#  >  > Living And Legal Affairs In Thailand >  >  > Living In Thailand Forum >  >  > Health, Fitness and Hospitals in Thailand >  >  Malignant Melanoma.....check Your Moles

## taxexile

In febuary this year I went to see a dermatologist at a local branch of a big name thai hospital.

I had noticed a mole on my shoulder, I dont exactly know what it wasthat drew my attention to it, it was hard to see being on the back of my shoulder, but for a few months my eyes had been drawn to it, it seemed to shout at me. I kept thinking I should get it checked, it looked darker than normal, or maybe a bit bigger than it should be.

After a few months I eventually went to see a dermatologist, took off my shirt and she immediately noticed the rogue mole and said that needs to come off and be checked, it doesnt look right.

Ten minutes later i'm seeing tne surgeon, a horrible little man who told me he had worked in florida for twenty years. On the wall in his office were five or six framed certificates, I stood up to look at them and he barked at me why are you looking at my certificates, dont you trust me.

He was a foul tempered man, shouting at his nurse for the equipment he needed to remove the mole.
Anaesthetic in, snip snip slice slice and it was off. In with a couple of stitches and I was on my way.

A week later I was back for the stitch removal and the lab. report.

I was called in, he was still in that kind of foul mood typical of short unfulfilled men with dyed hair and he said good news, the lab report was fine, lets get the stitches out. 

He took the stitches out and said i'll show you the report, as I was putting on my shirt he yelled oh my god, thats terrible, I was looking at the wrong report, yours is here and its very bad news. He said only twenty percent survival after five years, we need to operate immediately, I have time tomorrow morning. Go and book it at reception, i'll take out your lymph nodes too.

And so began my descent into the hell that is a cancer diagnosis,  given by an incompetent fool, in a dysfunctional thai hospital.
-----------------------------to be continued.

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## MANICHAEAN

Go to a UK dermatologist. I go every 6 months 150 pounds per session: two suspect moles cut out, liquid nitrogen on anything suspicious, efudix cream to treat yourself when back overseas.

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## Latindancer

Not sure whether to laugh or shout "aargh" ! But certainly waiting for the next chapter with bated breath. And glad to see you're still well enough now to be posting.....
I went to a doctor in Thailand who had been a plastic surgeon for years. He removed a suspected basal cell carcinoma from my arm, but although the cut was shallow, he made it really quite long....unnecessarily so. I would have much preferred the type of biopsy with a tube sharp at one end, leaving a neat hole. They fill out well enough. It was an odd thing to do.

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## Tickiteboo

Scary stuff taxexile - hopefully you're on the mend now.

The moral is to get any changes checked out asap, but many people, especially blokes, won't go to see a doc in case they find something wrong  :Confused:  ! Stupid I know, but I've been guilty of exactly that in the past.

Best wishes to you bud - hope the next installment brings good news.

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## MANICHAEAN

The positive aspect of this kind of cancer is you can see the bloody thing and get it treated. In the bowels or prostate would terrify me.

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## Kwang

> In febuary this year I went to see a dermatologist at a local branch of a big name thai hospital.


Why didnt you scour the backstreets ? 

Any fukkin idiot can see a mole has changed colour or got bigger





> it was hard to see being on the back of my shoulder


Hope you bought the Gent a drink for that :Smile:

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## Kwang

sorry just read the ending. hope it all works out Tax. I know people who have survived it when it has spread to the Lymph Nodes, if that's any consolation. It will work out, dont worry worry.

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## Loy Toy

I'm sure most of your fellow TD members thoughts are with you Taxexile.

Good luck with it mate and as Kwang advised keep a cool and positive attitude.

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## SEA Traveler

Taxexile, my best wished for a successful treatment and speedy recovery.  This is certainly acting as a catalyst for me to do same check up.  Good Luck.  Will follow situation.

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## larvidchr

> I'm sure most of your fellow TD members thoughts are with you Taxexile.
> 
> Good luck with it mate and as Kwang advised keep a cool and positive attitude.


Ditto... the best of wishes for you to beat this.

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## kmart

Best of luck, tax. The surgeon sounds like a complete fukcing dick, btw. Same type of guy (in the UK) that told my Dad that he had six months to live with just stage 1 prostate cancer. He had similarly mixed up the results with another patient.. Me Dad is still fine and healthy 7 years later, but the initial shock from Basil Fawlty MD nearly killed him

Get to see another surgeon in another hospital mate. All the Best.

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## DrAndy

go get a second opinion

the test results on your mole would be available for another doc to inspect

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## Bangyai

> I'm sure most of your fellow TD members thoughts are with you Taxexile.
> 
> Good luck with it mate and as Kwang advised keep a cool and positive attitude.


