MountainFun

11 hours ago, Sheryl said:

 

As I said before, the arrythmia needs more investigation. Do you have any copies of EKG, holkter report you could share? Even the actual rhythm strip showing what the doctor had pointed to, would help.

Hi Sheryl.  Yes sure, I will try and upload, appreciate you asking and having a look thanks.  The Holter is several pages so I will just upload the summary.  By EKG do you mean ECG?  

The UK doc refered me to some points on the Holter also, saying it showed eptopic beats?  She pointed me to a graph on one of the pages that shows a gap of sorts in between beats.  She also wants me to try and find, if possible, a wireless holter moniter that I can wear for 2 weeks.  I dont know if they have them in Thailand, probably not, might have to try and import one depending on price.  Maybe the Prof at Bangkok Christian Hospital has one, I am seeing him next week.

As a side note, my blood pressure is down quite a lot, which is great I guess.  I am taking BP medicines, but then again I was taking them before (Bisoprolol) so I guess the drop must be mostly owing to stopping smoking, and radical diet change?  Previously I averaged around 150/100, right now I am averaging out daily at 114/80.

On 7/6/2020 at 7:56 AM, 4MyEgo said:

Belated birthday wishes, hope you enjoyed your reds, good antioxidants so they say, I tend to find a glass of Vodka, soda and lime while watching a series on Netflix puts me in the zone for my evening siesta not long after, that said I still do drink, but a mild drinker, twice a week out to socialise a little and maybe shoot some stick, 3 glasses would be my upper limit over 2 and a half hours, sleep like a baby when I get home, as for beer, that sends me to the bathroom more frequently than does the VSL.

 

Glad to hear your chat with the UK specialist went well and her advice on you coming off of one drug and going back onto another, if me personally, I would wait till I saw the specialist Sheryl recommended you to see in BKK, because you don't know what he would suggest and you don't want to be coming off and going onto to more drugs in the mix.

 

Last but not least, you say your a stresser, most of us are, we just have to try to keep it under control, and if there is anything I will remember in this life is my late brothers words, mate, what we can't control, we can't control, get it, so just smile and as soon as the thought comes into your mind, focus on something else, I call it deflection, and I prefer to control my thoughts, not the guy in my head who wants to stress me out, so every time I think about how much longer will I live, who will look after the wife, the kids, etc, etc, etc, all we can do is plan to make sure things are in place and leave the things that we cannot control alone, we all have an hourglass and we don't know how long we have, so just eat well. exercise well, sleep well and breath that fresh every every morning and let the early morning sun touch your face, but do watch out for the mozzies ????

 

Good advice, and something I am working on for sure.  The last few days If I feel something coming on, palpatations or shallow breath, I just try and calm myself a bit and not jump to any conclusions.  Its easy to go down a mental rabit hole isnt it of like 'here we go, heart attack teritory' and start overthinking things when these episodes come.  Hopefuly I will get used to it and chill a bit more when it happens.

On 7/5/2020 at 3:29 PM, NancyL said:

You may want to consider elevating the head of your bed to be more comfortable and sleeping on your right side.  I have "heart issues" and we've elevated the head of the bed for years.  When we travel and I sleep in a flat bed, I notice a change after a night or two.  Last year we got a "Lady Americana" split king bed with electric motors that elevate the head and foot of each side of the bed.  The effect is great.  But the bed is expensive.  They're available at Home Pro, Bed, Baan & Beyond, etc.  

Hi Nancy.  I have seen those beds, they look great.  Right now I just sort of prop myself up on a  couple of pillows.  On a really bad night, I might have to jump in the recliner chair in the lounge and sleep like that all night.  Naff, isnt it, to have to do stuff like this!

On 7/4/2020 at 5:13 PM, Sheryl said:

A few glasses of wine should be fine.

 

The palpitations may be some sort of arrythmia and it is worth sorting that out but (1) they are not signs of a heart attack and (2) stress is likely to make them worse, might even trigger them. So while of course continuing your lifestyle adjustments, taking meds and having regular follow up, you should try to relax a bit.

 

As you were on bisoporolol before this I am wondering if the arryhtmia may be longer standing. Why were you put on it?

