Cardiologist Recommendations

[realthaideal]

I've been experiencing heart pain/ tightness, but no outright signs of a heart attack for the past few weeks and am feeling foolish for waiting to get it looked at. Because of the thaivisa updates, the search function is netting me zero results from the CM subforum. So please help me out....

 

I'd like to know who's been in for check-ups, where, what tests did you get, and any recommendations for the most competent cardiologists. I want to quit stalling and get this looked at tonight or tomorrow.

 

 

[masuk]

make sure you have the emergency ambulance number at hand.  You might not get a 2nd chance.

Head for the nearest hospital.   they won't mess around.  you will possibly need an angiogram to see where the problem is, but in the meantime, a doctor can prescribe  medication before going deeper.

 

 

 

[Oscar2]

until someone else chimes in, i got this off the pinned list above. sounds like a good place to start to me.

 

CARDIOLOGY (Heart)

Dr Patarapong

Chiang Mai RAM Hospital

053 920300

 

get on it quick!

[chiang mai]

Dr Patarapong at CM RAM is one of the best cardiologists in the north, he speaks excellent English and is a really nice guy. He's performed angioplasy and angiograms on me so I speak from first hand experience.

[Dante99]

Dr Pat at Ram will be a good choice and he will recommend tests better than anyone here can.  I have seen him with good results and others highly recommend him.

[jmd8800]

I just spent the weekend in ICU for heart problems. Dr Pattarapong was my doctor. Excellent English. I think he's a good doc. We discussed an angioplasty.

 

Is Suan Dok or other gov't hospitals much cheaper? What is the going rate for angioplasty with one stent?

[masuk]

Where did you stay?     I'm currently waiting on blood tests before proceeding to angioplasty at Sriphat..

 

I'm also trying to find prices, much as you are. It seems that if 2 stents are required, then a bypass is better and same price.

 

 

[jmd8800]

I don't see a way to edit my post. If you are asking me about which hospital, it was Chiang Mai Ram.

[NancyL]

Sripat is the private hospital portion of Suan Dok.  Unless you're in an emergency situation, you're going to face a long waiting queue for an elective procedure at Suan Dok.  This is something that even Thai people have to deal with at Suan Dok these days.  You'll be treated much more quickly (and at a higher price) at Sripat in the same operating room with the same doctors but you'll recover in a much nicer room with cuter nurses, who aren't as competent, in my opinion.

 

Suan Dok is a good place to go if you're having an emergency.  Not so for an elective procedure.

 

There are some excellent recommendations on this thread.

[jmd8800]

7 hours ago, NancyL said:

Sripat is the private hospital portion of Suan Dok.  Unless you're in an emergency situation, you're going to face a long waiting queue for an elective procedure at Suan Dok.  This is something that even Thai people have to deal with at Suan Dok these days.  You'll be treated much more quickly (and at a higher price) at Sripat in the same operating room with the same doctors but you'll recover in a much nicer room with cuter nurses, who aren't as competent, in my opinion.

 

Suan Dok is a good place to go if you're having an emergency.  Not so for an elective procedure.

 

There are some excellent recommendations on this thread.

Thanks NancyL! I'm glad you posted this. Now I understand how the Suan Dok / Sripat  hospital system works.

 

The next question would be: is Sripat a lot cheaper than Chiang Mai Ram? And that is only a relevant question if you have time on your hands to wait for the surgery. In the case of an angioplasty you may or may not have time. But if the Suan Dok / Sripat hospital is the same quality and cheaper, and you are headed to ER it might be wise to go there.

 

Is Suan Dok / Sripat substantially cheaper? I know some people don't have a lot of resources (I am one) but I'd not sweat the savings if it is a minimal amount.

 

Also: Am I missing something? I cannot find a way to edit a post I have made.

 

 

 

[KKr]

I had good experiences with Dr. Supadej Sudjaritruk at SuanDok. (Sripat)

He initiated coordination with my overseas Cardiologist to make sure all went smoothly, and it did.

Sripat private Clinic, across the street, organises the visits and the appointments in their Cardio check-up package.

