Disclaimer: I am not a medical professional. The information shared here is based on my personal research and experience and is for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.

This page is the ongoing story of being an older, uninsured expat in South East Asia and navigating a long-term (lifelong and still undiagnosed). As a very brief summery, the main symptoms are arthritic and weakness. My only firm diagnostic conclusion is a 2018 Xray showing a narrowed hip space on the left side (no other xrays given). I’ve been told I both do and don’t have myopathy by roughly the same amount of doctors. The last doctor I saw was pretty incompetent, but told me to get a hip replacement.

Six years later, I’ve had no further help (sidelined by covid somewhat). However, it’s obviously progressed. I’ve decided to use my limited resources to at least do something and try and learn options trading to increase my finances and access to care/treatments.

I want to share this site because I will list the resources as I find them. There are many sources online about help, operations etc. but just listings rather than actual stories or hard recommendations (or warnings) and also an idea of actual prices. So, incase it is useful, here it is! I’ll format all this nicely if anyone suggests they are finding it useful.

Update: I have published a first draft of my book, for FREE (full version), including my experience, recommendations and contacts. You can download it here.  If you have an experience of medical tourism (good or bad) and would like help other people, please submit it here for consideration in future edtions of the book and this website.

Main Symptom Chronology

The full story of my mysterious disease, and the investigations so far.

Initial advice from AI

This is the main reason I am returning now for more testing. OK, the symptoms are becoming unmanagable, but also in the past I did what most expatriates do in South East Asia, just turn up at a big hospital and get passed around a load of consultants and no oversite and ripped off.

Ofcurse nowadays I can direct much of the diagnosis myself using AI, order my own tests, decide what can be done. Then, get a recommendation for a surgeon/doctor. After 30 years in the tropics, I know it doesn’t work to just go to a hospital as the consultant you’ll get is a lottery, and likely the good ones will be busy. You MUST get recommendations before consultations.

So I’ll keep this document updated as the story progresses.

Update: Spring 25

So I did get an Xray. Unfortuantely, my experience of the clinic was pretty negative. A Review of Lim Taing Clinic, Phnom Pehn

I also wanted to get multiple xrays, which were simply refused. The clinic was largely a waste of money and I cannot recommend it.

However, I did end up with one Xray and have the interpretation and advice from AI (as the ‘doctor’ was clueless).

X-ray Interpretation – Pelvis and Hips Spring 25

So the vague plan now is to try and get a doppler ultrasound when I’m next in the city. Then plan a trip to Vietnam (possibly) to get an xray and scope out if it’s feasible to get any surgery there. I’ll perhaps time that with my next visa expiry.

At that point I’ll have the three main things I need to know about what can be done (or not) and so I can look further afield or online generally if Vietnam turns out to not be viable.

MRI interpretation

So I got an MRI after the xray and asked Grok to have a look at it. The main worry was the muscle, that I was previously investigated (without conclusion) for myopathy, but it’s complicated as I’ve have slimming disease at different stages of my life.

I made stills of two shots of the MRI and the analysis from Grok suggests that the muscles show loss due to arthritis rather than a seperate condition, which (in context) is great news.

Update: So I have this ongoing list of things I don’t understand things I don’t understand  and I have included a Q and A using some answers from AI. I’ve joined a useful Facebook group and when the list is complete, I will ask some humans the parts still unknown.

Currently I’m also looking into the resources in Vietnam, detailed below:

Health Resourses in Vietnam for Expats

Things have taken a turn for the worse and I’m not sure if I can actually make it now, I can barely walk 50 meters. However, I’m pressing forward and planning the trip to Vietnam. I will include some travel plans plus hotels and update here how it goes. I have no expectation as I tried a state hospital many years ago and couldn’t even get a doctor to talk to. The aim now is, bare minimum, just check out at least two places and ask the price (no one replied to my contact attempts). Stretch goal is an MRI and advice on the type of surgery I could get, if it is even suitable for me. In the unlikely event it works out, then the ultimate stretch goal is finding a surgeon I’m happy with, price, accomodation option and a number to call to arrange it. If that miracle happened, I just need to find a two week helper.