 

 

 

 

Hi Sheryl.  Yes that is a relief to know, the UK doctor said the same actually that palpatations is not a sign of a heart attack.  It does leave me wondering why I have them so often and if it is linked to the blocked vessels though.  The worst symptom i seem to have comes at night, when I try to sleep, often when I lie down I can really feel my heart working harder and I have a very slight problem with drawing breath.  Its not a major breathlessless issue its more like I have to work a little harder to catch breath.  I told the UK doc about this and she didnt seem too concerned so I guess I should just go with it.

I was put on Bisoprolol back in August when I first started having these problems.  A local heart clinic put me on them and I took them ever since.

3 hours ago, Sheryl said:

 

Most people do nto even have a RAMUS INTERMEDIUS, it is an "extra" branch of the left coronary artery that occurs in only  10-30% of people and it is rare for it to be the cause of a major heart attack. I believe it is also rather difficult to stent but as this is an unusual situation take the advise of an expert cardiologist. I have full confidence in Prof. Taworn.

 

Are the palpitations/fluttering continuing now that you are on meds? If so you may need a longer period of cardiac monitoring (i.e. more than 24 hours) or other electrophysiologic studies to get to the bottom of it. It is not necessarily related to the CAD.

 

In Thai culture the "not serious" bit is not a deception.  It is analagous to someone just saying "there, there, try nto to worry" and Thai patients understand this. You cannot blame a Thai doctor for using an approach that works in their own culture when that is all they know.

 

That said, I think you will get straight answers and explanations from Prof. Taworn who trained at UCLA and worked in the US for some years.

Thanks again Sheryl.  First of all just to say, my wife called the hospital today but was unable to book an appointment untill Monday, hopefully we can get down to Bangkok middle of next week.  I am definitley going to see Prof Taworn.

Secondly, the zoom meeting with a UK cardiologist I mentioned earlier in the week, was rearanged for today and I just came off zoom with Dr Clarke at Cambridge hospital.  She has looked at all of my results and spent a good 90 minutes on the zoom meeting with me.  She said the same as you: that the Ramus is a 'branch off' that not everyone has, and is one of the smaller vessels, not as life threataning as something like the LAD.  She also said that I would probably need a holter for 2 weeks to get accurate results as it looks like there may be some intaference in the 24 hour holter.  She said i probably do not need a stent fitted at this stage, there is no real need to panic right now and there is no need to rush home for further testing.  She said to continue with the lifestyle changes and in all probability I will be fine.  In her opinion it would be 'better' if I was at home for futher tests so she could conduct a stress MRI and a 2 week leadless/wireless holter, but it isnt something I should rush home to do and it could wait untill I was next back there.

She was slightly concerned that the medicine had not helped with palpatations, but feels there is no reason to be alarmed as I dont have angina, or any feleings of discomfort in the chest.  She said the slight bretahing problems i have when lying down might be an anxiety issue related to stressing or getting anxious about the palpatations.  I mean I had that just last night, at 2am the palpatations started a little, i went into panic mode a little thinking 'i have heart disease and this is the start of a major event' and the next thing you know I am sleeping in the recliner all night focusing too hard on my breathing.  It makes sense actually that there might be some anxiety causing this.  Im also acutley aware of my heart now, and the slightest flutter sends my imagination off.

She did say that I shoudl stop taking the Antanalol and change to Bisporolol, as the Antanalol probably does not help too much with the palpations and Bisoprolol would.  I was on Bisporolol before, since August last year, and the palpatations have been worse since the doctor here took me off them, so maybe she is right.

So all told, that was a great zoom call.  I feel relieved.  There is no reason to worry about dropping dead in the next few months, touch wood.

Just for absolutle peace of mind I will go and see Prof Taworn next week.

Can I ask what might be a silly question?  Its my birthday tomorow and whilst I am not in any way a big drinker (and have stopped completley since diagnosis) it would be nice to go out and have a few glasses of red wine with a nice meal.  I forgot to ask Dr Clarke if that would be ok.  Its not that important, would just be nice to round off a stressful week with a steak and a few glasses of wine for my birthday.  Is that a terrible idea, all things considered?

2 minutes ago, 4MyEgo said:

Your welcome.

 

As I moved to Thailand in 2015, 7 years after the heart attack, I had the procedure carried out back in Sydney and at no cost under Medicare, albeit you would pay 2% or so tax if working, or if not working no cost.