[jko]

Another +1 vote for Dr. Patarapong.

 

Some doctors at Chiang Mai Ram have a 'snooty-get-you-out-quick+next-please' attitude. They show little interest in either you as a human being, or any related symptoms/worries that you might describe. Because of this, there is one doctor who I have specifically requested is never allocated to me again. He always walks head down through the public areas.

 

Dr Patarapong by comparison is friendly, professional, reassuring, efficient, knowledgeable, thorough and caring. When I suggested I do a CT scan, he talked me through the high expense involved, balanced with the real necessity of doing the procedure. He is a credit to the medical profession. Wish there were more like him at Ram.

[NancyL]

6 hours ago, jmd8800 said:

Thanks NancyL! I'm glad you posted this. Now I understand how the Suan Dok / Sripat  hospital system works.

 

The next question would be: is Sripat a lot cheaper than Chiang Mai Ram? And that is only a relevant question if you have time on your hands to wait for the surgery. In the case of an angioplasty you may or may not have time. But if the Suan Dok / Sripat hospital is the same quality and cheaper, and you are headed to ER it might be wise to go there.

 

Is Suan Dok / Sripat substantially cheaper? I know some people don't have a lot of resources (I am one) but I'd not sweat the savings if it is a minimal amount.

 

Also: Am I missing something? I cannot find a way to edit a post I have made.

 

 

 

No, Sripat isn't "substantially" cheaper than CM Ram, nor do you wait much longer than you would at CM Ram for service.  It can be a little more difficult to deal with due to lack of good English language signage and the fact that part of their facilities are mixed in with the Suan Dok facilities, so you're literally rubbing elbows with the Suan Dok patients and families in the queue for the elevators and in the halls.  It can be overwhelming for newcomers.  

 

The advantage of Sripat is that your doctors are either professors at CMU or senior residents working directly under the close supervision of CMU professors.  Also, you have access to the latest and greatest medical equipment.  You wouldn't necessarily know it from the condition of the physical plant, however.  For some procedures, like radiation treatment for cancer patients, CM Ram sends its patients, including in-patients, over to Sripat.  

 

We're very fortunate to have several very good hospitals in CM and some excellent doctors.  Many of the doctors work at several hospitals AND have their private "after hours" clinics where it's easy to see them for a low price.  The good doctors know each other and usually are very good about referring patients to each other, no matter which hospital they're at.  (Although some are reluctant to make a referral out of the hospital if a nurse i.e. spy, is sitting in the room listening during the consult.)

[jmd8800]

@masuk .. let us know of your experiences.

[masuk]

I'm very interested to know if anyone has costs.

[jmd8800]

On 8/5/2016 at 10:12 AM, masuk said:

I'm very interested to know if anyone has costs.

 

I've just returned from a 'shopping spree' on angioplasty costs. Disclaimer: Do you own research. What applies to me may not apply to someone else. This is just a guideline. All amounts are THB

 

Sripat: Angioplasty with 1 stent starts at 150,000. Room, doctor and other fees added on. The lady at the desk said around 200,000

Chiang Mai Ram: Angioplasty with 1 stent starts at 200,000 includes room and doctor fees etc. CM Ram added that a second stent would be 120,000 more.

 

Both hospitals said that is base price and could/would go higher. Sripat said a 100,000 THB deposit before surgery. Both hospitals are pay as you go. (Pay at discharge) I always wonder what happens if the bill is over the patients ability to pay. Do they handcuff you to the chair in the lobby? With that in mind, I have asked a cost estimator at CM Ram if it is possible to place  a ceiling on the amount. Like... stop what you are doing and sew me up at 300,000. The estimator said I should ask the doctor about this. If the doctor says this is possible (say put 1 stent in but cannot do number 2) then the cost estimator would work it out.

 

I hope that helps someone. But honestly, if one is in this situation they need to be at the hospitals asking for themselves as each person / case / hospital is different.  Age of the patient, health of the patient etc.

 

I had a Thai person with me who did all of the talking when at Sripat, but not CM Ram.

[Dante99]

What happened to the OP?  Still breathing?  Just had some heartburn and now okay?

