Thailand Medical Tourism and Travel Blog Finalist

My participation in the FAM trip for the Medical Tourism Blog Contest has certainly put a new spin on Thailand for me.  Before I participated in the event I really did not know much about medical tourism to the Kingdom, true I knew that it happened and I also knew that Thailand had some top class medical facilities. But that was about it.

Spending five days in Bangkok as a guest of the Tourism Authority of Thailand(TAT) however has changed all that. My whirlwind, sometimes exhausting schedule exposed me to facilities, treatments and terminology that quite frankly were difficult to take on board as the week flew by.

However it also sparked an interest that quite surprised me.  I have always enjoyed writing about my adopted home, but its always been tourist, expatriate or travel orientated writing along with commentary on the country,its politics and media. Now I find that there are so many issues, related to healthcare and yes medical tourism, that fascinate me just as much as writing about my visit to a fantastic temple or discovering some part of what I like to call my unseen Thailand and reporting it to my readers.

So why am I so surprised? Well I guess its about expectations, or at least my expectations of what the FAM trip and subsequent competition might involve.

I remember doing an Internet search when I found out I was a finalist and finding an article written on a medical forum.  It wasn’t particularly complimentary to me and my fellow finalists, but what really stuck in my mind was a part that said something to the effect that we would not be independent and what we wrote would not be a true reflection of medical tourism in Thailand. The article also added that we(the contestants) were motivated by cash prizes which was also likely to colour our thinking on the things we experienced.

It certainly made me think and given that we were supposed to be promoting medical tourism to Thailand I decided I needed to find a balanced way of presenting what I had experienced while exploring other issues surrounding the subject.

Reporting my week in Bangkok hasn’t proved too difficult, but just reporting facts, figures and my personal experience of treatments is somewhat limiting in reader appeal in my opinion. So where to go? The answer I soon discovered was already there for me since the FAM trip had sparked an interest in medical matters that I really didn’t know existed before I arrived in Bangkok.

Perhaps it was the shock of finding out that I was not as healthy as I thought when I had a medical on first day of the FAM activities, but I was hooked, albeit at that time for very personal reasons. I then started to look at other medical issues that affect me and people in my particular age group. Snoring, high blood pressure, diet and ageing for example, all of which suddenly demanded further research,  my appetite now wetted by what I had experienced.

Writing about medical tourism and personal medical issues has certainly not proved to be the chore I thought it might be when I first embarked on this journey. It has proved to be both interesting and personally rewarding and whatever the results of the competition I know that for me it has been a worthwhile trip. Not only have I found a new interest but as a direct result of the FAM trip I am now a healthier person too.

Of course the competition was not really about the personal satisfaction I have gained from my participation. So I sincerely hope that my written work and promotion of medical tourism goes some small way to repaying the organisers for having the faith in me in the first place to help promote Thailand as a top destination.

Like I said at the beginning of the article for me the FAM trip and the subsequent experience has put a totally new spin on Thailand for me.

I hope that if you have been following this blog then maybe you have another take on Thailand too.

With the availability of both flights and instant access too top class medical facilities in Thailand, you could literally jump on a plane to the Kingdom to get medical treatment.  However short of some sort of emergency this is perhaps not the best approach to facilitating medical tourism in Thailand.

With this in mind here are my top ten medical tourism tips to help make your trip to Thailand successful.