 

Sheryl has offered you some great advice, as have some others, I would run with what suits you best, but as Sheryl stated Thai doctors tend to work differently to western doctors when it comes to disclosure, and if I was to get treated, it would have to be someone who was trained overseas, or go back home for the treatment, that said, if you are still covered under the system back in the UK, might be best to go back down the track if it's not going to cost you anything, I know it costs here and it ranges, but what price do you put on your life if you have to have it done and to be honest, none of my business, but to survive here you need private health insurance, otherwise your exposed or at least have enough funds to self insure as Sheryl mentioned with at least 3 million in reserves, hence the reason I depart with 63,000 baht per annum for private health cover for emergency and covering my pre-existing condition.

 

You have now found out that your body is like a car, it needs good oils changed every 15,000 kilometres, a regular service, new tyres, and regular maintenance, and don't forget the insurance, let it fall apart and well that car (your body) won't run as good as it should and you might just blow a motor or a gearbox etc etc, wouldn't want to think about brake failure going down a hill (heart attack) ?

 

Keep eating well, take your meds, exercise, research, research and research, and Dr Berg, love his video's straight into my inbox, wait till he starts talking about insulin resistance, which leads to heart attacks, strokes, diabetes and the rest, fascinating stuff, that no one else explains so well, as for Keto, I haven't started that yet, but I have reduced my carb intake and really only eat twice a day, a little yogurt in the morning with some homemade muesli and a banana, adding some electrolytes to water which is great, and yep you will hear about electrolytes, potassium, magnesium, vitamin D and so on and so forth, very educational stuff on how to keep our cars (body's) in shape and how not to over indulge on the <deleted> refined carbs, a good triple decker for lunch sandwich on brown bread with egg, melted cheddar cheese, lettuce and tomato keeps me going till 5pm for my salmon and salad or veggies.

 

Look at this as the new beinging.

 

Thanks, I will indeed look at this as a new chapter.  Ironicly it could have saved me in some way, my diet was terrible and I was smoking up to 2 packs a day on a bad day.  If I can survive this (and dodge the cancer bullitt over next 10 years that all those smokes propose) i might just go on to live LONGER than I did had i not got CAD because I likely would have continued to smoke and eat garbage.

I really do enjoy this new diet, im suprised how easy it is to eat healthy and how good it tastes.  I have honestly never cooked a salmon, mackeral or tuna in my life untill this last 10 days and its great, I love it.  I made a seared tuna the other night with roast asparagus and salad and i thought blimey, this is honestly good enough to serve in a half decent restaraunt!  And it took like, 15 minutes.  So much better than throwing an XL lasagne in the microwave served with a bunch of chips, as I used to do.

Well done to you for keeping a firm grip on your health - I wish you a long and fun life and im sure you will have it ????

4 hours ago, Sheryl said:

I suggest you come to Bangkok and consult this excellent Cardiologist:

 

Prof. Taworn Suithichaiyakul (sometimes spelled Thaworn). US trained and president of the Thai Heart Association

 

https://www.bch.in.th/find-doctor/doctor-profile/?smid=4730

 

The usual indication for a stent is at least 70% blockage so with 75% it might be advised though will also depend on which vessel is affected.

 

Bring all your test results with you including actual films/CDs not just reports

 

Saying "not serious" or "no problem" is a cultural trait in Thailand no matter how actually serious something may be, and this finds its way into medical practice.   Thai doctors will do this literally up to a patient's death even when it is blatantly obvious that the patient is in serious condition. To the Thais this is considered good patient skills and emotional reassurance. ...and Thai patients know not to take it literally.   Thai doctors who have trained and worker in the West, like Prof. Taworn above, will be less likely to do this and will be more direct in  their communications.

 

Certainly CAD is something to take seriously but millions of people live for decades with it.  The medical regimen you were put on is pretty standard, and you are making the right lifestyle changes so the only remaoning issue is whether or not to consider a stent for the most blocked vessel. And of course to have regular follow up.

 

You do not mention the results of the 24 hour Holter but the palpitations and  flutters you report strongly suggest a cardiac arrythmia of some sort, did the doctor mention it? What does the report of the 24 Holter say? You may be  experiencing either atrial fibrillation or paraoxysmal atrial tachycardia/flutter and this would be why the atenolol was prescribed. There are risks associated with AF quite apart from the risks associated with CAD. If you do have AF,  given your young age and depending on your overall physical condition there are more definitive treatments that might be considered e.g. cardioversion or ablation. Prof. Taworn can advise on this.

