Commets from Monika
I have read Kunaporn's reply and all I can say is POPPYCOCK!!!
Kunaporn's reply to you is riddled with BLATANT LIES!
Kunaporn's FIRST BLATANT LIE is that the initial surgery went smoothly! He told me on the phone, personally as well as telling Nicole that there were complications from the onset. "Something happened that I do not know" were his EXACT words to tell me that her expected 2 hour procedure had turned into 6 hours and that she had EXTENSIVE bleeding!
When I pressed him for further information as to the cause of the excessive bleeding, his EXACT WORDS this time were "This is medicine, not science".
His SECOND BLATANT LIE is that she was given antibiotics immediately. She was NOT given any antibiotics until her fever had reached 103 for the SIXTH day in a row. I again called and spoke to him, asking him why she had not been given any antibiotics. His EXACT WORDS AGAIN..." I not know what kind of infection, must wait for lab results". This was 5 days after he had done the second stage of the surgery, WHICH HE DELAYED for several days. And WHY did he delay the second stage???
Read on..........
His initial pre-operative evaluation of Nicole was that she would have plenty of skin for a full 5" depth vaginal opening. It was not until AFTER the first stage was done ("Something happened that I do not know"-HIS WORDS) that he changed his evaluation. He then came to Nicole and said that she would need a ADDITIONAL skin graft...at an ADDITIONAL CHARGE of $500!!!!! Nicole questioned why he had changed his evaluation of her needs. He ignored the question and changed the subject. He INSISTED that she needed the second graft and had to pay an additional $500. She reminded him of their conversation at the initial evaluation and the fact that he stated unequivocally that she had enough skin. She also told him that she had only enough money for the SRS. He then left her room. Each day, for the next three days, he came in and insisted she needed the additional graft. Nicole and I discussed this and both came to the conclusion that this was perhaps a "bait and switch" tactic. Nicole then told him she was becoming very uncomfortable with his pressuring her to pay EXTRA money for something he had said would not be needed in the first place. Nicole told me that night that he stormed out of the room!
By this time, 4 days after the initial phase, Nicole started to run a low grade fever. I, being here in the US and not able to question the nursing staff or doctor, started to become upset and nervous. I wrote an e-mail to Sanguan's office and received a rude e-mail back from them, which basically said...
HOW DARE YOU question the doctor?
Although the nurses came into to check on her bandages and other perfunctory items, they never asked her about her progress with other things such as voiding or bowel movements. It was later to be discovered on the 6th day, that the fever that was getting higher was a direct result of her not having had a bowel movement since the surgery. They finally gave her an enema and her fever subsided the next day.
The following day, day 8, ALL HELL BROKE LOOSE!
The VAC dressing which Sanguan refers to in his reply to your initial inquiry, FAILED!
Nicole awoke to sharp pains and a bed SOAKED IN BLOOD! She called me and the absolute terror in her voice made me cry. Nicole stated to me at that point that she did not believe she would make it back to the US alive. They had to reapply the VAC dressing.
It was at this point; that I said enough is enough! I contacted the US Embassy in Bangkok, Thailand. I spoke with Mr. Rod Gonzalez from the Embassy. I informed him of what had happened up to this point. I also told him about the rude e-mail and the fact that the hospital and Dr Sanguan's office had refused to have any further communications with me. We also told him of our concern about the pressure Sanguan Kunaporn was putting on Nicole to pay for the extra surgery.
Rod Gonzalez immediately called the hospital and told them that the US Government wanted to know what was happening to one of their citizens in the hospital.
Fifteen minutes later...I received a rude phone call from Kunaporn asking me why I had involved the Embassy. I told him in no uncertain terms we were concerned about his treatment of her and that he had failed to provide either Nicole or I with adequate explanations about what was going on. His demeanor was, to say the least, very insulting!
It is my personal opinion that at this point Kunaporn perhaps realized that we were NOT going to be bullied into paying extra money for an additional graft. Realizing this, I believe he decided to stop delaying her second procedure.
The next day, day 9, Nicole was abruptly taken into the OR and Kunaporn did the standard graft which is part of the procedure. She was sent back to her room. Less than 24 hours later, she began to develop a high-grade fever. Sanguan Kunaporn did not respond to this immediately as he claims he did. It was not until the third day after, when examining her surgical site, that he admitted to her that she had an infection. He said he would have to wait for the lab to do a culture to determine what antibiotics to prescribe. The infection was allowed to continue to grow for another three days. Every Doctor we have talked to since then has expressed nothing less than total shock that he did not start some type of broad spectrum antibiotic immediately. Kunaporn did not, he LIED in this letter to you about that.
