Moving to Thailand with Heart condition

[sirineou]

Me and my Thai wife who live in the US now ,were planing in retiring in Thailand and more specifically in Khon Kaen where we own some property and plan to build a house.

During a routine physical at age 53 a heart murmur was detected, had an echo cardiogram and was advised that it was nothing serious yet and to periodically monitor the situation.

Fast forward several years (now 56), after several follow-up examinations , echo-cardiograms , three cardio catheterization .

it was determined that a congenital heart valve defect existed, and that due to progressively valve calcification, I would need Valve replacement. , I was always very healthy , eat healthy, and exercised, I am and was most of my adult life 5' 10'' and weighted 165 lbs

and now this, It is all very depressing.

​So now I need to re- asses my situation and plans for the future, and would like to hear from others in similar situations.

These are some of the questions running in my mind

-would I need to maintain a residence in the US so that if needed I could fly back for medical attention. (not sure if I can afford to maintain two homes in two different countries)

- I Have relatively good insurance here in the US through my Union, What would be the chances, if any, of getting insurance in Thailand with a pre-existing condition? what are my options?

- What if something happens while in Thailand and I cant or don't have the time to travel back to the US?

Are there any other questions I have not thought of yet?

Would appreciate any and all advice.

Thank you in advance.

[thaiexpat21]

All the questions you pose should be asked of your cardiologist .

It is unlikely that you will be able to insure against a pre -existing condition.

[transam]

Think you must get your heart fixed before coming here.

[sirineou]

Thaiexpat21 and Transam Thank you for taking the time to reply

I am meeting with a Thoracic Surgeon this week to discus the options and to possible schedule valve replacement surgery to occurs in the next few weeks, Having no experience in the subject, I don't know what to expect in he future,I have a general idea from discussions I had with my cardiologist as far as the long term implications are concerned, but my cardiologist has no first hand experience with Thailand, That is why I post these questions here.

I appreciate all replies, there is value in everything I learn about the subject,

but I would like to hear from some one that had a similar experience,

what their challenges are as it pertains to their condition in Thailand, and how they face these challenges.

I also don't believe that I would be able to purchase medical insurance that will cover my condition in Thailand, So what happens if I need medical attention resulting from this uninsured condition while in Thailand?, also after having the valve replacement surgery, there must be periodical check up to make sure the valve is working properly, would I need to return to the US for that? or can I have them in Thailand, and if so (since I would be un-insured, what would the proximate costs be?

Just thinking out loud, hope some one with experience on the subject could help

[thaiexpat21]

It is extremely unlikely that you will be able to insure against a pre -existing condition.

Any follow -up would have to be self funded as would any further necessary treatment.

There are excellent facilities in Thailand which would be able to provide all the care needed.

Costs whilst likely less than in the USA will still be significant and could amount to many thousands of Baht.

[benalibina]

Seems to me that you need to keep an adress in USA insurancewise.

My guesstimation is that a check up can be done in thailand. Bangkok ??

Travelinsurance would cover something IMO

Northeast of thailand should have private hospitals. Check that out.

Go on the net and read about the dos and donts after valveoperation.

Good luck.

[citizen33]

If you move to Khon Kaen you will have access to an excellent heart centre - see thread in Isaan forum. This is a public university facility, but offers treatment to private patients at a cost well below that of the leading Bangkok private hospitals.

The feasibility of a move to Thailand probably depends on your degree of risk aversion and also whether the Thai government goes ahead and provides an affordable public health insurance option for foreign residents - something that is under discussion on another thread in this part of the forum. It seems to me that a period in the US after surgery to assess your condition wouldn't be a bad idea.

[sirineou]

All good advice.

Good to know that there is a good heart care facility in Khon Kaen, I will look in to it, and sure hope the Thai gov. provides an affordable health care option for foreigners.

I am not planing to move to Thailand for at least five years, by that time I would know how the valve replacement would work out, but I have being told that the replacement valves do not last for ever and that I would need to monitor the situation and at some point, possible having to re-do the procedure.

At this point I am trying to see what the options are, as I would need to make some long term decisions.

[Mobi]

Your condition csn be monitored and treated in Thailand, no problems.

I had heart valve replacement surgery in bangkok last year and have made a full recovery.

The top heart places for this procedure are in bkk and possibly Chaing Mai. Definitely not Kohn Kaen.

The top cardiac centres can monitor the deterioration of your valve and carry out the echo cardiograms. It is difficult to imagine a situation where you couldn't fly back to usa for the op when the stenosis becomes acute. I could've easily flown to uk but I cant get it free there so had it done in bkk.

