Bumrungrad for Hospital Checkup

[TotallyOz]

I do a yearly health check up plan at Bumrungrad. I find the level of service excellent and the care of the staff amazing. They offer prearranged packages and I also get an HIV test at the same time. Everything is done in less than 4 hours and the results are with you and you are on your way out the door. I have not had a colonoscopy for ages but now over 50. The doctor said I need to have one so I have one scheduled in a few months. How often do others get these?  Does anyone use the checkups in local hospitals? I find the convenience of doing everything in one morning very convenient.

https://www.bumrungrad.com/en/health-check-up-center-bangkok-thailand-jci-best/check-up-packages

 

[Guest]

1 hour ago, Michael said:

I do a yearly health check up plan at Bumrungrad. I find the level of service excellent and the care of the staff amazing. They offer prearranged packages and I also get an HIV test at the same time. Everything is done in less than 4 hours and the results are with you and you are on your way out the door. I have not had a colonoscopy for ages but now over 50. The doctor said I need to have one so I have one scheduled in a few months. How often do others get these?  Does anyone use the checkups in local hospitals? I find the convenience of doing everything in one morning very convenient.

I suspect it may depend on where people come from & what the culture is there.

In the UK, our NHS state monopoly called me in when I reached 50 for a medical check up.  This "high end" check up included blood pressure (which I can do at home),  checking my weight (which I can do at home), a few questions and a urine test (which I can do at home).

We don't get invited in for anything more thorough and there isn't much of a culture of people paying for their own healthcare.

 

However, I did pay for a much more thorough check up at BCH (Silom) a few years ago, which also took a morning & was very professional compared with what I am used to in the UK.   I might just book in another one this year or next.

The stock portfolio might have to go well over the next few years for me to even think about upgrading to Bumrungrad

 

[DivineMadman]

2 hours ago, Michael said:

 Does anyone use the checkups in local hospitals?

 

I went to Bumrungrad last year.  Agree it's all very good and professional.  Also something very fun and uplifting about hanging out with all those people from all over the world and everyone is just the same in his/her hospital gown.    Most difficult part of the whole thing was the stool-sample-on-demand.  

My final interview with the doctor was a bit rushed, I thought, but I think that's just the modern healthcare system.  Red things on the computer that showed out-of-normal ranges for some tests but his answer for everything was just drink more water and were a mask when the pollution levels are up, which suited me fine. They are very proud of their state-of-the-art everything there, including the non-invasive prostrate exam.  I joked that I was rather looking forward to the regular prostrate exam.  It took him a minute before he had a good laugh.  

The guidance in the U.S. used to be  colonoscopy every 10 years starting at 50.  Earlier and/or more frequently depending on risk group or more importantly family history.  I don't know if that thinking has changed.

Just for comparison purposes I was thinking of trying BNH this year.

[zombie]

3 hours ago, Michael said:

How often do others get these?

Depends on result of the last one. Consult the specialist and see what is recommended. At the moment I have one about every 4 years but not sure any hard and fast rule.

[martinsen]

I get a colonoscopy every 5 years.  My last one was at Bangkok hospital.  That is also an upscale hospital.

[PeterRS]

8 hours ago, Michael said:

How often do others get these? 

I believe it all depends on age and what the doctor finds - if anything. I was always told everyone should get one at 50. If clear, then ten years before the next one is OK. But if he finds a few polyps, I was always told every 5 years. Now close to 70 I have had 4 over the years and nothing has ever been found thankfully. A few weeks ago at Bumrungrad, I had a different doctor. After she had prescribed some medication for an unrelated illness, I asked when I should have another colonoscopy procedure. My regular doctor had said 5 years since the last. After looking at my file, this doctor said 10 years after the last! Curious!

[reader]

Although colonoscopy has long been considered as the gold standard, complications do occur. The National Institutes of Health (NIH) performed an extensive study and found that 2.01 patients per thousand required hospitalization within 30 days for complications.

You can read an abstract of the study at link below. Found it worth noting that the rate of complications increases with age.

Was surprised to learn that among the common drugs administered prior to a colonoscopy is Fentanyl.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821994/

 

[ceejay]

Every 5 years for me, but I am in a slightly higher risk group than average. Had the most recent done last month, as it happens. It found one non-malignant polyp. It was done at the Sriphat Medical Centre in Chiang Mai. The doctor who did it is a teacher at CMU Medical School, trained in the US and has recently spent 4 months in Japan learning advanced endoscopy techniques.

Total cost for initial consultation, special laxatives for preparation, the actual colonoscopy, biopsy on the polyp and follow up consultation with the doctor around 17,000 baht.

