I noticed after swimming in the pool in Bangkok that my left ear was badly blocked. Took a few days to get the water out and, even then, ear still blocked. Happened again during a sea swim in Railay. Woke up one morning still with a blocked ear and the realisation realisation that my Dive Master training starts in Ko Toa in less than a week....mmm, best I do something about this.
Walking around Railay I had noticed a british woman at one of the local travel agents so asked her about good local doctors.
"You have a choice," she said. "There is a pharmacy on Railay. It's not like back home, you don't need a prescription so you just ask for what you want." Either that or go over to Ao Nang (a 15 minute long boat ride) and go and see Dr Sumboon (oft quoted as a good Dr for westerners to see in this neck of the woods).
Never having been a fan of self medicating (somewhat akin to letting a kid loose in a gun shop in my view), I opted for option 2.
By the time I arrived (around 4.30) Dr Sumboon's clinic was closed (I later found out they had not yet opened for the day - they open after 5.00 so customers can see them in the evening. Something worth noting in comparison with NZ!)
A few doors down is the Ao Nang Clinic.
They were incredibly apologetic that I would have to wait for 10 minutes to see the Doctor (I was a walk in without an appointment). The nurse spoke good English, asked me for my symptoms, got me to fill in a form and took my blood pressure and temperature in the meantime. Dr Napannop was charming and very helpful. he spoke excellent English and was very efficient. Turns out I had a very blocked eardrum full of wax. He went in with a speculum ? and tried removing it. Got some but then spent the next hour with their nurse sluicing out the ear. I got both the prescription and the medication at the same place (Doctors prescribe and dispense here). In comparison with NZ, the medication was the most expensive part of the consultation.
A picture (Shayne Hunter - take note of the drug labelling. Clear and pretty simple really).
They don't seem too systemised here.
I was later to find out that this clinic is regarded as one of the more expensive ones. In all, for about 1 hour's consultation I was pretty happy with the service and the price.
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| Consultation summary |
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| The bill (with NZ equivalent prices I've put beside it. Notice the fact they ask you to sign it before paying. They have to get the signature before they bill you. Nice touch! ) |
So - some lessons for NZ General Practice here I think. Now, if only they could systemise it better over here....
POSTSCRIPT. They said to leave it for 3 days and take the medication in that time and to come back if still not getting better. I went again yesterday as ear still blocked. They were able to pull more of the blockage out, a half hour more of sluicing and now clear as a bell. Still a slight infection in the drum, still on medication but OK for diving and swimming in 5 days.
Some refection's on the safety net of an electronic person centred medical record
Before leaving NZ, I hypothesised with a few people about the scenario of a person travelling and the great utility of an on-line medical record that they are able to access and update and that has their notes and meds history from back home. I thought it would be a great idea and a great service that could be offered. Now I am certain of it.
Sadly my GP (my medical home !?) does not offer a portal. Those Docs I spoke to who do usually relate this to their own patients and said they would probably take an email/on line consult through a portal for one of their patients who is travelling. What about the Travel Doctors themselves offering this as a value added service. Would be great to get a second opinion and to validate the medications that you have been asked to take. Equally (and probably not ? something that would be considered by the NZ Docs is the virtual prescription that I could have filled here). Anyway, suffice it to say, this is a need that could and (I don't think) is being filled in NZ General Practice or travel doctors.
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