Very satisfied very professional.

Would write more but currently in hospital awaiting op on an unrelated condition.

Sent from my GT-N7100 using Thaivisa Connect Thailand mobile app

[Mobi]

Carbon valves (eg St Jude) will see you thru without the need to replace. Animal (pig) valves last about 10 years. There's masses of good stuff about this on internet.

Sent from my GT-N7100 using Thaivisa Connect Thailand mobile app

[Naam]

All good advice.

Good to know that there is a good heart care facility in Khon Kaen, I will look in to it, and sure hope the Thai gov. provides an affordable health care option for foreigners.

I am not planing to move to Thailand for at least five years, by that time I would know how the valve replacement would work out, but I have being told that the replacement valves do not last for ever and that I would need to monitor the situation and at some point, possible having to re-do the procedure.

At this point I am trying to see what the options are, as I would need to make some long term decisions.

sure hope the Thai gov. provides an affordable health care option for foreigners

unfortunately there's no such thing like the Thai government providing affordable health care for foreigners.

[meatboy]

Think you must get your heart fixed before coming here.

take this advice i was in the same boat as you,diagnosed with exactly the same symptoms back in 2001.after 6yrs of back and fo to the hospital it was decided 2007 that it was time to have the surgery plus a by pass.done in sept.new aorta valve plus by a by pass.2 weeks in total in hospital then 2yrs at home making sure i was fit before moving to thailand permanent,never felt better.

my advice is to have a mechanical valve which lasts for life otherwise if you have an animal skin one it only lasts about 15yrs so you wont want to go through it all again.

as for medication its all available here,the main one is warfarin which you have to take for life plus you have to have your blood checked every 4weeks that is your inr.the blood clotting level.

so dont rush things just stay put,one thing i found in thailand before i had my op.was the heat and the humidity will more or less make it very uncomfortable.

if you want any further info please be free to ask.

good luck.

[Sheryl]

As others have indicated the problem will not be in availability of adequate care-- especially in Khon Khaen where there is a very good university hospital -- but rather paying for it. Even travel insurance will not cover a pre-existing condition like this.

It is possible you might be able to get a local insurance policy which covers other than this i.e. excludes issues relating to your heart and the use of anticoagulaents. If so, that is still very much worth doing...right now it is the heart condition that you are understandably focused on, but you could in future have any number of unrelated illnesses or be in an accident.

If you moive here you will need to put aside sufficient funds to cover catastrophic health care costs. Simple outpatient care, including periodic blood tests related to your anticoagulent meds, is affordable enough, but major hospitalization even at a government hospital can easily run over a 100,000 USD, and costs are going up all the time.

[citizen33]

The top heart places for this procedure are in bkk and possibly Chaing Mai. Definitely not Kohn Kaen.

Khon Kaen has a centre with a national reputation for excellence. Valve replacements are well within its compass.

http://www.heart.kku.ac.th/en/index.php?option=com_content&view=frontpage

I didn't say that affordable public health insurance was a sure thing, and indeed I advise caution about the longevity of the scheme that is currently being discussed, but policy makers do seem to have put some kind of provision for long stay foreigners on their policy agenda. It would probably provide care at far too modest a level to interest an independently wealthy Klingon.

Edited October 28, 2013 by citizen33

[sirineou]

Thank you all for taking the time to answer my Post

Though I don't have enough time to Thank you all and reply individually, I have given each one of you a "Like" as a token of my appreciation

People like you is the strength of this forum and the reason why I keep coming back

[Naam]

The top heart places for this procedure are in bkk and possibly Chaing Mai. Definitely not Kohn Kaen.

Khon Kaen has a centre with a national reputation for excellence. Valve replacements are well within its compass.

http://www.heart.kku.ac.th/en/index.php?option=com_content&view=frontpage

I didn't say that affordable public health insurance was a sure thing, and indeed I advise caution about the longevity of the scheme that is currently being discussed, but policy makers do seem to have put some kind of provision for long stay foreigners on their policy agenda. It would probably provide care at far too modest a level to interest an independently wealthy Klingon.

it should be noted that even "independently wealthy Klingons" hold since decades first class private health insurance, worldwide coverage, no deductable, no life time cap, free selection of hospital/medical procedure/eggsburt in any country of their choice.

for this insurance they pay virtually peanuts (warrior discount) and because they are more than four decades "members" of said insurance (Continental €uropean Klingons do not "buy" insurance).

however, potential wealth comes in handy as prefinancing is required till insurance refund kicks in.

