An Allergist from an Allergic Family
– Dr. Tachakwan Intapuntee –
With 16 years of immersing herself in allergy treatment, Dr. Tachakwan Intapuntee, or ‘Auntie Doctor Tach’ to her young patients at the BNH Asthma and Allergy Centre, has handled countless challenging cases. What sets her apart is that she herself is an allergy sufferer, hailing from a family with several members affected by severe allergies, and her own children also experience severe allergies. This places her in the unique position of being a doctor, a patient, and a patient’s relative. It is this real-life family care that enables Dr. Tach to understand her patients and their relatives so profoundly.
A Smile That Changes Minds
“Back then, I passed the entrance exam for the Faculty of Allied Health Sciences, Chulalongkorn University, when I was in Year 10.”
Dr. Tach’s path to becoming a doctor involved eliminating unsuitable future options until only a career in public health remained. Like many high school students over 30 years ago, she chose to save time by taking the university entrance exam early, succeeding whilst still in Year 10.
“My elder sister was already dressed in her university uniform, ready for classes, but my mother told me not to be impatient. Initially, I didn’t understand, but eventually, I complied. I continued to Year 11, took the medical entrance exam again, and got into Chulalongkorn Medical School. That’s how I became a doctor.”
Life in medical school was far from easy. Dr. Tach, formerly an excellent student in high school, had to work harder, try harder, and persevere more to maintain her academic performance amidst a community filled with exceptionally bright individuals. However, another life experience that transformed her was taking a personality development course at the suggestion of an elder relative during her second year.
“Before, I was just a student who came late and did nothing else; I didn’t participate in any activities. But after taking the personality development course, from being a quiet person who couldn’t speak in public, I had the opportunity to be the MC for my cohort. Almost 30 years have passed, and I still feel fortunate to have had that opportunity; it gave me the skills to educate patients. I learned how to speak and explain effectively.”
During her six years in medical school, the term ‘paediatrician’ never appeared in Dr. Tach’s future plans. She disliked being close to noisy children and intended to become an obstetrician-gynaecologist or a surgeon due to her passion for surgery and the moment new life comes into being. But one day, at a community hospital in Chom Thong district, Chiang Mai province, where she was doing her rural service, her perspective changed.
Amidst 200-300 patients daily, which brought pressure upon Dr. Tach, treating crying children caused even more stress than treating adults. One day, a hill tribe mother brought her one-year-old child to see the doctor. Just as the examination concluded and the mother was leading the child out of the room, the little one turned, smiled, and waved goodbye to Dr. Tach.
“At that moment, I was so stressed with the many patients still waiting to be seen, and the child was screaming. I grew even more irritated. But once the examination was over, the child stopped crying, turned, waved goodbye, and smiled. It made me realise, ‘Why was I angry with this child? They don’t understand anything.’ Children cry because they might feel uncomfortable, anxious, or scared, but in reality, they don’t hate us; they are so innocent. From that moment on, I felt I wanted to be a paediatrician.”
After entering her residency in paediatrics at Chulalongkorn Hospital, she had to choose a subspecialty. Since Dr. Tach came from a family where everyone suffered from quite severe allergies, including her sister who had a severe shrimp allergy, her father who had allergic rhinitis and drug allergies, and she herself suffered from allergic rhinitis, she pursued a subspecialty in allergy after completing her general paediatrics training.
“And it was the right decision because ever since I started studying it, I’ve applied it to my family constantly.”
The Pinnacle of Pride
Dr. Tach began her career as a paediatric allergist at a private hospital. Her 16 years of specialised work provided her with extensive experience in handling numerous allergy cases, eventually leading her to lead a project to develop the hospital’s allergy centre.
“It wasn’t just about setting up a centre. We had to improve the facilities, plan projects, establish service guidelines, and create various content to make the centre known. This was a project I was truly dedicated to, and it turned out well. The allergy centre became well-known to patients, and I was nominated in Rak Luk magazine as one of the ‘Top 80 Paediatric Allergists Chosen by Parents’.”
During 2020, the COVID-19 pandemic impacted almost every sector, including public health. Hospitals needed to reserve space for COVID-19 patients and restrict treatment for other outpatient diseases to reduce virus transmission. Yet, people still suffered from other ailments and needed to see doctors for treatment. Thus, Telemedicine became crucial for patient care, avoiding risky travel for infection. However, the COVID-19 situation, which arose without preparation, forced the Telemedicine system to be implemented as an emergency response plan under tight deadlines. At that time, Dr. Tach was the project leader, primarily responsible for making the Telemedicine service system, which many considered impossible, a reality.
“I’d say it was the most difficult challenge because we started from scratch, or even from below zero. The hospital I was at then had never had such systems before, and no one in the hospital had provided remote patient services. The difficulty was that Telemedicine was a system the hospital needed to help patients contact doctors during COVID when they couldn’t come to the hospital. But we didn’t know how to develop the system. IT thought it was impossible. So, we had to try to understand how each hospital’s system worked, act as service users by registering, pretend to be patients to learn what patients would experience, and then bring all the information back to discuss with the team. We researched and gathered information on system setup, and then requested to launch the service. We did it step by step.”