Thirded .  Good luck with it Tax. If its in its early stages might not be too bad .
 A lot of useful info on cancer in S Landreths thread.

In the meantime if you discreetly let us know the surgeons name I'm sure some of TD's cyber warriors can mask up and go and rearrange his facial features for you.

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## taxexile

Before dismissing me he yelled at his nurse to bring him his camera, when the camera finally arrived he fiddled around with it before telling me that due to him being in a hurry when he excised the mole heforgot to take a photo of it,  he also toldme that the malignancy was classified as a clarkes grade three, this relates to the depth of the thing, he also told me that the pathologist had forgotten to include the actual depth in millimetres in his report.

He tried to call him but he had already gone home, so the doctor estimated the depth as around two millimeters.

I went out toreception in a bit of a daze and booked in for the operation . Due to the inefficiency of the staff there, this procedure took over an hour.
Whilst waiting for the paperwork etc. I called my health insurance and spoke to the claims secretary, she told me that they have never dealt with thishua hin hospital and seeing as this was serious I shouldcome up tobangkok tomorrow and she would arrange an appointment with a suitable doctor at bumrungrad.

I was quite grateful for somebody to have taken control of tne situation because I was not really thinking straight.

When I arrived home I looked up malignant melanomas on the net, and soon broke out into a cold sweat.  A tumour depth of two millimeteres is quite advanced, with a poor cure rate.

The next day we drove up to bangkok, half way into thejourney we phoned thehua hin hospital to cancel the operation and ask for the lab reports and tissue samples to be sent tobumrungrad.

The little fuckwit of a doctor was furious that I had decidedto go elsewhere,  gave me his opinion of bumrungrad and the doctors there and refused to release the lab report or the tissue samples.
He demanded to know my reasons for cancellation and his attitude and behaviour was nothing short of disgusting. 

When i told him I had lost confidence in a hospital where doctors have to yell at the staff,  where it takes an hour to make an appointment and where a professional clinician forgets to make a photographic record of a suspicious mole before its removal he just said it was abusy day but things are different in the in patient department and operating theatres, but he still refused to release the records or samples saying I have to drive back to hua hin and make the request personally and complete the relevant paperwork.

So of I headed to bumrungrad with nothing but a rather vague verbal diagnosis of an aggressive cancer.

To be continued, and if anyone has any moles that have changed appearance or clour or size, do yourselves a favour and get them looked at by asuitably qualified dermatologist.

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## superman

> Anaesthetic in, snip snip slice slice and it was off. In with a couple of stitches and I was on my way. A week later I was back for the stitch removal and the lab. report.


Price at a government hospitat 700 Baht. I had one done a few months ago.

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## Davis Knowlton

I truly hope things work out for you, Tax - but what the fuck were you thinking? The second the doctor presented as an asshole, you should have been out the door - that second. And, thinking that it could be something serious, you should have been heading immediately for the best hospital around.

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## Eliminator

Just get the name of the company that did the test and get the BKK hospital to call them. the so called DOCTOR sounds like a money grubber. Best of luck to you.

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## DrAndy

> but he still refused to release the records or samples saying I have to drive back to hua hin and make the request personally and complete the relevant paperwork.


I think if your new doc asks him personally, he may send them on

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## The Ghost Of The Moog

^I think TE is narrating events from February onwards, so many of the SNAFUs chronicled probably are resolved by now.

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## DrAndy

or he is dead

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## taxexile

Everything that happened so far in the narrative is within twenty four hours,  from being a happy go lucky expat enjoying life to being told I have a serious cancer, from which there were no symptoms, no pain, no bleeding, no lumps, nothing.

It comes as a big shock, had I suspected that there would have been anything serious developing I wlould have gone straight to a decent bangkok hospital, as it was I went to a recently opened branch of a large hospital, there is the main one in bangkok, pattaya has one nd I think there is one on samui too, I had heard goodreports about this place, I just happened to get this doctor on one of his very bad days and his commu ication skills were tactless and unprofessional.

His poor performance caused me anxiety, despair and stress beyond anything I haave ever experienced, and it is very hard to think straight under those conditions. You need hospital staff who understand empathy, in thailand all they can do is askfor your credit card in between their nose picking and spot squeezing and giggling.  Thankfully my wife and the insurance company took over.

More later.

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## The Ghost Of The Moog

> Everything that happened so far in the narrative is within twenty four hours,.


The last 24 hours, or within 24 hours some time ago?

Reason being is that looking at the advice being given, some posters may think that this is happening in real time, today, whereas if not, some of the issues they are raising now may well have been tackled by you already.

Anyway, get well soon, and I hope the story ultimately reveals a happy ending.

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## Troy

Get a second opinion NOW. 

I wouldn't trust the first doctor further than my little niece could throw a 747.

Did you see the mole? Was it circular or asymmetrical? Could the end of a pencil cover its size?