 

 

 

 

 

 

 

 

Thank you so much for the cardiologist lead, I will call them first thing tomorow morning and book the earliest available appointment.  

Its shameful that the doctors report 'not serious' for soemthing that really could be serious.  They are suposed to offer a proffesional prognosis, not pull the wool over patients eyes thats terrible!  That is such a Thai aproach its incredibly annoying!

Which vesell is affected....basaicly, quoting the CT report:

LAD: Calcified plaque at proximal LAD causing mild stenosis 25%.  The rest of the LAD, including the 1st diagonal branch appear normal.

RAMUS INTERMEDIUS: Calcified plaque at origin and proximal part, causing severe stenosis 75%

Other findings: Two small group of subpleural blebs at left apical lung are seen

Good LV systolic function without regional wall motion abnormality

The holter report showed nothing alarming, apart from a few blips here and there which he pointed out (on the graph) and said "this not normal, but dont worry not too bad".  Again, quite vague!

The echo was normal, he said the shape and structure of my heart was good, as are the valve functions

The ECG was also normal, but that usualy is.  

I strongly suspect I have had 3 or 4 episodes of AF over the last 12 months.  Each episode was way more than heart palpatations and is quite hard to explain, but they are are series of hard, weak, fast and slow beats all in a few second period, lasting for a few hours.  Moving around makes them way worse.  The palpatations I have are more like little flutters, skipping beats, but the 3 or 4 times i suspect it was AF was way different.  As I said, different verocities, jumping up, down, left, right!  Hard then weak, fast then slow.  Very strange and unsetteling to say the least.  I can think of 4 times that has happened total, in one year.  Hopefuly with the diet change, stopping smoking and the meds, they will not return as they are quite scary.

Thanks very much indeed for the advice and Doctor suggestion, I will absolutley go and see him as soon as possible, with a little luck early next week if he can fit me in.

3 hours ago, lopburi3 said:

You also have to be cleared for travel with Thai Embassy paperwork at the current time I believe.  Also have 100 thousand in medical insurance I believe is another requirement and then get queue ticket for flight.  Still not easy to return.

 

But 75% is not considered that bad in my understanding (they will not even stent if less than 70%).  As said above get a review by a doctor outside of a bar and try to stress less.  Know it sounds bad at your age but most people live decades with such issues and you seem to be on the right path with your lifestyle changes.

Thanks Lopburi, thats a relief to hear.  I know the disease is incurable, but hopefully with the meds and lifestyle changes I can possibly reduce it a little?  Im doing everything I can anyway.  No coffee, tea, only water basicly with the odd electrolite.  Fish every night with salad, beans, seeds, olive oil, avacodos, loads of gralic and garlic supplements, fish oil suplements.... Basicly everything and anything that is supposed to be good for the heart.  Trying my best ????

So there is a que system for flights to thailand from UK?  Yah, I guess that makes sense although stupidly that never occured to me.  There must be a bunch of people desperate to get back to be with there families right now.  I wonder how bad the wait is?

3 hours ago, 4MyEgo said:

The best part about this is that you have identified a very common problem, let's not forget that heart attacks are one of the biggest killers to us mere mortals around the world, why so, well, we are what we eat, and of course smoking doesn't help.

 

The above said, it doesn't hurt to get a second opinion if you do not have the confidence in this Cardiologist, and I am sure he didn't tell you that you had CAD because he probably saw you as a worrier and didn't want you to worry further, the meds will do their job in reducing your cholesterol, blood pressure and thin your blood, I get blood test every 6 months to keep a check on things, and they are spot on, always at the lower range, so get ready for some education for yourself.

 

I suppose I woke up and realised what that saying really meant, i.e. 'your body is your temple', treat it badly and it will eventually crumble. You will turn this around, I have had 12 years with a stent and meds and all going great.

 

Sheryl will come along when she can and provide you with a few Cardiologist choices and perhaps give you some solid advice on your situation, she is a valuable asset here on TVF.

 

Try not to stress, it doesn't help your situation, I used to be under a lot of stress from work, but as the Cardiologist said to me back then, either change jobs, or retire early as stress kills, however is not scientifically proven, just his opinion at the time, later a fews years after it was proven scientifically.

 

One day when they cut out all those processed carbs in our foods, or people start to realise we have been poisoned all of our lives with what we eat, then only will we see less people dying from heart attacks and living longer.