“On the day the Medical Council came to inspect the Telemedicine system and we received permission to launch the service, I felt so proud that the team’s dedication had enabled the hospital to have a functional Telemedicine system. Back at that hospital, many patients used this service, and most were satisfied with Telemedicine. Sometimes, for young children, instead of having to travel and wait at the hospital with the risk of infection, they could consult from home, reducing travel time and costs for patients.”
After two major projects that Dr. Tach successfully led and brought to fruition, bringing significant change to her previous hospital, it was time for her to embrace change and seek new opportunities in life to advance to the next level as an allergist. Thus, she began a more challenging role at a new location: the BNH Asthma and Allergy Centre at BNH Hospital. Here, she can dedicate her time to treating allergy patients of all ages and genders, beyond her previous role as a paediatrician.
“It’s a good timing for me to work directly in a specialised field. I believe in the BNH brand because we will be in a place where we can provide standard treatment and services to patients. I believe that for the remaining 15 years of my working life until retirement, I must do as well as I have always done.”
The Allergist
For effective allergy treatment, identifying the cause of the allergy is a crucial part of care. Doctors and patients must collaborate to find the allergen, and once the root cause is removed, the patient’s condition often improves.
“There was a young child, only two months old, who would vomit and scream constantly after drinking just half an ounce of breast milk. The child wasn’t thriving at all. The parents and family were very worried because the baby couldn’t eat anything; they would vomit after eating. As the allergy symptoms worsened, they started affecting other systems, including skin rashes and bloody stools.”
Whilst allergy treatments are mostly not as severe as other illnesses, they cause immense suffering for patients and families, especially when symptoms affect infants who cannot communicate and have treatment limitations.
“For this case, we had to perform a Skin Test when the baby was just two and a half months old, which is usually done at around 4-6 months. But for this severe case, after discussing with the parents about the severity of the symptoms and the need to find the cause quickly, the parents understood and agreed to the Skin Test because the child was suffering immensely.”
The allergist’s duty is to investigate what the patient is allergic to and then gradually remove it. For this child, it was food allergies transmitted through breast milk. So, the mother had to eliminate all foods her child was allergic to, whilst the baby received amino acid-based formula milk, waiting for the mother’s body to be ready for breastfeeding again. Once the offending allergens were removed, the child was able to consume milk almost like a normal baby and their health improved, bringing peace of mind to the parents.
However, treating allergies involves more than just finding and eliminating the cause. The doctor must also help the patient and their close ones understand the disease’s progression and management, because without patient cooperation, treatment is unlikely to succeed.
“A Saudi Arabian patient brought a 2-3 year old child to BNH Hospital for treatment. The child had very severe skin rashes that prevented them from sleeping. They had been treated at multiple hospitals and had undergone at least five blood tests. When I tried to talk to the father, it felt like there was a thin wall between us. He didn’t want to be examined or asked by the doctor; he seemed ready to get frustrated with us, even though we had never met before.”
“After a while, I had to adjust my own perspective. I thought he must be stressed and distrustful of medical treatment. I had to explain things slowly and then gradually teach him about the disease. This case took about 45 minutes of conversation. Ultimately, I was able to gain his acceptance.”
This case became one of the allergy cases Dr. Tach is most proud of. Her perseverance and good intentions to help the patient understand the disease’s progression enabled the patient’s family to open up and comprehend what they were facing, breaking down the first barrier towards successful treatment. When the patient returned for a follow-up, their condition had significantly improved, though continued follow-up and treatment were necessary.
However, good treatment cannot be viewed from a single perspective. One male patient in his early 30s with allergic rhinitis came to the doctor seeking allergy medication as he always had. But his blood pressure, which was as high as 150, could not be overlooked by Dr. Tach. High blood pressure in a young person can indicate several underlying conditions that require diagnosis beyond simply taking prescribed medication. The patient needed to both adjust their behaviour and monitor for complications of the disease, receiving Complete Care – holistic care that goes beyond just addressing the initial reason they sought the doctor’s help, which is BNH Hospital’s treatment policy.
“Complete Care is very important from the perspective of allergic diseases because allergies don’t just end with a cure. If they don’t receive appropriate care, if they don’t know what triggers their symptoms and they continue to be exposed to it, it will keep provoking and can lead to subsequent abnormal symptoms. For example, initially, they might have allergic skin rashes, then as they grow older, they’ll develop allergic rhinitis. If not treated well, it could end in asthma. And some children have delayed allergic reactions, which many doctors often don’t consider. Over time, the body has a continuous inflammatory process that leads to chronic illness.”
Turning Points from Close Ones
“I am a dedicated person. Every case that comes to me, I give more than a hundred percent. I perform detailed physical examinations, and I talk and advise patients. Some take 45 minutes to an hour and a half, and I’ll still talk to them. We want patients to see the importance of treatment. When I’m so dedicated, but some patients don’t follow my advice, and their condition doesn’t improve, I used to scold them and feel very discouraged when the outcome wasn’t as good as I intended.”
