ranked Thai cop. I asked him to get me out of the hospital because I wanted to return to our local hospital instead. They kindly kept constantly in touch with us and he visited my ward to see how things were on the third morning for a brief chat.
My overall impression was that the hospital administration is swamped by a multitude of patients. The corridors and all available spaces were used to take the overflows from the wards, so it is likely that the hospital, despite being full, tries hard to accept all the patients they possibly can, which is a commendable maxim. The doctors and some nurses can speak passable English and they all work incredibly long hours. These factors can cause stress and tiredness though, and as the matron, rightly protective of her staff said, they are all wonderful people but they are understandably not perfect sometimes. As we all know, the truly impressive people in any country are the unsung heroes and heroines, and we all would be lost without them. Modern mobile X ray equipment (bedside) and also modern mobile ECG (bedside) were available. The endoscopy was performed in another building. The standard of care by the doctors and nurses was excellent. In particular, the hospital matron is an absolute gem. The general ward is not air conditioned and only ceiling fans are available, though additional bedside fans can be brought in by the patient's family or friends. Payment can be made by cash, credit card and there are many insurance companies available to process your claim.
For the technically minded, the IV's and other matters are disclosed in the slide show and notes which follow below:
Prescribed medicine to take at home:
Omeprazole to take 30 minutes before each meal
Vitamin B tablets - twice daily
Amino acid tablets – twice daily
Thonburi Roi Et Hospital is much cheaper despite being a private hospital. There are various types of room and standards of care available at very sensible prices. The facilities are excellent and there are ATM machines on the premises - take a look at the address and rates in the slide show below