Refused surgery.

[wardp]

I sent,my ud cd4 reports to a surgeon in bangkok.i need blepharorplasty on my upper eyelids as the droop is effecting my vision.anyway he refused to do the procedure and said it was because of an underlying condition.when I asked what that meant I was told that it was his policy. I'm waiting for word back from another hospital to see if this is  just one surgeons policy or if it's widespread.

[terrymoore]

1. This is against the law in Thailand and you can report him. I suggest you file a report in the hospital AND i suggest you "out" him by giving us his name so that we can avoid him.
2. Which hospital?
3. At Bumrungrad Hospital in BKK, Dr. Anuwat Keerasuntonpong is an HIV specialist and VERY down-to-earth, non-judgemental, and very sympathetic to our plight. He can help find you someone to do the job regardless of your HIV status. He helped me many times.

Unfortunately, there are still some people, who, even though studied science and medicine, do not necessarily practice what they preach. The stigma is still strong in Thailand. Really curious to know who the a-hole is.

[joemutt]

It is illegal. I had it happen once but it was 22 years ago; "the doctor will not see you" the nurse said.
I personally can recommend Doctor Krik Asavametha at BNH, he's a cool guy and a great doctor, was a student of my previous doctor, Dr Matana who pioneered aids/hiv care and research in Thailand, now retired. Krirk gives good recommendations for other specialists, too.

[wardp]

I don't think it would be a good idea to name him as this is Thailand and I am a guest here.the hospital said they will deal with it.he only does one day a week there.

[joemutt]

I don't think it would be a good idea to name him as this is Thailand and I am a guest here.the hospital said they will deal with it.he only does one day a week there.

You would be right. Name and shame simply isn't an option. Defamation laws are much stricter here than in other countries.

[wardp]

Hospital number 2 request I pay 30.000 baht extra because I'm HIV. I replied back asking why.

[harleymc]

This thread has been running off the implied assumption that the surgeon is the 'problem'.

But surgery involves a team, surgeon, nurses an anaesthetist, wards people etc etc.  It also needs a facility.

What enquiries have been made to find out where the refusal or the additional costs are coming from?

I was turned down for life insurance years ago, it wasn't because I was living with HIV, it was because at the time I was a smoker.

Sometimes obvious go-to answers are not  applicable.

Good luck on getting an affordable surgery.

Have you considered setting up a fund me web page?

[wardp]

Nothing to do with cost. And I don't need go fund me thank you.its about blatant discrimination and stigma.the cost of the procedure was quoted then had 30000baht added on BECAUSE I am hiv 
 undetectable.its a blepharorplasty under local anesthetic.2 hour procedure not brain surgery! Thank you for judgement on my financial situation I really appreciate!

[harleymc]

Why on earth are you turning on me, you rude git

[wardp]

I wasn't been rude .why did you assume I  would need a go fund me?

[harleymc]

I'm not making any assumptions.

[Jim Allen]

I sent,my ud cd4 reports to a surgeon in bangkok.i need blepharorplasty on my upper eyelids as the droop is effecting my vision.anyway he refused to do the procedure and said it was because of an underlying condition.when I asked what that meant I was told that it was his policy. I'm waiting for word back from another hospital to see if this is  just one surgeons policy or if it's widespread.

Look if it was me nothing that could happen now would convince me to let this doctor anywhere near me.
So looking for a different doctor would be the way to go as you are doing for the procedure.

That aside if you really want to know what the issue is perhaps ask them for a copy the policy in writing or confirmation for the reason for the increased cost and if you don't like the answer then consider if you want to do something about it or not. Perhaps at that point talk to the local NGO or if you have time/money and energy a lawyer.

Anyhow that's my two cents and I hope all goes well when you have the procedure.

Best, Jim

[wardp]

Point taking Jim.I am waiting on reply from hospital.I have an important question re surgery in general.if you had a viral load test 3 days prior to any operation and the result was undetectable. What are the odds of becoming detectable in that 3 day period and what is the risk to the surgeon?

[joemutt]

1/I got this reply from a friend in the medical field concerning rights and complaints:

https://tmc.or.th/En/act_rules_en.php
 
-complaints have to go to :
The Medical Council
7th Floor, Office of the Permanent Secretary, The Ministry of Public Health,
Tiwanond Rd., Nonthaburi 11000, Thailand.
tmc@tmc.or.th
 
-there is also an NGO that might be interested in helping:
 Thai Medical Error Network
Preyanan Lorsermvattana
ouidolla@yahoo.com
 
-and as this is related to HIV I would suggest to involve some HIV advocacy groups e.g.
https://ahfthailand.com/
or any others you may know of
 
When contacting the Medical Council I suggest to do in writing, sent by courier, and prominently cc the Medical Error network and ahft;

2/If you're looking for another surgeon you might contact the specialists named further up this thread for referrals and to also answer your last question.

[joemutt]

double post.
 

[virgo313]

Not sure if They are not doing elective case surgery for now is due to covid or not?
Is this one of The reasons?
https://journals.sagepub.com/doi/full/10.1177/0218492320926886

[wardp]

Just had a reply from the hospital.they won't send me a photo of this (new) equipment they use for HIV patients and they won't disclose any info on the extra charge for HIV..nothing about covid but this HIV equipment that just arrived but they can't tell me what it I is.make your own mind up.case closed

[Mindless]

Hello Wardp,

I know this is a bit old but I was wondering how the whole situation worked out in the end. Reason is I've been recently diagnosed with several gallstones (one of which 2 cm large) and suggested surgery as an option. The gallstones were found by chance during a routine ultrasound.