Have heard some real horror stories of skin cancer...but these were left untreated for 6 months or longer. Identified early and it has the best survival rate.

Once in the Nymph gland you would have known by now...nasty big lump would have sprouted out somewhere on your body...and only thing to do is live out the dreams you haven't managed already.

Best of luck mate...

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## The Ghost Of The Moog

> Once in the Nymph gland you would have known by now


I would think any Nymph like activity is the last thing on his mind right now.

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## Troy

^^ & ^

Lol...sorry about that...Freudian slip ...writing whilst talking to the g/f is never a good idea...meant lymph nodes of course ...which I believe is the most aggressive way of cancer spreading.

Probably not the best thread to make such a boob...so apologies and all that...

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## hazz

> The little fuckwit of a doctor was furious that I had decidedto go elsewhere, gave me his opinion of bumrungrad and the doctors there and refused to release the lab report or the tissue samples.
> He demanded to know my reasons for cancellation and his attitude and behaviour was nothing short of disgusting. 
> 
> When i told him I had lost confidence in a hospital where doctors have to yell at the staff, where it takes an hour to make an appointment and where a professional clinician forgets to make a photographic record of a suspicious mole before its removal he just said it was abusy day but things are different in the in patient department and operating theatres, but he still refused to release the records or samples saying I have to drive back to hua hin and make the request personally and complete the relevant paperwork.


Some people should simply not be doctors.... and there in might the clue as to why he is working in thailand and is not so happy about people looking at his certs.

best of luck

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## Bangyai

> It comes as a big shock, had I suspected that there would have been anything serious developing I wlould have gone straight to a decent bangkok hospital,


I think a lot of westerners who are not used to living in a really hot climate with a lot of sun don't fully understand the potential danger and therefore don't react fast enough ,  so you are not alone.

I have had three things cut out of my skin in recent years , two on my right arm and one on my right cheek. Of the two on my arm , one was sun damage and not serious , the other ( 6 months back ) was a veruka ??

Only the one on the cheek was potentialy dangerous but I caught it early and the danger seems to have passed. 

Hope that you're lucky Tax and that its treatable. Although serious it might not be as serious as you fear.

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## taxexile

My appointments at bumrungrad were very disheartening, armed with only the information that the lesion was two millimetres deep and without any photographic record of the thing does not give the doctors much to go on, they neeced the tissue sample to do tneir own tests on and the hua hin branch of the large internatilnal hospital were not willing to release it, even though itbelonged  to me.

The first doc, an oncologist  specialising in advanced cancers was professional but unfriendly and cold, he told me thailand has no doctors with any experience of melanoma, thais dont have skin cancer, and that realistically I should go to a centre of excellence for melanoma in the west, or australia. I should try and get the tissue sample from hua hin so thry could test it themselves, but in the meantime they could arrange for me to have something called a p.e.t. scan which could pick up any cancer spreading to other parts of tbe body. Sitting in the waiting area before seeing him, surrounded by living skeletons and their weeping relatives brings home the fact of the temporality of our existence and how easily it can allbe taken away, without our health we are nothing.
I was then sent to see a surgeon who told me in no uncertain terms that thailand has no surgeons trained in the kind olf surgery needed to dissect out cancerous lymph nodes that might lie deep in the chest. He explained the procedure for dealing with malignant melanomas deeper than1.5mm.

Above that depth it is probable that spread would have already occured, and spread is via the lymph nodes, and they need to find the first lymph node distal to the lesion, and its not always the closest one, lymph drainage patterns are irregular and complicated. They use a radioactive dye and follow its path using sensors, when the dye has reached the first node they remove that node and analyse it, if it is clean they assume the cancer has not spread and they sew you up, if after analysis it is found to be cancerous they inject more dye and locate the next node in the drainage chain and remove it, and so on until they find a clean node.

Drainage patterns from the shoulder are complicated and can involve the chest cavity, and there isvery little call for this type of surgery in thailand as thaisdont get melanomasd, he told me I would bebetter off going to the west to have this done, but dont waste any time,  I knew someone who was dead within five months after a cancerous mole was discovered.


By now I was convincedi had a nasty cancer and was resigned to having to return to theuk to seek treatment thst could involve extensive surgery followed by chemo and even after that to have a pretty lowchance of being permanently rid of this thing.

The insurance company phoned and advised me to arrange flights etc to the uk and they would find me a doctor in the uk, and by the way we havegot your tissue biopsy from hua hin and it is being couriered up to bumrungrad.

More later

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## Spin

> without our health we are nothing


Indeed.

I hope this story goes in the direction I want it to........