[chiang mai]

1 hour ago, jmd8800 said:

 

I've just returned from a 'shopping spree' on angioplasty costs. Disclaimer: Do you own research. What applies to me may not apply to someone else. This is just a guideline. All amounts are THB

 

Sripat: Angioplasty with 1 stent starts at 150,000. Room, doctor and other fees added on. The lady at the desk said around 200,000

Chiang Mai Ram: Angioplasty with 1 stent starts at 200,000 includes room and doctor fees etc. CM Ram added that a second stent would be 120,000 more.

 

Both hospitals said that is base price and could/would go higher. Sripat said a 100,000 THB deposit before surgery. Both hospitals are pay as you go. (Pay at discharge) I always wonder what happens if the bill is over the patients ability to pay. Do they handcuff you to the chair in the lobby? With that in mind, I have asked a cost estimator at CM Ram if it is possible to place  a ceiling on the amount. Like... stop what you are doing and sew me up at 300,000. The estimator said I should ask the doctor about this. If the doctor says this is possible (say put 1 stent in but cannot do number 2) then the cost estimator would work it out.

 

I hope that helps someone. But honestly, if one is in this situation they need to be at the hospitals asking for themselves as each person / case / hospital is different.  Age of the patient, health of the patient etc.

 

I had a Thai person with me who did all of the talking when at Sripat, but not CM Ram.

 

That's good info., thanks.

 

The type of stent used makes a big difference to cost, a DES (drug eluting stent) coated in meds is far higher than a BMS (bare metal stent). Folks should also do their research on which to use, a BMS in combination with oral co-plavix produces the same mortality rate statistics over time hence is the better way to go - restonisis rates are almost identical.

[realthaideal]

21 minutes ago, Dante99 said:

What happened to the OP?  Still breathing?  Just had some heartburn and now okay?

Still breathing. Had a double whammy of being sick as well as the month of heart pains. I did an initial visit to Ram and got an EKG that looked normal. The doctor I saw was Dr. Patarapong as recommended earlier, though I just got him thru default, and didn't request him. He was very knowledgeable and reassuring. I've put together a buffet of other cardio and organ function (blood) tests I want to run, including an EKG stress test, that I'll get to this week. I didn't do it last week as the cold I was experiencing had me totally in the dumps. Haven't had that bad a flu/cold in several years. Sucked to have both at same time.

 

Back to the main point though, Dr Patarapong was very well spoken and explained the usual order of things when investigating. Because of the normal 1st EKG he said it's not necessary to jump straight to things that give direct pictures of the heart. I could choose to do so if I like, but he recommends the stress test and then if needed a carotid artery doppler sound scan. Apparently if they see plaque forming there, then it's an indicator that I've likely got it around my heart too. But at this point, that would be a third step. I also know I've been stressing over politics in two countries as well as sick parents overseas, been working too hard, and not sleeping regularly. Overall I see this as a warning to let go of alot of things and just focus on my own health and finding peace. I'll update when I have more info on how it all goes.

[jmd8800]

1 hour ago, chiang mai said:

 

That's good info., thanks.

 

The type of stent used makes a big difference to cost, a DES (drug eluting stent) coated in meds is far higher than a BMS (bare metal stent). Folks should also do their research on which to use, a BMS in combination with oral co-plavix produces the same mortality rate statistics over time hence is the better way to go - restonisis rates are almost identical.

 

Yes. .... there is so much more involved to this than just getting a price. Lots of options and maybe some surprises along the way.

 

Best of luck to the OP.

[masuk]

The prices quoted for Sriphat are certainly much more than what I was quoted.  I'm obviously going to have to have a serious talk to the med staff there.

 

Seems my best option is to head out back to the Gold Coast, but first see if an angioplasty can be done to determine how serious things are.

[chiang mai]

23 minutes ago, masuk said:

The prices quoted for Sriphat are certainly much more than what I was quoted.  I'm obviously going to have to have a serious talk to the med staff there.

 

Seems my best option is to head out back to the Gold Coast, but first see if an angioplasty can be done to determine how serious things are.

