Surprise Heart Issues, where to start in CM?

[Bonobojt]

this is your  choice and I'm just trying to help, but if you have heart disease because of a bad diet, then I suggest you try a whole foods plant based diet, which means a vegan diet, it has been scientifically proven to reverse heart disease, lucky your in CM, plenty of vegan restaurants. 

 

check out this video, this is Dr Michael Greger, author of How Not To Die -    

 

[cmrichsw]

8 hours ago, ehs818 said:

Go to RAM Hospital. Good staff and doctors.

That is debatable - Ram is a Private hospital, Sipot is better

 

[meatboy]

what the op should be concerned about is the amount of meds he has been given when his topic is,

SURPRISE HEART ISSUES if so how can the docter prescibe these without tests.

this sugests he has serious heart problems.

could the op descibe all the symptoms that he has been having.

i am sure all of us that have had heart problems can give him our experiance of surgery.

[akentryan]

In 2014 had no physical symptoms but quarterly visit to cardiologist at the biggest hospital in Pattays where testing caused concern. Diagnosis was that I had blockages requiring 2 stents. Went to the USA to see my cardio doctor there. He said stents were not required and changed one med to Atorvastatin. Just got back last month from having my Pacemaker replaced. There were no problems with blockages. Second opinion well worth the time and cost. 

[chiang mai]

9 hours ago, cmrichsw said:

That is debatable - Ram is a Private hospital, Sipot is better

 

 

Sriphat is more a private hospital than it is anything else.

[lopburi3]

55 minutes ago, meatboy said:

what the op should be concerned about is the amount of meds he has been given when his topic is,

SURPRISE HEART ISSUES if so how can the docter prescibe these without tests.

this sugests he has serious heart problems.

could the op descibe all the symptoms that he has been having.

i am sure all of us that have had heart problems can give him our experiance of surgery.

Actually he had at least two EKG's and exam and expect blood and blood pressure tests and medications were designed to be used temporary until proper tests could be performed (if done in public government hospitals there are waits for such tests).  The drugs seem fine to me and are almost the same as I am taking (expect do not have pain so angina specific medication not required).  And my heart is fine and his could also be fine - it is blocked arteries that I have and expect that is the suspicion for him.

[meatboy]

at least 2ekg's and some blood tests, wasnt the op told what was diagnosed. surely whoever done the tests must have some idea what could be comeing his way.

every test i had done i was consulted by a doctor in the uk.

even here when i had a mini stroke awhile back, had a brain scan, and an ekg after a seizure both results were discussed by a doctor with me.

so surely the op must have had some incline of what to expect.

so it would be interesting to now what he was experiancing. 

eg.left arm feeling as if he was carrying a half ton weight.

not being able to walk after food.

joint pain from taking statins [lipitor ]

although i wasnt getting any chest pain it was more of an uncomfortable feeling.

mind you being overweight [5-6 stone] didnt help my BP. at one time over 200.

cholesteral level was 8-9.

 

[Tracyb]

I suggest you get over to Bangkok Hospital in Chiang Mai.  Best in the area.... although a bit more expensive than other "hospitals" in town.  They are the best in terms of countrywide connections and even video conferencing with specialists (if necessary) from any of their locations.

[Sheryl]

There are no "best" hospitals,  it is possible to have both good and bad experiences in almost any hospital - it comes down to the individual doctor.

 

Sripat is affiliated with CMU, a major teaching hospital and regional referral center -and while a private arm of it, considerably less expensive than a private hospital. IF OP has ischemic heart disease, costs of treatment in a private hospital will be huge (500,000 - 1 million + baht depending on number of vessels involved etc) vs about 1/3 as much at Sripat.

 

If OP prefers a private hospital  and can afford it, my recommendation would be  Dr. Patarapong  at Chiang Mai Ram Hosp.

 

 

[muskoka]

32 minutes ago, meatboy said:

at least 2ekg's and some blood tests, wasnt the op told what was diagnosed. surely whoever done the tests must have some idea what could be comeing his way.

every test i had done i was consulted by a doctor in the uk.

even here when i had a mini stroke awhile back, had a brain scan, and an ekg after a seizure both results were discussed by a doctor with me.

so surely the op must have had some incline of what to expect.

so it would be interesting to now what he was experiancing. 

eg.left arm feeling as if he was carrying a half ton weight.

not being able to walk after food.

joint pain from taking statins [lipitor ]

although i wasnt getting any chest pain it was more of an uncomfortable feeling.

mind you being overweight [5-6 stone] didnt help my BP. at one time over 200.

cholesteral level was 8-9.

 

 

About 10 days ago I picked up a stomach virus - nausia, diarrhea , nothing serious and a few customer/friends also had picked up this virus so I thought nothing of it. Next day my chest started hurting, dull pain not sharp, was off and on and not serious. Just thought it was a side effect of the virus.

 

The stomach virus was a one day experience, but over the next few days the off and on chest pain (sore chest) began to get a bit more uncomfortable -  I thought it was still from the virus and it would pass. It did not pass.

 

During the night after about 7 days my chest discomfort became quite serious, and I decided to go to the hospital the next day, still thinking it was virus related that somehow had infected my muscles. The last couple days I experienced slight pain in my right arm, very slight, and some pain in my left shoulder joint occasionally. That shoulder joint was a problem many years back so no big deal.

 

The Dr at Rajavej (he had to work at using his English) sent me for EKG & blood test. After reviewing he said it looks more serious than I thought it was. He showed me the EKG and where it showed a problem with blood flow to or thru the heart. The blood test showed some enzymes (or something) that indicated heart disease. He gave me a needle (blood thinner I think, his English was poor but that is what I thought he said) and he gave me an Isordil LS. About 30 minutes later I felt much more relaxed, better than I have felt in quite some time. The follow-up EKG the next day showed everything normal which to me indicated the meds are effective for me.

