Thursday, February 20, 2014

Lanna Care Net to the Rescue!

Some time ago I became aware of a small organization called Lanna Care Net.  Their basic mission is to help old foreigners who are in trouble in Chiang Mai province.  The vast majority of their clients have a serious medical condition, some at the end of life, and most are without sufficient resources to cover the costs.  I applaud their structure, organization and efforts.  They have an extremely low budget, just simple operating and transportation costs really.  The officers take no compensation.   What they do have is extremely good credibility within the Thai and ex-pat communities.

Lanna Care Net (LCN) is appropriately named.  One of the definitions of Lanna is Northern Thailand.  Care is what they facilitate.  Net is short for network, and that's what they really do the most and the best.   The organization has no paid positions, no company cars, or big offices. The composition is that of compassionate people networking to help those in need.  Their mission is really two fold:  First they provide assistance to aging foreigners who are in trouble, usually people with insufficient financial resources to deal with serious medical conditions.  They lighten the burden of the hosting Thai community by helping their clients understand what is possible within the Thai health care system.  

LCN finds resources, both local and ex-pat, and facilitates their clients interaction.  Notable is another volunteer organization called Cancer Connect, the consulates from various foreign governments especially Great Britain and the United States, Alcoholics Anonymous, various churches and of course most of the health care facilities in the province.
They regularly coordinate with air-lines to facilitate transport of patients as well.

To describe what LCN is about let's look at it three ways, NO, YES, EXAMPLE:

  • LCN does NOT provide financial assistance.  However, in many instances they can and will assist a client in obtaining emergency financial assistance.
  • LCN does NOT provide health care.  They do advise clients on appropriate nursing and medical care.

  • Facilitates care through liaison and cooperation
  • Advises clients on their options
  • Trains volunteers
  • Advises and educates the community on how to avoid problems associated with aging.

EXAMPLE:  There are many, this one I know because the man is a dear friend of mine.   Jim has a degenerative condition in his spine, I'm not sure of the exact diagnosis, but I do know that he has had back surgeries in the past.  For several years ago he has been comfortable and physically fit.  He even made the 490 mile Camino de Santiago Pilgrimage  last summer.  Several days ago he found himself with excruciating back pain.  With the help of some friends he was admitted to the Chiang Rai hospital where he languished for a week.  Chiang Rai hospital acknowledged that they did not have the expertise to help him and suggested he go to Chiang Mai University hospital.  The best specialist would be there every Tuesday he was told.  He was also told that the two hospitals were networked.

The next Tuesday morning Jim came down to Chiang Mai by ambulance, arriving about 8:00 a.m.   The hospital had no idea that who he was, or why he had been sent to them.  They had zero communication from Chiang Rai.  Another friend stayed with Jim most of the day while the hospital tried to figure out what to do with him.  I even went and relieved Steve for part of the time.   Finally, after an ordeal that might be good background for a fictional work, he was admitted to the hospital around 5:00 pm.

I called LCN on Wednesday to give them a heads up.  They had already been notified by the hospital that he was there and were on the way to assess his situation.  Thanks to the credibility LCN brought to the case, Jim was able to get an MRI and other needed treatment without having to pre-pay.  On Friday the results of the MRI were known and the orthopedic spinal specialist  saw Jim and presented him with his options, which frankly are very few.  Jim has choices to make.  In the meantime LCN was researching  various options.  

What came to light was the fact that Chiang Mai University Hospital was ill equipped to handle Jim's case.  Not surprising when you learn that his medical condition was so complicated that the Mao Clinic had him as a study case.  His back problems started with a viral infection in his spine. That was over 30 years ago.  His February 2014 MRI pointed multiple problems with his spine.  After a week it was decided the best course of action was to return him to Chiang Rai hospital for physical therapy and work on sending him back to the United States.