 

I do have a question for you, has anyone in your family passed from or had a heart attack, because it can also be hereditary, e.g. my dad passed from a heart attack aged 72 as did all his brothers in their 70's, but mine at 47 was due to over exerting myself, 4 times in one day shouldn't be attempted by any means ????

 

Hope my replies have put you at ease a little and offered you some insight.

 

This guy is a legend, subscribe and listen, he covers everything.

https://www.youtube.com/watch?v=WgVJyMsNpQI

  

Thanks mate, appreciate that - great reply!  Glad to hear you are doing well with the stent and general health.  Can I ask, did you have the stent fitted in Thailand?  I dont know if I actualy need one, although its looking likely, but I dont have health insurance so cost is a factor.  I have heard different prices for the procedure, between 250,000 and 600,000 THB.  If it costs as much as that, I would be better to go home to the UK (I think) for a few months.

This has been a wake up call for me, absolutley.  I have never really looked after myself that great with the smoking, terrible diet, and bouts of drinking too often.  Its only been 10 days on this really strict new diet, but strangely enough im really enjoying it.  I just had a real nice scottish salmon fillet, baked in the oven with chilli and a huge bowl of salad - and it was better than any pizza or lasagne i can ever remember eating ???? also quitting smoking has been much easier than I always feared.

I have just subed to that YT channel thanks for that, will have a gander through some of his videos today.

6 minutes ago, NancyL said:

Keep in mind that if you return to the U.K. for medical treatment, you may not be able to return to Thailand for a long, long time because of Covid restrictions.  It would be a good idea to seek  second opinion here.  Sheryl should be along shortly to give you a good recommendation of who to see.

Thanks Nancy.  Yes I agree, that could be a problem.  As it stands right now as you know I would be fine to return (I am married here and have a long term visa), it means staying in a covid hotel for 14 days at 30 to 60,000 baht but if thats what I have to do so be it.  The problem I guess is if the infections spike back in the UK, which is quite likely.  If that happens I could be stuck there for who knows how long.

15 minutes ago, rak sa_ngop said:

I have a history of heart palpitations and atrial fibrillation. One thing I have learnt since the Covid-19 lockdown is that putting stress on body by excessive exercise or stressful situations can stimulate my irregular heart episodes. Since lockdown I have stopped running in the park and stopped swimming, and lo and behold my irregular heart episodes have almost disappeared. I have had a few mild episodes when I experienced some stressful domestic situations.

 

So some of your heart problems are maybe being caused or exacerbated by the the stress and anxiety you are experiencing. That is not to say you do not have other heart issues, but reducing your stress levels can help with the palpitations....if you can do it.

 

Check out the effects of the vagus (vagal) nerve on the heart.

Thanks, Ill have a read up on that - glad to hear you are doing much better.  

3 minutes ago, dddave said:

It would seem obvious that gathering all your test results and consulting with a top rank cardiologist, perhaps in Bangkok  would be your first option but whether or not that would provide a more definitive diagnosis and prognosis is questionable. 

There's an old trope that says the more watches a person has, the less certain they are of the time.  That wisdom can also apply to having too many consultations; which opinion does one chose to follow.

I experienced what I called "pressure" in my upper chest any time I exerted myself for a year, totally in denial. A friend who is a former physician visited for a few days.  When we were on a quiet walk and I had to stop and sit because of "pressure", he basically dragged me by the ear to a local hospital for some tests.  Similar to your experience, I was told I had a "mild" blockage; less than 30%, was given nearly the same meds as you and sent on my way with the admonition to loose weight, eat better food and exercise.

I did ok on taking the meds, not so much with the weight loss and diet.  I did try to walk at least 1km a day.  

Things were tight financially for me at the time. Though the local cardiologist did say a stent would probably be a good idea, I couldn't afford it's B300K-500K price tag and waited an additional six months before I was able to return to the USA where I get free veterans health care. 

I went directly into an "Urgent Care" unit at my local Veterans Hosp. and complained of chest pain.  I was in a ambulance within 15 minutes going to their surgical center.  Several days of tests later, I was on the table for a stent when I kind of died.  I was resuscitated and awoke the next day, having had a triple by-pass.   My blockages were much more severe than had been indicated in any of the testing and as a result, I came very close to checking out.

This was all three years ago.  I recovered from the surgery and have had a normal life since.  I'm in my 70s.

