I'm on a blood thinner and have type 2 diabetes. Will a Thai hospital still take me for a knee, and when do I tell them?

#1Margaret F(Joined Mar 2026 · 17 posts)August 25, 2026, 9:12 am

Knee replacement is pencilled in for October and I have finally got the itemised quote and the surgeon confirmed in writing, thanks to everyone on the other thread. So naturally a new worry has arrived to fill the gap.

I am 63, type 2 diabetic (tablets, reasonably controlled, HbA1c was "fine" at my last check whatever that means) and I take a blood thinner for an irregular heartbeat that was picked up two years ago. The hospital's medical history form was a single page with a box that said "current medications" and I wrote them in, and nobody has said a word about either since. Not the surgeon on the video call, not the coordinator.

So is that normal?? Do they just deal with it on the day? Part of me thinks a big hospital sees this every week and part of me thinks I am about to fly eleven hours and be told at the bedside that they will not operate. And if they DO need me to stop the thinner beforehand, who decides that, them or my GP at home? I do not want to be caught between two doctors on different continents with me in the middle holding the tablets.

#2Alan G(Joined Jun 2024 · 34 posts)August 25, 2026, 6:40 pm

Normal in the sense that the form is a formality and the real questions come at the pre-op assessment after you land. Not normal in the sense that it is fine to leave it there. I have a blood pressure tablet and a statin and nobody mentioned either until the anaesthetist went through them line by line the day before my shoulder. Fine for me, because neither changes anything. A blood thinner is a different animal.

Email the international patient office, not the coordinator, and ask for the anaesthetic department to review your medicine list now, before the deposit goes any further. Put the name and dose of the thinner in the subject line if you have to. When I asked something similar for a friend the reply came from an actual anaesthetist within two days with a written plan. That is the kind of hospital you want to be flying to.

#3bkk_bound(Joined Sep 2025 · 19 posts)August 27, 2026, 7:55 am

The chap I mentioned in the arrival thread, the one whose hernia got pushed two days, that was a blood sugar result. He had not told them he was diabetic at all because he "did not think it counted" on tablets. They did not refuse him, they just wanted it looked at properly first, which meant a day of waiting and an extra night in the hotel. He was fairly relaxed about it because he had left a gap in the plan. If he had booked the surgery for the morning after landing it would have been a mess.

#4Dr Helen WardMedical moderator(Joined Mar 2024 · 82 posts)August 29, 2026, 10:20 am

Margaret F said:

who decides that, them or my GP at home?

To take the direct question first: the hospital operating on you decides the peri-operative plan for the blood thinner, because they are the ones managing the bleeding risk on the table, but they can only make that decision well if they know why you take it and what your own doctor thinks about interrupting it. So this is a three-way conversation, and it belongs before booking rather than at the bedside. Neither type 2 diabetes on tablets nor an anticoagulant for atrial fibrillation is a reason a well-run hospital would decline a knee replacement. Both are reasons it should be planning around you now.

What the planning normally involves, in general terms. For the anticoagulant, the anaesthetist and surgeon will want to know which drug it is (the older warfarin-type drugs and the newer direct oral anticoagulants are handled quite differently), why you take it, and whether your risk of a clot without it is high enough that they need to cover the gap with something else. The usual pattern is a short planned interruption before surgery and a planned restart after it, with the exact timing set by the hospital in writing; how long that gap is and whether it needs bridging is precisely the thing your cardiologist or GP at home has a view on and the hospital needs to hear. For the diabetes, they will want a recent HbA1c and will typically adjust or hold the tablets around the fasting period, then monitor your glucose in hospital. An HbA1c that is too high is one of the commoner reasons an elective joint replacement is postponed anywhere in the world, because it raises infection risk, so "fine" is worth converting into a number you know.

Practically: ask the hospital, in writing, for the anaesthetic department to review your medicine list and confirm the plan for both conditions before you pay the balance, and take that plan to your GP for their view so nobody is guessing. Your pre-operative assessment then becomes a check on a plan that already exists rather than the first time anyone has thought about it. The site now has a guide to the pre-operative assessment and who gives the anaesthetic which sets out what that day looks like and the questions worth asking. The specifics of your own interruption and restart, though, are for the anaesthetist who assesses you and the doctors who prescribe for you, not for a forum, and I would include this post in that.

#5petem1970(Joined Aug 2025 · 16 posts)September 1, 2026, 9:14 pm

Dental so no help on the clinical side, but on the "why has nobody said anything" worry: a one page form with a box is how the sales end of a hospital works. The clinical end has not seen you yet. Make them meet.

#6Margaret F(Joined Mar 2026 · 17 posts)September 14, 2026, 4:36 pm

Update, and thank you Dr Ward, that was the clearest anyone has been about it.

I emailed the international patient office with the drug name, dose and why I take it, and asked for the anaesthetic department to look at it before I paid anything further. Reply came in three days from an anaesthetist, not a coordinator: a written plan for stopping and restarting the thinner around the surgery, a request for a recent HbA1c and an ECG from home before I fly, and a note that they would confirm the final timing at the assessment. I took the whole thing to my GP who was, frankly, relieved to be asked, and she has done the bloods and the ECG this week and written a short letter to go with them.

HbA1c turned out to be a number rather than "fine", and it is on the right side of the line, so October stands. Feeling a great deal less like a parcel being posted to Bangkok.