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## Little Chuchok

> The first doc, an oncologist  specialising in advanced cancers was professional but unfriendly and cold, he told me thailand has no doctors with any experience of melanoma, thais dont have skin cancer, and that realistically I should go to a centre of excellence for melanoma in the west, or australia. 
> 
> More later


I hope all goes well for you Tax.

Australia and New Zealand oncologists are well versed in Melanoma due to the strength of the sun etc. kids are taught to cover up completely between the hours of 10 and 2 during the summer or use a high factor UV block'

At the age of 29 I had one removed from my back.I was lucky that it had not spread.


This link may help a little

New Zealand Melanoma Unit - Comprehensive integrated multidisciplinary care

Good luck.

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## CNF55

I can't imagine what you must be going through - I am scared shitless just reading your posts.

On the plus side it seems that you definitely picked the right insurance company. They sound very helpful and competent, definitely not the norm.

Stay strong and don't give up hope.

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## Latindancer

Gawd, Taxexile...you've got us on the edge of our chairs !

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## rickpattaya

About 5 years ago i collapsed at home with a raging temperature hallucinating and the works. my wife had the sense to take me to the nearest hospital where I was examined by a specialist. Maybe he was a specialist in basket weaving because he sure as hell was not a doctor. They X rayed my lungs and found that I had a growth in my right lung. Her said that this must be removed immediately because it was probably cancerous. 2 million Baht minimum.
To cut a long story short my missus put me on the next flight back to the UK. My GP referred me to the hospital and they put me in an isolation ward. I was in a bit of a mess. The doctor did numerous tests and said that I had pneumonia and I had a lump in my right lung. He said not to worry as he could treat it with drugs. I was cured in around 3 months.
This is the worst experience that I have ever had in my life, so I heavily recommend that you get the next flight out and get a diagnosis from someone that knows what they are doing.
I will never trust a so called Thai doctor again.

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## Smug Farang Bore

I hope it all works out for you Tax.

Im sitting in Molly malones just had an op in BNH Hospital and I can't. Sing their prases enough.

Doc was great.




Well apart from the price..

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## terry57

Scary story hence why I will always keep my gaff in the west so I can bolt back to a country that can treat an illness like this one.

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## rickpattaya

> n bolt back


Good plan Terry

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## hazz

> The first doc, an oncologist specialising in advanced cancers was professional but unfriendly and cold, he told me thailand has no doctors with any experience of melanoma, thais dont have skin cancer, and that realistically I should go to a centre of excellence for melanoma in the west, or australia.


Personality issues aside, this is exactly what you want in a doctor. And understanding of the limits of his own skill and the confidence in himself to admit this and advise you where to get the help you need.

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## Kwang

so what you have had so far is a biopsy, then Tax, your next stage will involve more surgery, just a local anaesthetic, then maybe a 4 inch scar, then around a week wait to see if it has all been cut out. I had one cut out which was. 2 of a mm. and that is what happened with me. 

Then i was an outpatient only returning once a year for 5 years where a doctor feels and inspects your throat, armpits and groin, they will show you how to check yourself too, which you are supposed to do regular. I was given the all clear after 5 years. Don't miss any of those appointments or they will refuse to see you.

Hopefully yours will have the same result and path I had, the worst bit for you now is not knowing I guess

Good Luck and best wishes

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## taxexile

The next morning I turned up at 7.30 for a PET scan, positron emission tomography.
PET scanning with the tracer fluorine-18 (F-18) fluorodeoxyglucose (FDG), called FDG-PET, is widely used in clinical oncology. This tracer is a glucose analog that is taken up by glucose-using cells and phosphorylated by hexokinase (whose mitochondrial form is greatly elevated in rapidly growing malignant tumours). 

These scans can pick up malignant activity much sooner than ultrasounds, x rays and blood chemistry can


I had to change into hospital gowns and was placed in a small cubicle, covered with a warm electric blanket and told I needed to be perfectly relaxed for the scan, no music, no reading, just clear your mind they said, brain activity can lead to false readings.  Not so easy to relax though considering the reasons for having the test.

The nurse gave me a quick course in deep breathing relaxation techniques and left me to it. After an hour or so another nurse came in wearing what looked like a diving suit and carrying a big metal bottle which she handled with metal pincers, this was the radioactive gunk that was going to be injected, using an enormous contraption, a supersized metal syringe for protection I assume from stray radiation, I was injected and told to go back to sleep.

Eventully I was wheeled in to the scanning room and placed on a narrow tray which slid into the centre of a large metal and plastic doughnut. The actual scan, in my case a full body scan took about forty minutes during which time the tray moved inand out of the doughnut and red laser crosshairs moved up and down my body. The scan was more relaxing than expected, the scan is accompanied by both a mechanical and an electronic soundtrack as it goes about its business and for some strange reason I found it all rather pleasant.

When I left the room they told me that my biopsy had arrived  from hua hin and that I should come back in four days to see the doc. for all the results and to make some decisions.