Then came the day Dr. Tach had children. Her first child had a severe allergy to tree nuts and also had asthma. Her second child would vomit and have bloody stools after drinking breast milk. This made her realise that the theories of patient care she had learned couldn’t be fully implemented in real life.
“When I had the opportunity to treat my own children, I realised that some things aren’t just theory; you need practical experience to truly advise patients.”
Over 13 years of off-textbook experience caring for her children became a crucial turning point that made the doctor focus more on patients’ feelings than just treatment outcomes. Everyone’s limitations mean patients cannot follow all medical advice, and approaches need to be adjusted to suit each individual.
“If I didn’t have children, I wouldn’t know what it’s like to care for a sick child. There’s so much unease and worry hidden within.”
But another significant event was when her father suffered cardiac arrest. Although it was extremely fortunate that he could eventually be treated and returned to near-normal, Dr. Tach had to re-evaluate everything in her life. From a doctor who worked incredibly hard, spending more time at the hospital than with her family, Dr. Tach turned back to balancing her precious time with loved ones, alongside a new intention to view patients as her own relatives, based on the feelings she experienced that day.
“Especially with young children, we must always think of them as our own children. If our child is unwell, what would we want to do? And then we choose the best, safest, and most appropriate treatment for them to help a child recover.”
“And we must understand parents with children. In an era with so much information, whether right or wrong, they don’t know what the correct information is. Sometimes they see others breastfeed their children who then grow plump, but their own child cannot drink breast milk at all, and they might feel like bad parents. Sometimes, we have to understand them and try to be their guiding light.”
From these two events involving her close ones, today Dr. Tach has become a doctor patients feel comfortable consulting, almost as if she were a family member. She puts herself in the patient’s shoes to understand their perspective and calmly and empathetically finds care approaches tailored to each individual’s situation.
“Treating children is like water filling my heart. When they are refreshed, when they recover from illness, when they smile at us, love us, run to us and call ‘Auntie Doctor’, there’s always happiness with every case I treat.”
Slow-Life: Happiness in Simplicity
“I like peace in life, I like the slow-life. I want to live upcountry. I was very happy when I was doing my rural service.”
For a Bangkok native like Dr. Tach, life in the provinces was a new experience she had never encountered. But her first year of rural service in Chiang Kham district, Phayao province – a remote area near the Laotian border that required multiple transfers to reach – offered a new perspective to someone willing to embrace it, making her fall in love with a leisurely lifestyle that contrasted sharply with the fast pace of the capital.
“Living there, I’d ride a tricycle to eat in town, eat by waterfalls. It was so happy and comfortable. Life was slow. Initially, I even thought about applying for a scholarship around there and living in Chiang Mai or Phayao. But then, my family suddenly fell ill, and it would have been difficult to reach them from so far away, so I had to change my plan and return to Bangkok to care for my parents.”
Her fondness for the slow-paced life has stayed with the doctor until today, even as she has become a mother. She imparts the joy of simplicity to her children by raising them to be grounded. Although her medical profession provides enough financial means to take her children on luxurious trips abroad, that is not her approach. Dr. Tach’s children have experienced life in the provinces, where people are content with what they have, even without expensive possessions, and where riding bicycles or building sandcastles can bring joy, even if they get dirty.
“Just eating together at home, that’s enough to make me happy. I don’t need to eat anything expensive.”
Amidst a society of competition and acquisition, her child’s simple sentence reflecting their life philosophy made the doctor realise she had achieved her first objective in raising her children.
In a fast-paced world, Dr. Tach continues to find happiness in a simple and slow life, consistently putting herself in her patients’ shoes. She provides empathetic and understanding care, ensuring patients receive what is most appropriate for their unique circumstances.
“Everyone wants a skilled doctor, but what I feel is truly lacking is a doctor who views and treats patients like family, and who also cares about their feelings. I believe that if we have good intentions, patients will feel confident and trusting, and the treatment outcomes will be as good as we intend.”
ทำนัดหมายแพทย์ออนไลน์ | Appointment
TACHAKWAN INTAPUNTEE, M.D.
พญ. ธัชขวัญ อินทปันตี
Speciality
Pediatrics
Pediatric Allergy and Immunology
Clinical Interest
Asthma in Children
Food Allergy
Board and Sub board Certification
The Medical Council of Thailand, Pediatric Allergy and Immunology, Chulalongkorn University
The Medical Council of Thailand, Pediatrics, Chulalongkorn University
Language
English
Thai
Gender
Female
Schedule
BAAC BNH ASTHMA AND ALLERGY CENTER
| Day | Time |
|---|---|
| Monday | 10:00 - 17:00 |
| Tuesday | 08:00 - 18:00 |
| Wednesday | 08:00 - 15:00 |
| Thursday | - |
| Friday | 08:00 - 14:00 |
| Saturday | - |
| Sunday | 08:00 - 18:00 |
This is the doctor's regular weekly schedule. Actual availability may vary — please confirm the available date and time when you make an appointment.