Neurology in Phuket

Neurology is a branch of medicine that focuses on the diagnosis and the treatment of diseases of the nervous system. The nervous system is a complex and sophisticated system that regulates and coordinates our body activities. It is divided into two major parts:

• The central nervous system: the brain and spinal cord
• The peripheral nervous system: all nerves branching out from the brain and spinal cord, and extend to other parts of the body, including organs and muscles.

Since the nervous system is complex, there are numerous subspecialties within the field of neurology, including:

• Neurodevelopmental disabilities
• Pediatric or child neurology
• Neuromuscular medicine
• Pain medicine
• Hospice and palliative care neurology
• Headache medicine
• Vascular Neurology (stroke care)
• Sleep medicine
• Autonomic disorders
• Brain injury medicine
• Neuropsychiatry
• Epilepsy
• Neurointensive care

A doctor who specializes in treating diseases of the nervous system is called a neurologist. Symptoms that often require a neurologist help may include coordination problems, muscle weakness, confusion, dizziness, and a change in sensation. People who are having problems with their senses, such as vision, touch, or smell, may also require to see a neurologist since problems with senses are sometimes caused by disorders of the nervous system.

A neurologist may also treat patients with:

• Stroke
• Seizure disorders, such as epilepsy
• Migraines and headaches
• Brain aneurysms
• Brain tumors
• Peripheral neuropathy
• Multiple sclerosis
• Infections of the nervous systems, such as meningitis, encephalitis, or brain abscesses
• Neuromuscular disorders, such as myasthenia gravis
• Neurodegenerative disorders, such as Alzheimer’s disease and Lou Gehrig’s disease
• Sleep disorders
• Spinal cord disorders, such as autoimmune and inflammatory disorders
• Speech and language disorders

Keep in mind that neurologist does not perform surgery. If you need surgery, you will be referred to a neurosurgeon.

What does Neurology Involve?

A wide variety of different tests and procedures are used to diagnose and treat neurological conditions. On your first appointment with a neurologist, a physical and neurological exam is likely to be performed. A neurological exam is done to test muscle strength, coordination, and reflexes.

Because different diseases can have similar symptoms, more than one testing may be required for your neurologist to make a diagnosis.

Some of the procedures that fall into the field of neurology may include:

Electromyography

Electromyography (EMG) is used to measure how well your muscles react to electrical stimulation from motor neurons, which are specific nerves controlling muscle movement. It can help neurologists diagnose general muscle or nerve dysfunction, as well as spinal cord disease.

During an EMG, small needles called electrodes are inserted into the muscle by a specially trained technician. The electrodes can measure the different electrical activity occurring in muscle tissue during periods of movement and rest.

Electroencephalogram

Electroencephalogram (EEG) is performed to assess and record electrical activity in your brain. Neurons in our brain communicate with other neurons through electrical impulses, which an EEG can record. Brain wave patterns can also be tracked by an EEG. It is used to help diagnose conditions of the brain, including tumors, inflammation, injuries, as well as psychiatric disorders, epilepsy, and seizures.

During an EEG, electrodes are placed on your head. The electrodes are connected to a computer, which converts electrical signals into patterns that can be seen from a screen or printed on a piece of paper.

Lumbar puncture

Lumbar puncture is done to test your spinal fluid. It involves inserting a needle into your spine after numbing it with an anesthetic. Using the needle, a sample of your spinal fluid is taken.

A lumbar puncture can help diagnose the following conditions:

• Meningitis
• Encephalitis
• Leukemia
• Myelitis
• Dementia
• Autoimmune diseases, such as multiple sclerosis (MS)
• Bleeding in the brain

The procedure can also be used to treat conditions affecting the spinal cord. Your neurologist may inject anesthetics, cancer treatments, or antibiotics using a lumbar puncture needle.

Tensilon test

To help diagnose myasthenia gravis, your neurologist may perform a tensilon test. It involves the injection of a medicine called Tensilon. Then, your neurologist observes how medicine affects your muscle movements.

Sleep study

Chronic sleep problems are diagnosed in a Sleep Study. Also known as a Polysomnogram (PSG), this procedure involves monitoring patients during sleep and physiological data is recorded electronically.

Other tests

Other types of tests may be used by your neurologist to make a diagnosis. These may include:

• Magnetic resonance imaging (MRI scan)
• Computed tomography (CT scan)
• Positron emission tomography (PET scan)
• Biopsy
• Genetic testing
• Angiography

Botox injections

Botox injections can be done to treat some neurological conditions, such as cerebral palsy, that can cause your limbs to pull in toward your center. Sometimes, these contracted muscles can be relaxed with Botox injections.