I spoke to a doctor friend in the UK about what had happened and he advised me to wait for the results and in the meantime he would line up a dermatologist in the uk if I decided to return. 

Flight availability was checked and plans A, B and C formulated. I had accepted the fact that my life had probably changed  but I was determined to fight the good fight, put my best foot forward, keep a stiff upper lip,  even put my sick shoulder to the wheel and all the other trite meaningless sayings so beloved of people when they are consumed by fear but want to appear positive

I spent the next four days stuck in my room quite happily doing sudoko puzzles, coming out only to eat and shit.



Four days later, I turned up for my appointment with the oncologist and was given some good news, the depth of tne lesion was under one millimetre, and the scan and blood tests showed no cancer activity anywhere else in my body.  The treatment for a lesion of under a millimetre in depth is a wide full depth excision of skin to a diameter of two or three centimeters around the original lesion, the oncologist told me how lucky I was to have caught it before it had penetrated too far into the skin. There was no need to go digging for lymph nodes, and no need for chemo.

Unbelievable relief at the result after a week of quite frightening worry.

The trouble with detailed scans and investigations is that they can discover all kinds of hidden signs that necessitate further investigations, they can be a very good income generator for hospitals like bumrungrad, and a source of great worry for patients as they feel they have to get every shadow and blip checked out. More about that later too, as something strange was found on the scan, completely unrelated to the melanoma, but involved a whole raft of rather unpleasant probings, pokings and insertions.

Later that day my wife had to call the original doctor in hua hin for some insurance related information, and the [at][at][at][at] told her that he had spoken to the hua hin pathologist shortly after we cancelled the hua hin operation and was told  that the lesion was under a millimeter in depth, but he (the doctor) had forgotten to call  and tell us.


Thanks for all the good wishes, much appreciated.

I will continue in a day or so the story of the operation and the follow up I have just had with a malignant melanoma specialist in the uk.

I wouldnt want anyone, not even socal or calgary, the boards most obnoxious characters, to go through this kind of anxiety, or be at the mercy ofthe doctor at hua hin who initially refused to relese the biopsy, and didnt inform me when he had the full result, that would have saved me and my wife a terrible week.

To anybody looking at a mole and wondering about it, the sooner it is checked the better.

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## The Ghost Of The Moog

> involved a whole raft of rather unpleasant probings, pokings and insertions.


Ok, I definitely want to hear about these please.

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## Kwang

I'm pretty sure the insertion is not normal practice :Smile:

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## Loy Toy

> Four days later, I turned up for my appointment with the oncologist and was given some good news, the depth of tne lesion was under one millimetre, and the scan and blood tests showed no cancer activity anywhere else in my body.


Bloody wonderful news mate. Made my day.................. :Smile:

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## MANICHAEAN

I'ts been one hell of a frightener for you, but glad of a good end result.

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## Little Chuchok

Good news Tax.

Hopefully the rest will be easy.

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## CNF55

You really kept us on the edge...

Can't possibly imagine what a relief that must have been.

Congratulations - must feel like a second life.

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## kmart

Enthralling and educational thread, tax. Hope it's all plain sailing from now on, matey. 

Congratulations, indeed.

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## SEA Traveler

fantastic news "tax".  keep on truckin...

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## Davis Knowlton

Good news indeed, Tax. Welcome back. Hope the rest of it is nothing major.

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## hazz

A nice bullet dodge, lets hope it all works out for you.





> Later that day my wife had to call the original doctor in hua hin for some insurance related information, and the [at][at][at][at] told her that he had spoken to the hua hin pathologist shortly after we cancelled the hua hin operation and was told that the lesion was under a millimeter in depth, but he (the doctor) had forgotten to call and tell us.


first time I read this I was was thinking 'forgot' my arse and was appalled by this demonstration of petty minded meanness. But thinking about it and the character the doctor demonstrated on your first visit... I think I was being unkind, he probably is simply that crap at his job and being a human in general that he did genuinely forget.

Rather suggests that thailand licences its doctors with all that care with which it licences its drivers... a worrying thought really

we should all consider thai registered doctors, what ever their nationality,  to be as competent as thai registered drivers

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## taxexile

The hua hin doctor was really a disgrace to his profession, his arrogance and the way he spoke down to his assistant should have alerted me immediately, but I was not expecting this mole to be anything more than just a mole.

His negligence in not photographing the mole before he removed it,  his anger when I cancelled the operation with him and his forgetting to inform me that the diagnosis had changed from cancer srage three to cancer stage one would see him grovelling before a disciplinary committee in a country where the profession is properly regulated, to say nothing of the damages that patients would be awarded for their inconvenience etc.