Regardless, when I come back, I’ll take a second opinion from a doctor in Phnom Pehn. I’ll check with Intercare, Khema and Calmette to see if any can do it, and I have one private clinic that say yes. I’ll have a consultation at the best of the bunch there, plus make contingency plans where to go if I experience a dislocation (which will be a risk going forward).

If there is no clear path forward, I will contact the fixers, such as Bookimed, and ask for help. I will also, as a last option, contact the major chain hospitals in India, Apollo and Supermax. I know of these as I have been looking into this on and off for the past five years plus.

At that point, I’ll make a decision and jump in. I have no choice. Last night, I walked home, only 50 meters, and ended up lying on the floor crying and praying. If I can’t take the trip to Saigon, I might have to just take the first person I can find who is prepared to do it. The clock is ticking and clearly I don’t have long.

Update: Summer 25 I went to Vietnam and am back. I did receive a hip MRI with dicom file and report.  All the story and contacts are in the Vietnam section. Essentially, the osteoarthritis in both hips confirmed. He told me no myopathy observed. Recommended bi-lateral replacement.

So I’m not overjoyed with the MRI now as I don’t feel the analysis was so thorough. However, I do have firm prices from three possible places (in Saigon). My best (and only good) friend offered to come with me and nurse me, which is too kind and I probably would rather pay someone but it’s a great gesture.

The Vietnamese doctor suggested a place that can do it in Phnom Pehn, so I will try there next, plus the other place there I haven’t tried. I’m back in Kampot but will do that this month.

Then I will get info about Indian options (which is my last resort). I already had a very negative experience contacting Apollo and Max Healthcare but I will try the arranger companies such as Bookimed. This was always by goto (i.e. I’d assume this is how I’d do it, but I’m more cynical now).

When I have that I still have a number of unanswered questions  so hopefully I can post these to forums and have them generally answered.

Then I need to work on accomodation and nursing options in Vietnam.

Then I will return to Vietnam for consultations. Essentially I’ll investigate my specific concerns (myopathy) and get a few opinions (eg. bi-lateral possible/advisable). I think it might by University, FV and Vinmec.  Possibly I’ll stay over for more investigation if they want to look into anything more.

At that point, I’ll know enough to make a decision (I guess)… and start making arrangements. No idea what the timeframe is, but my friend leaves in October, and for me, January would be the latest.

Update: Cho Ray in Phnom Pehn was completely unsuitable and I won’t consider it. All of the Indian options fell through as amatuerish and unprofessional. Check out the health facilitators page to see the experience.

I returned to Vietnam and was able to rule out Vinmec and so I’ve been boxed into a corner. There is only one remotely suitable surgeon and hospital, who wasn’t even that good.

So far this journey has been over six months, closer to eight? and the overall low standards, of just everything, is depressing. The one option I have is in Saigon. It’s the same price as Europe and I will still need to return and pay them yet another full consultation fee for basic information that they could have just provided in an email.

After all this work, there is still no suitable accomodation. I have looked around Phnom Pehn for the things I would need like raised toilet seat etc. and have not found anything suitable considering I would need to take it on a bus.

My friend is leaving next month, and so I’m going to be alone. I’ve going to have one more push (the third trip to Vietnam to try and arrange it), after that, if it isn’t arranged I need to be stoic, is isn’t possible and so I’ll look into acceptence, a crutches option or something. I might even end up doing that anyway. The more I research it, the more I find out about the downsides and risks, most of which are not discussed on forums and especially not on hospital websites. Many, many people are not helped by this and end up worse off.

Three hip surgery options in Thailand

Next attempt

Firstly, I need my teeth cleaned. I already had a consultation and xray. The options at this point are the korean hospital, or careplus as I had a negative experience in Roomchang.

