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  New Posts New Posts RSS Feed - KK RAM Strikes Again!!!
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KK RAM Strikes Again!!!

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rexall View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote rexall Quote  Post ReplyReply Direct Link To This Post Topic: KK RAM Strikes Again!!!
    Posted: 03 Aug 12 at 21:54

Fri 3 Aug 2012, 8:32 pm

Hi All,

See my post a few minutes ago about raccoons and cat bites.

After major cat bite, went to KK RAM.  Got wound cleaned and booster rabies.  They did not want to give me antibiotics, which seemed a little conservative for such a deep wound from an animal!  Oh, well.  Easy enough to self-prescribe.   Prescribed paracetamol, which is mostly unhelpful and probably cost three times as much as buying it at a pharmacy.  Also, something called diclofenac , a non steroidal anti inflammatory drug (NSAID) which works works by reducing substances in the body that cause pain inflammation.

And get this :

Quote http://www.drugs.com/diclofenac.html 
Do not use diclofenac just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Diclofenac may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term.

This medicine may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking diclofenac, especially in older adults.

You should not use this medication if you are allergic to diclofenac, or if you have a history of allergic reaction to aspirin or other NSAIDs.

To make sure you can safely take diclofenac, tell your doctor if you have any of these other conditions:

+ a history of heart attack, stroke, or blood clot;
+ heart disease, congestive heart failure, high blood pressure;
+ a history of stomach ulcers or bleeding;
+ liver or kidney disease,
+ asthma;
+ polyps in your nose;
+ a bleeding or blood clotting disorder; or
+ if you smoke.


Pretty nasty stuff to reduce non-urgent  inflammation.  They had consulted my chart which had history of them treating me for hypertension.  

Please take responsibility and perform due-dilligence  for your own health and well-being.  Research any meds before you take them.  Check with Dr. Ken first if you have questions.

XeReX


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Vicco View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Vicco Quote  Post ReplyReply Direct Link To This Post Posted: 04 Aug 12 at 08:30
^
Negligence seems to be standard MO at da Ram.....  They would not give you anti-biotics for a bite.....but they almost poisoned me with them for my now famous fissure.   They gave me so much anti-biotic that my digestive system was messed up for weeks.    The doctor at Bumrungrad (where I eventually went)  was really quite shocked when I told my story of medical pracitice Ram style........Confused
 
The place is actually quite dangerous for anyone injured or sick.... 
 
PS  Any medicine given to me or my wife is subjected to research on the internet before it is taken. 
You may be shocked at what you find sometimes.  I'm not sure the concept of medical malpractice  is understood here.  
Vicco



"The power of accurate observation is frequently called cynicism by those who don't have it." - George Bernard Shaw
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Post Options Post Options   Thanks (0) Thanks(0)   Quote drfeelgood Quote  Post ReplyReply Direct Link To This Post Posted: 04 Aug 12 at 19:03
so what do you guys think is the most efficient hospital in Khon Kaen?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote rexall Quote  Post ReplyReply Direct Link To This Post Posted: 04 Aug 12 at 19:32

Doc., it depends on for whom and for what.  There is a BIG difference in getting treated for cat bite compared to a heart attack, for example.

Others may not agree, but if you are asking about a hospital in KKC that provides care that is more or less equivalent to what you would expect in a hospital in a Western country, I don't think there are any.

I had hernia surgery at RAM two years ago.  That is the first time I have every been hospitalized, fortunately, so don't have much to compare it to.  However, the injections for the spinal anesthesia were crude and painful, and they had me bent forward like a pretzel while giving the injections.  I have since learned that that is not a standard way to do it.  I think some of the significant post-op pain I experienced as to as much or more to the crude spinal as it was to the incision and futzing around with my innards.  After the procedure, the doc told me my appendix was situated in such a way as to make the hernia repair difficult, so they removed the appendix.  Surprise!!!  Who knows?  But that seemed very strange to me.  Recourse?  Forget it!

Finally, I strongly suspect that they gave me iv penicillin even though I was quite clear in telling them I am allergic to penicillin.  I don't know for sure that is what they did (and fortunately no ill effects), but I did not like them cautioning me to tell them if I experienced any breathing problems while getting the iv.  The fact that I contracted an infection that needed to be medicated, and necessitated an extra day in hospital, was not exactly charming either, although I suppose infection is a risk you run anywhere.  Still, in context, not very inspiring.

In my opinion, if you can sustain the travel and being away from home,  and the higher $$$ , Bangkok should be a serious consideration if there is something serious you need taking care of.

XeReX

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drfeelgood View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote drfeelgood Quote  Post ReplyReply Direct Link To This Post Posted: 04 Aug 12 at 20:10
yeah its amazing/....I'm assuming that RAM is "supposed" to be the best in KK but obviously its not...where are they shipping these doctors and nurses in from if they are practicing such antiquated or even wrong techniques...you would think if there are hospitals and doctors doing the right thing just down the rpoad in BKK, then why not here
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Vicco Quote  Post ReplyReply Direct Link To This Post Posted: 04 Aug 12 at 21:02
^
There is also the myth that it's cheaper in KK.   I was charged 28K for 15 minutes in the OR at Srinakalin Hospital  (not sure about that spelling)  in KK and 4K for 15 minutes in the OR at Bumrungrad in BKK....both minor procedures without general anesthic or complex equipement.
 