Antibiotics were not started until the 6 th day !!!!
IT WAS TOO LATE! the graft "failed" as he puts it because HE ALLOWED IT TO DIE!
The tissue necrosed and turned black. Nicole told me on the phone that she could smell death in her room! At this point, I started making calls to airlines to see if I could get tickets at a reasonable price, to go there and be with her. No such luck. the price was $3,000!!
I wrote e-mails to Dr Ann Lawrence and also to Sally Jesse Raphael, explaining our situation and asking if they might be able to help. I phoned my personal Plastic Physician here in Dallas, who agreed to take over Nicole's case immediately if I could get her back to the US. Her condition at that point was so severe, she would need to be transported by air ambulance.
I contacted a private company, an Emergency Medical Evacuation Company. I was told yes they could evacuate her and bring her to the US for treatment for about $250,000. Needless to say, that was not an option for us.
I had been maintaining phone and e-mail contact with the US Embassy all along. After discussing other options, Nicole, Rod Gonzalez and I decided to see if she could be moved to be either under the care of Dr. Preecha or Dr. Suporn. Rod Gonzalez made calls to both of them. I believe it was Dr. Preecha who said, YES, he would take over her care.
Sanguan Kunaporn was told about our decision. He was NOT HAPPY! He insisted that Nicole was unable to travel even that short distance. WHY? Plain and simple, Nicole had NO SKIN on the area of her genitals it was all exposed flesh at this point. She would possibly bleed to death form making the trip.
It is my opinion at this point; Sanguan Kunaporn knew he was in trouble. He convinced Nicole and Rod Gonzalez that he would do a third operation to replace the skin graft he had not been successful with, at no additional cost. Where would the skin come from??? From her backside!!
We felt trapped! The operation was scheduled; her stay in Thailand and in the hospital was extended 10 days.
THIRD BLATANT LIE!!!!! Sanguan Kunapoorn states he has not had problems other than one other time with this surgery in the last 2 years. POPPYCOCK! At the very same time that Nicole was there, ANOTHER ONE OF HIS PATIENTS HAD PROBLEMS AND HAD TO HAVE HER STAY EXTENDED FOR AN ADDITIONAL WEEK!
He has the unmitigated gall in this letter to say he was most concerned about Nicole's welfare.
If so, why has he not responded to a single e-mail from us, since she left?
If so, why did he discharge her from the Hospital 3 hours before her flight, KNOWING FULL WELL, that she STILL had a staff infection? Nicole had to be treated at Parkland Hospital EMERGENCY ROOM in Dallas, Texas with intravenous and oral antibiotics 2 days after her return from your "care".
It is very easy for him to claim that he would fix all this at no charge. When he discharged Nicole, he told her that he would pay for any additional medical services she would need and pay to fly her back for more surgeries. He has not answered a single e-mail from us. he has never once called us to see how Nicole is doing.
Dr Sanguan Kunaporn..
I call you an outright liar to your face! I state without any reservation that you are a disgrace to the field of medicine!
HOW DARE I SAY THAT TO YOU????????
Some may think my letter here is libelous.. It is only libelous if I make false statements about you! Every statement though is FACT!
BECAUSE, unlike your lies in this response, I have PROOF of every single thing I have stated here. I have the name, address and phone number of another patient who was in the hospital during Nicole's disaster at your hands! I have the letters and e-mails I wrote to you and your responses! I have every e-mail and response from the US Embassy! I have the long distance records of EVERY phone call placed to Nicole, your office and the Hospital and US Embassy.
My phone bill alone due to YOUR NEGLIGENCE and MALPRACTICE is over $1,000!
I have records of conversations with other transsexuals who have corresponded with your office since this happened and YOUR LIES to them. that Nicole had other health problems that she did not disclose to you! POPPYCOCK!!!!!!!!!!!!!!!
Nicole was healthy and vibrant prior to going to you! She now has 2 hideous scars on
her back from where you had to harvest skin for the third operation to save her life.
LIES LIES LIES and more LIES from you!
If you had practiced medicine of this caliber in the US, you would most likely have your license to practice revoked!
You state that Nicole has no confidence in you. You are DAMN RIGHT! Be glad Thailand does not allow medical malpractice suits!
It is now going to cost Nicole and I thousands and thousands of dollars...for what?
So that she can have some semblance of a normal genitalia. She will never be able to have normal sexual relations thanks to your horrendous work!
How dare I make these statements???
HOW DARE YOU CALL YOURSELF A DOCTOR OF MEDICINE????
Monika L. Mann
