Insurance decision will cost an expat no matter what

Part 4: It’s gonna hurt

(In my three previous posts, I explain the complicated decisions expats must face regarding their healthcare, especially when the unexpected occurs.)

When expats consider medical insurance, they quickly learn the decision about getting or foregoing it can be complicated.

What they don’t always accurately take into account is how the costs of insurance will grow and how risky the lack of it can be.

Having it is expensive. Not having it can cost a bundle too.  Worse, not having it can be dangerous.

With insufficient insurance, inadequate personal resources or both, a patient who is unable to receive quality care in his or her adopted country or another one could end up permanently maimed.  Or Continue reading

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Deciding where and which treatment to get took days

Part 3: Lucking out

(In Parts 1 and 2, you can read how I came to be self-insured and how I struggled to decide what to do about my injury.)

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The proof is the putting in of my bionic bone

Bangkok made the most sense to be treated.  But which hospital, which doctor?

Online, I checked three reputedly very good hospitals in Bangkok looking for a specialist whose training was not confined to Thailand.

I found an orthopedic surgeon at arguably the best and most expensive hospital in the country, Bumrungrad, which is among several there favored by many expats and medical tourists. A middle-aged Thai who has had training in the U.S., Dr. Siripong Ratanachai, telephoned me twice and answered my emails quickly before I reached Bangkok and connected us to each other via the Line free message service.  (He asks and answers questions at all hours, even months post-op and sometimes with just a whimsical emoji in response to a condition report.)  I count myself lucky to have found him.

Next came more decisions.  While making them, I lived on massively unhealthy and effective doses of ibuprofin.  Hey, it worked!

My subsequent choices related to getting to Bangkok and staying there.  It took the rest of Tuesday and Wednesday — two and three days since my fall — to complete my research so as to book airline tickets, arrange for wheelchair assistance, ascertain that the crutches that I had acquired would be acceptable onboard our hour-long Bangkok Airways flight, figure out how long we might need a hotel at a competitive price and then make a reservation there.

Thailand adjoins Cambodia, but we were, after all, engaging in international travel with no notice.

Immediately following my flight on Thursday, we met with my exceptionally patient doctor after my admission to Bumrungrad, which has its own waiting area at the airport and a free shuttle van to the hospital.

Dr. Siripong confirmed what I had discovered online about screwing my bones together as a poor option.  According to him, that approach would result in my right leg becoming about an inch shorter than it was prior to surgery and require me to put no weight on it for six weeks. As I recall, he also said that such treatment results in a 30-40 percent risk of problems in the future.  His remark about ensuing problems was consistent with what I had read, the rest of what he said being news to me.

I had a total hip replacement at 6 a.m. that Friday morning and was, incredibly to me, out of bed by 4 p.m. using a walker for a few minutes.

(I have been aware that post-op treatment these days means getting the patient out of bed as soon as possible.  It helps that they don’t stint on painkillers at Bumrungrad; their use explains why I am smiling in Part 1, I suspect.   I did put a stop to opioids after two days, and any pain was by then not a problem.)

I was on crutches the next day, out of the extraordinary hospital after my fourth night, by which time I could manage experimentally indoors without a cane, and had an unremarkable follow-up appointment with Dr. Siripong the next Monday.

I was instructed  to send him photos and videos from time to time and visit again at some point.  Call me a bad patient, but my recovery has been so swift and easy that I was in touch only twice.  I’m guessing Dr. Siripong understands why I haven’t otherwise messaged him.

Next: It’s gonna hurt no matter what

Email: malcolmncarter@gmail.com

Being diagnosed, picking doctor not a walk in the park

Part 2: New York or Bangkok?

(In Part 1, I discuss how exposed to major expense are expats who elect to go without medical insurance tailored to living abroad.  I also explain what went into my decision on purchasing a policy.)  

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One day after surgery. I thank drugs for my smile and the hospital for my fashion statement.

Let me say that I never have thought of myself as the fragile sort of person who could easily break a hip like so many older men and women who topple because their bones give out while they are upright.  For them, such a fracture is usually the cause, not the result, of a fall.

After all, as I am inclined to boast, I work out daily with a combination of lifting weights or sweating on an elliptical training machine.  Then there are walks of several miles most days as well so as to help me manage my weight.

I also enjoy hiking, frequently upward, on vacations, so I’m unusually fit for someone my age, I like to think.

I confess viewing with horror the prospect of being referred to as “elderly” should I be so described as the victim of a crime or a collision with a motor vehicle.

My level of fitness undoubtedly contributed to my uneventful and quick recovery.  My bones, according to my doctor, are strong.

I broke my hip on a Sunday evening in July, and an x-ray Monday morning Continue reading

An expat’s dilemma: Would getting sick break my bank?

ambulance

Injured construction worker is to be transported to hospital.  Source: Phnom Penh Post

Part 1: Decisions, decisions, decisions

It began with my absent-mindedly stepping on a wet tile floor and falling down hard on my right side.  It ended with important lessons not only for me but for many others, especially older individuals, who also choose the expat life.

In addition, the incident could prove illuminating to anyone who seeks some insight into the complexities of obtaining first-rate medical care overseas, whether tourists or expats.

One of the lessons that I learned reinforced the importance of my paying undivided attention to where I walk, especially if I am outside in Phnom Penh.  I walk for miles everywhere, in large part for my health, despite the dangers that pedestrians face here. We cannot navigate cluttered sidewalks and must always be on guard in a city where the multitude of cars and two-wheeled vehicles pays virtually no respect to the right of way of pedestrians in seemingly chaotic traffic.

Equally important, the whole experience of my fall taught me that I had made the correct decision about medical insurance when I retired to Cambodia from Manhattan at the end of 2013.

Having done my research before my arrival, I learned that Continue reading

In Phnom Penh, home often is where the tuk-tuk parks

See you again in September

It is a common enough sight to see tuk-tuk drivers sound asleep with their bare feet sticking outside their vehicles, mostly rented for $100 a month more or less, when the sun is high.

Less frequently, a pedestrian may well spot drivers taking more than a short nap when it is dark.

There is a simple reason: Continue reading

Homelessness is not surprising, but its face has changed

Homeless Paris 6 - 1

Visitors to Europe expect to see sites such as the Eiffel Tower, the Colosseum and remnants of the Berlin Wall.  Probably most also are little surprised to see homeless individuals on the street.

But the sight of homeless (presumably) whole families like the ones in three of my photos can be jarring.  I know that I was shocked to see Continue reading

Surprisingly, New York City is loosening its grip on me

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The Oculus, imposing portion of New York’s transit hub cum shopping mall that I photographed near One World Trade Center (also called Freedom Tower) in downtown Manhattan.

Thirty-five years.

That is how long I had made my home in New York City — only in Manhattan, from Washington Heights to Greenwich Village — in two long periods before moving to Phnom Penh toward the end of 2013.

How I loved New York over any other place I had lived such as Boston, San Francisco, Hartford and the Washington, D.C. area, where I went in my relative youth to work in the Pentagon and again, in 1995.  At that time, I worked in the U.S. Treasury Department before heading back to Manhattan in 2006 after having transitioned to real estate sales.

To my mind, Manhattan’s highlights run the gamut of the many clichés that you know as well as I do — energy, diversity, cultural opportunities, Central Park and, among so many other attributes, paradise for a food lover.
Continue reading