Vascular doctor

[cmsoulbrother]

Does anyone have a recommendation for a good vascular doctor for lower leg circulation issues?

Thanks

[Yme]

Can't help you with a name, but I've just had an aorta to femoral Iliac by-pass and "kissing stents" - one off each side of the aorta – done.

I originally went to Siriraj, but just got totally screwed around by them. They originally wanted to angioplasty where I eventually had the Iliac bypass done and quoted Bt250,000 for that.

I was booked in for the surgery and then the surgeon didn't show up because they had an emergency. Was left on fast for 26 hours even though they ddn't do the surgery and wern't able to do it the next day. F*ckers still gave me a bill for the hospital stay plus extra needless blood tests.

Then I was told they couldn't operate until I sopped smoking for for two months. After I sopped the smokes for three months they said they couldn't operate while I was using nicotine patches. Total BS.

Then I went to Ramathibodi and they wanted to do the same. I sent the CT scans to Singapore and Malaysia for a second and third opinion. Singapore quoted S$20,000 (about twice the price of here) to do an angioplasty and one stent from the Iliac into the femoral and Malaysia quoted RM 20,000 (a bit less than here, but for a lot more work) for all of what I eventually had done.

Instead I got on a plane a flew to Darwin where the surgery was done in two rounds (two trips) at Royal Darwin Hospital. In the time I was getting messed around by Siriraj and waiting between the two different rounds of surgery the popliteal artery below the knee became 100% blocked.

The surgeon in Darwin (English) who did the bypass was exceptionally good. The by-pass took nine hours instead of the expected three though. The stents were inserted a month ago by a vascular specialist under a local anesthetic and took about three hours.

A few points to come out of all of this.

1. Once an artery becomes 100% blocked the blockage becomes hard like coral and just about impossible to pass the angioplasty wire through. In other words, what Siriraj, Ramathibodi and Singapore were suggesting was unlikely to work.

2. Regarding the blocked lower artery (popliteal) below the by-way split. The specialist and the surgeon both said they doubted they could get a wire through it now that it is 100% blocked. They said it is only about 2mm in diameter compared to 7mm for the Iliac.

They both said that even if stenting was possible it was unlikely to be successful. The option was either a gortex by-pass the same as I had done on the upper leg or replacement with a vein. They both said the success of these was varied and generally only lasted about 5 years. They said the procedure could be done twice (don't know why only twice).

First thing you'll need is a CT scan. At a public hospital in Bangkok a CT from Aorta to toes of both legs was about Bt1,800 baht including the iodine (contrast material). Siriraj did a whole bunch of other PBR tests, etc, but in Australia all they were interested in was the CT scan and there was no battery of blood tests before the new CT scan or the surgery such as I was ripped off here.

Here they'll probably prescribe you Pletaal if you are having claudication. It's available in 50mg and 100mg. Siriraj prescribed 50mg twice a day, but the dosage in Australia is 100mg twice a day - though they said they don't use it a lot. The wholesaler price of the 100mg were about Bt330 for 10.

Siriraj prescribed aspirin 81mg, but in Australia they don't have that so it's 100mg once a day. 81mg is okay though they said.

Post surgery Australia put me on a cholesterol lowering med even though my cholesterol was fine. Australia dispensed a atorvastatin 20mg for once daily consumption. When I came back the local wholesaler charged Bt880 for a one month supply of Atorvastatin by Sandoz.

I went to the local pharmacy last weekend and they have Bestatin at Bt200 for a month. The Australian docs said not to waste money on Lipitor (very expensive here) as one "statin" was the same as another "statin".

If you decide to proceed I would strongly suggest you get the diagnosis and the CT done here and then get the surgery done in Malaysia or India if you are having to pay cash.

Hope some of that is of help.

[orchidlady]

Yme, what were your initial symptoms?

[Yme]

Yme, what were your initial symptoms?

Claudication in the calves at increasingly shorter distances. No ridiculously short, but why wait until it gets to that.

Edited November 8, 2014 by Yme

[northernjohn]

Can't help you with a name, but I've just had an aorta to femoral Iliac by-pass and "kissing stents" - one off each side of the aorta – done.

I originally went to Siriraj, but just got totally screwed around by them. They originally wanted to angioplasty where I eventually had the Iliac bypass done and quoted Bt250,000 for that.

I was booked in for the surgery and then the surgeon didn't show up because they had an emergency. Was left on fast for 26 hours even though they ddn't do the surgery and wern't able to do it the next day. F*ckers still gave me a bill for the hospital stay plus extra needless blood tests.

Then I was told they couldn't operate until I sopped smoking for for two months. After I sopped the smokes for three months they said they couldn't operate while I was using nicotine patches. Total BS.