 

All this to say that testing only reveals so much and doctors can only make educated guesses as to what is really going on.  If you feel something going on inside that doesn't feel right and aren't 100% confident in what the Doctors are telling you, then you need to educate yourself as much as you can and advocate for yourself.   

If you think you need a stent, then push for it and make them explain why not.

Thanks Dave, and well done for pulling through.  Blimey that is scary to say the least.  Your story sort of confirms my opinion that I do need a second opinion to be honest - I am told 75% blockage in one and 25% in another but I mean who knows, it could be worse than that.

I simply cant afford to have a stent fitted here if it is 500K.  The pandemic wiped out my busienss earlier this year and for 4 months have been living off savings.  I have enough stashed away for me and the wife to live well enough for another year while I figure out my next business move, but with hospital treatment in Thailand that would wipe me out almost.  If I am looking at stents or anything of that nature, I think I need to go home to the UK for a couple months, get in the system again and hopefully get treatment there.

Good luck mate, stay healthy

12 minutes ago, churchill said:

I have similar problems to you and take similar medications .. I am 62 and had a calcium score of 137 . I had catheter ablation for palpitations which did not really work and then later had a cardioversion which was more successful . I take cordarone 200mg along with 2.5mg concor  which slows the heart and keeps the palpitations under control , although recently I have noticed a few flutters .

 

I think you need to get your palpitations under control , they can be very stressful .

 

I am sure this can be managed in Thailand , I don't think you should worry .

 

I do regular exercise classes and push as hard as I can ... however I did crossfit previously and found this too much .

 

Good luck 

Thanks Churchil, appreciate the advice.  

Its a wierd thing with the palpatations, I dont know if you find the same but sometimes I think 'ah ok, thats normal, just my heart working it all out' and other times I think '<deleted>, this is the one that send me to the grave'.  You are right it is stressfull, the amount of times I thought I was dying in the last year, that cant be good for the soul!

Anyway, it would be nice just to get a firm, concrete second opinion from a cardiologist here who can say yep, your done for mate... Or calm down you big girl, you are going to be fine.  Just to know, either way, would be good as a starting point to planning all this.

Keep up the exercise, well done mate.

2 minutes ago, RichardColeman said:

Why ? Plenty of B and B's around the UK for long term workers, etc. I'm stuck in the Uk now and I can get a room £70 a week - though I pay £90 for a larger room. Which is little more than a Thai condo or house. Course, you may have to stay in a city town that you don't like if on a budget

Hi Richard.  I couldnt see much on airbnb in the way of value to be honest.  I have a budget of 2000GBP for 6 weeks, looking under monthly rents on airbnb all I could see for that money was small rooms in shared houses.  I tried looking at a few different areas, within 50 miles of cambridge (good hospital there) and within 30 miles of Watford (friends there) and seen nothing in the way of 'entire place' for that budget.  There is nothing wrong with just a room only of course, but I just dont want to lol.  Its been a naff year, lost my business in March because of covid and now have heart disease - I dont want to be stuck in a room with a shared kitchen for 6 weeks on top of it all.  

I could stay with family, but that would be a nightmare after 5 days.  I have friends I could stay with also, but again I just dont want to for different reasons.  Not being picky or anything, there are genuine reasons why it sbetter I stay at my own place.

That is assuming I even need to go back.  Hopefuly I wont have to.

Hello everyone, thanks for having me in the forum. 

After having some heart issues over the last year, mostly random palpatations and a few pretty scary episodes of wild heart flutters, we had a holiday a couple of weeks back and whilst in the hotel one night I was unable to sleep lying down, I couldnt catch my breath properly and had realy wild palpatations when flat.  I had to sleep in a chair all night.  Actualy thats not the first time over the last year I have sleapt in a chair all night, either.  I have been to three different hospitals about this since August (and one heart clinic) and have had blood tests, ultrasounds, x rays, and the obligatory ECG.  Each time I was told I am fine, probably too much coffee or something (despite always telling them I only drink one cup a day in the morning).