[Bob]

8 hours ago, PeterRS said:

I believe it all depends on age and what the doctor finds - if anything. I was always told everyone should get one at 50. If clear, then ten years before the next one is OK. But if he finds a few polyps, I was always told every 5 years. 

Your understanding is the same as mine.

While I don't know if it is available in Thailand as yet, there's an alternative (called Cologuard) in which you send a stool sample in for analysis and, supposedly, it actually is more precise in detecting all kinds of issues (especially various types of cancers).  The benefits are obvious - none of the night before preparations or cost (in US, Medicare pays for all of it) - but it's not recommended for people who have had prior issues (discovery of questionable polyps, etc.) and, also, if the analysis does show an issue, then an actual colonoscopy is usually the next step.  And the Cologuard is recommended for every three years.  I had one colonoscopy about 12 years ago (luckily, no issues) and did the Cologuard deal last summer while in the US.  Two more years and I'll do it again.

I attended a funeral in June for the wife of a friend who died from complications from her first colonoscopy 3 weeks earlier.  Those kind of fatal complications don't happen often from a colonoscopy procedure but, like most medical procedures, it's not risk-free. 

[billyhouston]

2 hours ago, ceejay said:

Total cost for initial consultation, special laxatives for preparation, the actual colonoscopy, biopsy on the polyp and follow up consultation with the doctor around 17,000 baht.

At Sriphat Centre about four years ago I happened to spot an advert, in one of their elevators, for colonoscopy and gastroscopy. Unfortunately because of the 'transparent' covering it was not east to photograph. The deal was Gastroscopy Bht11,000, Colonoscopy Bht15,000. Special offer have both done Bht20,000. Date was March 2015.

[Guest]

At the margins, this probably depends to an extent on how your healthcare is funded.

Let's say reasonable pure medical advice is somewhere between 5 & 10 years for an average person over 50.

If the doctor giving the advice is part of the same organisation that pays for the procedure, there will be pressure or incentives to reduce the frequency.   In the case of the NHS, I'm not aware of any routine colonoscopies for people over any age point.    

If the doctor is working for a business which is separated from the payer, there will be pressure or incentives to increase the frequency.   So maybe down to the 5 years.

From what I read, the US healthcare model has a bias toward intervention, since the doctors don't want to be sued for not acting & payment is often separate from the hospital.    The UK system has a bias towards non-intervention.   

Which system is best ?     Probably neither.   Although the UK has a higher life expectancy than the US, the UK ranks 29th and the US 53rd.   Not a great deal in it though & of course, diet may be a factor in the difference.

http://www.geoba.se/population.php?pc=world&type=15

Of course, I'm not claiming that the advice in low corruption countries will ignore pure medical factors.   Merely it might influence what goes on within the medically acceptable limits.

 

As the tendency in the UK is for less intervention, it's very interesting to read what goes on in other countries.   Then selectively fill in the gaps when visiting Bangkok.

 

[PeterRS]

34 minutes ago, z909 said:

As the tendency in the UK is for less intervention, it's very interesting to read what goes on in other countries.   Then selectively fill in the gaps when visiting Bangkok.

In the case of a colonoscopy, I recking this is a false saving.  Colorectal cancer is the second leading cause of cancer deaths in the USA for men and women combined. This year it is estimated 51,000 men will die from the cancer. In the UK, approx. 100 males are diagnosed with colorectal cancer each day. I believe I am right in saying polyps which develop and may become cancerous are a leading indicator of the cancer. These are easily spotted and whipped out in a routine colonoscopy.

[NIrishGuy]

On 9/8/2019 at 11:11 PM, z909 said:

In the UK, our NHS state monopoly called me in when I reached 50 for a medical check up.  This "high end" check up included blood pressure (which I can do at home),  checking my weight (which I can do at home), a few questions and a urine test (which I can do at home).

Just in case anyone around 50 years old or so who is also from the UK and wondering ( as I was) "Hmmm, I wonder why haven't been called for something like that" it seems ( from my just checking on Google there) that you dont get called for the Bowel cancer screening test until you're 55 apparently - not sure as to whether that's because based on the data they think that's time enough OR ( more likely) they're trying to save some money by increasing the screening age they're working on the assumption that some of us will croak it in the meantime perhaps ! ( What? ME,  a cynic!? - never ! :-) 

[Up2u]

I get my annual checkups at Bangkok Hospital Pattaya (BHP) and is part of the Bangkok Dusit Medical Services group (http://www.bdms.co.th/our-network). The prices at Bumrungrad are often twice the price of of other private hospitals. Looking at the OP's link I would have selected Executive but that excludes the Hg a1c so the price for that would have to be added. Private hospitals have these specials all the time. The BHP special is 1/2 the price of Bumrungrad. For comparison purposes BHP charges 18k THB for a colonoscopy. 

