Chao Phraya Abhaibhubhejhr Hospital

A part of our two-week Neuro course is a day trip to Prachinburi province to visit Chao Phraya Abhaibhubhejr Hospital (pronounced as /dzao-pya-ah-bai-bu-beh/). It is a tertiary hospital located on the eastern side of Thailand, 2 hours away via van. CPAH is on the forefront of promoting Thai traditional medicine. Patients are treated and cured with the use of Thai traditional techniques and herbs alongside modern medicine. In fact, they have a pharma lab within the institution that formulates and does scientific research on different locally known herbal medications.  They also have a museum beside the main hospital building housing intriguing medicinal displays.  

    

With Dr. Makorn Limudomporn (in dark blue polo and tie), a PNI alumnus who is now practicing at CPAH. He toured us around the hospital including the ER and Acute Stroke Unit. He also showed us the efficiency of Tele-Stroke and how it speeds up stroke management and patient recovery. 

In front of the Thai Traditional Medicine Museum

This Renaissance-style building was built as a residence for King Rama V, no wonder why most of the furniture and antiques inside are related to him. Inside is an old-style pharmacy with shelves containing different potions, herbs, and medicinal insects and reptiles. Yes, reptiles! 

 

 

Just like in PNI, Thai traditional massage and acupuncture is also incorporated in the rehabilitation program of stroke patients. They have shown us their vast massage room as well as the oils and herbal medications used. There were particular leaves and oil they apply on the skin to loosen muscles which I observe my grandmother used when a cousin accidentally sprained an ankle. More or less those leaves and the pharmacological mechanism are the same.

CPAH is the main referral center of  the secondary hospitals in the surrounding provinces. They only refer neurosurgical patients to Bangkok which happens seldom since the most ischemic stroke patients are immediately brought to the hospital and are given rT-PA with the help of the Stroke FAST Track and the Tele-Stroke program. FAST Track is an efficient process in assessing and managing stroke starting with the Emergency Medical Services (EMS) which coordinates between patient and the right hospital. EMS must have a goal of shortening the time of transporting a patient to the hospital. FAST is an acronym for Face (face fallen on one side?), Arm (can they raise both arms?), Speech (slurred speech?) and Time (call emergency hotline if any of these signs are present). An ER personnel must detect signs and symptoms of ischemic stroke for fast administration of thrombolytic therapy (rT-PA, which has a window period of <4.5 hours only).  

Dr. Makorn showing us how to use the Tele-Stroke machine and its advantage over using Facetime or other video-calling apps. 

Tele-Stroke is a technology that uses electronic communication methods such as telephone, internet and videoconferencing to provide exchange of medical information. This aims to improve patient care among stroke patients. Dr. Makorn even emphasized how Tele-Stroke is efficient and effective as he can see patients and start medical therapy while he is still at home. This is very easy to install and to adapt in our provinces in the Philippines for as long as the electricity ceases to fluctuate and the speed of our internet improves. 

Tele-stroke machine at the Stroke ER. Do you see me? Haha!

After the tour, a sumptuous lunch was waiting for us at the dining area of Abhaibhubhejr Day Spa. They have a private spa inside the hospital premises! How awesome! The dining area was enclosed in a glass room with a beautiful garden view. 

With Wai Phyo (on my right), a fellow Muslim physician from Yangon, Myanmar, sharing the table with us.

 

Our last stop was the herbal pharmacy shop inside the hospital where we were given 30% discount! Wahahaha! I bought some herbal turmeric face and body scrub, rose extract soap, and lotion. I thought about my Mom who, most of the time, prefers using traditional Meranao herbs in treating illnesses until now. I remember the bitter taste of papaya leaves extract she used to make us drink whenever we're down with a fever. Also, remember the gunda leaves extract she made me drink when I was in labor? Haha! I swear that precipitated my labor! Had she been a doctor, she'd definitely advocate the use of scientifically tested (or in her case, circumstantially tested and proven) herbal medications together with modern medicine. Nevertheless, she is a very compliant patient.

This field trip made me all the more admire the Thais. Western knowledge came to them but they didn't threw away nor resent their traditional ways and culture. Instead, they made scientific research about what they already have and use it alongside modern and new techniques. Indeed, they are the unconquered people.