Angeoplasty

[nonthaburial]

A while ago, there was a poster who was shouting the praises of a hospital and Doctor in Chiang Mai for heart surgery etc.

Unfortunately after spending a long time looking through the old posts I cannot find this one. However does anyone know a good hospital in Chiang Mai OR Bangkok who can carry out angeoplasty at a reasonable cost.

[nonthaburial]

Disappointed to get no responses as this is quite urgent.

Anyone in CM have experiences / informayion please

[PeaceBlondie]

Maybe it's too soon to get many replies. Maybe you could ask your topic to be moved to the Chiang Mai forum if that would help you. Since you say it's urgent, I'll move it.

[nonthaburial]

thanks PeaceBlondie, I actually thought of putting into that forum in the first place, but didnt want my knuckles wrapped !!

[Sateev]

A while ago, there was a poster who was shouting the praises of a hospital and Doctor in Chiang Mai for heart surgery etc.

Unfortunately after spending a long time looking through the old posts I cannot find this one. However does anyone know a good hospital in Chiang Mai OR Bangkok who can carry out angeoplasty at a reasonable cost.

I recently had an angioplasty in Bangkok, at Paolo in Saphan Kwai.

While I do not have any specific info about a venue in Chiang Mai, it might be helpful to understand how the logistics work. This applies to PRIVATE hospitals, only. Government hospitals offering this type of procedure are likely to be teaching hospitals (which I will address later).

First, the hospitals 'rent' space, and support personnel to the doctors to perform these procedures. The doctor, usually called a 'cardiac interventionist' gets a call from the cardiologist who admits you, and helps get you prepared. Then he shows up, does the deed, maybe stops by afterwards to be sure you are not rapidly exsanguinating, and on to the next case, in the same, or another hospital.

What this means is that wherever you go, the expertise of the doctor is not connected to the hospital. What IS important is the experience, and state of preparedness of the Cardiac Catheterization Lab personnel and facilities. Do they have all the various medications, contrast dyes, even stents in stock? Do they do the procedure often, or is it a 'emergency-only' procedure for them?

Now for specifics: At Paolo Memorial, they have a respectable ICU/CCU, with skilled nurses, one of whom, I firmly believe, saved my life. There are TWO cardiologists, one of whom simply turned his back on me and walked out, after I asked a couple of pointed questions. After I described the incident to her, the nurse in question gave me an understanding look, and immediately called the other cardiologist, who took excellent care of me, and whose treatment was the exact opposite of that insisted upon by his 'colleague'. He seemed concerned, however, about whether I would actually proceed, and wanted my assurance before he called the interventionist. I have been through this before, and knew I needed the angioplasty, so I told him to proceed.

The interventionist was quite thorough, and spoke perfect English. He was relatively young, and had been trained in the US. He understood all the issues, including the need to hydrate the patient (me!) before the procedure to prevent kidney damage from the dye, and to use some medication to further protect the kidneys.

I should mention, at this point, that this was being paid for by Thai Social Security, which I was entitled to by participation through my employer. I have no other health insurance. This would become important.

When the time came, I was wheeled down to the Cath Lab, and all went smoothly, except they didn't have the super-safe dye I would have preferred. They had the second best, and I was assured by doctor that he would either get it all done in the safe exposure time, or, if extensive repair was needed, he would find all the problems, and wait 24 hours to redo the catheterization and fix everything. So far, OK.

The procedure began, and he found two blocked areas, and then the fun began: the doctor said I needed one of the new drug-eluting stents, which slowly release medicines to keep the artery from re-closing. Unfortunately, however, the Thai insurance only would pay for a normal, unmedicated stent.

The negotiations began in earnest, with questions about my income, any other insurance (asked and answered repeatedly during my stay), etc. I had to plead poverty, because, in truth, I worked for a Thai company, and wasn't making a lot of money. After several phone calls to the stent salesman, and hospital administrators, all while I was on the table, catheter in my crotch, and slightly sedated, he finally said that his 'best price' was 60,000 baht, of which the insurance would only pay 25,000, so could I pay the additional 35,000?

Pretty hard to say no at that point, and I had exhausted my negotiation skills, so, of course, I acceded.

From that point onward, everything went well, and I am alive to relate this to you. They did try to inflate the bill, after the fact, but I got the doctor on the phone, and reminded him that we had an agreement, and he relented, bringing the bill back down to 36,000 from 51,000. I got out with a payment of 10,000, and a promise to pay the balance in three installments. FYI, the total cost was in the neighborhood of 350,000 baht, mostly paid by the Thai system.

I feel I was lucky, but this should provide you some insight into how the game is played.

I would have the same procedure, by the same doctor, and, especially, with the same nursing staff, and at Paolo again, if (heaven forbid) I ever needed it.

I realize this is long, but I would like to add one more thing, regarding government and/or teaching hospitals.

If I were in your shoes, I would get down to Siriraj or Chulalongkorn as quickly as possible, and get seen by a cardiologist there. I don't know if Chiang Mai University has a medical school (I know they have a dental program), but if they do, they may be your best bet.