Botox injections involve injecting tiny amounts of botulinum toxin into your skin of muscles using a thin needle.

Brain tumor treatment

A range of treatments can be done to treat a brain tumor. If your neurologist believes that you need surgery, you will be referred to a neurosurgeon who will remove as much of the brain tumor as possible through surgery.

A brain tumor may also be treated with radiation therapy, which uses high-energy beams to kill tumor cells.

Brain tumor treatment may be integrated between the departments of neurology and oncology.

Brain rehabilitation therapy

Brain rehabilitation therapy is used to help you relearn functions that are lost as a result of a brain injury. Brain rehabilitation therapy is usually integrated between specialty teams in the departments of neurology, sports medicine, psychiatry and psychology, neuroradiology, and the vestibular/balance laboratory.

Deep brain stimulation

During deep brain stimulation, electrodes are implanted within certain areas of the brain. The electrodes generate electrical impulses that can regulate abnormal impulses. These electrical impulses may also affect certain chemicals and cells within the brain.

Deep brain stimulation can be done to treat numerous conditions, including dystonia, essential tremor, epilepsy, and Parkinson’s disease. It is also being studied as a potential treatment for multiple sclerosis and stroke recovery.

Spinal stenosis treatment

Spinal stenosis is a condition that occurs when the spinal canal narrows and pinches the nerves, leading to back and leg pain. Spinal stenosis may be treated with pain medications, physical therapy, steroid injections, decompression procedure, or surgery. Surgery is usually performed if other treatments have not helped.

How Long Should I Stay in Phuket?

Your length of stay depends on the type of procedure you have, you may be allowed to leave the hospital on the same day or you will stay for several days. For diagnostic procedures, you should be allowed to leave the hospital on the same day. However, you should wait until the results of the test are ready before you can fly home, which may take as long as 7 days, sometimes even longer. If you undergo brain tumor treatments or other types of treatment, especially treatments that involve surgical intervention, you should aim to stay in Phuket at least for 10 days.

What's the Recovery Time?

The recovery time can be different for each procedure. It may also depend on the reason why you are having the procedure and your overall health. Your neurologist and neurosurgeon will give you a recovery timeline for each procedure. The recovery period for diagnostic procedures is typically short and you may be able to resume your normal activities within a week or so. For surgical procedures, you may need to wait 4 weeks or months until you can go back to your daily routine, including work and exercise.

What About Aftercare?

A detailed aftercare instruction will be given to you following your procedure. While the instructions will be different for each procedure, they typically include a diet plan, exercise, restrictions, and wound care (if any surgical intervention is involved). You should follow these instructions carefully in order to have a speedy and smooth recovery.

You may also need to attend follow-up checkups to monitor your overall condition and healing. For brain tumors, you may need to attend regular checkups to ensure the tumor has not come back.

What's the Success Rate?

The field of neurology is constantly advancing. The success rate of each procedure is typically high, particularly when performed by highly skilled and experienced medical professionals. Still, some procedures may carry some risks, such as bleeding, infection, and nerve injury.

Are there Alternatives to Neurology?

Since neurology is the branch of medicine to diagnose and treat problems of the nervous system, there are no other alternatives. However, if your doctor found that your disease or illness is found to be caused by other problems unrelated to the nervous system, your doctor will recommend you to see the relevant doctor.

Neurology in and around Phuket

About Phuket

Phuket, Thailand’s largest island nestles in the Andaman Sea. The island is an incredible blend of beautiful beaches, lush green hills, mangroves and rainforests. The tin mining industry has been the major contributor to its economy since the 16th century. However, In recent years, the tourism industry and rubber production have developed as major industries which contribute to the economy.

But beyond its breathtaking beaches and sceneries, Phuket also boasts an exceptional infrastructure, including advanced property development and luxurious hotels and shopping malls, catering to the needs of every visitor. It offers a plethora of recreational and entertainment options to everyone willing to enjoy its beauty and ambience.

Phuket has quickly become a preferred destination for medical tourists worldwide due to the unparalleled quality and affordability of its healthcare services. Whether it's critical life-saving procedures or elective cosmetic surgeries, the medical care provided in this city is commendable. A significant factor in Phuket's appeal is the comparative cost efficiency - the expense of dental and cosmetic treatments, in conjunction with the costs of travel and accommodation, is significantly lower than similar expenditures in numerous other countries.

Furthermore, the exceptional aftercare services in Phuket are a key component of the fully-rounded healthcare experience. Patients receive top-notch care and attention during their recovery process, enabling quicker recuperation and return to health. In this wellness-centered environment, patients are both physically replenished and mentally rejuvenated in the tranquil, picturesque settings of Phuket.

