Angiogram/Angioplasty

[GregBow]

Looking for advice.

I am 68 and retired last year.

I did a complete physical check at Bangkok hospital in Udon.

The ECG and ECO show a blocked left ventricular artery and follow up was recommended with Angiogram and Angioplasty if needed. 

Angiogram I was quoted 40 to 50k plus another 50k for overnight stay in observation room.

If Angioplasty is needed 250k with one stent and 50k per additional.

My queries are below 

1) If anyone can advise if this is reasonable price?

2) should I do in Udon or would Bangkok be better?

Note I live 50 km after Bueng Kan and travel is a nuisance but doable.

I now feel a bit uneasy about living in a remote village and think maybe this will drive me to move to the coast near say Rayong. 

I assume access to Rayong decent medical services and long term rental is a big change to my retirement life plan but after working for so long I would like to live on and enjoy for a while.

Thoughts and ideas please?

[Sheryl]

Prices are reasonable for a private hospital but it would be significantly less at a government hospital. 

 

Aldo need to consider the experience and expertise of the doctor. 

 

Both on cost and quality grounds I recommend you  go to the Khon Kaen University Heart Hospital https://heart.kku.ac.th/

A long drive but well worth it. Will cost much less than in Bangkok 

 

Good idea to relocate to less remote place. Rayong is not great for medical care (no place on the coast is except Songkhla) but is certainly better than where you are now. And not too bad for travel into Bangkok. 

 

Best places for medical care are Bangkok, Chiang Mai, Khon Kaen, Songkhla. But air pollution a big minus for CM and Bkk. 

 

 

[scubascuba3]

Have a read of this so you have an alternate view on whether worthwhile

 

https://www.drmcdougall.com/education/information-all/the-angioplasty-debacle/

[Peabody]

About 2 months ago, I had some minor chest pain, difficulty catching my breath, and extreme sweating, even in air con. I was at Central Festival at the time. I drove across the street to Pattaya Memorial.

They did an EKG, said I was having a small heart attack. They said they were not equipped to handle it and took me in an ambulance to Samitivej in Sri Racha.

Angiogram showed almost zero blood flow in left coronary artery. Doc installed 2 stents. Stayed 2 nights, discharged on my 71st birthday.  The nurses gave me a nice party!  Now 90% flow.

Total cost: 660,000 THB (out of pocket).

Now on expensive drugs for at least the next year, total about 10,000 THB/month. Statins, aspirin, anti-coagulants, etc..  Brilanta is the worst. ~ 4,500 THB/month. Might switch to Pavlix after one year.

BP was regularly 135-140/80-90. Now 100-110/65-70 every day.

May have been cheaper at Pattaya City (if they could even do it) or Bangkok Pattaya hospital, but I was in no shape to shop around.

One thing I like about living in PTY is the availability of several hospitals. Hope that helps to inform your decision.
 

Best of luck.

[prakhonchai nick]

If you are in Udon, then you are not too far from Khon Kaen. I recommend the Queen Sirikit Heart Hospital there.   Had stents done in Bangkok, for much the same price as was quoted, but later had a  defibrillator inserted under my left shoulder for about 60% of the price quoted by Bangkok Hospital.  Excellent service, very helpful doctors...thoroughly recommended.

[Sheryl]

1 hour ago, Peabody said:

About 2 months ago, I had some minor chest pain, difficulty catching my breath, and extreme sweating, even in air con. I was at Central Festival at the time. I drove across the street to Pattaya Memorial.

They did an EKG, said I was having a small heart attack. They said they were not equipped to handle it and took me in an ambulance to Samitivej in Sri Racha.

Angiogram showed almost zero blood flow in left coronary artery. Doc installed 2 stents. Stayed 2 nights, discharged on my 71st birthday.  The nurses gave me a nice party!  Now 90% flow.

Total cost: 660,000 THB (out of pocket).

Now on expensive drugs for at least the next year, total about 10,000 THB/month. Statins, aspirin, anti-coagulants, etc..  Brilanta is the worst. ~ 4,500 THB/month. Might switch to Pavlix after one year.

BP was regularly 135-140/80-90. Now 100-110/65-70 every day.

May have been cheaper at Pattaya City (if they could even do it) or Bangkok Pattaya hospital, but I was in no shape to shop around.

 

Pattaya City cannot do this.

 

Bangkok Pattaya would have cost much  more.