The docs at bumrungrad were much more professional, but their bedside manner is very cold and they do like sending you of for test after test.you have to watch out for having the same blood tests requested twice or three times a day if you are under the care ofmore than one doctor, as I was initially.

My wife was very good at spotting duplicate tests, and saved the insurance company thousands of baht, the doctors are too lazy to refer to the notes to see what tests have already been done.

The nurses there, in their tight uniforms are straight out of the benny hill show, and. Every encounter with them was erotic. I had to have a pelvic ultrasound,  due to something that showed up on the pet scan, and was taken into the darkened ultrasound room, told, yes told as opposed to asked, to lie face up on the bed and left for about a minute.

A very pretty young nurse then walked in and told me, and these were her exact words because I remember them so well "i want to take your trousers off, can I take your trousers off please" and proceded to, as I was lying there, to undo my belt, unbutton the top button and pull down the zip, whilst standing over me with a completely straight expression on her face, she then  pulled them down over my hips and pulled my underpants down to point where my rapidly swelling penis was still restrained but my luxuriant pubage was exposed.

The underlying dom/sub frisson was quite intense

Why coudnt she have asked me to do this before I got onto the bed?

During the ultrasound examination when the oiled probe is moved back and forth over your pubic area  by the doctor, do they really need two nurses, in clinging uniforms to stand over you at waist level. An ultrasound on the national health in the uk wouldnot have been like this.

There is a strong undercurrent of eroticism in just about everything that happens in thailand where a woman is involved, even at a subconscious level, and i,m sure it is this, the possibility, however remote, of a sexual encounter hinted at by these constant subliminal erotic impulses, that keep us men coming back. Its not the hookers or the bars, but. The eroticism is all pervading.

As part of the pelvic investigations, that eventually came up with nothing more than a swollen appendix, I also had to have a barium enema, i'll save that story for later, but it was singularly unpleasant, and very unerotic.

it was administered by two giggling gay male nurses and the whole event could have come straight out of a carry on film.

The operation to remove the dermis over myshoulder was done on mybirthday, it was quite uneventful, and my dsay and a half in hospital was one of luxury and pampering by the wonderful staff at thathospital, thecare was second to none, the operation is quite minor, they take a circle of skin, thefull depth down to theunderlying muscle, two or three centimeteres around the spot where the mole was and stitch you back up, they told me that if they couldnt pull the edges together then they would tske a skin graft from my thigh, but in the end they were able to stitch it together, and now I am left with a depression and long scar onmy shoulder.

The operation and stay in hospital cost 110,000baht, and the PET scan cost 80,000baht, there was another 20,000 to cover blood tests etc and the insurance paid up promptly, but incredibly they queried and refused to pay for the supply of a 150baht sling to support the arm after the op.

Even after all this I was still anxious as to whether they hadcmade the correct diagnosis asto the cancer staging, thais are so vague about everything, even cancer and in the days after the operation I started worrying again, so I got thetissue samplesfrom bumrungrad and sent them to 
a malanoma centre inthe uk, I had spoken to them previously and they said they would be happy to have their pathologist re examine thetissue.

Last week I came to the uk and saw the consultant who confirmed the thai diagnosis and told me the treatment I had was exactly thesame as he would have done, and that they actuallymeasuredthe thickness as slightly less than the thai lab.
He told me how lucky I was to have caught this before it had spread, and that there was an almost negligable chance of recurrence.

A full body mole check twice a year, check my armpits and groin for swollen lymph nodes.

He told me these cancers are on the increase and that too many are not caught in time, he told me of the lorry driver who used to drive with his arm out of the window who showed up with stage three melanomas alldown his forearm, of sunbed users with incurable cancers, of binge sunbathers on two week jaunts to the sun developing melanomas.

When I was a child, I had severe sunburn on my shoulders, two or three times beforei was 12, holidays in spain before sunscreen was popular, I had blistered burns on my shoulders, and it was this he said, that was the predisposing factor to my cancer.

Blistered sunburns as a child, followed by exposure later in life.

Take care out there,  if youhave moles, photograph them every few months and compare and note any changes in colour, shape and size, I think one poster has already advised this.

The intense sun in thailand can do a lot of damage, if you swim, play golf or cycle, watch yourselves.

Later I will relate the barium enema story.

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## dirtydog

> but incredibly they queried and refused to pay for the supply of a 150baht sling to support the arm after the op.


Thats considered as out patient stuff.

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## taxexile

Thats what they said, but it was supplied during my time as an in patient.

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## CNF55

Really glad that this episode ended so positively - but I don't think that I am going to hang around for any 'enema' stories.