After this holiday recently I went back to my local cardiologist at Bangkok Hospital, Udon Thani and had an ECG.  He told me everything appeared fine and suggested changing my BP medicine.  I put my foot down a little, told him I could feel something serious was going on and demanded a battery of tests.  So I had the lot - a full heart check up includiong echo, CT, BP/ECG, Blood, 24H holter, stress test, Xray.  I have no insurance and the tests cost me 27,000 baht. The blood test showed a high colesterol and lipd count but more alarmingly the CT scan showed actual heart disease (although they didnt tell me it was heart disease at the time).  I have a calcium score of 120, and 75% stenosis (narrowing of vessel) in one vessel, and 25% stenosis in another.  According to the CT report, this places me in the 89th percentile - meaning I am in the bottom 11% for people of my age group.

The Doctor told me, and I quote 'not serious, not serious, can give medicine to help, come back in 1 month'.  I thought oh well ok, not serious thats great!  But then a retired British GP who I got chatting to in a cafe the following morning purely by chance told me actualy, this is very serious - its Coronary Heart Disease.  How could the cardiologist not tell me that the day before and just say 'not serious'?  The CT report clearly states in English that without lifestyle changes, a major cardiac event/stroke could be expected in 3 to 5 years.  is that not serious enough???

Anyway, I was prescribed some medicine: Atorvastatin 40MG, Asprin 81MG, Atenolol 50MG and Losartin 50MG all once a day after breakfast.  I have radicly changed my diet for the last 10 days, leafy greens juice with a little fruit in mornings, im eating seeds, nuts, berries and salads for lunch and fresh salmon/mackeral/tuna with salad for dinner.  I was a smoker, but quit cold turkey 10 days ago.  Im not expecting immediate results of course, but plan to stick with this liefstyle change for years to come now.

I am nervous about my condition though.  I dont know actualy how dangerous this is.  I went back to my cardiologist a few days ago and asked him, do I actualy have Coronary Heart Disease then?  he said yes.  So I asked him, why did you not tell me that and say it is not serious?  He said it isnt too serious and the medicine should fix it because the 75% blockage/narrowing is "only in one vessel".  But I dont know, I mean this retired GP seems to think I could keel over at any moment.  He said "you probably wont, with medicine, staying off the smokes and healthy diet, but yes im not going to lie according to your report you are in dangerous ground right now"

I dont know who to believe.  I have been trying to set up a virtual consultation with a cardiologist in the UK but it has been problematic.  I paid 320 GBP for a cardiologist in Cambridge, UK, to look at my results and have a 60 minute zoom call with me but after spending a really stressful week trying to get my reports over to her clueless secretary (she couldnt open CSV files and then Google drive links) and lots of messing around (46 emails swapped in 5 days), the meeting has been rescheduled three times and I eventualy gave in, threw a bit of a wobbly with her and cancelled the whole thing.  Im in the process of looking for someone else and hope they will refund my money.  I would like someone to look at the results and just simply tell me, yes this is really quite serious - you need a stent fitting right away, OR dont worry, medicine will help, stay with the diet and off the smokes and you will be fine.  Im just looking for concrete advice.  

I am begining to worry here quite a bit.  10 days into the medicine and lifestyle changes and I still have heart flutters, occasional palpatations and sometimes feel just a little short of breath.  I want to start excersising but worry I will drop dead half way around the jogging track.  I am only 46, but worry I might only have weeks/months or a few years to live.  I really havent been told quite how dangerous this is.  My cardiologist seems popular with the local ex pats here (one guy on a local forum reporting that this doc saved his life when other cardiologists failed him) so he must know his stuff.  But I cant get out of my head the fact that he was so nonchalant about it all, saying it is 'not serious' and not telling me I had CAD for a full week untill I went back and asked!  Compare that to the British GP who although it was only a casual chat seems to think it IS serious.

Should I pursue finding a cardiologis back home in the UK and look at my results remotley?  Or should I find a Thai cardiologist with a good reputation to look over my results and offer a second opinion?  Apparently there is a great heart hospital in khon Kean but it is government hospital, which means sitting around in a waiting room for hours and hours being shuffled from pillar to post, with poor English skills (and my Thai is terrible).

Should I fly home to the UK and put myself through the system?  My sister seems to think that is a non starter as there is a massive back-log of patients waiting to be seen there owing to the pandemic?  I also dont have property in the UK which means having to stay at expensive airbnb's.

I really dont know how to proceed and im really quite worried here.  As I said, I am only 46 - not ready to keel over and die just yet!  I just wish someone could look at my results and confirm as a second opinion, if this is a serious issue that could kill me in the short term, or not.

Any advice greatly appreciated, I am very very worried here!

Thanks!