Monday, December 16, 2013

Mark's Medical Adventures Continue...Bumrungrad Hospital.

Bangkok has created a new form of tourism.  Medical tourism.  Build world class facilities, stock them with top notch staff and charge less than other places and voila, you have yet another reason to come to Thailand.

Bumrungrad International Hospital is considered by many to be the star in the crown of upscale hospitals in Bangkok.  My week in the hospital was at Camillian, which is Catholic and whose mission is to serve indigent HIV/AIDS patients.  If you consider a spectrum of healthcare options, Mandalay General hospital would be at one end, Bumrungrad would be at the other and Camillian would be toward the middle.  Sort of like comparing a fleabag on Route 66 to a Holiday Inn to the 4 Seasons.

It had been a tiring and stressful trip to Bangkok and that was from my perspective.  I can only imagine how Mark was feeling, especially since we discovered that the "pain medicine" he'd been given for the trip were actually antibiotics for the scrapes and cuts on his legs and arms.

We weren't sure where to go.  Mark voted for the clinic where he'd been before.  I voted for the hospital which was next door and had an emergency room.  I'm pushy and mobile, Mark was in a wheelchair.  I won.  In the ER, though, we discovered that Mark was correct.

No matter, the ER staff took his card from a previous stay, entered him in the system, set up appointments and off we went.  Rolling through the air conditioned lobby, subtly decorated with understated Christmas ornaments and flowers was very different than rolling through dirt and fighting dogs in Mandalay.

We were whisked to the 20th floor on a glass elevator.  The only thing that kept me from saying "Holy shit!" when the doors opened into what appeared to be a very large, opulent living room were the number of well dressed people in the area.  That did not stop me from using the f word, very quietly but with great feeling on a later trip on the same elevator.  I felt it was warranted since Mark's wheelchair (with him in it) had just rolled over my big toe.

The decor seems to be going for that "We're not showing off, we just want you to be comfortable and let you know we spent truckloads of money on this place" style of decor.  By far, nicest most comfortable hospital I've ever seen.  Much more like a hotel than a clinic.

First stop was to get Mark's vitals taken in a room dedicated to that.  When they wanted to weigh him, Mark groaned because when he's sitting still the pain isn't bad.  But getting up and down is horrible.  No problem here at Rich Peoples Hospital.  Oh, sorry, Bumrungrad.  He stayed in the wheelchair while the nurses weighed him.

Next, radiology for more X-rays since the ones taken in Myanmar didn't include all his ribs.  A minor technicality.  I was asked to wait outside but from Mark's demeanor when he was wheeled back to me, it was a relatively pleasant experience.

After a few minutes wait and some paperwork we were escorted to the orthopedic surgeon's office.  He explained what he'd seen and what he thought the plan should be.  I asked questions about length of time in the hospital and length of recovery time.  I made sure to quickly let the doctor know that I was leaving for Mandalay and Mark planned to care for himself in a hotel room.

Next we got to visit a very cardiologist.  Because Mark's impact on his chest had been so severe he wanted to rule out any damage to his heart.  A quick EKG later, the all clear on the heart was given.  Because Mark and I both enjoy poetry by Robert Service I couldn't help reminding him of the one about the lady with a boil on her butt.  She went from "doctor" to "doctor" being examined when the final one told her the doctors were out and they were all just painters.

When we were told we were on our way to a third doctor, we both just giggled.  The final doctor was a critical care/thoracic guy.  His job was to determine if the damage to the lung would prevent surgery to the ankle or to figure out the best type of anesthesia to use.

Ok, we had a plan.  Surgery on the ankle on Tuesday, using an epidural.  During one of our waiting periods, we were given room choice options.  I was pushing for the Deluxe Suite on the Premier floor.  Mark was leaning toward something more modest that didn't cost more than a monthly mortgage payment per day.  He opted for a shared room/bath.  The room is very nice and no one is in the next bed so he got a private room (at least for now) for half price.

When the charming ladies provided an estimate of total cost, I thought stroke or coronary would be added to the list of ailments.  And it had to be paid before any treatment began.   That's when the real stress began.  Mark's phone charger was in another bag, which they'd kept at reception.  I would have gone to get it but it was 3 a.m. where he wanted to call and so he wanted to wait.  By that point it was after 7:00 p.m. in Bangkok.  Mark hadn't peed for about a month (and it was in another country); neither of us had eaten except for a small snack on the plane and we were both cranky.

Both of us just wanted him to be settled in a bed where he didn't have to move and could get sone rest.  And some pain meds for him and an adult beverage for me.  Eventually we were taken to his room and worked on getting him settled.  There was much to be done:  blood tests, IV ("you have small veins, let me try again"), etc.

The nurses were kind and well meaning but as in hospitals everywhere when you combine tired, hungry people in pain with busy, tired medical professionals there can be tiny bumps in the road.  I finally went to the nurses station and in the most respectful, polite way I could asked for food and pain meds.  The nurse sweetly smiled and nodded and said "Yes!  Tomorrow!"  I gently tried again.  She kindly responded "Tomorrow!"  She had a bit more of an edge in her tone and she started pointing vehemently at some papers, repeating "tomorrow!  tomorrow!"  I took a step back and tried to consider where our communication had broken down.  I started making eating motions and pointing towards Mark's room.  Then acting like I was giving myself a shot and pointing to his room.  She and the other nurses were excited - how fun, charades at 10:00 p.m.!  They got it though and I discovered she thought I was insisting on getting the paperwork back that she was going to copy.

Five minutes later Mark had food and a shot in the IV for pain.  Since I had no idea where I was going to sleep that night, I wanted to get that sorted out.  I considered just using the extra bed in the room but couldn't afford it.

I got in a cab and found a place to stay.  Mark had stayed there before.  The major appeal was that it's close to the hospital and has both a 7/11 and a Pizza Hut attached to it.  At midnight I was enjoying a slice of pizza and a cold beer.  That's when I discovered I needed to be back at the hospital by 6:30 a.m. on Tuesday.

When I arrived, Mark was up continuing a marathon session of finding a way to transfer funds so he could fork over a large amount of cash to the hospital.  It took a couple of more hours, a laptop and smartphone and the help of Mark's best friends and his investment company but a temporary solution was found, money is being transferred and now it's on to the surgery.

Once we'd gotten cleared for the surgery financially we both began to relax and just spent the time talking.  It wasn't long before they came in to move him to the gurney to head for the operating room.  Luckily, they were able to slide him from one bed to the other which was much less painful than all previous transfers.

I followed along to the door to the operating suite.  Since he was flat on his back I was describing what he couldn't see.  Like the doors to the operating room and the cashiers window just outside it.  We had a hearty laugh at that.  I'm sure these are dedicated health care professionals but there is no doubt this is big business.  There is a bank branch in the lobby with ATMs and a Western Union office.  There are cashier desks everywhere.

Now I'm just waiting to hear that Mark is safely out of surgery.  They said between 1:30 and 2:00 p.m. I'm hoping sooner rather than later.

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