The medical tourism sector in Phuket is also buoyed by the introduction of attractive and competitive all-inclusive packages offered by numerous medical tourism agencies. These packages ingeniously integrate health and holiday elements, affording medical tourists the chance to recover and relax simultaneously. Tourists are thus afforded the opportunity to enjoy Phuket’s awe-inspiring landscapes and leisure offerings even as they benefit from top-tier medical treatments.

Maintaining its high standards in healthcare, Phuket houses two of the region's top-ranking private hospitals - the Phuket International Hospital and the Bangkok Hospital Phuket. These institutions are renowned for their state-of-the-art medical facilities and services, and their proficient English-speaking doctors. Highly recommended for a range of procedures including Cosmetic Surgery, Lasik Laser Surgery, and dental treatments, they guarantee an excellent standard of care and professionalism.

Popular Areas in Phuket

For a truly immersive Thai experience, one can opt for a walking tour through the heart of Phuket town. On your journey, you will be charmed by the robust impression of the Sino-Portuguese houses, shophouses, and opulent mansions. This architectural splendour is a vivid testament to the Chinese and Portuguese influence that has shaped the island's identity since the 16th century.

In the next phase of the tour, you will traverse the meandering streets, where each corner beckons with a tale of its own. As you further explore the town, you'll see local shops selling traditional Thai goods, bustling markets brimming with fresh local produce, and small family-run restaurants serving authentic, scrumptious Thai cuisine. Each stop underscores the rich, cultural tapestry of Phuket and its unique blend of Thai, Chinese, and Portuguese cultures - a melting pot that has been simmering since the 16th century. It's more than just a tour; it's a delightful plunge into the vibrant history and palpable heritage of Phuket.

For a complete holiday feel, you can visit the numerous small islands around Phuket and visit Phang Nga Bay as it is a mesmerizing site with limestone cliffs jutting out of the turquoise blue waters. You can also try sea canoeing, as many grottoes are accessible only by canoes. Phang Nga Bay is home to the now-famous James Bond Island with its iconic large leaning rock. Patong Beach is the most popular beach resort on the island and is always full of people as the town is bustling with activity and hosts many bars, discos and restaurants serving International cuisine.

Imbued with a profound Buddhist legacy, the island of Phuket is dotted with an abundance of quaint Buddhist temples, each boasting its distinct charm. Standing proudly amongst them all is the illustrious "Big Buddha." This awe-inspiring marble statue graces the peak of a hill and captures the onlooker's attention with its towering stature of 150 feet in height and 85 feet in width, poignantly portraying Gautama Buddha in a serene sitting position.

As you draw closer, the Big Buddha’s elevated location offers panoramic views of Phuket that are genuinely unrivalled – a mélange of the blue-green sea, unbroken stretches of sandy beaches, and the verdant green of the island’s lush hilltops. It’s not just the scale of the statue that captivates visitors, but the soul-soothing tranquillity that pervades the area. Every detail, from the rhythmic chants that resonate through the air to the soft whispers of the winds, adds a spiritual depth to the site. Whether you're a follower of Buddhism or simply a traveller curious to explore, the towering Big Buddha invites you to contemplate the interconnectedness of life and nature, honouring the philosophical principles of Buddhism.

You will not be short of things to do as Phuket has many more islands, museums, the Khao Phra National Park and the Tiger Kingdom to visit.

Weather and Climate in Phuket

Phuket experiences a predominantly tropical climate wherein it's usually hot and humid for most parts of the year. The temperature consistently hovers at a high average of approximately 86 degrees Fahrenheit, making it an ideal destination for sun-seekers.

However, there is a welcome respite during the dry season, which spans from December to March. During this period, temperatures and humidity levels take a slight dip, becoming more agreeable and comfortable, making it the most popular time for tourists. Occasional brief showers may occur, but they do little to interrupt the enjoyment of the tropical paradise. Meanwhile, the southwest monsoon introduces the rainy season from May through to October. At this time, the island is subject to an average rainfall of around 87 inches, with the heaviest deluge typically occurring in May and the September-October timeframe.

Despite the precipitation, this period also offers its unique charm to visitors. The rains bring about a different kind of beauty to the island, with lush greenery awash with life and spectacular waterfalls seen in their full glory. Indeed, the rainy season can be an ideal time for those seeking fewer crowds, more solitude, and the chance to experience a more lyrical and poetic side of Phuket's tropical charm.