The same doctors that practice for-profit medicine at the private hospitals, often teach or do research at the medical schools and affiliated government hospitals. The treatment you will receive will be the best available, if the accouterments are not exactly Bumrungrad style.

Give me competent medicine over fine art on my walls, and a McDonalds on the mezzanine, any day. Bumruingrad, Samitivej, BNH, and others of the 'boutique' hospitals are, IMHO cashing in on their publicity, and have little accountability for their service. A few years ago, I thought they were great, but they have steadily declined into hype and PR, with an arrogant attitude, and with little recourse for their patients in the event of a 'boo-boo' - which may be costly, healthwise.

I hope more members will post their experiences with cardiac care in Thailand.

Best of luck to you. And remember, an informed patient has a better chance of a good outcome. Don't blindly place your trust in ANY doctor. Ask questions, take responsibility for your own care, even if such action is considered impolite or unseemly. Better to be a live prick, than a dead sycophant to some arrogant medico.

Sateev

[nonthaburial]

A while ago, there was a poster who was shouting the praises of a hospital and Doctor in Chiang Mai for heart surgery etc.

Unfortunately after spending a long time looking through the old posts I cannot find this one. However does anyone know a good hospital in Chiang Mai OR Bangkok who can carry out angeoplasty at a reasonable cost.

I recently had an angioplasty in Bangkok, at Paolo in Saphan Kwai.

While I do not have any specific info about a venue in Chiang Mai, it might be helpful to understand how the logistics work. This applies to PRIVATE hospitals, only. Government hospitals offering this type of procedure are likely to be teaching hospitals (which I will address later).

First, the hospitals 'rent' space, and support personnel to the doctors to perform these procedures. The doctor, usually called a 'cardiac interventionist' gets a call from the cardiologist who admits you, and helps get you prepared. Then he shows up, does the deed, maybe stops by afterwards to be sure you are not rapidly exsanguinating, and on to the next case, in the same, or another hospital.

What this means is that wherever you go, the expertise of the doctor is not connected to the hospital. What IS important is the experience, and state of preparedness of the Cardiac Catheterization Lab personnel and facilities. Do they have all the various medications, contrast dyes, even stents in stock? Do they do the procedure often, or is it a 'emergency-only' procedure for them?

Now for specifics: At Paolo Memorial, they have a respectable ICU/CCU, with skilled nurses, one of whom, I firmly believe, saved my life. There are TWO cardiologists, one of whom simply turned his back on me and walked out, after I asked a couple of pointed questions. After I described the incident to her, the nurse in question gave me an understanding look, and immediately called the other cardiologist, who took excellent care of me, and whose treatment was the exact opposite of that insisted upon by his 'colleague'. He seemed concerned, however, about whether I would actually proceed, and wanted my assurance before he called the interventionist. I have been through this before, and knew I needed the angioplasty, so I told him to proceed.

The interventionist was quite thorough, and spoke perfect English. He was relatively young, and had been trained in the US. He understood all the issues, including the need to hydrate the patient (me!) before the procedure to prevent kidney damage from the dye, and to use some medication to further protect the kidneys.

I should mention, at this point, that this was being paid for by Thai Social Security, which I was entitled to by participation through my employer. I have no other health insurance. This would become important.

When the time came, I was wheeled down to the Cath Lab, and all went smoothly, except they didn't have the super-safe dye I would have preferred. They had the second best, and I was assured by doctor that he would either get it all done in the safe exposure time, or, if extensive repair was needed, he would find all the problems, and wait 24 hours to redo the catheterization and fix everything. So far, OK.

The procedure began, and he found two blocked areas, and then the fun began: the doctor said I needed one of the new drug-eluting stents, which slowly release medicines to keep the artery from re-closing. Unfortunately, however, the Thai insurance only would pay for a normal, unmedicated stent.

The negotiations began in earnest, with questions about my income, any other insurance (asked and answered repeatedly during my stay), etc. I had to plead poverty, because, in truth, I worked for a Thai company, and wasn't making a lot of money. After several phone calls to the stent salesman, and hospital administrators, all while I was on the table, catheter in my crotch, and slightly sedated, he finally said that his 'best price' was 60,000 baht, of which the insurance would only pay 25,000, so could I pay the additional 35,000?

Pretty hard to say no at that point, and I had exhausted my negotiation skills, so, of course, I acceded.

From that point onward, everything went well, and I am alive to relate this to you. They did try to inflate the bill, after the fact, but I got the doctor on the phone, and reminded him that we had an agreement, and he relented, bringing the bill back down to 36,000 from 51,000. I got out with a payment of 10,000, and a promise to pay the balance in three installments. FYI, the total cost was in the neighborhood of 350,000 baht, mostly paid by the Thai system.

I feel I was lucky, but this should provide you some insight into how the game is played.

I would have the same procedure, by the same doctor, and, especially, with the same nursing staff, and at Paolo again, if (heaven forbid) I ever needed it.

I realize this is long, but I would like to add one more thing, regarding government and/or teaching hospitals.

If I were in your shoes, I would get down to Siriraj or Chulalongkorn as quickly as possible, and get seen by a cardiologist there. I don't know if Chiang Mai University has a medical school (I know they have a dental program), but if they do, they may be your best bet.