[thaiophilus]

17 hours ago, NIrishGuy said:

Just in case anyone around 50 years old or so who is also from the UK and wondering ( as I was) "Hmmm, I wonder why haven't been called for something like that" it seems ( from my just checking on Google there) that you dont get called for the Bowel cancer screening test until you're 55 apparently -

The UK is not united (now there's a surprise) on this topic. In England you get the cheap & cheerful postal occult-blood screening test (non-invasive, you take samples over three days, scrape on a special card, seal the envelope well , post back to the lab) starting at 60 and every two years thereafter. In Scotland I believe screening starts at 50, for Wales and N. Ireland I have no idea. It's only a screening test and only detects blood, but that's what screening is about - low-cost, low-risk, imprecise, but if it catches even a fraction of potential cancers early it will save lives. Of course the literature that comes with the kit includes advice about seeing your doctor if you have any other symptoms that might indicate cancer.

[Guest]

5 hours ago, Up2u said:

The prices at Bumrungrad are often twice the price of of other private hospitals. 

Well, it is a very highly regarded hospital.    We obviously have some very wealthy board members here & well done to them.   If any want to start a thread on financial coaching I'll be reading .

Mind you, I suppose none of us who enjoy long holidays in Thailand can plead poverty !     For now, I'll rely on BCH to fill in the gaps left by the NHS.

 

 

 

[NIrishGuy]

2 hours ago, thaiophilus said:

The UK is not united (now there's a surprise) on this topic. In England you get the cheap & cheerful postal occult-blood screening test .........

Apologies I believe you are correct Thaiophilus re your above (the downside of me quoting google it seems!).  My office manager (who is 62) concurs with you in that they too received the "samples" card for completion when they hit 60 too, as did their twin Brother as well, so it seems that is may be only the Scottish who are ahead of the curve in this regard here in the not so United Kingdom of late.......I'm guessing that'll be down to all that itchy kilt wearing that they do there no doubt or something ! :-) 

[PeterRS]

11 hours ago, Up2u said:

For comparison purposes BHP charges 18k THB for a colonoscopy. 

Four years ago a colonoscopy at Bumrungrad was 30,000 baht!! Bumrungrad has been consistently raising its prices over the last ten years.

[kokopelli]

On 9/9/2019 at 5:41 PM, reader said:

Was surprised to learn that among the common drugs administered prior to a colonoscopy is Fentanyl.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821994/

 

For many years the drug administered to me for a colonoscopy was propofol, which I believe, is becoming the drug of choice.

[reader]

Since those of us who take meds for common age-related conditions are most likely taking generic versions, this news items may be of interest.  Rather than starting a different thread I thought this might be an appropriate place for this post.

Excerpted from Bloomberg Financial

Carcinogens Have Infiltrated the Generic Drug Supply in the U.S.

An FDA quality-control nightmare reveals how impurities end up in America’s blood pressure pills .

The chemical N-Nitrosodimethylamine, or NDMA, is a yellow liquid that dissolves in water. It doesn’t have an odor or much of a taste. It’s known to cause cancer in animals and is classified as a probable carcinogen in humans—it’s most toxic to the liver. A single dose of less than a milligram can mutate mice cells and stimulate tumors, and 2 grams can kill a person in days. An Oklahoma man poisoned the family of an ex-girlfriend in 1978 by pouring a small vial of NDMA into a pitcher of lemonade. In 2018 a graduate student in Canada sickened a colleague by injecting the chemical into his apple pie.

NDMA no longer has industrial uses—it was once added to rocket fuel—but it can form during industrial processes at tanneries and foundries as well as at pesticide, dye, and tire makers. It can be found in drinking water disinfected with chloramine. It’s in tobacco smoke, which is one reason secondhand smoke is dangerous, and it’s what makes eating a lot of cured and grilled meat potentially risky. The U.S. Food and Drug Administration says it’s reasonably safe to consume as much as one microgram—one millionth of a gram—of NDMA a day.

In July 2018 the FDA announced that NDMA had been found in the widely used blood-pressure medicine valsartan and started overseeing a recall of drugs from three companies. They’d all bought the active ingredient for their valsartan from Zhejiang Huahai Pharmaceutical Co., one of China’s biggest generic companies. The recall has since been expanded 51 times, to include two related drugs, irbesartan and losartan, made by at least 10 companies—some since 2014. Drugs sold to millions of people in 30 countries could be tainted.