Then I went to Ramathibodi and they wanted to do the same. I sent the CT scans to Singapore and Malaysia for a second and third opinion. Singapore quoted S$20,000 (about twice the price of here) to do an angioplasty and one stent from the Iliac into the femoral and Malaysia quoted RM 20,000 (a bit less than here, but for a lot more work) for all of what I eventually had done.

Instead I got on a plane a flew to Darwin where the surgery was done in two rounds (two trips) at Royal Darwin Hospital. In the time I was getting messed around by Siriraj and waiting between the two different rounds of surgery the popliteal artery below the knee became 100% blocked.

The surgeon in Darwin (English) who did the bypass was exceptionally good. The by-pass took nine hours instead of the expected three though. The stents were inserted a month ago by a vascular specialist under a local anesthetic and took about three hours.

A few points to come out of all of this.

1. Once an artery becomes 100% blocked the blockage becomes hard like coral and just about impossible to pass the angioplasty wire through. In other words, what Siriraj, Ramathibodi and Singapore were suggesting was unlikely to work.

2. Regarding the blocked lower artery (popliteal) below the by-way split. The specialist and the surgeon both said they doubted they could get a wire through it now that it is 100% blocked. They said it is only about 2mm in diameter compared to 7mm for the Iliac.

They both said that even if stenting was possible it was unlikely to be successful. The option was either a gortex by-pass the same as I had done on the upper leg or replacement with a vein. They both said the success of these was varied and generally only lasted about 5 years. They said the procedure could be done twice (don't know why only twice).

First thing you'll need is a CT scan. At a public hospital in Bangkok a CT from Aorta to toes of both legs was about Bt1,800 baht including the iodine (contrast material). Siriraj did a whole bunch of other PBR tests, etc, but in Australia all they were interested in was the CT scan and there was no battery of blood tests before the new CT scan or the surgery such as I was ripped off here.

Here they'll probably prescribe you Pletaal if you are having claudication. It's available in 50mg and 100mg. Siriraj prescribed 50mg twice a day, but the dosage in Australia is 100mg twice a day - though they said they don't use it a lot. The wholesaler price of the 100mg were about Bt330 for 10.

Siriraj prescribed aspirin 81mg, but in Australia they don't have that so it's 100mg once a day. 81mg is okay though they said.

Post surgery Australia put me on a cholesterol lowering med even though my cholesterol was fine. Australia dispensed a atorvastatin 20mg for once daily consumption. When I came back the local wholesaler charged Bt880 for a one month supply of Atorvastatin by Sandoz.

I went to the local pharmacy last weekend and they have Bestatin at Bt200 for a month. The Australian docs said not to waste money on Lipitor (very expensive here) as one "statin" was the same as another "statin".

If you decide to proceed I would strongly suggest you get the diagnosis and the CT done here and then get the surgery done in Malaysia or India if you are having to pay cash.

Hope some of that is of help.

You said

Post surgery Australia put me on a cholesterol lowering med even though my cholesterol was fine.

I was under the impression that cholesterol was what caused the blocking of the blood vessels. Can you tell me what it was that caused the blockage. I do worry about the circulation in my feet as they are often cold when I am at home doing nothing.

[jimmym40]

I too am interested in what the initial symptoms were/are. My feet are always cold when not wearing footwear. Tme, maybe could give us some info on his diagnosis or symptoms along with soulbrother (hopefully).

Can't help you with a name, but I've just had an aorta to femoral Iliac by-pass and "kissing stents" - one off each side of the aorta – done.

I originally went to Siriraj, but just got totally screwed around by them. They originally wanted to angioplasty where I eventually had the Iliac bypass done and quoted Bt250,000 for that.

I was booked in for the surgery and then the surgeon didn't show up because they had an emergency. Was left on fast for 26 hours even though they ddn't do the surgery and wern't able to do it the next day. F*ckers still gave me a bill for the hospital stay plus extra needless blood tests.

Then I was told they couldn't operate until I sopped smoking for for two months. After I sopped the smokes for three months they said they couldn't operate while I was using nicotine patches. Total BS.

Then I went to Ramathibodi and they wanted to do the same. I sent the CT scans to Singapore and Malaysia for a second and third opinion. Singapore quoted S$20,000 (about twice the price of here) to do an angioplasty and one stent from the Iliac into the femoral and Malaysia quoted RM 20,000 (a bit less than here, but for a lot more work) for all of what I eventually had done.

Instead I got on a plane a flew to Darwin where the surgery was done in two rounds (two trips) at Royal Darwin Hospital. In the time I was getting messed around by Siriraj and waiting between the two different rounds of surgery the popliteal artery below the knee became 100% blocked.