• Make sure you do sufficient medical research. This includes finding out about the procedure, the doctor, the hospital and post operative recovery times. All this information and much more is available on the Internet where you can often schedule face/face contact with the doctor of your choice. Check out and explode myths about medical tourism to Thailand.
• Do research about Thailand, its climate, visa rules and the quality and cost of medical procedures carried out there. Thai hospitals and clinics clearly advertise their prices so you can compare them too.
• Consider working with a specialised medical tourism facilitator who can make all the arrangements for you. Be aware that such a person or company may well be tied in with certain suppliers.
• Be flexible with your travel plans. Prepare to stay longer than expected or indeed return home early. Complications or different recommended procedures could effect your length of stay.
• Prepare comprehensive lists of emergency contacts. This should include folk back home and details of such things as your countries embassy in Thailand. If you have a travelling companion don’t forget to include them in the loop.
• Make sure that  you have relevant medical documents to take with you. This could include things like x-rays. Your doctor in Thailand will also want as much information on your clinical background as possible.
• Make sure you comply with any regulations in Thailand that restrict treatment on your procedure to certain people or conditions. For example in SRS surgery you must supply certain documents to the surgeon in Thailand regarding post operative hormonal treatment.
• Check that your passport and credit cards are in order and not due to expire. Consider taking travellers checks with you as well.
• Inform your own doctor of your plans and consult with him/her before you go and when you return. You might consider scheduling a check up with him when you return home.
• Finally don’t forget the tourism part of your trip, so plan a few treats for before and after your procedure. But consider travel distances and getting around Thailand as well as the type of activity, after all elephant trekking is great fun but maybe not after an operation has left you tender. However a gently walk around the grounds of Siam Niramit and watching the show don’t take too much out of you.

There you have it then my top ten medical tourism tips for Thailand. Hope you find them useful.

Thailand Trivia File: Do you know the different areas of a Thai temple. A Wat’s layout and buildings will vary but each will have a public area , a sacred area and an area where the monks live.

There are lots of different forms of massage in Thailand but I wonder if you have ever tried a  foot massage with a difference. One rather quirky service which is also quite good entertainment too is a visit to a fish foot spa.  There are several around the capital and I even discovered one at Siam Ocean World when I visited the large indoor aquarium during my familiarisation trip that was part of the Thailand Medical Tourism Blog Contest.

Now I say a different type of foot massage since as the name suggests it is delivered by tiny fish rather than a petite Thai massage therapist.

Given that there are even Hammerhead Sharks in the Siam Ocean World Aquarium you might be a little concerned about dangling your toes in the water for a fishy pedicure there. Well you need not worry since the idea of a fish foot spa, which originated in Turkey,  is to let very small fish from a species called Garra rufa which are commonly called Doctor Fish, swim around your feet which are immersed in a tank full of the fishy therapists.

The results of this fishy massage are super smooth feet and toes after the vicarious little blighter’s have stripped away all the accumulated dead skin. Now while there are some that claim that the process is not particularly hygienic there are others that claim it is very helpful for the sufferers of skin disorders like eczema and psoriasis. I guess the juries still out on that one although I have read that such treatments are banned in the USA but practised in the UK.

Besides Siam Ocean World you can also find fish foot spas in Bangkok at Suan Lum Night Bazaar, Chatuchak weekend market and the popular backpackers area around Khao San Road.

Now I haven’t actually tried a fish foot spa but I have had a similar experience when I was trekking in the Erawan National Park near Kanchanaburi. The park has several waterfalls with large pools which are full of wild fish. If you wade into any of the pools  barefoot you will find that you get a free foot massage thanks to the resident fish who seem to have the same ideas as their captive cousins.

By the way if you try the free version at Erawan be prepared for the fact that the fish there don’t just confine themselves to your feet!

PS. I mentioned entertainment when I started this article. Well in some of the fish foot spas mentioned you might actually be the source of the entertainment since many are glass fronted and passers by can watch you squirm

Thailand Trivia File: Visiting a Thai Wat or temple can be extremely rewarding but make sure you follow these simple rules of etiquette.

Three of the ten most popular plastic surgery procedures in Thailand involve female breast enhancement in some form or other. The most popular procedure is breast augmentation but patients also seek breast reduction and breast reshaping/reconstruction too.

Breast enhancement is certainly not a product of the 21st Century although now procedures are simpler and safer than what they were when doctors first experimented at the end of the nineteenth century. Pills, potions and creams claiming to enhance the female breast have been around just as long and you will still find many available in this day and age, offering “natural breast enhancement” without the need for surgery.

However while there may well be a market for these products nowadays surgical breast enhancement is by far the most popular choice of women seeking to change the shape and appearance of their breasts.