I need to get the veins scanned, I don’t know if I have venuous insufficiency or PAD, and this will affect management. No one has mentioned this to me and I’ve worked it out myself. It’s just another example of the extremely poor care and standards all around the region. AI has worded me a paragraph to get a quote for what I need:

I am scheduled for a hip replacement and have significant varicose veins on the affected leg. To assess for venous insufficiency, peripheral artery disease, and baseline DVT risk, I kindly request a bilateral lower limb arterial and venous duplex Doppler ultrasound (including ankle-brachial index and reflux testing). This will help guide post-operative VTE prophylaxis — I will be recovering alone and prefer to discuss prophylactic anticoagulation (e.g., rivaroxaban) instead of compression stockings. Please let me know the earliest appointment and any preparation needed. Thank you.

Update: Winter 26

I did another trip to Vietnam (I’m home now).

Because the consultation with Dr. Phat at FV hospital was so vague I had to return for more information. For example, the reason he didn’t want to use dual mobility was ‘your cup is not a cup’ and I didn’t know if he meant dysplasia. Also, he wasn’t able to look at my MRI as the internet was slow (although I’d brought it on usb as requested, he said his computer doesn’t take it).

For the second visit I again voiced concern about my muscles and again said I’d bring an MRI. For this visit, again there was no physical exam. He straight up refused to even try and look at the MRI. When I asked about dual mobility he said that’s not possible with Superpath as the tools don’t exist, and I knew straight away this was untrue as I’d already contacted the manufacturer. I tried to engage him and he gave me a card for the manufacturer and told me to ask any more questions from them (i.e. completely dismissive). I knew at that point that this option has just slipped away from me.

I was despairing by them because I’d contacted all the major hospitals. So I asked AI about it and it recommended Tam Ahn, which had a clinic near me. I popped in just to check if they had dual mobility and they said no charge to see a doctor for basic information. I spoke to a doctor and had the best consultation of my life. I was completely reinvigorated and made an appointment to see his collegue who could do the operation. He was reluctant to use dual mobility but took no medical history and basically just doesn’t do them. But he agreed to look into it and I had the prepatory tests.

I had knee xrays as I get a lot of pain there, but all is good, no problem. Then I had a dexa scan (bone density) and was diagnosed with oesteoporosis. He said the acetabulum is misshappen and will need rimming, and screws, which is a reason not to use dual mobility. Now I’m no expert, but again, this seems to make no sense. He said he’d template me (measure the hip from a special xray to see which implants wil fit) and find one which takes screws.

I had to follow up with messages and visits four times and he still hadn’t done this by the time I left Vietnam. I saw yet another collegue of his to start oesteoporosis medication. The main guy had told me it would cost 400usd twice for injections to treat it but not before surgery. I did my own research and found the treatment is unnesesarily expensive, and was started on the cheap weekly pills. This doctor who put me on this said he would never let me have dual mobility if I was his patient (although no one has ever taken a medical history from me there) and so it’s just a surgeon policy, they don’t like it. They get to know a small range of implants and stick to them; I need a revision specialist for a complex primary to take a proper history from me.

I left Vietnam and the main surgeon got back to me. He’s templated the hip. It’s 60-64mm. which is jumbo size and they don’t have the stock. When I looked at the xray he’s templated the wrong side (right) when the left is visibly the surgical side, even to the untrained eye. They have dual mobility up to 58mm in stock and there can be a difference in two sides so I asked if he could do the correct side and let me know but he never got back to me (I also asked about the possilbility of special import).

So I found the contact details for the implant manufacturers and their distributors. I sent an email to each of them asking about their stock. Zimmer replied with correct contact detais, the rest ignored me except one who contacted the surgeon at Tam Ahn directly. The surgeon emailed about me and repeated that they don’t have stock, but didn’t elaborate whether it’s in Vietnam, or could be imported, nor which company it was who answered. I asked again for him to re-template the correct (surgical) side but again there is no answer.