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## Kwang

> A full body mole check twice a year, check my armpits and groin for swollen lymph nodes


Where are you gonna get these check ups done, are you gonna fly back to the UK twice a year. I only had to go once a year for 5 years






> The operation and stay in hospital cost 110,000baht, and the PET scan cost 80,000baht, there was another 20,000 to cover blood tests etc and the insurance paid up promptly, but incredibly they queried and refused to pay for the supply of a 150baht sling to support the arm after the op


If you would have flown home instead of scouring the backstreets of a third world banana monkey republic (DJ Pat) it would have only cost you the airfare. You would have got a free sling too

Oh and dont get tempting fate counting your chickens and listening to the doctor thinking that it wont come back because they can and do

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## taxexile

If I had gone back to the uk, I would have had to wait at least a month for an appointment, then another month for the biopsy and its results, had the results been bad, I doubt if I would have received the expensive chemotherapy considering the low cure rate. I would not want to have cancer treatment under the nhs, they have the poorest success rate in europe.

In the uk I would choose private treatment for cancer, if I could afford it.

But I would opt for treatment in a good thai hospital every time, providing they arrive at the correct diagnosis, and for that you need to know where to find the right doctor.
For routine easy to diagnose illnesses most thai hospitals are up to the task.
The problem in thailand is the lack of a good referral system, you have to find your own doctors, and many of them will attempt treatments beyond their capabilities and experience.

If you can find the right doctor then you need have no fears about treatment in thailand,  

I know full well that cancers can recur, and have been well informed about the unpredictable and aggressive nature of melanomas, I am under no illusions as to my mortality on this earth, but for the time being I will celebrate by good luck.

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## Kwang

> If I had gone back to the uk, I would have had to wait at least a month for an appointment


I was seen in a week






> then another month for the biopsy and its results


wrong again, I dont know where you get this info from, that was another WEEK






> had the results been bad, I doubt if I would have received the expensive chemotherapy considering the low cure rate


Poppycock, Of course they would have offered you Chemo, again where do you get this info from of Low Cure Rates. I know 1 person who has had cancer in his Lymph Nodes, he is cured. Thats a 100 percent success rate that I know of






> I would not want to have cancer treatment under the nhs, they have the poorest success rate in europe


Once again, where is your evidence to back this up ?

They cured mine ( FOR FREE )






> In the uk I would choose private treatment for cancer, if I could afford it


Sigh







> But I would opt for treatment in a good thai hospital every time, providing they arrive at the correct diagnosis, and for that you need to know where to find the right doctor


Which is where exactly ?






> If you can find the right doctor then you need have no fears about treatment in thailand,


Where are these Right Doctors then ?
I think I know what your answer will be, Bumrungrad, solely because its the most expensive. 






> many of them will attempt treatments beyond their capabilities and experience.


So you would choose that over the NHS  :smiley laughing:

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## Troy

> If I had gone back to the uk, I would have had to wait at least a month for an appointment, then another month for the biopsy and its results, had the results been bad, I doubt if I would have received the expensive chemotherapy considering the low cure rate. I would not want to have cancer treatment under the nhs, they have the poorest success rate in europe.


Is this true? I thought they had the best success rate for breast cancer...and possibly others. Certainly my Sister, Father and Step-Father have all been cured of Breast, Prostate and Colon cancer respectively...

It is a subject that worries many people and the success rate is not good unless the cancer is caught early. I think it is wrong to criticise the UK for their success rate...not without a lot of statistical data.

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## hazz

Personally from what I have seen of the NHS, if you are suffering from something life theatening and time critical; they really will pull pout the stops for you, cancelling other peoples treatments to make way for you. The people who tend to get the shit end of the stick are those suffering from chronic, non time critical, non life threatening cases... who do tend to end up with long waiting lists.

If what you are saying true, then I really think you should back it up with some data.

You should also take a long hard look at your own private health insurance, if you are on an expat type package, you will probably find that unless you pay extra they will only pay for the first 9 months of any long term medication, if you do pay the extra you need to pay for 3 years before the insurance will cover you and then there is a lifetime limit in the order on 60k pounds. you may also find that they will only pay for treating diseases which in principle can be cured, diabetes being one that cannot. Thinking about my cousin would have blow the typical life time cover limits of about 1.5 million pounds before he was 12. 

The nice thing about the NHS is it doesn't come with all the small print and exclusion clauses that you find in a private health scheme that can leave you in a serious financial mess or worse.

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## taxexile

There was a report a few months ago comparing the survival rates of different cancers in different countries, the uk came out worst.

I dont know how the results were analysed, the age of the patient and the stage of the cancer at the time of treatment will affect the results.

I have worked in the nhs myself, in hospitals, and I know doctors who work in nhs hospital system, 
And they all say avoid the nhs if possible.

I know they do provide good services for emergency care, for paediatric care and there are many centres of excellence for malignant disease. If you live in the right district you may be lucky enough to be treated in the right hospital. 

