Visiting Sriphat - a very different Thai experience

As many of you know we lived in Thailand in the 70's and both of our children were born in Bangkok. For the last four years we have been escaping New England winters and volunteering at Kids Ark Foundation, enjoying Thai food and many interesting experiences with the Red Lahu ethnic minority etc. After living here all those years and returning for the 4th time we are feeling more and more at home. Still there are times when we find ourselves outside our "comfort zone" and last week was one "learning experience" for me (Tom).

A couple of weeks before leaving the US I was having a hard time sleeping through the night, frequently waking up with a lot of indigestion that would persist for several hours preventing me from sleeping and getting a good nights sleep. I had been seeing a great naturopathic doctor who was trying to help me with the symptoms but we decided that maybe it was time to visit a GI doctor. The naturopathic principles and treatments really make sense to me and I will certainly use that approach when at all possible but it now seemed time for a look inside and that was outside the scope of her expertise. I was told it would be a month before I could get an appointment so I decided that I would visit a GI doctor in Chiang Mai.

So if you don't want to read about my colonoscopy now is a good time to stop reading!

One of our friends who lives here has Crohns disease and he gave me the name of a contact to find a doctor to consult. We had arrived on Monday and once we were finally settled I called Sriphat Medical Center on Thursday morning to see a GI doctor. I was told to come to the 13th floor at 6pm that day to see Professor (Ajan) Piset. Sriphat is part of the Chiang Mai University medical school. Bev and I walked to the center which was only 30 minutes away. I registered and went into a big waiting room with maybe 50 people sitting in rows of seats outside a series of maybe 8 numbered rooms where apparently each doctor saw patients. Each patient is given a colored numbered card and I was assigned green number 15. Each doctor had a color and we saw that Ajahn Piset was seeing number 1 so we prepared for a long wait. Considering I had just called that morning it didn't seem unreasonable to wait, compared to a month in the States! The nurse took my blood pressure with an automated pressure machine and my weight with a broken scale because it said I was too heavy :-) and told me to wait. However, within a few minutes my number was called, almost on the dot of 6:00 PM. I calculated that Ajahn Piset must have been at least in his late 40's, though he looked like he was in his 20's, who had studied in Boston. He asked me questions about my symptoms and had me lie down on his exam table and did some serious pressing on my stomach where there were all kinds of sore places. At this point he suggested I have an Xray.

So I was told to wait and then called to prepay for the Xray and reading - cost $21 Then off to the 4th floor escorted by a nurse to an empty waiting room and right into the Xray room. Remember it was now about 6:30 pm so I suspect that room is not empty during the day! The Xray equipment was an older vintage but everything was clean and they took a standing and reclining film, and I returned to the 13th floor. In about 20 minutes I was called back into the exam room and Ajahn Piset showed me the Xrays on a big LCD screen and pointed to (according to him - to me it was a snow storm at night) intestines quite full of gas - hence my discomfort. At this point he suggested a closer look which meant a colonoscopy which I had had 5 or so years ago. He also suggested an endoscopy since we were "looking" so that we would have covered both ends of the "system". They took a blood sample and sent me home with the drugs needed to clean out my system. If you have never had a colonoscopy you can rest assured that it is not big deal BUT the preparation the night before, while not terribly painful, is no fun. It basically consisted self inflicted diarrhea by drinking some chemicals that left me sitting on the toilet from 11pm to 2am and from 7am to 9:30am just in time for my 10am appointment on Friday. So now it has been a little over 24 hours and we are back on the 13th floor waiting room where I am handed a hospital plastic bag, a shirt and a sarong and told to go to the mens' room and change. Luckily I have learned to tie a sarong as I had to walk back though the length of the waiting room full of people to a wheel chair. At this point they started a saline drip and rolled me down into the elevator to the OR on the 2nd floor.

I was then wheeled into a special sterile area while Bev waited outside. Then I was transferred to a gurney and wheeled to the OR. They hooked me up to pulse sensor on a finger and an automatic blood pressure cuff that took my pressure every few minutes. After 10-15 minutes they told me that Ajahn Piset would be late due to an emergency so they "unhooked" me and I was rolled out of the OR to wait my turn. After sometime the doctor appeared and we headed back to the OR. He then asked me if I wanted sedation and how much, and I took the slightly stoned option (my description). From there I have some recollection of things being poked into both ends of the intestinal tract but no pain really. Not my idea of fun but I just wanted the procedure to be over so I could go to eat! I had not eaten from about 4:00PM the previous night as Bev and I had planned to have dinner after my appointment. Even worse I overheard the nurse ordering a fantastic lunch while I was waiting.

Once the procedure was over I was taken to a recovery room where I practiced my Thai and learned that the Thai word for colonoscopy is "colono" and endoscopy is "endo" :-). After about an hour they rolled me out of the sterile area and I felt good enough to walk to the accounts dept and the pharmacy for my follow-up medications, and most importantly to EAT LUNCH! However, the nurse would have none of it, and insisted that I be wheeled down to pay my bill. One consequence of the "colono" and "endo" is they pump your system with air so it takes a while for it all to escape! The doctor had reported to Bev that things looked very good though he did take a small sample for a biopsy but didn't expect anything from it. Conclusion: a long term bad case of constipation! and a slew of meds (6) to take for a week. Everyone was very nice, total cost for everything was about $800. More importantly was the quality of care which was great. While the hospital didn't look so fancy as what we are used to in the US the care was professional. Now we will see if the insurance company will apply it to my deductible. The doctor had me call him the night he did the procedure, the following day, and now I have a follow up appointment next week.

So I had the best sleep I have had in a long time and hope to not visit Sriphat soon again!