Getting Around in Phuket

Phuket International Airport is located north of the island and there are many frequent flights to and from Bangkok and other regional airports like Singapore and Kuala Lumpur. Seasonal flights operate from major cities in Europe and Australia, during peak tourist season.

Phuket International Airport has services from major International airlines such as Singapore Airlines, Cathay Pacific, Emirates, Qantas, Etihad, Air China, and Edelweiss Air.

For domestic travel, Nok Air, Thai Air Asia, Orient Thai, and Thai Lion Air operate flights from the domestic terminal of the airport.

Once you land in Phuket, there are many transport options available to you and you can take the Municipal air-con airport bus to Phuket Town bus terminal 1 for 100 Bahts. There’s also the airport shuttle to Patong Beach for 120 Bahts. Phuket smart bus is another service that operates to various islands at a fixed rate of 170 Bahts. The other option is the Minibus services, which operate every time a flight arrives. They charge between 100-200 Bahts.

You can also hire metered taxis from outside the airport. The average fare starts from 400 Bahts with an extra surcharge of 100 Bahts. You can also reach Phuket from Bangkok by private car. The Sarasin Bridge connects Phuket Island to the mainland.

To move around the island, you will need some mode of transport. Public and private bus services are available from the two bus terminals in Phuket. Long distance buses operate from the new terminal but these only connect Phuket Town to the beach towns.

In Phuket, reliable means of navigation around the beautiful island consist of tuk-tuks and taxis. Of these, the minivan-like tuk-tuks or Songtaews, distinguishable by their distinct red colour, are immensely popular. However, as these vehicles do not have meters, agreeing on the fare before beginning the journey is advisable.

On the other hand, metered taxis often turn out to be a less expensive choice compared to tuk-tuks. Despite this, during peak traffic hours, drivers often switch to flat rates. For reliable and reasonable fares, opt for taxi services associated with your hotel. Other alternatives to exploring the island include rental bikes, motorbike taxis, and traditional longtail boats, each offering a unique perspective of the stunning landscape.

Tourist Visas in Phuket

International tourists travelling to Phuket and other parts of Thailand must have a passport which is valid for at least six months over and above their period of stay.

On the other hand, Effective September 25, 2023, Thailand has granted a temporary tourist visa exemption to passport holders of the People's Republic of China and the Republic of Kazakhstan. This visa exemption is valid until February 29, 2024. Also, Thailand has announced that it will be launching a new visa program for long-term visitors starting from October 1, 2023. The new visa program will allow visitors to stay in Thailand for up to 10 years.

Thailand provides tourist visa exemption to the nationals of 48 countries, which include Australia, the USA, Japan, and New Zealand. Under the exemption policy, they can stay in the country for not more than 30 days during each visit. However, passport holders of 28 countries which include India and Russia need to get a visa on arrival. You can get a tourist visa on arrival at the immigration checkpoints for a period not exceeding 15 days.

If you are required to apply for a Thailand visa, you can do so at a Thai embassy or consulate in your home country. You can also apply for a visa online through the Thai eVisa website.

When applying for a Thailand visa, you will need to provide the following documents:

• A valid passport
• A visa application form
• A passport photo
• Proof of onward travel
• Proof of financial support

Additional Information

• Thai is the official language of Phuket and is widely spoken on the island. However, you can manage with English in the main parts of the city and the tourist areas.
• Thai Baht is the currency of exchange in Phuket. As of late 2023, one US dollar is worth about 36.94 baht. You can, of course, use debit and credit cards anywhere in Phuket.
• Many of the major banks have their branches in Phuket Town and Patong. You can find ATMs in all shopping and tourist areas and in Seven-Eleven stores. Almost all currency exchange booths also offer an ATM service.
• Buddhism is the major religion in Phuket. However, you can find many Muslims too, who constitute about 20 percent of its population.
• Thai people are very friendly and forgiving and understand that visitors are not very aware of their customs and culture.
• The Royal family is held in the highest esteem. It’s a criminal offence to criticize them in public.
• Thailand follows the lunar calendar. Hence, religious holidays fall on different dates every year. Some important holidays in 2019 are Makha Bucha (19th Feb), Songkran Festival (12-16th April), H.M. King’s Coronation (6th May), Visakha Bucha (20th May), Queen Sirikit’s Birthday (Mother’s Day 12th August), Commemoration of King Bhumibol (5th December) and Constitution Day (10th December).
• Thai people are known for their warm hospitality and friendly nature. It is customary to greet people with a "wai" (a slight bow with the hands clasped together in front of the chest). It is also important to be modest in your dress and behaviour, especially when visiting temples and other religious sites.