Jim is a guy with a big heart and a great attitude.  His friends and family were very supportive.  They marshalled by his bedside to give support where they found themselves often laughing at Jim's humorous stories.  When he was in the orthopedic ward at CMU hospital, he established a goad of making all the other patients smile.  He succeeded!  He even made them laugh, but the "enema story" is best kept for another writing.  The bottom line is that as he laid in a hospital in terrible pain, not speaking the language and being attended by people who had great difficulty understanding the specifics of his condition, he was concerned for the other patients.  I'd go see him and maybe the pain he was suffering was apparent, but the moment he'd see me, especially if I had a camera, he would light up.    He has the best attitude of anyone I've ever seen in a hospital setting.  The great attitude was not enough to keep his problems at bay.  He needed health insurance and a degree of financial solvency.
Jim being visited by Maliwan.
They made each other smile! 
Some friends raised money to defray his medical costs, coordinate transportation and provide conveniences.  In the middle of  fray I noticed the volunteers from LCN working quickly and efficiently to provide suggestions for the best options.  They accomplished several things that simply could not have been done without them:

LCN negotiated with CMU to allow Jim medical testing, including an MRI without pre-payment.  Then on discharge from CMU hospital LCN negotiated a 20% discount.

LCN was instrumental in allowing Jim and has family and friends to understand the medications prescribed, and in convincing the Thai doctors to prescribe appropriate dosages.  They also made sure that Jim knew what meds he had and when he should be taking them.

A wheelchair was provided for his use while he was still in country.

LCN coordinated with the airline, friends and family to make sure that Jim's trip back to the United States was as comfortable as possible. 

Jim at CNX - Wheels up minus 3 hours

The nurse gave me this.  Maybe the bear can help me know it's meaning! 
Frankly, it doubtful that Jim would have been able to get back to the United States to receive the treatment he needs if it hadn't been for the good work of the LCN volunteers.  When I gave LCN a heads up that I would be writing this they asked not to mention their names, just provide the phone number and website.  In keeping with this request, I'll simply say thank you three angles, two in Chiang Mai and one in Chiang Rai.  You have been instrumental in improving the quality of life an reducing the suffering of my dear friend Jim.

Lanna Care Net makes it blatantly clear that they DO NOT want you to be their client.  They don't want anyone to be their client.  The truth is that there are many people here who need or will need their help.  They make suggestions that as an ex-pat getting older in this country, I am taking to heart.  LCN will be happy to advise you on any of these points which include:

  1. Execute an Advanced Health Care Directive.    Do you want someone to guess what you might have wanted if you were not able to communicate?   The Thai doctors will honor these directives and welcome the guidance.
  2. Establish a relationship with a primary care physician.  There are many reasons for this, not the least of which is having some one who knows you who can prescribe pain medications as needed.  -- Jim had not done this! 
  1. Purchase health insurance ( or at least personal injury accident insurance) and put some cash away for emergencies.  Many ex-pats are here because they simply can't afford to live in their home country.  Many live month to month here.  WE need to have health insurance and we need to put away some money for emergencies.  Unless you have health insurance, most hospitals will not begin to treat you without an initial deposit of at least one-half the anticipated amount of your entire bill!  -- Jim was uninsured, without Lanna Care Net's help negotiating with CMU hospital it would have been much worse! 

Lanna Care Net can be contacted at +66 85-709-8801 (085 709 8801) and at

This was sent by email from Jim's sister 20 February at 5:05 am Bangkok time.

Jimmy arrived on time and safely.  The transition went smoothly.  However, our experience at the hospital emergency room could have been better.  The attending Dr. was reluctant to perform tests or admit him to a room.  He suggested that we go to a facility that had neurosurgeons on staff.  Finally xrays, and bloodwork was done and they have a MRI scheduled for tomorrow afternoon.  They did end up putting him in a room for the night.  Jimmy is exhausted and broke down once.  Things seemed to pick up after I made a call to Hospital Social Services.  I just spoke with her and we are getting together tomorrow to discuss Jim's condition and options for us.  I feel so badly for him!  I am doing research on neuro-specialists in a 100 mile radius.  The xrays revealed extreme degenerative disc disease, but he already knew that.  Hopefully the MRI tells us more and will warrant a longer stay so he can be transferred to a facility where intensive physical therapy can begin to work for him.  Will keep you all posted.  Love.  Joy

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