Breast Augmentation

Breast augmentation or breast enlargement as I said above is by far the most sought after treatment in Thailand with most patients seeking it for cosmetic reasons as well as after Sex Reassignment Surgery(SRS) in the country. Breast augmentation involves the use of implants that are inserted into various positions in the breast depending on the procedure chosen but are commonly located between the breast tissue and muscle layer.

The implants that are inserted into the breast contain either a saline solution or silicon gel compound contained in an outer skin. The saline breast implants are inserted into the chest empty and filled after insertion while the silicon implants are inserted already filled. It therefore follows that scars are smaller with saline implants. However results may not be as cosmetically pleasing as with the use of silicon.

As with all surgical procedures there may be side effects from the insertion of breast implants. Those most commonly experienced include breast pain, asymmetry of the breasts, loss of nipple sensation and visible wrinkling particularly with saline inserts.  The ability to breast feed may also be affected.

A  concern within the medical establishment and patients is rupturing of the breast implants. This has led to much debate and opinions being expressed on the subject. One thing is however clear and that is that breast implants do not last forever and may at some point need removal and replacement. It is however less clear exactly what effect either saline or silicon gel leaking into the surrounding body tissue will have on a person with a ruptured breast implant.

Common sense would suggest that anyone considering undergoing breast enhancement should consult with their doctor and weigh up any associated or potential risks against their desire to undergo breast augmentation and the reasons they are seeking this option.

The breast enhancement procedures mentioned in this article were all available at some of the international class hospitals and clinics that I visited in Bangkok on my familiarisation trip that was part of the Thailand Medical Tourism blog contest. You can find out more details of what is on offer by following these links. Yanhee Hospital, Bangkok Hospital,Vejthani Hospital, Bangkok Laser Surgery and Dr Sarans Clinic.

Thailand Trivia File: Did you know that the real name for Wat Pho in Bangkok is Wat Phra Chettuphon Wimon Mangkhlaram Ratchaworamahawihan(วัดพระเชตุพนวิมลมังคลารามราชวรมหาวิหาร) this famous temple is located near the Grand Palace.

Non invasive skin rejuvenation using skin tightening treatments seem to be very popular at the moment. During my familiarisation trip that was part of the Thailand medical tourism blog contest I came across several such procedures which included, Thermage, Titan, Fraxel Lasers and injectable dermal fillers that were available at hospitals and clinics around Bangkok.

So I wonder what makes these treatments popular and just what practioners are trying to achieve when they employ the likes of Thermage, Titan and Fraxial Lasers since these procedures involve the use of different types of equipment and applications to achieve the desired results.

To answer these questions I suppose it is really necessary to understand a little about what happens to our skin as we age and what happens when the treatments are applied.

In simple terms our skin looses it elasticity and bulk as we get older since the production of structural proteins like collagen and elastin diminish. The results being plain for everyone to see i.e. saggy skin on our faces, abdomens and under arms to name but a few places.

While from the treatment perspective it appears that all of these procedures have one thing in common and that is that they “wound” the skin in some way in the hope of stimulating natural collagen production.

For example Thermage applies heat to small areas of the skin using radio frequency’s to heat up the dermis and skin tissues, the heat  triggers collagen production and therefore fills out or tightens the skin after one or two treatments. Titan, which is often referred to as a non surgical facelift, uses infra-red technology to penetrate the layers of the skin and stimulate collagen production. While the Fraxel Laser is used to vaporise small areas of skin and stimulate collagen reproduction as the skin repairs itself.

The use of injectable dermal  fillers is another non-surgical option for skin tightening. It involves injecting collagen or other substances directly into the skin to achieve results.It can be used to fill out the cheeks, reduce wrinkles and improve areas of sagging skin. Fillers tend to be longer lasting than the other procedures mentioned above.

It seems to me that there is a divided opinion on who benefits the most from skin rejuvenation using non surgical skin tightening treatments.  The general consensus of opinion seems to favour patients who are under 60 years of age and have a mild to moderate looseness of the skin.  It also seems a commonly expressed opinion that non invasive skin tightening treatments cannot replace surgical procedures such as a full facelift when it comes to the quality of the end result in terms of rejuvenation.

