Heart Disease diagnosis

[sidjameson]

I had a very similar experience years ago in Japan. Palpitations where I thought my heart would explode. Chest pains so bad that I was scared to fall asleep as I thought I may not wake up. Drs gave me the ECG tests and said it showed nothing. 

Even when there was no symptoms I would find myself walking and doing nothing but monitoring my heart waiting for the next episode.

When the stress in my life was sorted.....now my ex wife lol.....its been 99% better. This for the last decade. Strangely just this last week I did havea 20 sececond episode, first "non small event" in years.

Start of lockdown had first chest pains in years too. 

Examine the stress in your life.

Just wrote, in case the do nothing option after disappointment at the hospital is your route.

[lopburi3]

7 minutes ago, MountainFun said:

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?

I would review those reports and echo cardio for heart status - CAD by itself does not mean there is anything wrong with your heart, it may be fine.

 

[4MyEgo]

1 hour ago, MountainFun said:

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.

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 beginning.

 

Edited July 3, 2020 by 4MyEgo

[MountainFun]

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.

 

 

[4MyEgo]

3 minutes ago, MountainFun said:

I will absolutley go and see him as soon as possible, with a little luck early next week if he can fit me in.

Let us know how you go and best of luck. 

[MountainFun]

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 ????

[4MyEgo]

2 minutes ago, MountainFun said:

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. 

Good attitude to have, and yes I reckon the palpitations (I'm no doctor), were a sign your body was saying, oi, your slowly killing me and if you didn't like how I responded to you choking me with the 2 packs of smokes a day, consider yourself lucky you didn't hit the tarmac as other do, so you got the message, your still alive and on the amends because you sort medical help, albeit with your persistence when others were telling you that you were ok.

 

It's now your the 2nd chance at life for as long as the body gives you, take care of it, respect it and feed it good oils and the old ticker should go for a good couple if not more decades, that's what my Cardiologist said to me, so I am almost halfway there ????

 

[Trillian]

9 hours ago, MountainFun said:

 

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.

 

 

I think their interpretation of what is serious or not is a relative thing. I had a CT64 slice diagnostics test done first and that showed one blockage of 87% and another of 92% yet there was no sense of alarm or urgency on the part of the doctor at BG, he simply said to me that the next step is the gold standard angiogram test and to see what that says, when you have time.....I was asymptomatic BTW and only came across the problem as part of my annual cardiac stress test. So my interpretation of your finding of 75% stenosis is not necessarily a major high priority risk, medical people may disagree however.

 

With regard to drug eluting stents versus bare metal stents: if you get to the point of having to decide which to use, the former are significantly more expensive than the latter and studies have shown there is no difference in the twelve month mortality rates of patients using either one. The caveat is that both types of users are prescribed blood thinners as well. The medicated stents exhaust their supply of drugs after about three months as I recall.

 

[Sheryl]

16 hours ago, MountainFun said:

 

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.

 

 

 

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.

[MountainFun]

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?

 

 

[Sheryl]

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?

 

 

 

 

[Sheryl]

P.S. What you might want to go easy on is caffeine, in addition to stress this is often a trigger for arrythmias in susceptible people.

[scubascuba3]

Sounds like you need to work on the anxiety, it doesn't help, just causes problems. If you get that under control you may feel a lot better

[Why Me]

Just want to throw this in here for the OP to consider if he does require surgery at some stage. Consider getting it done in India. There are some very good hospitals in the major cities and the cost is a fraction of Thailand.

 

E.g., this site

https://www.indiacardiacsurgerysite.com/cardiac-procedures/angioplasty-surgery-cost-in-india/

says angioplasty costs on the average Rs. 200k, about 85k THB.

 

Top Indian hospitals do get foreign patients so they know to make arrangements and you can teleconsult with their specialists first.

 

But I don't think you'll need any of this. A diet rich in tuna and salmon you say? You'll live to 120.

[tavernier]

MountainFun,  Been there, done that, and far worse than you. If you want to live for a long time, read and act on an e-book named Eat rich, Live long by Ivor Cummings. It is serious, state of the art, and nearly free. - By the way the NHS pays my pension.

[NancyL]

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.  

[4MyEgo]

On 7/4/2020 at 7:34 PM, MountainFun said:

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. 

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 ????

 

Edited July 6, 2020 by 4MyEgo

[izod10]

On 7/5/2020 at 12:13 AM, Why Me said:

Just want to throw this in here for the OP to consider if he does require surgery at some stage. Consider getting it done in India. There are some very good hospitals in the major cities and the cost is a fraction of Thailand.

 

E.g., this site

https://www.indiacardiacsurgerysite.com/cardiac-procedures/angioplasty-surgery-cost-in-india/

says angioplasty costs on the average Rs. 200k, about 85k THB.

 

Top Indian hospitals do get foreign patients so they know to make arrangements and you can teleconsult with their specialists first.

 

But I don't think you'll need any of this. A diet rich in tuna and salmon you say? You'll live to 120.

Ill say, light years in advance of Thailand,I undertook surgery there (few times)  likened to stepping on a conveyor belt,every bod for miles around,the world and his wife want blood/samples of whatever before commencement Medifee.com      Can get there and back in a morning parts are close to BKK 

[MountainFun]

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.