So currently I’m still contacting these companies in other ways. After that I will contact them in their own countries. Then I will go straight to hospitals and try and get from them what stock they have and/or could get. Next I will go online to expat groups looking for any personal experience of this situation. If none of this works I’ll be looking outside of Vietnam (disaster) or accepting crutches as I progress. Doesn’t sound great but I’m starting to not care about my outcome nowadays.

Update: Spring 2026

I made one last trip to Vietnam (returned home yesterday) to try and resolve thing. The objectives were to A – find out from both Tam Ahn and Vinmec if the implant can be inported; B – get an ultrasound.

So since I last returned from Vietnam, I changed tack and contacted Indian Surgeons directly and an ultrasound is the last test I will need for an online consultation. I already tried twice to obtain this in VIetnam. Once during the disasterous visit to careplus when they couldn’t actually do it. Then on the last visit I thought I’d found my guy Dihn Khoa and I asked him for the tests I would need to prepare for surgery. I already told him about the failed ultrasound attempt at Careplus and thought I was going for this amoung other tests. I remember he said, sending me to the testing area, an ABI is not needed (when I had talked about ultrasound and ABI and so assumed an ultrasound had been ordered.

When I got back from those test I only received a templating xray and Dexa. The dexa showed oesteoperosis and so I was swept up in that (though he refused to recommend treatment until after surgery).

Then he said he’d template me, and I had to follow this up with emails, calls to customer service, visits to the clinic (in district 7, he’s usually at the main branch). By the time he let me know I need this difficult size I was already home in Cambodia.

Anyway, I already said I messaged him (after the distributer contacted him) numerous times asking can the implant be ordered and he never got back to me (after four months). So I went back fully prepared this time, with my questions in English and Vietnamese to hand to reception.

When I went to the hospital this time an English speaking woman looked at the question. I’d phrased it that I don’t want to refer to the surgeon, just ask procurement, is the size I need available to import. She said she understood and went off for about fifteen minutes.

When she came back she said she’d asked Dihn Khoa and he will email me. I was not happy. I explained I’ve waited four months and no answer so she went to ask precurement, if it can be ordered.

She came back fifteen minutes later and said she asked another surgeon and they don’t have it. So, I already know they don’t have it, I need to know if they can order it. She said she doesn’t know, but Dihn Khoa will email me (after four months?). That was it.

So the other problem was I need the medical file digitally. By default their site won’t let you log in with a non-Vietnamese number, but while I was home they managed to send me a link to allow it and I got a dicom of my templating xray, but then it stopped working and I couldn’t log in again. I asked her if that can be solved and she said flatly it’s never been possible to log in at all with no Vietnamese number. But I had a screenshot of my file, from when I was logged in on my phone. So she left again and came back with a form to receive the file by email.

The last issue was the ultrasound, customer service had already quoted me and told me I can receive the dicom to USB, but I needed to know the file size. She went to check for me and came back and said firstly, external usb’s are not allowed, I would have to purchase one from them for 150,000.00 and also no DICOM is available, only jpegs.

That was the end of that meeting. I sat there in reception and spoke to AI about it. It told me to contact VINMEC, about the import and the ultrasound, and also Cho Ray. I have never received any reply from VINMEC before and the consultation before was not good. But I did these things anyway.

Never heard from Cho Ray. I nearly fell off my seat when VINMEC actually replied. Yes, the ultrasound was available and can be taken as DICOM. They would contact orthopedics about the implant.

Then, believe it or not, they did indeed get back to me again. I was in SHOCK. So, for dual mobility, they have up to 60mm in stock (only 58mm in Tam Ahn). They can use bone grafting to size up to 62mm. Beyond that they can import but there is a three month lead in for import. I did also ask about 3d printing but it’s experimental and not available for foreign patients.

