Sheryl

None of these meds would cause low potassium. Heavy sweating could. So could diarrhea.

Stress alone cannot put a healthy heart into A-fib (if it could everyone would be in AF!). However excessive caffeine use can sometimes trigger it and so can low potassium. The qestion is, why was your potasdium low? What regular medications are you on? If your heart rate is now regular you may have been in what is called paroxysmal AF. With just a borderline rise in Trop T and no EKG sign of ischemia the only reason to have kept you would gave been if you were in severe heart failure which the doctor obviously did not think was the case. He opted for conservative approach and this seems to be working. It may be worth getting a thorough cardiac work up at some point but does not sound urgent. Assuming everything checks out OK on repeat visit, suggest you get full revords of the event and follow up while in UK.

Sports clinics are known for this type of thing and best avoided. By your own account second cardiologist said no angio needed. So hardly the case that all or most doctors in US are likely to advise unneded stenting. You encountered unethical practices in a partucular type of commercial establishment known for that sort of thing. Having some blockage does not mean a stent is indicated. >70/75% blockage and symptomatic yes but even then not always. Depends on which vessel and overall clinical picture. Having a heart attack yes.

Warfarin is indeed a cheaper option but has a very narrow therapeutic range so higher risk of bleeding episodes and requires regular monitoring through frequent blood tests. NT-probnp test helps determine if you are in heart failure and if so how severe. I have no idea what they would charge for it. Combination of clinical findings, chest Xray and maybe echocardiogram are usually sufficient to diagnose heart failure so if the test turns out to be costly you could ask the doctor if really essential/how likely is it to alter the treatment plan. With Troponin T import thing is that it be back in normal range. Exactly where in that range does not matter. However if you are in heart failure a slight elevation may remain. You do not mention it but I trust they gave you something to lower your heart rate? Heart failure in a-fib results from thd ventricles going too fast in an effort to keep up with the atria. It is important to control that and usually possible with medication.

The best place in Khon Kaen for this is KK University Hospital (Srinagarind) https://srinagarind.md.kku.ac.th/ It has a private wing https://www.smckku.com/en/

As above. Available here but expensive and no generic equivalent. However a lot cheaper than in US.

"They" do not decide whether to stent or not. Patient decides based on doctor recommendation. Of course, best to think it through beforehand and discuss pros and cons with doctor beforehand. Doing a CT angiogram first will add to costs and still be less conclusive than an angio. Where it is useful is if the patient is asymptomatic as it may avert the need for an angio. If significantly symptomatic he should definitely proceed to angio IMO. We have no idea if this patient is symptomatic or not. And that, together with the extent and location of any blocakge, makes a big difference in terms of whether stenting is of likely benefit

Not remotely true. A doctor will not even do an angiogram unless there are clear indications for it. And they will often say no stent needed (or needed yet) based on angio findings. The indications for stenting are quite clear.

OK then the extent of blockage is not sure. But yes, likely one or more stents will be needed. Stent is done during angiogram if findings indicate it. As the stents themselves are the main cost driver, cost will greatly depend on how many. BKK Christian in BKK, about 250k if 1 stent (Includes angio), more if more. Khon Kaen Queen Sirikit Heart Center (not to be confused with Queen Sirikit Navakla Hospital in Sattahip) will be less but of course more of a trip. The savings will especially add up if he needs more than 1 stent.

lKKU Heart Center would certainly be the best in terms of good quality at lowest price but is quite a distance from Pattaya. Queen Sirikit in Sattahip Pattaya does not, AFAIK, have a cath lab or do interventional cardiology. BPH does but quite expensive. In Bangkok I would recommend Bangkok Christian Hospital, this cardiologist (he is older and no longer does the angios& stents himself but will oversee it) https://www.bch.in.th/find-doctor/doctor-profile/?smid=4730 OP please clarify, to know he has 70% blockage (of unspecified number of arteries, plural?) he must have already have had an angiogram. Where was the angiogram performed and why was stent not inserted at the same time? How many arteries are blocked and what % for each? Stents are usually done at 75% blockage and even then not always if it is a minor artery affected. Does he have the angiogram report on disc? The angio alone carries a cost which is why stent placement done at same time, to avoid paying for it twice.

Nothing "revolutionary" about amoxicillin + clavulanic acid, been around for years You would definitely have seen improvement by now if it were working.. Can you post a pix? I am a bit confused by your reference to it seeming ready to burst as that is more suggestive of an abscess than a diffuse cellulitis Possible that you will have to be admitted for IV antibiotics. What hospital are you going to ?

https://www.sukumvithospital.com/finddoctor.php?lang=en&action=Search&name=&department=1&specialist=34&weekday=&gender=

If it seems to be worsening do not wait for appointment. Also, whatever hospital you saw that doctor at, will have an Infectious DIsease specialist. They all do.

That is nto Amoxicillin alone. It is Amoxicillin + Cl;\avulate (same as Augmentin) and is usually used as first line treatment of cellulitis (albeit usually along woth another drug).

https://www.samitivejhospitals.com/doctor/detail/jackrapong-bruminhent

Depends on the exact cause/nature of injury

If it were just pain I'd agree but the numbness and tingling is worrying and warrants seeing a doctor now as there may be nerve entrapment. OP: https://www.bumrungrad.com/en/doctors/Pritsanai-Pruttikul

Yes 73 would be mid age band. I am wondering if he actually had April Thailand rather than April International.

There is no test as such for gluten intolerance and you would not have newly acquired it. Plus if you had it, eating brown bread alone would set it off. There is no such thing as fruit intolerance. You may have small bowel overgrowth, fits the symptoms and would tend to act up when starch & sugars ingested. The test for this is a hydrogen breath test.

Where are you being treated? And can you share doctor(s( names? For future reference.

Make sure you have not underestimated what even that can cost. For proper palliative care you are not looking at a government hospital. Private hospital care will run to at least 10K a day once room, board, medications and doctor visits etc are factored in. .And they will require an upfront deposit before you go in.

No, there are not (hospices here) The place in CM you are thinking of is this: https://mckean.or.th/ And it is a good option, less costly than a hospital (if they have an available bed) But OP is in Bangkok and may not be physically up to travelling to CM.

The OP has terminal cancer so withdrawal will not be an issue for him. The only issue for him is ensuring adequate pain control and managing unpleasant side effects. For those not terminal, of course, opiate withdrawal is a very real problem and a good reason to minimize their use.

Both nausea/vomiting and constipation are extremely common side effects of morphine and other opiates at any dose. Virtually every one suffers constipation from these drugs, unless they have soem other condition that offsets it. . The nausea/vomiting is more individual. Some people are more sensitive than others. Personally, I cannot tolerate even the tiniest quantity of any opiate (such as low dose codeine as in cough suppressants) without vomiting unless I also take an anti-emetic. No reason to think OP is taking "way too much" -- especially as he has terminal cancer. It sounds like the meds were not prescribed by a Palliative care specialist and that is what he needs. They are very, very familiar with these common opiate side effects and know how to deal with them. They also have a wider range of treatments and meds which can sometimes (not always) reduce the amount of opiate needed.

Closed at OP request.