   I was also charged 600 Thb for a bottle of saline solution and some cotton swaps in KK........  and another 600 Thb for a med from the Doctor's clinic which was clearly marked "Free Sample" when I opened the package at home.....  I spend over 12K at the RAM alone....on totally useless and inappropriate drugs.
 
 I would take the time to go to Bankok for anything other than dire emergencies after all the BS I've been through with these people...... and it does not seem to matter which hospital because I've tried just about all of them  and wasted a considerable amount of money and time trying to get help with a problem which required a surgeon in BKK about 2 minutes to diagnose and 15 minutes to fix.
 
The only drawback is the travel and hotel expenses.....but I have absolutely no confidence or trust left in the local medical establishments.  
 
This thread started off with a cat bite.......  If they can't treat a cat bite properly without handing out life threatning drugs, what can they do???   Maybe they just check the inventory to see what surplus stock they have in the pharmacy and prescribe accordingly......Confused
 
 
Vicco



"The power of accurate observation is frequently called cynicism by those who don't have it." - George Bernard Shaw
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Post Options Post Options   Thanks (0) Thanks(0)   Quote screamer Quote  Post ReplyReply Direct Link To This Post Posted: 04 Aug 12 at 21:14
Diclofenac is the same as Volterol as is a very standard, basic, anti-inflammatory drug. It is so harmless (ignoring heart surgery patients and the usual NSAID bleeding problems) that it can be bought over the counter in the UK, though in lower doses.
The warnings that come with any drug are always way over the top as they list absolutely everything that can be a side-effect, no matter how rare, just to cover themselves against being sued.
Any chemist in Thailand will sell you Volterol.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote KK Veteran Quote  Post ReplyReply Direct Link To This Post Posted: 05 Aug 12 at 01:05
I would have gone to the nearest doctor for the anti rabies shot and round to Tones pharmacy for 
the drugs. As I've said before it's the drugs where they catch you at the Ram.

Having said that a friend had his gall bladder removed in the Ram and has nothing but praise for the surgeon and his treatment. Had his hernia done on another occasion by the same surgeon and again
nothing but praise.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Vicco Quote  Post ReplyReply Direct Link To This Post Posted: 05 Aug 12 at 10:13
Originally posted by screamer screamer wrote:

Diclofenac is the same as Volterol as is a very standard, basic, anti-inflammatory drug. It is so harmless (ignoring heart surgery patients and the usual NSAID bleeding problems) that it can be bought over the counter in the UK, though in lower doses.
The warnings that come with any drug are always way over the top as they list absolutely everything that can be a side-effect, no matter how rare, just to cover themselves against being sued.
Any chemist in Thailand will sell you Volterol.
 
You can buy ASA over the counter too....just about anywhere,  but that does not mean ASA should be given to everybody.   You don't give ASA to someone with a bleeding ulcer or to a haemophiliac.
...and you don't give Volterol to someone with high blood pressure...........which is I believe,  the main point in the OP.   The hospital had records that indicated ongoing treatment for BP yet they prescribed a drug with was specifically on the NO list for this condition.   That is negligent by any measure in the medical profession.    There are lots of anti-inflamatory treatments available.... but these people are so cavalier about the way they dish out stuff like this....  it is indefensible.
 
Any drugstore (chemist if you like) in Thailand will sell you all kinds of things which could cause harm, up to and including killing you if you were unlucky.    My wife was given an anti-biotic by a drugstore in Hua Hin a few years back.   It was unknown to me so I checked it out.   It had been taken off the market right across the "civilized" world because of the excessive side effects and organ damage it was causing.   It was given for a simple sore throat.  It was described as a drug of last resort by the US regulators.....who eventually banned it, quickly followed by just about everybody else.....except of course the pill pushers of LOS.  No doubt it was some residual stock they had sitting around  and they needed to get rid of it.
 
Ironically when I was given my prescribed meds at Bumrungrad.....the pharmacist gave me a stern lecture on the potential harmful effects of my post-op "painkillers"    Upon opening the package I found that the doctor has prescribed 2 standard dose Tylenol  ever  4 hours.......another pill you can buy over the counter anywhere.    It's the first and only time any medical professional has ever informed me about anything.....and Tylenol is about as harmless as you can get in the world of drugs and suchlike.  Apparently it can cause kidney damage if taken in large doses over a prolonged period, but all I had was 12 pills.....enough for 24 hours.
 
They sort of go from one extreme to the other..........Big smile
 
 
Vicco



"The power of accurate observation is frequently called cynicism by those who don't have it." - George Bernard Shaw
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Post Options Post Options   Thanks (0) Thanks(0)   Quote rexall Quote  Post ReplyReply Direct Link To This Post Posted: 05 Aug 12 at 12:04
I am aware that official drug info tends to be conservative, and for legal as much as for medical  reasons.  However, the warnings for Diclofenac, among several different sources I googled, were WAY over the top.  Nothing I would want to mess with.  But especially, as Vicco pointed out, specifically contra-indicated for people with hypertension, it was simply negligent for the doc to prescribe this drug when he was looking right at my chart.
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