 

[GregBow]

5 hours ago, scubascuba3 said:

Have a read of this so you have an alternate view on whether worthwhile

 

https://www.drmcdougall.com/education/information-all/the-angioplasty-debacle/

Wow. Thanks, certainly thought provoking.

Would be more interested in preventive action than surgery.

Maybe cholesterol cleaning meds and better food choices will help.

Any other suggestions?

Regards

Greg 

[scubascuba3]

8 hours ago, GregBow said:

Wow. Thanks, certainly thought provoking.

Would be more interested in preventive action than surgery.

Maybe cholesterol cleaning meds and better food choices will help.

Any other suggestions?

Regards

Greg 

Maybe check on his website for articles, he focuses on better food choices but gives meds as required

[mania]

15 hours ago, scubascuba3 said:

Have a read of this so you have an alternate view on whether worthwhile

 

https://www.drmcdougall.com/education/information-all/the-angioplasty-debacle/

Thanks that was a fascinating read & seems quite logical & in agreement with many other cardiologist info on the subject I have read.

 

Here is another good read I recently found a year or two ago

When You Really Need a Stent (or Don't)

 

[KhunLA]

@GregBow  That's actually a decent price from BKK Hosp. group, as usually on the high end.

 

The cardiologist probably works all 3 hospitals, Govt, probably much cheaper there, BKK Hosp, and AEK Udon, probably most expensive of the 3.

 

Best option, would be as suggested, KK, if money not an issue, as excellent heart hospital there.   Though placing a stent is pretty standard, low tech procedure now of days, and the 1 cardiologist in UT was excellent, and highly recommend by those who used.   Don't know his name though, so can't recommend.

[Sheryl]

1 hour ago, mania said:

Thanks that was a fascinating read & seems quite logical & in agreement with many other cardiologist info on the subject I have read.

 

Here is another good read I recently found a year or two ago

When You Really Need a Stent (or Don't)

 

If you already have significant blockage in a major left coronary artery you may well be dead  before any preventive measures could kick in. Aggressive treatment of risk factors can  prevent additional or worsened blockages. It takes a very extreme reduction in lipids (which few can achieve and even for them takes time)  to actually shrink existing plaque.

 

No responsible doctor would advise relying on this alone if there is already severe blockage in a major left coronary artery.

 

The only way to know the extent of the blockage and its location for sure is to have the angiogram. 

 

The KKU Heart Hospital I and others have recommended is a government facility. They will not insert a stent unless clearly needed. 

 

[scubascuba3]

5 hours ago, mania said:

Thanks that was a fascinating read & seems quite logical & in agreement with many other cardiologist info on the subject I have read.

 

Here is another good read I recently found a year or two ago

When You Really Need a Stent (or Don't)

 

Thanks for that, interesting

[GregBow]

4 hours ago, Sheryl said:

If you already have significant blockage in a major left coronary artery you may well be dead  before any preventive measures could kick in. Aggressive treatment of risk factors can  prevent additional or worsened blockages. It takes a very extreme reduction in lipids (which few can achieve and even for them takes time)  to actually shrink existing plaque.

 

No responsible doctor would advise relying on this alone if there is already severe blockage in a major left coronary artery.

 

The only way to know the extent of the blockage and its location for sure is to have the angiogram. 

 

The KKU Heart Hospital I and others have recommended is a government facility. They will not insert a stent unless clearly needed. 

 

Thanks so much for your help. 

[Kwaibill]

My experience cardio wise was all in the US. First angiogram and angioplasty with statins and investigational Clopidigrel. ( sp?) a few years later a MI resulting in one stent placement. Another few and another MI. Doc did an angiogram and asked why I had only one stent placed. It wasn’t presented as a need or option at New Mexico Heart Hospital.

” Well, no choice now. Air ambulance to Banner Heart Hospital in Phoenix for a three way bypass procedure.” 
A PM required a few years after that, but for a different issue. The cabage procedure was in Feb. 2012, so apparently very effective.

I did sign a release to donate the  equipment to a poor nation that would sterilize and reuse it.

As mentioned above it is SOP pretty much globally now. I have been well served at Queen SiriKit , Sattahip and Siriraj government hospitals (food and wait times could be a factor) often by teaching faculty after granting permission for student observation.

All done on our dime as “ Diabetic? No can do!” has been the response to insurance inquiries. Couple of outfits offered coverage but at rates that self pay has been much less.

We do have an Accident policy. I’ll report if they will cover a slip and fall broken pelvis ( last week). 
Your mileage might vary, but hope my long story might help.