[Mobi]

I'm sure khon khan will carry out valve replacement ops but imho I would go to a place of excellence for this type of op that can only be found in Bkk.

During my own research last year I found even in the uk where there are dozens of cardiac centres that carry out open heart surgery, there were only a few that did valve replacements.

Rajavithi, where I went, (at Sheryl's recommendation) is Thailand's leading heart centre for this op and the surgeons & staff there are very experienced. Patients come from all corners of thailand to be treated there.

I doubt if even the top Bkk private hospitals have the same in depth experience.

Also my gut feeling is that Khon khan would bring in an outside specialist or maybe use a less experienced team.

Certainly in the UK most normal cardiac units refer valve replacement to the few highly specialist units that can handle these type of high risk ops.

I may be wrong but that's my take on it.

Sent from my GT-N7100 using Thaivisa Connect Thailand mobile app

[Sheryl]

Valve replacements are more common in Thailand than in the West, and in any case as I understand it he will have had it done already in the US, issue is the aftercare (which should not be hard to arrange) and more significantly overall health care costs given that he may find it hard ir impossible to get health insurance.

[harrry]

It may be worth considering the time for an ambulance to reach you and then the hospital is many times more than in the US. The ambulance crew are generally not trained to do more than safely transport you.

Edited October 29, 2013 by harrry

[Mobi]

As far as Khon Kean is concerned I was referring to the op itself. Not pre/post care which I'm sure would be fine.

But I bow to Sheryl's greater knowledge in these matters.

Sent from my GT-N7100 using Thaivisa Connect Thailand mobile app

[Mobi]

As a matter of interest why do they have more valve replacements in thailand?

Sent from my GT-N7100 using Thaivisa Connect Thailand mobile app

[citizen33]

I'm sure khon khan will carry out valve replacement ops but imho I would go to a place of excellence for this type of op that can only be found in Bkk.

During my own research last year I found even in the uk where there are dozens of cardiac centres that carry out open heart surgery, there were only a few that did valve replacements.

Rajavithi, where I went, (at Sheryl's recommendation) is Thailand's leading heart centre for this op and the surgeons & staff there are very experienced. Patients come from all corners of thailand to be treated there.

I doubt if even the top Bkk private hospitals have the same in depth experience.

Also my gut feeling is that Khon khan would bring in an outside specialist or maybe use a less experienced team.

Certainly in the UK most normal cardiac units refer valve replacement to the few highly specialist units that can handle these type of high risk ops.

I may be wrong but that's my take on it.

Sent from my GT-N7100 using Thaivisa Connect Thailand mobile app

The Queen Sirikit Heart Centre has undertaken several thousand valve replacements going back at least the 1990s. KKU is a major research centre, and it is risible to suggest that it would need to bring in an outside specialist to do valve surgery.

http://www.surgeons.or.th/ejournal/files/Vol30_No1_34%20-%2038.pdf

http://www.md.kku.ac.th/library/main/eresearch/12694885f.pdf

The information on the UK is equally questionable.

If we take the most common valve replacement, mitral valve replacement, 36 centres in England and Wales undertook the procedure in 2008-11. (see page 38 audit report in link). The report will show you that the results were not so bad across all these centres..

http://www.hqip.org.uk/assets/NCAPOP-Library/NCAPOP-2012-13/Adult-Cardiac-Surgery-Report-2010-11-published-2012.pdf

[Mobi]

I'm sure khon khan will carry out valve replacement ops but imho I would go to a place of excellence for this type of op that can only be found in Bkk.

During my own research last year I found even in the uk where there are dozens of cardiac centres that carry out open heart surgery, there were only a few that did valve replacements.

Rajavithi, where I went, (at Sheryl's recommendation) is Thailand's leading heart centre for this op and the surgeons & staff there are very experienced. Patients come from all corners of thailand to be treated there.

I doubt if even the top Bkk private hospitals have the same in depth experience.

Also my gut feeling is that Khon khan would bring in an outside specialist or maybe use a less experienced team.

Certainly in the UK most normal cardiac units refer valve replacement to the few highly specialist units that can handle these type of high risk ops.

I may be wrong but that's my take on it.