Further information about the practitioners I visited in Bangkok who offer skin rejuvenation using the skin tightening treatments mentioned above can be found at, Bangkok Laser Surgery, Dr Orawan Holistic Clinic and the Romrawin Clinic.

Thailand Trivia File: Did you know that banana leaves are used as a biodegradable environmentally food packaging in Thailand?

Thai markets provide one solution to eating healthy in Thailand. The vast array of fresh produce available locally affords even the most amateur cook the opportunity to experiment with their favourite Thai recipes tailoring them to their own taste and cutting down on the harmful additives that raise questions about how healthy Thai food really is when purchased pre-cooked.

Apart from the nutritious advantages of doing it yourself with fresh produce, a visit to a local Thai food market provides a rare insight into parts of Thai culture that many foreigners do not experience.

As a Westerner you might be surprised to know that Thai markets are an important part of the local culture. They are social gathering points that provide a lot more than just the ingredients that are the cornerstone of Thai cuisine.  Although of course you will also find all manner of spices, aromatic herbs, vegetables, fruit, meat or fish  in the market  too. Each village in Thailand usually has its own market, where stall holders rent a pitch and sell their wares, these are not permanent markets and perhaps only operate on one or two days a week. However all big towns and some larger villages have permanent markets as well.

So just what can you expect to experience in a Thai market? Lots of noise, colourful stalls, cheerful smiling vendors and yes some sights and smells that are certainly not for the faint hearted and might be enough to turn a Western stomach. Most refrigeration is done with crushed ice and you will often see meat and fish surrounded by a host of flies particularly when the weather is really hot. You may well also see the occasional rat or snake that has escaped the attention of the fat cats that patrol this rich hunting ground.

You can buy just about anything in a Thai market ranging from small plastic bags of freshly made green and red curry paste to fresh chickens that are plentiful and cheap but come complete with the head and feet, in fact chicken feet are considered a delicacy. Other fresh produce includes prawns, these are produced locally in large ponds and they come in a variety of sizes which by Western standards for this product range from large to huge.

Fruit comes in all shapes, sizes and tastes in Thailand, availability varies but most weeks you can get fresh from the field pineapples, bananas, guava, oranges grapes, dragon fruit and papaya. Seasonal fruits include ranbatan and mango’s. While vegetables include potatoes, greens and carrots which sit alongside more exotic and less familiar products that almost beg you to purchase them and experiment with new tastes. The range of fresh herbs is also large and while some are familiar others are not and the help of a Thai friend to explain their purpose is always welcome.

Personally it took me a while to overcome my qualms about market shopping having been used of the antiseptic sterile environment of the big supermarkets back in the UK. Now?  I wouldn’t miss my weekly shopping trips there and you know what I have never had a stomach upset as a result of things that have been purchased in the market.

Now that I speak a little Thai I also enjoy the banter of the place where the normally reserved Thais let their hair down a little. Just like anywhere in the world market traders in Thailand are always cheery and enjoy a joke, once they get to know you as a regular customer they always give you a bit extra or reduce the bill by a few Baht too!

So next time you are in Thailand can I recommend that you check out  some real Thai markets even if you only want to take a few photographs and saviour the atmosphere.  Although given the huge array of fresh produce I am sure you might well be tempted to make some purchases and try you hand at producing some healthy Thai dishes of your own.

I don’t know about you but I love Thai food whether its from a street vendor, a shop house restaurant, food court or standalone restaurant the resulting meal is usually very satisfying and cheap. However I wonder where does Thai food fit in with the concept of healthy eating, indeed is Thai food healthy?

On the face of it Thai food should be healthy and nutritional given the local preference for using fresh ingredients as opposed to preserved stuff, with plenty of fruit, vegetables and herbs combined with small amounts of meat and plenty of fish. Deaths in Thailand from heart disease and cancers(excluding liver cancer) are lower than other Asian countries although people succumbing to diabetes is higher than average for the region. Perhaps these somewhat isolated health facts are in some way indicative of the Thai diet.