Some of the contaminated valsartan contains as much as 17 micrograms of NDMA in a single pill. That’s equivalent to eating 48 pounds of bacon. The FDA estimates that for every 8,000 people who took the highest dose of contaminated valsartan daily for four years, there would be one additional occurrence of cancer.

You’d find nitrosamine—a category of carcinogen that includes NDMA—but you wouldn’t find 17 micrograms of it. European health regulators put the cancer risk from contaminated blood pressure medicines higher: They estimate that one out of every 3,390 people could become sick.

The FDA has a rigorous approval process for new drugs. Companies conduct clinical trials in humans over several years to prove a drug is safe and effective. But 90% of all medications prescribed to Americans are generics. They’re cheaper, they’re supposed to work the same way, and they receive less scrutiny right from the start. Companies manufacturing generic drugs have to show only that patients will absorb them at the same rate as the name-brand medications they mimic. At least 80% of the active pharmaceutical ingredients, or APIs, for all drugs are made in Chinese and Indian factories that U.S. pharmaceutical companies never have to identify to patients, using raw materials whose sources the pharmaceutical companies don’t know much about. The FDA checks less than 1% of drugs for impurities or potency before letting them into the country.

Huahai, the first manufacturer found to have NDMA in its valsartan, is also the one whose product had the highest concentration. When an FDA inspector visited in May 2017, he was alarmed by what he saw: aging, rusty machinery; customer complaints dismissed without reason; testing anomalies that were never looked into. He reported that the company was ignoring signs its products were contaminated. Senior FDA officials didn’t reprimand Huahai; they expected the company to resolve the problem on its own. Huahai didn’t. The agency didn’t try to identify any impurities at that point, and Huahai didn’t either. It wasn’t until a year later that another company—a customer of Huahai’s—found an impurity in Huahai’s valsartan and identified it as NDMA. That was when the FDA demanded drugmakers begin looking for NDMA in their valsartan. They found it again and again.

Quality-control problems in the generic drug industry go beyond the visible lapses. The valsartan recall has revealed the once-invisible failures in the chemistry itself, sometimes undetected for months, maybe years. “Valsartan is just the one we caught,” says David Gortler, a former FDA medical officer and now a consultant focusing on drug safety. “Who knows how many more are out there?”

Continues at

https://www.bloomberg.com/news/features/2019-09-12/how-carcinogen-tainted-generic-drug-valsartan-got-past-the-fda?srnd=premium

 

[anddy]

Just done my first ever colonoscopy yesterday. Was given propofol, which makes it a rather pleasant experience (as the doctor promised when talking me into it, had originally planned on doing it without to follow the proceedings on the monitor). Nothing found, so was told  next time in 10 years. Don't know the price yet, will get the bill probably next week and report back here to compare to prices in BKK.  

[Up2u]

On 9/13/2019 at 3:47 AM, anddy said:

Just done my first ever colonoscopy yesterday. Was given propofol, which makes it a rather pleasant experience (as the doctor promised when talking me into it, had originally planned on doing it without to follow the proceedings on the monitor). Nothing found, so was told  next time in 10 years. Don't know the price yet, will get the bill probably next week and report back here to compare to prices in BKK.  

Where was this done? 

[Up2u]

Re: Reader's recent post, somewhat relevant, 

https://www.bangkokpost.com/thailand/general/1503598/fda-pulls-heart-drug-from-shelves

 

 

[fedssocr]

I think the recommendation is still to have a colonoscopy at 50 in the US. The gastro doctor who did mine said come back in 5 years. My primary care doctor says 10 years. So I presume the gastro has an incentive to see you more frequently. My primary care doctor teaches at one of the local medical schools and thinks our health care system is a screwed up mess. He has very strong opinions.

[Guest]

5 hours ago, fedssocr said:

My primary care doctor teaches at one of the local medical schools and thinks our health care system is a screwed up mess. He has very strong opinions.

Some very bright & well read US citizens also think the US healthcare system is a screwed up mess.  

I'm not in a great position to assess the US system, but I do know that US healthcare spending is way in excess of comparable countries and life expectancy is typically lower.   Which is not a good result.    https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/

Unfortunately, the US system is also used as a defence to criticism of the UK state monopoly system.  

Of course there are many other countries that manage to provide good healthcare for all, with more public-private consumer choice than the UK, lower costs than the US and a better average life expectancy than either country.    The smart move would be for the US and UK to benchmark the better systems, then figure out how to migrate in that direction.

Also, thank you for advice on colonoscopy frequency.