Phuket Experience, July 2003

By Susan; edited by Anne A. Lawrence, M.D., Ph.D.

I've read some of the comments about SRS in Phuket and having just been there July 2003, I would like to tell how it was for me, and maybe add some details that might prove helpful.

First, you should know I had a major complication that, after consulting with a very well known doctor in New York City, I believe had nothing to do with the doctor or hospital in Phuket. It was a rare occurrence that the NYC doctor had seen two or three times in his long career as well.

Now, on to my experiences: I took a non-stop flight from New York City to Tokyo, and from there to Bangkok. One thing anyone should have with them is some readily available money that can be exchanged for Thai bhat right in the airport using an ATM-like machine they have in the International section of the airport. There is also an all-night food place there that you'll appreciate. Youíre going to want to catch your breathe after the flight, and it's a long walk from the international section to the domestic section of the airport. I suggest you go to the domestic area after a snack. There are going to be a lot of people waiting to travel in-country, and when I was there we all gathered in the same area. So you can nap, or have others you can chat with.

When I arrived in Phuket after my flight on Thai Air (great flight), I was met by one of Dr. Sanguan's drivers. He spoke little English, but was extremely friendly. It took a while to get to the hospital, which was fine with me. I thought of it as a mini-sightseeing tour.

When I got to the hospital they were all friendly. Pim is the person you deal with for most things, and she is friendly yet very down to earth. She started processing me almost immediately, and within an hour I was unpacking in my room. The room was large airy, with sliding glass doors to a private porch -- my favorite place to be. It also had a small refrigerator, a private bathroom, and a lounging area, which I didnít get much use of. After the long flight I was exhausted, and I went directly to bed and slept for 6 hours.

I guess the nurses were checking to see when I was going to wake up, because within 15 minutes of my waking they came in, and I met the 'crew'. They started getting me ready for the next day's surgery, and then I went back to sleep. The next day I woke up very early. It was still very dark and there was a light rain. I stood at the balcony and basically thought of all that had led up to this point and that in 5 hours there would be no turning back. And I smiled.

The operating room was clean and well laid out. Everyone there performed their tasks professionally. Beyond that, I was out cold, all I can say is that the operation took 5 to 6 hours. At least it was 6 hours before I woke up in the recovery room. There really wasn't much pain; mostly I felt uncomfortable. They gave me a shot and I went back to sleep. Then they took me back to my room.

For the next couple of days my life consisted of TV, eating, drinking, taking pills and bitching about the catheter. The doctor came to visit me a couple times a day and the nurses always seemed to be coming in asking if I needed anything, or if there was anything they could do for me. On the 3rd day I was allowed to get up. The first thing I did was go out on the balcony and have a cigarette. I know I shouldn't smoke, but I'd gone from 2 packs a day to 2 cigarettes a day. I talked the nurses into buying me a pack of cigarettes, but they put a tag on them and kept them at the nurses station and only allowed me 2 a day. For those not familiar with Thai food, ask Pim. She will tell you what food is what, and will write down what foods she thinks you'll like. I didn't discover that right away, and I regret that I wasn't given that advice.

Dr. Sanguan has you wait a few days until you go back for the vaginal graft. I suggest that, as soon as youíre allowed, you walk around as much as permissible. It will help your circulation, and you'll be bedridden for a few days after the skin graft. And it helps reduce the risk of a blood clot in your legs. The skin graft operation went well. The vacuum device didn't seal well, but they fixed that quickly in the room. After 3 days in bed I was able to get up as long as the vacuum tube and the catheter were still connected. I found I could just make it to the door of the patio and have a cigarette.

When all the bandages were taken off I finally got to see myself, and my first thought was, Oh my God, look at all those scars I'm going to have. I got over that quickly and my first dilation went extremely well. The happiest day was when they took out that damn catheter Ė thatís the one thing everyone complains about. It's the most annoying part of the whole process.

Everything went smoothly until the day of my release. That day I hemorrhaged while taking my last shower there. Actually it was a good time for it; two or three hours later I would have been in a hotel when it happened. When I hemorrhaged I immediately went to the bed and called the nurse. She came in almost immediately, saw the bathroom covered in blood, called out into the hallway to the other nurses, and then came running to me. Within a minute the other nurses were there with a medical cart, working on me. In less than 5 minutes Dr. Sanguan came in, holding his cell phone in his left hand. The nurse put a glove on his right hand and he checked me out. As soon as the nurse took away the bandage he was talking on the cell phone as he inspected me. Within 15 minutes I was back up in the operating room and he was working on me.

He stitched up the area of the hemorrhage and told me there was a good chance he'd have to do a skin graft to repair the damage, but he wanted to wait a couple days to see if the repair worked. It didn't, and 2 days later I had a skin graft. The problem was that instead of the skin thickening (granulating), it thinned out instead; that led to the hemorrhage. When he did the skin graft Dr. Sanguan took this into account, but this time the skin did thicken as it was supposed to the first time. This is the problem I mentioned at the beginning, and it is very rare.

I ended up spending 5 weeks in the hospital. Everyone was great. The only problem I had was a 2 week delay until I could get a flight home. My total time in Phuket was 7 weeks. The plus side to all of this was a 2 week vacation in one of the most beautiful places on the planet. The hospital even helped cover the cost of my hotel stay. The doctor himself was a great help. Since I returned home, he and I have exchange emails at least once a month. He is concerned about my progress after my problem.

As a postscript, I have dilated to where I am functional, all sensations are in order, and those scars have all disappeared. All in all, I am very happy with the results. I may have to go back to Phuket to correct the way the skin graft thickened, but both Dr. Sanguan and my physician in NYC agree I should wait two years and decide then. Even with the problem I had, I would still recommend Phuket: That problem could have happened no matter where I had had surgery done.

- Susan

© 2011 by Anne A. Lawrence, M.D., Ph.D. All rights reserved.