The same doctors that practice for-profit medicine at the private hospitals, often teach or do research at the medical schools and affiliated government hospitals. The treatment you will receive will be the best available, if the accouterments are not exactly Bumrungrad style.

Give me competent medicine over fine art on my walls, and a McDonalds on the mezzanine, any day. Bumruingrad, Samitivej, BNH, and others of the 'boutique' hospitals are, IMHO cashing in on their publicity, and have little accountability for their service. A few years ago, I thought they were great, but they have steadily declined into hype and PR, with an arrogant attitude, and with little recourse for their patients in the event of a 'boo-boo' - which may be costly, healthwise.

I hope more members will post their experiences with cardiac care in Thailand.

Best of luck to you. And remember, an informed patient has a better chance of a good outcome. Don't blindly place your trust in ANY doctor. Ask questions, take responsibility for your own care, even if such action is considered impolite or unseemly. Better to be a live prick, than a dead sycophant to some arrogant medico.

Sateev

Thank you so much for a very informative piece of writing. Highly appreciated.

Is the Paolo hospital the one located behind the Grand Hotel on rachada ?? As it happems I am BKK based, and only enquired abouyt CM after reading a previous post.

[chinthee]

Very good post by Sateev. Chula is your absolute best bet for several reasons. First they have the best cath lab probably in Thailand and have done some recent innovative left and right artery stent procedures. Secondly, their price is much less than private hospitals, where the procedure will be very expensive. Having said that, the cost will still exceed 300k for a one stent procedure.

If you have good insurance or money no object, PM me and I will give you the contact details for some good cardiologists in BKK.

[PeaceBlondie]

The faculty of medicine at CMU operates Majaraj Hospital, near Suan Dok Gate. But obviously, this is real high tech stuff and I have no idea.

[cmsally]

My next door neighbour had the procedure done at Sripat (private section) of Suan Dokh hospital a few years back. I seem to remember posting this before and there was another person posting who had just had it done at Sripat. Sorry can't remember who the poster was.

[cmsally]

I found this old topic

Heart Specialist

[helitool]

Here is a link to the post about my angyeoplasty and stent installation at Suan Dok hospital by Dr. Taniwat. Excellent Dr. who speaks english very well. Message me if you need further info.

http://www.thaivisa.com/forum/index.php?sh...43&hl=heart

[nonthaburial]

Thanks helitool, it was your posting that I remembered and was looking for. Will try to take this further now.

By the way, how you feeling these days ????

Edited August 17, 2007 by nonthaburial

[Sateev]

Thank you so much for a very informative piece of writing. Highly appreciated.

Is the Paolo hospital the one located behind the Grand Hotel on rachada ?? As it happems I am BKK based, and only enquired abouyt CM after reading a previous post.

Very sorry for the late reply.

The Paolo Memorial Hospital I referred to is in Saphan Kwai, near the Skytrain station, and adjacent to Big C.

Sateev

[helitool]

Thanks helitool, it was your posting that I remembered and was looking for. Will try to take this further now.

By the way, how you feeling these days ????

I feel better than I have in years! It is amazing how a medical condition can cause your physical performance to slowly deteriorate and you don't notice it until the problem is removed. You needn't worry about the procedure, it is completely painless and installing the stent takes about one hour. The hardest part is watching it all on the monitor in real time!

[billd766]

Last year i was diagnosed in Bangladesh as having a partly blocked artery but as I was returning to Thailand I decided to wait until then.

I came back and went to the Bangkok International Hospital just over the back of New Phetburi road near the Thong Lor junction. It is a private hospital.

It seemed like a good place and the price seemed reasonable so I booked in and Dr Witaya Jongsupangkarat who would be doing the angioplasty explaing what would happen the next day. Then I was shaved from knee to navel by a very nice nurse who was fotunately using an electric razor or I would have been on the way to become an involutary katoey.

I was the first patient around 6 am to be done and after he injected the dye he pointed out that I actually had two part blocked arteries on the left side and asked me if I wanted them both done at the same time. I am lying down stark naked and he asked a silly question like that. OK was my reply.

Did I want the cheaper stents or the new ones so I settled for the older model. The whole thing took less than an hour and the worst part for me was being in a side ward lying on my back and not being allowed to turn to a more comfortable position which I did after a while anyway.

I checked out the followingeveing so only had 2 nights in hospital and the whole thing cost around 275,000 baht which I paid as I have no insurance.

One minor problem is that I only had a Kasikorn cash card and could only pay 100,000 baht that day but the next day I went to the bank got the cash and paid the bill.I had to go for a weekly check upa couple of times and then a monthly for 3 months and then every 3 months.

At the check ups try not to get the hospital to supply you with the drugs as there are quite a few pharmacies that sell the same drug for 40% or more cheaper than the hospital.

Since then I have lost 19 kg (I was 125kg) and started exercising but not so much and I feel much better.

I had no idea before that I actually had a heart problem and just though that I was too fat and out of condition (very true).

I was 62 when I had the operation and I am still going stronger than I have been for a few years.

That was my third best investment in Thailand.

The first was my wife and the second was our 3 year old son.