Generally speaking nutritionists tend to promote much of what you find in the Thai diet as a way to healthy eating, however in most cases they would also discourage the over use of salt, sugar and mono-sodium glutamate(MSG) when preparing food. Unfortunately in Thai cooking the use of these three additives is very common and might explain why many Thais have a very sweet tooth. Indeed many Thai dishes are high in calories and don’t be mislead by the normal Thai stereotype of a petite pencil thin person, yes they exist, but so do a lot of obese people too.

While it might be argued that salt and sugar are essential in a hot climate to help balance the bodies electrolytes the liberal use of MSG is more difficult to justify since it is purely used as a flavour enhancer although is perhaps understandable particularly with street food where cheap cuts of meat and overcooked vegetables are often in need of  a boost from a taste perspective.

The over use of coconut and palm oil is also common and while both these oils do have good nutritional values they can be high in saturated fats depending on the quality and refinement of the product. Unfortunately many tasty Thai dishes are fried, so even if the oil used is fresh and this is very rare in food cooked by street vendors, the calorie count is certainly not going to be low.

Earlier I mentioned cancer rates in Thailand being low this is true except in the case of liver cancer.  While the main cause of liver cancer in the country may well be directly attributed to Hepatitis B and C infections  it can also be linked to food as in the case of Aflatoxin B1 and liver fluke infestation.

In the former a cancer-promoting chemical is produced by the  mould Aspergillus Flavus, which can be found in food stored in a hot and humid environment. Foods such as peanuts, rice and soy beans are all susceptible and of course used in Thai food preparation. While liver fluke infestation which is more prevalent in North Eastern Thailand, comes about by eating raw(or under cooked) fish that are commonly infected with the fluke in that area.

Clearly where you purchase your food and how it is prepared are important too. A general rule of thumb in Thailand is too check out potential eating spots around lunch time, empty tables are often indicative of poor quality food because Thai people love eating and snacking but appreciate quality. So if a restaurant, street stall or shop house is empty you might well be better off avoiding it too.

So is Thai food healthy? I would say that to my mind Thai food remains a great choice for a tasty and nutritious meal. However it may not be the most healthy choice if you are concerned about saturated fat and the overuse of sugar, salt and MSG in your dishes or if you are watching your weight and counting calories.

Thailand Trivia File: The largest park in Bangkok is called Suan Luang, its a great place to exercise or enjoy the beautiful manicured gardens.

Thailand is a top destination for plastic surgery. But I wonder what are the ten most popular plastic surgery procedures  in Thailand. Since there are no directly available statistics to help answer this question we perhaps need to look elsewhere to try and establish an answer for Thailand.

Different authorities who provide statistical information on plastic surgery procedures worldwide tend to agree that the following are universally the top treatments that people seek. This list is in no particular order and was obtained by combining different sources of information.

• Breast Augmentation
• Liposuction
• Breast reduction
• Anti wrinkle eye treatments
• Tummy tucks
• Rhinoplasty
• Face lift
• Forehead lift
• Male breast reduction
• Breast lift

Looking at the list the only thing that really surprises me based on my experiences visiting medical facilities in Thailand,  is male breast reduction, certainly not something I would have put on a list if I had been asked to compile one.

Similarly if you check-out the web sites of popular medical tourism destinations in Thailand you will also find that generally speaking all the above procedures feature heavily. So based on this information I think it would be fair to say that the ten most popular plastic surgery procedures in Thailand pretty much follow the world trend, with the possible exception of male breast reduction.

However do a little research into some of the top Bangkok hospitals and clinics  used by medical tourists and you will find that treatment for Gynaecomastia(male breast enlargement) is offered by many  in the form of microcannular liposuction. Some, like the Yanhee Hospital,  also offer surgical procedures for men that are more commonly associated with women including nipple reduction and areola reshaping.

So perhaps after all Thailand does in fact follow the worldwide trend in popular plastic surgery procedures.

Thailand Trivia File: Did you know that the Baht is the name of the currency of Thailand and also the name of a unit of weight for Thai gold.