Sent from my GT-N7100 using Thaivisa Connect Thailand mobile app

The Queen Sirikit Heart Centre has undertaken several thousand valve replacements going back at least the 1990s. KKU is a major research centre, and it is risible to suggest that it would need to bring in an outside specialist to do valve surgery.

http://www.surgeons.or.th/ejournal/files/Vol30_No1_34%20-%2038.pdf

http://www.md.kku.ac.th/library/main/eresearch/12694885f.pdf

The information on the UK is equally questionable.

If we take the most common valve replacement, mitral valve replacement, 36 centres in England and Wales undertook the procedure in 2008-11. (see page 38 audit report in link). The report will show you that the results were not so bad across all these centres..

http://www.hqip.org.uk/assets/NCAPOP-Library/NCAPOP-2012-13/Adult-Cardiac-Surgery-Report-2010-11-published-2012.pdf

Yes well, lets not start ww3 over this. I did say it was my 'gut feeling' and maybe my gut was a bit off colour.....

I won't attempt to challenge your stats which I am sure are well researched.

As far as the UK is concerned, I was looking for a cardiac centre that would replace my aortic valve, and not only me but my family and friends back home contacted a number of cardiac centres throughout the country and they, and me, were all referred to the top London and Cambridge units. Maybe mitral valve replacement is more common - I don't know - I was just relating my personal experience.

As far as Thailand is concerned, I accept that K K is a notable centre for valve replacement, but I think I know where I would go, even if lived in KK.

I've just been discharged from another Q Sirikit hospital, and while I have no real complaints, I'm not sure I would trust them with a major operation, they're not in the same league as Rajavithi. But maybe KK is different - I would need to take a look.

Sorry if I I made a 'risible' comment - that's what old farts like us do sometimes....

[citizen33]

No personal criticism intended Mobi! It is just that for people living in Khon Kaen the Queen Sirikit Heart Centre is a good option. It is not part of a chain, but a centre within Khon Kaen University hospital, named after the queen who was renowned for her personal qualities..

Only two private hospitals, alongside 21 public ones, took part in the latest published audit of cardiac surgery outcomes in Thailand, so it is hard to know whether the expensive Bangkok centres get significantly better results.

http://www.ncbi.nlm.nih.gov/books/NBK154619/

Unfortunately the hospitals are given code letters rather than real names. Rajavithi is in there somewhere though as is QSHC.

Interestingly the % of the total that are simple valve operations in Thailand seems to be declining, while combination operations are becoming more common. I'm not sure whether this means a falling trend of overall numbers of valve procedures completed though.

Hope your present hospitalisation results in a speedy return to good health.

Edited October 29, 2013 by citizen33

[Sheryl]

As a matter of interest why do they have more valve replacements in thailand?

Sent from my GT-N7100 using Thaivisa Connect Thailand mobile app

Rheumatic valve disease . Now uncommon in the West and will soon be so in Thailand but at this time still many people who had untreated or improperly treated strep infections as children.

[thailiketoo]

It may be worth considering the time for an ambulance to reach you and then the hospital is many times more than in the US. The ambulance crew are generally not trained to do more than safely transport you.

http://www.bangkokhospital.com/medical-services/Mobile-Cardiac-Care-Unit/

[Amavel]

I have a similar condition, am the same age, but moved here because I could not afford the $1600/mo.Wash. State employee insurance at my early retirement. I maintain my murmur AND Aneurysm with overnight trips to my Cardiologist in Pattaya every 2 mos. You are lucky to have the option of the US for medical care, but only because of the insurance. I feel the quality of care here is superior as long as you go to Bangkok or Pattaya. I go for a Heart scan promotion next week. The whole 9 yards including Cholesterol, Blood work, Kidney function and Echocardiogram for $260.

Sent from my iPad using Thaivisa Connect Thailand mobile app

[joealx]

Does your insurance cover you overseas?

[puukao]

I have an athlete's heart, miss a beat now and then, and my EKG is always worrisome. I've had surgery because of super low iron (ping-pong size blood clot near my heart) and I'm still extremely active to this day (3+ years later). so, get the surgery, relax, recover, and then listen to your body. i've never gotten depressed over this. i'm 99% sure this isn't as life-changing as you think.

[meatboy]

I have an athlete's heart, miss a beat now and then, and my EKG is always worrisome. I've had surgery because of super low iron (ping-pong size blood clot near my heart) and I'm still extremely active to this day (3+ years later). so, get the surgery, relax, recover, and then listen to your body. i've never gotten depressed over this. i'm 99% sure this isn't as life-changing as you think.

for me it was life changing allright i am now a new man,30 going on 70