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My Chariot To Bangkok to have the appendix removed.

As I was walking to church on Sunday, I felt a sudden pain in my leg. It quickly dissipated but the pain in my right abdomen did not go away. Not waiting for Mass to be over, I went back to my apartment for the rest of the day. The next day, I went to the French clinic in Vientiane. They ran an EKG noting my functions were normal. They were unable to diagnose the problem but I had an extremely high white blood count. I got a shot of antibiotic with the instructions that if I wasn't in a place of higher medicine that day, come back the following day for more antibiotic on my way to the airport.

We called the medical evacuation folks. Many conversations and emails exchanged that day. Because my condition was undiagnosed, they flew me to Bangkok. Early in the evening, a full medical contingent of doctors tapped on my door and soon we were off to the airport where there were even more folks waiting. Though I could walk, they whisked me away in a wheelchair barely passing through immigration and security. I could get used to this without much effort. I was driven to the tarmac where the jet ambulance was waiting. We quickly boarded and were off to Bangkok. I rested on the gurney. It made business class look like coach. In Bangkok, someone else went through immigration for me...oh the joys of travel! Off by ambulance to the hospital.

Upon arrival, I was admitted to the hospital. Not a lot of time passed before I was off for a CT scan, x-ray, and heart stress test. The nurse said I need to be prepped for surgery. Surgery? They were going to do an appendectomy. Yikes! Here's the official terminology complete with video: Laparoscopic Appendectomy Surgery for Appendicitis. My surgery took three hours instead of 15 minutes and my hospital time was a week...ruptured appendix...a whole new ball game that would have killed me if I had delayed my treatment by letting the contents of the appendix spread. Given that I was returning to Laos with almost no medical care, my doctor and I agreed to extend my visit to ten days to err on the side of caution.

My mother had a ruptured appendix that spread years ago. Her recovery lasted several weeks. My niece recently had this surgery so we had current technology.

Her older sister, my niece graduated from college a couple of years back. She recently passed her medical exams to allow her to legally practice medicine. My oldest sister is a pharmaceutical doctor. Both had correctly diagnosed my condition from my oral description. It scares me that a doctor couldn't (or wouldn't) diagnose my common condition even with the proviso "I think it's _____ but I can't be 100% sure without further testing."

Our site safety manager in Laos told me he recommends going to the Australian rather than the French Clinic in Vientiane. I'd be willing to try something different than the doctor who couldn't diagnose a ruptured appendix.

My general practicing doctor suggested that the stress test they ran on me in the Bangkok hospital may have caused the appendix to rupture.

Much like international construction, the biggest hurdle at the Bangkok hospital was communication. I've dealt with the subject for twenty-one years but never in medical terms. Even if it's the highest level nurses, they were using the terms ‘poo-poo' and ‘pee-pee'. I couldn't bring myself to their crude terminology. Like construction, I couldn't be sure what I said was understood so I watched and patiently corrected if needed. The smartest nurses where the bottom level nurses...the ones that cleaned me and took care of me as I used the toilet. They had a street sense...a family sense that was more practical than academic. I've maintained that nurses and doctors are God's angels. These were no exception. In spite of their shortcomings, they took great care of me and I'm very grateful.

My sister, the Pharm D advised me every day via email and Skype. From our conversations, we both concluded that I had the best available medical care and technology.

Everyone is baffled that my ruptured appendix didn't cause any pain. I had a cold before the appendix burst. Coughing and bending were the only things that caused pain. Unlike most appendix ruptures, the infected appendix didn't spread anything except infection which was the biggest part of my recovery.

Skype and email kept me in touch with family and friends. Some folks from the Laos office visited me twice. They even brought me ice cream.

I'd been on a liquid diet for a week...not an easy way to lose 17 pounds. The closest thing resembling solid food was egg whites. With the egg whites, I tried not to be too ravenous. Solid food came a week after the surgery.

I spent ten days in the hospital before returning to Laos where I hung out in my apartment resting before I returned to work.

It took a while to recover from the appendectomy. I waited a couple of weeks before I started walking. In Vientiane, it's too far to walk to work from my apartment. I didn't set up my kitchen so I'd have the driver drop me off at a restaurant for dinner and I walk home. That's usually about a mile and a half minimum. In retrospect, I'm amazed about how well I adapted to a hospital in a strange land under emergency circumstances. I didn't skip a beat. I think I was too busy ensuring that I didn't get lost in translation from English to Thai...something like my work...except it was me.

A friend of mine asked me if I was a medical tourist in Thailand. No, I was flown out of the country in an air ambulance but I'm hearing more and more about this concept from some of my associates who have had a lot of work done at the same hospital where I stayed. The all-inclusive cost of the medical evacuation, surgery, doctors, nurses, prescriptions, and ten days in the hospital was about twenty-five thousand dollars US. The air taxi alone was about four grand which was all paid by a separate policy my company has with an emergency evacuation organization. The rest was covered by insurance except for two-grand deductible. Last time I had surgery in the US, on an out-patient basis, the cost of the operation was well over sixty-grand. I lost track of all the other expenses but I remember the sixty-grand as my company was switching insurance companies. I coordinated the change with all my doctors but somehow, they didn't coordinate the change with their billing offices and I got to reroute the invoices to the medical providers.

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