Personally I would want to be in charge of my own treatment, I would want to be able to choose my. 
consultant and the hospital. I have health insurance in thailand and so the bills dont concern me.

Wherever you are treated, it all depends on the skill and knowledge of the doctor, and it is up to the patient to choose the doctor, I eventually found a very good doctor in bumrungrad, we had many talks about the relevant advantages and disadvantages of the private system versus the state system.

He told me he disliked working at bumrungrad because of the subtle pressure put on the doctors to generate income, but that its facilities were second to none and he was able to treat using advanced techniques that were not available elsewhere, he also told me how to get the best out of the thai system and how to build up a relationship with one doctor in much the same way as one does in the uk with the gp system, possibly the best aspect of the uk system, one doctor who knows you as a first port of call when treatment is needed.  

These days there are too many bean counters in the nhs, treatments are subjected to a cost benefit .analysis, and based on my knowledge and experience of the nhs, I would avoid it if at all possible.

My father was in  a nhs hospital, he lay in his own piss and shit, unfed and uncared for after a stroke for two weeks until we discharged him and brought him home .
A good friend died of lung cancet after being refused a chemo drug on the grounds of expense, he was a non smoker by the way. Its a system creaking at the seams.
When I asked the melanoma consultant I saw last week, I saw him as a private patient, how long it would take me to get into the nhs system and receive treatment for my melanoma, he told me about six to seven weeks,  in bangkok from my first visit to bumrungrad to walking out after the operation was nine or ten days.

Had I returned to the uk with a stage three melanoma maybe i would have been seen quicker, but hopefully before mid june when all non emergency operations are due to be cancelled and many diagnostic departments will be non functional  due to a strike by uk nhs hospital doctors .

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## MANICHAEAN

The remarks about your mortality are a big step. Im currently on top of my skin problems, but am only too aware after different scares, of a recurrence and being physically overwhelmed. I therefore came to the conclusion that its no use just sitting worrying about death. If anything its an inconvenience and no big deal. Thats why the nowness of every day should be grasped.

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## Capex

Glad to hear that you have escaped a bullet Tax. You may be interested in the story about a friend of mine. See here:Black Salve Basal Cell Carcinoma Skin Cancer Nose

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## DJH77

> The hua hin doctor was really a disgrace to his profession, his arrogance and the way he spoke down to his assistant should have alerted me immediately, but I was not expecting this mole to be anything more than just a mole.
> 
> His negligence in not photographing the mole before he removed it, his anger when I cancelled the operation with him and his forgetting to inform me that the diagnosis had changed from cancer srage three to cancer stage one would see him grovelling before a disciplinary committee in a country where the profession is properly regulated, to say nothing of the damages that patients would be awarded for their inconvenience etc.
> 
> The docs at bumrungrad were much more professional, but their bedside manner is very cold and they do like sending you of for test after test.you have to watch out for having the same blood tests requested twice or three times a day if you are under the care ofmore than one doctor, as I was initially.
> 
> My wife was very good at spotting duplicate tests, and saved the insurance company thousands of baht, the doctors are too lazy to refer to the notes to see what tests have already been done.
> 
> The nurses there, in their tight uniforms are straight out of the benny hill show, and. Every encounter with them was erotic. I had to have a pelvic ultrasound, due to something that showed up on the pet scan, and was taken into the darkened ultrasound room, told, yes told as opposed to asked, to lie face up on the bed and left for about a minute.
> ...


 You just convinced me to go back to Australia. I had a Malenoma in situ cut out a month ago, when i went back to have the stiches removed the Doctor informed me that i had to have another appointment as she had failed to get it all and would need to have a larger circle cut around, maybe 3 cm in diameter. I said well you had better do it now as i am flying out in 2 days, but she said she had no time to do it now as she had other appointments waiting. So i thought what the hell, i.ll get the rest cut out back in Thailand. Well i've spent 2 weeks going to different hospitals in the North east and got nowhere so i have been waiting for 3 days now for an appointment at Bumrangrad hospital but no Reply as yet. But after seeing your costs i am dumbfounded. In Oz it cost me 15,000 baht for the procedure and your cost was 110,000 baht, so much for cheap Thai hospitals. I can fly back to OZ, 30,000 return plus 15,000 for the 2nd cut, total 45,000 baht, that it and the government gives me some back. And the whole thing takes 30 minutes in a clinic and i walk out the door and go home. So I'm off to Australia again. If i knew these wankers couldn't even make a small cut like this i would have cancelled my other flight home and had it done a week or so later. Arn't they a joke.

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## taxexile

i had a day and a half in hospital for my 110,000b. the insurance paid so i wasnt too bothered by the cost.

if you have the op. under local anaesthetic without a hospital stay then i dare say the costs would be much much less.

either way, good luck to you, and glad that your melanoma was caught early.

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