[MountainFun]

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!

[MountainFun]

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.

[4MyEgo]

25 minutes ago, MountainFun said:

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.

There was a time that I had trouble breathing due to a chest infection and a narrowing of my windpipe due to an allergy, I found that a puffer helped make my breathing better, you know like asthma sufferers use, might want to discuss with your doctor/specialist, and believe you me, if and when you have a heart attack you will know it, for me, it was a crushing chest pain, right smack in the middle between either side of your pecs and when I say crushing, imaging a the back part of a stiletto (kinky) I know pressing really hard against that section with you not being able to breath, I put my head to my knees and tried hard to relax as I knew something really bad was wrong, and desperately tried to relax with my wife saying she will call an ambulance with me putting my hand up with one finger as to say one minute, as the pain slowed and I could breath, I put my jeans out and headed to the car, her in pursuit jumping into the passengers seat as the car was leaving, hospital 2 minutes up the road, the rest is history, had I waited for an ambulance, who's knows, Cardiologist said I was lucky that the ambulance got me to the hospital quick enough as there was no muscle damage to the heart, told him I drove, he looked at me and shook his head, looking around and then said, wouldn't recommend it when having a heart attack, but glad you made it ????

 

[sapson]

 

Quote

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).

.......................................

 

 

Been to the heart hospital Queen Sirijit at Khon Kaen many times, they have an evening clinic after 4pm which isnt so chaotic and the prices are much less than the regular private hospitals.

 

They too can be not serious dont worry, I had missed beats in the morning then in the evening for a while heart was skipping every 6/7 th beat so got myself to this hospital and of course ECG was ok and palpitations skipped beats had calmed down...... so sent on my way with explanation PVCs normal.

 

However what could help you they have a premium clinic Monday to friday 8am intil 4pm its on the same floor as outpatients and ER and you are unlikely to wait at all, you could order have all the tests you want at a major saving on private hospitals. I think their Stent price is around 200k if it came to that.

 

Clinic has separate entrance etc peaceful reception few people and an English speaking nurse.

Edited July 7, 2020 by sapson

[geriatrickid]

You cannot reverse the blocked arteries and you cannot change the past, but you can change the future and slow down the progression of heart disease.  Your decision to stop smoking is the most important  change for the best. Because of that, you will see some improvements within 90 days. Your cholesterol levels will be  impacted in a positive manner.

 

Next up is your diet change. Common sense will guide you. Forget about nutritional supplements, vitamins and  all those fanciful concoctions. What they don't tell you is that most of those products are either difficult to absorb or to metabolize. Vitamins and minerals obtained from a natural diet are not only more cost effective but are absorbed and metabolized much easier.

 

Accompanying all this is a  cardiac rehabilitation program. It pays tremendous dividends. Exercise will reduce the cholesterol and  bring back a life you thought was long gone. It is an established fact that the patients most likely to have normal lives, to recover after a heart attack or stroke and to minimize the mental health issues associated with the disease are those who have  undergone a cardiac rehabilitation program. What this is, is a  supervised  exercise program that teaches you how to exercise while monitoring  the heart and body functions. This is what kinesiologists are trained for.

here is a quick summary of what rehab does. https://www.heart.org/en/health-topics/cardiac-rehab/what-is-cardiac-rehabilitation

here are more specific details in the pdfs. 

https://www.heartfoundation.org.au/recovery-and-support/cardiac-rehabilitation-for-health-professionals

 

Some  of the Thai teaching hospitals can offer this. Even some of the private hospitals do.

https://www.health-tourism.com/cardiac-rehabilitation/thailand/

 

Readily available in Australia, Canada, USA, EU and UK.

best investment a heart patient can ever make and pays off better than all the vitamin supplements and self help  books.

[Sheryl]

15 hours ago, MountainFun said:

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.

 

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.

[sapson]

On 7/3/2020 at 1:21 PM, 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

Would really like to know where you can get accommodation in the Uk for 90 quid a week or less, do you have any details? Seems many places need employment and Uk bank references etc .....if only going back for 6 to 9 months thats not easy.

 

Any information appreciated, thanks.

[scubascuba3]

1 hour ago, sapson said:

Would really like to know where you can get accommodation in the Uk for 90 quid a week or less, do you have any details? Seems many places need employment and Uk bank references etc .....if only going back for 6 to 9 months thats not easy.

 

Any information appreciated, thanks.

check airbnb and gumtree, also you can offer 6 months in advance then the landlord doesn't worry so much if you can pay or not so is more likely to accept you with no employment, references etc

[izod10]

It is possible to seek out a private doctor,possible for 300 or so,then short list you onto the NHS

[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.

 

 

[Sheryl]

You are not in A fib, that much is clear.It appears you have both occasional premature ventricular contractions and premature atrial contractions. In this recording it did not capture any prolonged episodes of either, longest seems to have been 3 in a row and that, only once. Occasional isolated premature beats will not cause the symptoms you report and do not require treatment. 

 

It could be that at other times you have occasional longer runs, would need a longer period of monitoring to determine that and indicated only if these symptoms continue to trouble you. Or it could be that the symptoms you report are due to anxiety and not a cardiac cause.

 

For both premature ventricular and atrial contractions, common triggers are: caffeine, stress and smoking.