Well the next question was to clarify as this was my understanding but the email was ambiguous, plus I need to know which manufacturers could they import and what was the price, so the next day I went over there in person.

The women in reception said no information about price can be given without having a paid consultation. Remember, I went here before on this same advice and the surgeon didn’t know either the price nor the manufacturer, and so I flat out refused. They made a call and said someone would get back to me.

I was also there for the ultrasound. I’d asked the price as a follow up but no one got back to me, and I needed to know the file size for a usb. I had to go and sit further in the building and she answered one question at a time, going back to the counter to make calls each time. She said the price was 1.7 million. I asked if it includes arteries and veins. She went to check, and came back and said 6/700k per leg, but neither arteries or veis but ‘only basic’, and DICOM isn’t possible, only pictures. I showed her the email saying it will be DICOM.

She went away and another guy came back. He said 1.7 million for two legs, but DICOM isn’t possible, leg ultrasounds don’t use DICOM, DICOM is only for MRI and CT, this will be JPEGS anywhere, and he left.

Well I was confused. I showed pictures of my collapsed veins to ai and it told me to find this as the Indian surgeon will need it as I’m asking bilateral. I asked two other AI’s and they confirmed he was wrong and to push for DICOM as an Indian surgeon will insist on this before comitting to surgery.

Insanely, I asked one other place, Nam hospital District 7 and they confirmed they could do an ultrasound, it will be on USB, it’s a DICOM, but I pay 25% foreigner surcharge (nig*** tax). Nope, but infuriating it’s actually (possilby) doable.

So that this trip wasn’t a complete washout I got my last Shingle Vaccine at VNVC.

I reacted pretty badly and spent my last night in Saigon shivering in bed and managed to get myself up and on the bus (somehow) next day.

I contacted VINMEC about their email, telling me I can take the DICOM and the reply was ‘my colleague told you want can and cannot be done’ – which is actually completely insulting as it might have said, ‘Sorry, we gave you the completely wrong information resulting in a wasted day and taxifares, and then compuounded it by also giving out incorrect information in person as to what is possible).

I think I’m done with Vietnam now. Technically I’m waiting for VINMEC to get back to me with info about the import, and I could ask Tam Ahn for the same info (I’ve only ever been told my Dihn Khoa and one other surgeon what is in stock (up to 58mm. not what can be (nor not be) ordered).

Looking at the situation, the only decent result I’ve had on the whole journey so far, which hasn’t fell through, is direct contact with the Indian Surgeon. I have most of the tests I need to follow that up and yesterday, n the bus home, ordered a headset so I can have whatsapp calls and am awaiting delivery. I’m back to sleeping on the concrete floor on my yoga mat at home, waking in pain every few hours and only walking 100 meters a day. I’m getting a lot of chest pain on exertion now also and don’t know how I’m doing overall.

Health Resources for Expats in Kampot

I was living in Phnom Pehn but my mobility became so bad it was hard to get around, so I moved here pretty much for this specific reason, I can live life in the same 100 meter area, create this site, and make a plan. Initially I was going to get all this investigated in Vietnam, but then realised that I could actually get a lot of it done where I am, Kampot, and some more in Phnom Pehn, so I’m compiling these lists, mainly based on recommendations from expats here and m

Phnom Penh Health Resources for Expats

A European optionEuropean option for comparison.

How to Get a Dental Checkup Abroad Without Unnecessary Work

My teeth are OK in that there are no symptoms, but I thought I should get a check and so the above is advice, as this concern is always what keeps me away from dentists.

Dental Clinics in Phnom Penh for Expatriates

Insurance for Expats and Long Term Travellers

This is my experience with insurance. Recently I was refused coverage because of my unclear residency, although I have recently found a new potential candidate that might be suitable for me, and I am currently in discussion with them.

Red Flags — When to Walk Away

This article outlines practical red flags in consultations, pricing, communication, and care that signal when a provider may not be the right fit.

