Portal Venous Thrombosis (PVT)

[ozimoron]

Does anybody know if the hospitals in Pattaya have the skills to do an ultrasound and diagnose this condition? I had a blood clot in Pattaya a few years ago and the clinics failed to diagnose it. I travelled back to Australia and they diagnosed it immediately and hospitalised me. They didn't do much, gave me Clexane injections and then warfarin. Now I'm on Eliquis.

 

It's a serious issue and I need to make a decision quickly whether to try a hospital here or go home. Approx cost for an ultrasound in Bangkok Hospital (Pattaya)?

 

 

Edited November 21, 2022 by ozimoron

[Lacessit]

Your best option here would probably be to go to Bumrungrad Hospital in Bangkok, the facilities and doctors claim to be world class.

Condition your wallet for a severe beating if you do.

[Sheryl]

The issue is not the hospital -- all hospitals have the necessary equipment - but rather the skill of the doctor.

 

What symptoms exactly make you think you have portal vein thrombosis? This is not something one can self diagnose. I need to know the presenting symptoms in order to know what type of doctor to refer you to

 

@Lacessit I do not think Bumrungrad costs any more than BPH, in fact BPH is often higher cost wise.

[ozimoron]

31 minutes ago, Sheryl said:

The issue is not the hospital -- all hospitals have the necessary equipment - but rather the skill of the doctor.

 

What symptoms exactly make you think you have portal vein thrombosis? This is not something one can self diagnose. I need to know the presenting symptoms in order to know what type of doctor to refer you to

 

@Lacessit I do not think Bumrungrad costs any more than BPH, in fact BPH is often higher cost wise.

Last time it was preceded by blood in urine (bright pink), then a few days later abdominal pain and severe constipation, unable to pass a stool or eat for 3 weeks. This time, slight fever, I passed a blood clot in urine about 1 cm in diameter and constipation again plus loss of appetite. It's early days yet but I wanted to get in front of it just in case. I took a couple of senna capsules but, like last time, no effect after several hours. I have not suffered any constipation prior to this for at least a year.

 

The haematologist at home was going to take me off the Eliquis until I told him I was going back to Thailand. He told me to stay  on it. I missed one dose a couple of days ago.

 

edit: After the blood clot I started to take doxycycline (it was 1am) and the there has been no clot since or blood since. It's possible the doxy may be causing the constipation. I have a regular girlfriend, not live in. It is possible I got gonorrhea.

 

A couple of years ago I urinated a lot of blood and went to ER in Australia. Subsequently they did ultrasound, xray, MRI and cytoscopy but found no issues.

Edited November 21, 2022 by ozimoron

[ozimoron]

CT scan, not MRI.

[Sheryl]

Actually ultrasound would be first resort

 

OP - thrombosis is unlikely as you are in eliquis, but certainly let doctor know you have history of it

 

Could be urinary infection or  kidney stone among other things. Is there abdominal pain?

 

Problem is that doctors here are so specialized. You could start with a urologist to rule out kidney stone or infection, and ask him to pass you on to GI doctor if negative findings.

 

If you want to do this in Pattaya there has been favorable feedback on this  urologist

 

https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=205&depid=28

[ozimoron]

16 minutes ago, Sheryl said:

Actually ultrasound would be first resort

 

OP - thrombosis is unlikely as you are in eliquis, but certainly let doctor know you have history of it

 

Could be urinary infection or  kidney stone among other things. Is there abdominal pain?

 

Problem is that doctors here are so specialized. You could start with a urologist to rule out kidney stone or infection, and ask him to pass you on to GI doctor if negative findings.

 

If you want to do this in Pattaya there has been favorable feedback on this  urologist

 

https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=205&depid=28

There's slight sensitivity on my right side under the rib cage. Nothing more. No issues with urination. A specialist in Australia told me after a 6 month review that the chances of a thrombosis again was highly unlikely. The original blood clot was described as massive and block all three tranches of veins. Eventually, the veins grew bypasses.

Edited November 21, 2022 by ozimoron

[Sheryl]

17 hours ago, ozimoron said:

There's slight sensitivity on my right side under the rib cage. Nothing more. No issues with urination. A specialist in Australia told me after a 6 month review that the chances of a thrombosis again was highly unlikely. The original blood clot was described as massive and block all three tranches of veins. Eventually, the veins grew bypasses.

Certainly does nto sound like portal vein thrombosis (which in any case would be unlikley when on Eliquis). 

 

If I understand correctly what you currently have is:

slight fever, constipation, loss of appetite and some discomfort under the right rib cage.

And, separate from this (and probably unrelated) you had a single instance of blood in the urine.

 

If fever and discomfort under rib cage etc persist see a GI specialist, might be a gallbladder issue

 

As for I the isolated blood clot in urine, probably nothing and just related to the Eliquis, but it would be a good idea to have a urinalysis to check for any occult blood and see a urologist if present. That you have no trouble peeing does nto rule out pathology in the urinary tract and blood in urine can be a sign of kidney stones, bladder cancer, prostate cancer etc. All of which can exist with no other symptoms.

[ozimoron]

8 minutes ago, Sheryl said:

Certainly does nto sound like portal vein thrombosis (which in any case would be unlikley when on Eliquis). 

 

If I understand correctly what you currently have is:

slight fever, constipation, loss of appetite and some discomfort under the right rib cage.

And, separate from this (and probably unrelated) you had a single instance of blood in the urine.

 

If fever and discomfort under rib cage etc persist see a GI specialist, might be a gallbladder issue

 

As for I the isolated blood clot in urine, probably nothing and just related to the Eliquis, but it would be a good idea to have a urinalysis to check for any occult blood and see a urologist if present. That you have no trouble peeing does nto rule out pathology in the urinary tract and blood in urine can be a sign of kidney stones, bladder cancer, prostate cancer etc. All of which can exist with no other symptoms.

Thanks for that. Maybe the constipation was caused by the doxy. The symptoms have subsided now. I'm a little paranoid about a repeat clot since I nearly died from the last one according to the specialist. After the "gross haematuria" I mentioned, the urologist who performed the cytoscopy told me there's nothing unusual in a blood in urine occasionally. He also commented that my bladder looked quite healthy. He did mention some other condition that was apparent in the bladder (something like quilting?)  but said it wasn't a cause for concern. He was more concerned about my my prostate but the PSa was around high 3's if I recall correctly and 3.5 cm across the neck. He wanted to put me on duodart but I said I'd wait since I wasn't experiencing any difficulty urinating and haven't since. Again, I greatly appreciate you being here for us hypochondriacs.

Edited November 22, 2022 by ozimoron