The surgeon in Darwin (English) who did the bypass was exceptionally good. The by-pass took nine hours instead of the expected three though. The stents were inserted a month ago by a vascular specialist under a local anesthetic and took about three hours.

A few points to come out of all of this.

1. Once an artery becomes 100% blocked the blockage becomes hard like coral and just about impossible to pass the angioplasty wire through. In other words, what Siriraj, Ramathibodi and Singapore were suggesting was unlikely to work.

2. Regarding the blocked lower artery (popliteal) below the by-way split. The specialist and the surgeon both said they doubted they could get a wire through it now that it is 100% blocked. They said it is only about 2mm in diameter compared to 7mm for the Iliac.

They both said that even if stenting was possible it was unlikely to be successful. The option was either a gortex by-pass the same as I had done on the upper leg or replacement with a vein. They both said the success of these was varied and generally only lasted about 5 years. They said the procedure could be done twice (don't know why only twice).

First thing you'll need is a CT scan. At a public hospital in Bangkok a CT from Aorta to toes of both legs was about Bt1,800 baht including the iodine (contrast material). Siriraj did a whole bunch of other PBR tests, etc, but in Australia all they were interested in was the CT scan and there was no battery of blood tests before the new CT scan or the surgery such as I was ripped off here.

Here they'll probably prescribe you Pletaal if you are having claudication. It's available in 50mg and 100mg. Siriraj prescribed 50mg twice a day, but the dosage in Australia is 100mg twice a day - though they said they don't use it a lot. The wholesaler price of the 100mg were about Bt330 for 10.

Siriraj prescribed aspirin 81mg, but in Australia they don't have that so it's 100mg once a day. 81mg is okay though they said.

Post surgery Australia put me on a cholesterol lowering med even though my cholesterol was fine. Australia dispensed a atorvastatin 20mg for once daily consumption. When I came back the local wholesaler charged Bt880 for a one month supply of Atorvastatin by Sandoz.

I went to the local pharmacy last weekend and they have Bestatin at Bt200 for a month. The Australian docs said not to waste money on Lipitor (very expensive here) as one "statin" was the same as another "statin".

If you decide to proceed I would strongly suggest you get the diagnosis and the CT done here and then get the surgery done in Malaysia or India if you are having to pay cash.

Hope some of that is of help.

You said

Post surgery Australia put me on a cholesterol lowering med even though my cholesterol was fine.

I was under the impression that cholesterol was what caused the blocking of the blood vessels. Can you tell me what it was that caused the blockage. I do worry about the circulation in my feet as they are often cold when I am at home doing nothing.

[Suradit69]

Does anyone have a recommendation for a good vascular doctor ...

Since you haven't received a response to your request, you might consider posting a similar question in the health forum or else send a PM to Sheryl and ask if she can recommend someone.

[northernjohn]

Does anyone have a recommendation for a good vascular doctor ...

Since you haven't received a response to your request, you might consider posting a similar question in the health forum or else send a PM to Sheryl and ask if she can recommend someone.

Well it is Chiang Mai specific how ever there may be an answer in the medical forum.

[Yme]

The most common reason for blocked arteries in the legs - peripheral vascular disease (PVD) - is from smoking (nicotine).

In fact, the anesthetist in Darwin said every single by-pass surgeries he had done was on a smoker.

cold feet / toes is another symptom of poor circulation in the legs.

Edited November 9, 2014 by Yme

[cmsoulbrother]

Thanks for those that replied. I will keep looking. Cheers

[elektrified]

The most common reason for blocked arteries in the legs - peripheral vascular disease (PVD) - is from smoking (nicotine).

In fact, the anesthetist in Darwin said every single by-pass surgeries he had done was on a smoker.

That or diabetes.....

[DaamNaam]

Go see a GP. Although done with good intentions i would take anything you read on here with a grain of salt.

[northernjohn]

The most common reason for blocked arteries in the legs - peripheral vascular disease (PVD) - is from smoking (nicotine).

In fact, the anesthetist in Darwin said every single by-pass surgeries he had done was on a smoker.

cold feet / toes is another symptom of poor circulation in the legs.

It has been over 30 years since I had to smoke and have not touched one since. I don't see how nicotine could be the cause. As I said I was under the impression that it was cholesterol which I have in the last three years been able to bring in to an acceptable range. It was never that bad to begin with.

It was about 5 years ago when I first became aware of the problem. I do notice that sitting to long will bring on a chill to the feet. But why the poor circulation is beyond e. As the OP said his vessels are blocked. I find if I am laying on the bed reading or sleeping they get warm.