Using AI to Navigate Medical Care Abroad

How AI helped me research, communicate, and cope while navigating hip replacement surgery abroad. A practical, personal guide for patients facing complex medical care overseas.

Assessing leg pain

It’s sometimes hard to know what causes pain. In my case the veins are also not good.

Considering different types of hip implant

This article covers hip replacement planning in Asia, focusing on implant types, dislocation risks, manufacturer choice, implant documentation, and contingency planning for emergencies. It includes a checklist of questions to ask surgeons before surgery.

Recommended vaccinations before a hip replacement

I only just found out about this; it’s recommended to be up-to-date with your vaccines, plus have a few additional ones to protect the joint from being infected. These need to be somewhat in advance of surgery (but others not too far) – and so this also needs some advance planning. I’m included a clinic here which I’ve seen recommended numerous times (in HCMC).

Leg Length Discrepency

An in-depth look at leg length discrepancy after hip replacement, explaining why it happens, how it’s measured, its effects on walking and posture, and practical strategies for managing footwear and rehabilitation.

Preparing for a Hip Replacement: Practical Steps for Cleanliness, Safety, and Recovery

The Different Surgical Approaches in Hip Replacement

Getting a Hip Replacement in South-East Asia: The SuperPATH Method

MicroPort Hip Implants and the SuperPATH Approach: What to Know Before Surgery

This article explains what MicroPort hip implants are, where they are made, the main implant types, and how the SuperPATH approach works. It also covers safety, recalls, availability in Southeast Asia, and provides a list of key questions to ask your surgeon or hospital about the implant.

Hip Replacement in Vietnam: A Guide to SuperPath, MicroPort Implants, and Certifications

This article explores the SuperPath hip replacement technique and MicroPort implants used in Vietnam, detailing their benefits, USA-based manufacturing, and FDA/CE Mark certifications. It provides global expats and digital nomads with a comprehensive guide to ensure confidence in choosing high-quality, safe hip replacement surgery abroad.

UPDATE: I emailed Microport some time ago asking the geographical origin of implants imported into Vietnam. I also contacted the Vietnamese distributer asking the same thing. The distributer ignored me but Microport refered me to a webform and I did then get a reply. They were able to conirm that all implants into Vietnam are not Chinese made. The exact wording was:

All the implants sold in Vietnam are either of US or EU origin.

If you have any questions, once you receive your part/lot number combinations we will be happy to verify.

Paying for Major Medical Procedures in Southeast Asia: A Guide for International Patients

Understanding Hospital Pricing and How to Handle It

Getting to India for Surgery: Booking Flights When Your Hip Decides Everything

Vietnam eVisa: Your Essential Guide for Hassle-Free Entry in 2025

Your Guide to MicroPort Orthopedics Hip Implants: Understanding Options and Asking the Right Questions

This guide explores MicroPort Orthopedics’ hip implants, detailing cups, stems, and dual mobility options to help you understand their features and suitability. It equips you with questions to ask your surgeon about bone quality, stability needs, and long-term implant performance.

MicroPort Hip Implants and the SuperPATH Approach: What to Know Before Surgery

Your Guide to Hip Replacement in Southeast Asia and India: Imaging, Second Opinions, and Treatment Options

This guide explores affordable hip replacement options in Southeast Asia and India, focusing on the role of imaging and cost-effective second opinions. Readers will learn how to evaluate their condition, assess treatment alternatives like core decompression, and navigate tele-radiology services for informed decision-making.

Protection from dislocation after hip replacement

Dysplasia and reconstructive hip surgery

Dexa scans for hip replacement candidates

Ultrasound test for blood circulation for hip replacement candidates

Anesthesia Awareness: Separating Fact from Fear Before Your Hip Replacement

Navigating Hip Replacement: Seeking Advice and Second Opinions Online

Genetic Testing: Understanding the Link to Joint Health and Replacement

Medical tourism in the Philippines

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