 

Angiogram is the inspection of the site, angioplasty is inflation of the balloon, stenting is yet a third process. An angiogram should not be hugely expensive, seven years ago I paid under 35k at RAM. Angioplasty at Bumrungrad using a BMS cost 175k, seven years ago.

[masuk]

5 hours ago, jmd8800 said:

 

I've just returned from a 'shopping spree' on angioplasty costs. Disclaimer: Do you own research. What applies to me may not apply to someone else. This is just a guideline. All amounts are THB

 

Sripat: Angioplasty with 1 stent starts at 150,000. Room, doctor and other fees added on. The lady at the desk said around 200,000

Chiang Mai Ram: Angioplasty with 1 stent starts at 200,000 includes room and doctor fees etc. CM Ram added that a second stent would be 120,000 more.

 

Both hospitals said that is base price and could/would go higher. Sripat said a 100,000 THB deposit before surgery. Both hospitals are pay as you go. (Pay at discharge) I always wonder what happens if the bill is over the patients ability to pay. Do they handcuff you to the chair in the lobby? With that in mind, I have asked a cost estimator at CM Ram if it is possible to place  a ceiling on the amount. Like... stop what you are doing and sew me up at 300,000. The estimator said I should ask the doctor about this. If the doctor says this is possible (say put 1 stent in but cannot do number 2) then the cost estimator would work it out.

 

I hope that helps someone. But honestly, if one is in this situation they need to be at the hospitals asking for themselves as each person / case / hospital is different.  Age of the patient, health of the patient etc.

 

I had a Thai person with me who did all of the talking when at Sripat, but not CM Ram.

Thanks for this information:  it's given me a lot to think about.   I had a talk to one of the surgeons in the angiogram section at Sriphat, who gave me some costs, but from what you're saying, he was out by a factor of 10.  If I hadn't failed the blood test,  (too much creatinine)  I might have been on the table that day.

 

I'm interested in 'the lady at the desk'.   Can you give me more info please on who she is and where, as I'm obviously going to have to have a chat ASAP.

 

In view of costs, could be I'm going to have to head back to Oz pronto.  The alternative is to have the angiogram only, to determine where the problem is.

[jmd8800]

@musak ... I don't know the woman's name at Sripat.

 

I'm surprised to hear the price of an angiogram at 15,000. I would have guessed 35,000 and up. My price of 150,000 was for angioplasty with 1 stent. (chiang mai explained the basic differences above)

 

I'd be on the plane to OZ. Close enough (compared to USA) and free for you?

[masuk]

Thanks for the reply.     Certainly seems crossed wires somewhere.    I'll do some hunting tomorrow.

 

Yes, trip from here to the Gold Coast is not too bad.  Leave here 15.00, at the Gold Coast 0700 next morning.

 

Free hospital for residents.  No waiting period I'm told.

[jmd8800]

For those looking for price, I contacted Bangkok Hospital. Their price is 257,000THB. Again they say price might change after seeing surgeon. 100% payment upfront with balance due on departure.

 

155000 for angiogram and balloon

90,000 for drug eluting stent

12,000 angioseal

 

disclaimer: just passing on info ...your mileage may vary

 

[Loaded]

Good info so far.

 

I had a thought though - the people at Thai Visa should contact hospitals with reputable cardiology departments to sponsor the numerous burger threads on the CM forum. I'm serious.

[chiang mai]

I know that at  Bumrungrad today, the cost of an angiogram and angioplasty are very similar, the procedure is after all almost identical with the exception of balloon inflation and stent insertion - my cardio there explained that the difference is really only one disposable catheter. Regardless, he was unwilling to do an angiogram and then if a blockage was found, convert to angioplasty whilst on the table, he said he wanted inspection and thought time (for both me and him) between the two processes, which seems quite right to me. Major cost in it all is the stent, the cost of which you can control.

 

Afterthought: if you're going to avoid having the procedure immediately, you really should consider taking daily aspirin until you get sorted out, 81 mg of baby aspirin (Aspent in Thailand), it will "thin" the blood sufficiently to avoid further problems in the short term. BTW, the procedure is a doddle, painless and interesting.