FFS or facial feminisation surgery is the term used to describe a range of surgical procedures that are used to help transform the human face from being overtly masculine to more feminine. In the majority of cases FFS procedures are sought by people who are undergoing the transition from male to female(MTF).  These procedures may well be carried out after the patient has been subjected to sex reassignment surgery(SRS) to help complete the feminisation process.

The differences in the make-up of male and female facial features can be quite striking and distinctive. Just look in the mirror alongside someone of the opposite sex and it becomes fairly obvious. Generally speaking females have smaller chins and less prominent noses while they also do no have a large prominent Adams apple like men. Their foreheads and skull shape is also different around the area of the brows.

Given the obvious differences between the genders facial features it therefore follows that facial feminisation surgery tends to be concentrated on procedures involving the eyelids, cheeks, chin, forehead, nose and Adams apple particularly for SRS or transgender patients. When I visited Dr Saran, a top Bangkok based plastic surgeon, who specialises in SRS procedures,  I found this to be the case. Dr Saran’s Clinic offers a full range procedures to alter all these facial features including botox injections that can be used to enhance the shape of the lips. He further confirmed that FFS is very popular with his SRS patients.

So why is FFS so popular with SRS patients?  If you think about it for a moment and then ask your self what you do when you meet someone new you can probably answer this question because chances are you will say well I always look at their face first.  Not surprising really since this is part of the normal human process in these circumstances and yes it involves looking directly at the face of the person during which time we  formulate certain opinions, one of which is the sex of the individual.

It would therefore seem to follow that since sexual identity is important to all human beings, then those who are subject of SRS procedures or are transgender would be attracted to facial feminisation surgery since it helps them establish their new sexual identity.

You can find out more details of FFS facial feminisation surgery by contacting Dr Saran’s Clinic in Bangkok.

Thailand Trivia File: Thailand is one of the few countries in the world that recognise a third gender. Kathoeys or Katoeys who are sometimes referred to as ladyboy’s are widely accepted in Thai society although currently this is not recognised in law.

Rhinoplasty or more colloquially a “nose job,” or “nose reshaping” is a very common plastic surgery procedure in Thailand. Bangkok for example has a huge range of private hospitals and clinics that offer this service.

Rhinoplasty can be performed using one of two techniques, open and closed, where a general anaesthetic, local or other forms of sedation are employed. Generally speaking the cartilage and bone in the nose  are reshaped either naturally or by the use of inserts to help in the reshaping. If there is insufficient material in the nose this can also be enhanced using grafts from the septum or even the ear.

So what I wonder drives people to seek a nose job? Well the most obvious answer here would seem to be for functional or re-constructive purposes after an accident or to correct a birth defect for example.

However it also seems common to have rhinoplasty for purely cosmetic reasons.  Ethnic groups clearly have different facial make-ups and this is often very evident in the shape of the nose. For example in Thailand it is common to hear Thais say their nose lacks shape and they would like it more defined like in some Caucasian groups who they often secretly refer to as the “big noses.”  While at the opposite end of the spectrum people with a “Roman” shaped nose often seek to have the bridge reduced.

Rhinoplasty is generally considered to be a very safe surgical procedure however, as with any surgery complications can occur,  the worst of which is probably an accidental perforation of the septum which can cause nose bleeds and noisy breathing. While removal of too much of the bone/cartilage in the nose can result in a nose shaped like a parrots beak.

As with all plastic surgery, setting realistic expectations and goals about what can be achieved through rhinoplasty is important, definitely something to discuss with your medical practitioner before embarking on the procedure.

Full recovery usually takes place within seven days and inpatient treatment is not common.

While I was in Bangkok  on the familiarisation trip that was part of the Thailand Medical Tourism Blog Contest I visited several hospitals and clinics that provide rhinoplasty surgery facilities.  You can check out the details here:

The Bangkok Hospital.

The Yanhee Hospital.

Dr Sarans Clinic

Vejthani Hospital

Samitivej Srinakarin Hospital

Thailand Trivia File: Living in Thailand is great. Here are my top ten tips for living in Thailand.