I decided to hold on for the moment but I know I may need an urgency procedure if I get an attack (they told me it's particularly painful) and I was wondering what I'll go through in case of a surgery.

Thanks

Hugs

[wardp]

As this is Thailand,! I just went to bumrungrad hospital, no issues and happy with my outcome,

[Mindless]

As this is Thailand,! I just went to bumrungrad hospital, no issues and happy with my outcome,

Yeah... Been living here for more than 6 years, so I know a little about it 

Happy to hear everything worked fine with you after all!

By the way, do you know if the hiv test is part of the standard blood work they run before any type of surgery?

Hugs

[daveR]

I have had two surgeries here in Thailand, one at the Bangkok Had Yai Hospital in Songkhla and one at the Pattaya Memorial. Both times they did pre operation blood tests, including HIV. I was negative at the time.

I assume it is a common practice over here in Thailand.

Dave

[Mindless]

I have had two surgeries here in Thailand, one at the Bangkok Had Yai Hospital in Songkhla and one at the Pattaya Memorial. Both times they did pre operation blood tests, including HIV. I was negative at the time.

I assume it is a common practice over here in Thailand.

Dave

Thanks Dave! Ouch... My whole point was my insurance not getting to know my status: they may refuse to renew it and that's paid for by my employer. Would be a big problem. Big headache 

[harleymc]

Ardor you have been very rude to me you should apologize.

[leatherman]

My whole point was my insurance not getting to know my status

does your insurance also cover your medications?
if so, they already know

[Mindless]

does your insurance also cover your medications?
if so, they already know

they may refuse to renew it and that's paid for by my employer.

I'm sorry, maybe I didn't make myself clear, they may not renew the policy because no insurance company in Thailand covers HIV.

[leatherman]

I'm sorry, maybe I didn't make myself clear, they may not renew the policy because no insurance company in Thailand covers HIV.

maybe I should have explained better too. If your policy is currently paying for all or part of your medications, then the insurance company has a pretty good idea of your diagnosis as antiretrovirals (like complera and dovato) are only used for HIV.

that's really a bad deal with insurance there then. Does that mean you have to pay on your own for your viral load test? if so, that's terrible. 

[Mindless]

maybe I should have explained better too. If your policy is currently paying for all or part of your medications, then the insurance company has a pretty good idea of your diagnosis as antiretrovirals (like complera and dovato) are only used for HIV.

that's really a bad deal with insurance there then. Does that mean you have to pay on your own for your viral load test? if so, that's terrible. 

Yeah, no insurance company here covers HIV and therefore none pays HIV meds: all meds, treatments, tests etc are paid for by myself. The good thing is that meds are quite cheap (I pay about 30 $/month) and doctors and treatments, in general, have accessible prices (for me).
The very bad part is that if my insurance company knew I've HIV they may simply refuse to renew my policy (or renew it at rate so high I couldn't afford it). That's why I'm now concerned about the surgery I may need. Add to that that my insurance is paid for by my employer, who doesn't know about my status (hiv here is still a very big deal in terms of stigma).

Hugs

[leatherman]

all meds, treatments, tests etc are paid for by myself.

ah! I didn't realize you were having to pay for all your HIV medical care. That much be a heavy burden, monetarily and emotionally, to bear. Hopefully things will change.

The good thing is that meds are quite cheap (I pay about 30 $/month) and doctors and treatments, in general, have accessible prices

Nice! My meds here in the USA cost about $3000 a month! And have basically cost that much for the last 28 yrs give or take a couple hundred dollars. Thank goodness for what few social safety nets we have here like Ryan White, Medicare and Medicaid, or I would have died without meds decades ago.  My husband, a fellow long-term HIV survivor, has insurance through his company but still has to pay about $300 every three months to cover his labwork (CBC, VL, etc)

I assume it is a common practice over here in Thailand.

amFar states that 45% of Americans believe that an HIV test is done before a surgery however testing is in actuality rarely done. If it is done a separate consent document is usually required to authorize the test.

[joemutt]

When I worked here my Thai social security payed for my HIV medicine; meds were also more expensive then.
Now I pay out of pocket, about 17 usd a month.

[Mindless]

ah! I didn't realize you were having to pay for all your HIV medical care. That much be a heavy burden, monetarily and emotionally, to bear. Hopefully things will change.
Nice! My meds here in the USA cost about $3000 a month! And have basically cost that much for the last 28 yrs give or take a couple hundred dollars. Thank goodness for what few social safety nets we have here like Ryan White, Medicare and Medicaid, or I would have died without meds decades ago.  My husband, a fellow long-term HIV survivor, has insurance through his company but still has to pay about $300 every three months to cover his labwork (CBC, VL, etc)
amFar states that 45% of Americans believe that an HIV test is done before a surgery however testing is in actuality rarely done. If it is done a separate consent document is usually required to authorize the test.

Yeah, I did read the stories here on the forum by US fellas facing meds prices up to 100 times more expensive than here. I find it crazy. On the other hand, as I said, no insurance here is willing to cover HIV costs and most likely wouldn't accept any disclosed PLWHIV as a customer.

Regarding the pre-surgery hiv test, I really hope it's not mandatory as someone suggestd. I will try to ask my doctor, who knows my situation and is usually very sympathetic. Hopefully, there's a workaround.

By the way, Merry Christmas and Happy New Year to everyone! 🎉🎊