 

He insisted I check into the hospital immediately for 3 days while they do more tests & monitoring, and bring in a heart specialist to do more tests. I told him that was not possible, I had to go home first. We argued and I stated I had things to take care of at home first and I would check in the next morning. Done. I don't take orders well from anyone, stubborn that way. He gave me some more Isordil SL 5mg.

 

btw - my blood pressure can be above average normally and has been for at least 20 years. 155/95 is not out of the ordinary, sometimes higher sometimes lower is normal for me. I can adjust it down by consiously relaxing if given the chance. My BP was around 170/90 when I checked in, a bit high. After taking the needle/thinner and Isordil my BP was the lowest it has ever been!!! Somewhere around 130/65 - it has never ever been that low. It stayed very low with following BP tests which makes me wonder if perhaps I have had blood flow restrictions for a long time and did not know it.

 

Anyway, I am slim, not overweight, underweight if anything. Been slim all my life.

 

Today we go to the Special Medical Services Center - CMU (Sripat) as recommended by Sheryl and make arrangements to see Prof. Thanawat Benjanuwattra and begin to properly analyze my condition and options for treatment.

 

thanks to all !

 

Doug

 

 

 

[meatboy]

1 hour ago, muskoka said:

 

About 10 days ago I picked up a stomach virus - nausia, diarrhea , nothing serious and a few customer/friends also had picked up this virus so I thought nothing of it. Next day my chest started hurting, dull pain not sharp, was off and on and not serious. Just thought it was a side effect of the virus.

 

The stomach virus was a one day experience, but over the next few days the off and on chest pain (sore chest) began to get a bit more uncomfortable -  I thought it was still from the virus and it would pass. It did not pass.

 

During the night after about 7 days my chest discomfort became quite serious, and I decided to go to the hospital the next day, still thinking it was virus related that somehow had infected my muscles. The last couple days I experienced slight pain in my right arm, very slight, and some pain in my left shoulder joint occasionally. That shoulder joint was a problem many years back so no big deal.

 

The Dr at Rajavej (he had to work at using his English) sent me for EKG & blood test. After reviewing he said it looks more serious than I thought it was. He showed me the EKG and where it showed a problem with blood flow to or thru the heart. The blood test showed some enzymes (or something) that indicated heart disease. He gave me a needle (blood thinner I think, his English was poor but that is what I thought he said) and he gave me an Isordil LS. About 30 minutes later I felt much more relaxed, better than I have felt in quite some time. The follow-up EKG the next day showed everything normal which to me indicated the meds are effective for me.

 

He insisted I check into the hospital immediately for 3 days while they do more tests & monitoring, and bring in a heart specialist to do more tests. I told him that was not possible, I had to go home first. We argued and I stated I had things to take care of at home first and I would check in the next morning. Done. I don't take orders well from anyone, stubborn that way. He gave me some more Isordil SL 5mg.

 

btw - my blood pressure can be above average normally and has been for at least 20 years. 155/95 is not out of the ordinary, sometimes higher sometimes lower is normal for me. I can adjust it down by consiously relaxing if given the chance. My BP was around 170/90 when I checked in, a bit high. After taking the needle/thinner and Isordil my BP was the lowest it has ever been!!! Somewhere around 130/65 - it has never ever been that low. It stayed very low with following BP tests which makes me wonder if perhaps I have had blood flow restrictions for a long time and did not know it.

 

Anyway, I am slim, not overweight, underweight if anything. Been slim all my life.

 

Today we go to the Special Medical Services Center - CMU (Sripat) as recommended by Sheryl and make arrangements to see Prof. Thanawat Benjanuwattra and begin to properly analyze my condition and options for treatment.

 

thanks to all !

 

Doug

 

 

 

thanks for the reply,looks like sheryl hit the button with ischemic heart disease.this could be the cause of high BP.

GOOD LUCK DOUG.

[Taggart]

Doug,

 

Heart disease doesn't have to be your destiny.  Over the last few decades literally thousands of patients have managed to halt the progression of their disease and in some cases reverse it by making lifestyle changes.  There's plenty of free information available on the internet at sites like The Pritikin Longevity Center, Dr. Caldwell Esselstyn, author of "Prevent and Reverse Heart Disease",  Dr. John McDougall and Dr. Dean Ornish to name a few.  

 

There's also an excellent forty minute documentary on youtube from CNN called "The Last Heart Attack".

 

From a fellow Canadian, I wish you all the best in whatever you decide to do.

 

 

[mankondang]

With ref to the cardiologists in Chiang Mai, as anyone had first hand experience with Dr. Pattarapong of Chiang Mai Ram hospital, for Stent and/or Coronary Bypass procedure.

Preferably advice relative to the Professors at Bangkok Hospital Chiang Mau, and Siripat CMU.

I have heard mixed reviews, and found that he prefers NOT to medically operate on patients recently.

[Sheryl]

1 hour ago, mankondang said:

With ref to the cardiologists in Chiang Mai, as anyone had first hand experience with Dr. Pattarapong of Chiang Mai Ram hospital, for Stent and/or Coronary Bypass procedure.

Preferably advice relative to the Professors at Bangkok Hospital Chiang Mau, and Siripat CMU.

I have heard mixed reviews, and found that he prefers NOT to medically operate on patients recently.

 

A number of TV members have given positive feedback on Dr. Patarapong...but of course, for something like this, a private hospital is a very expensive route to go unless insured.

 

Dr. Patarapong is a specialist in intervention cardiology (stent placement, balloon angioplasty etc) so I very much doubt he has suddenly developed a "preference" not to perform these procedures. More likely he had reason not to do so in a particular case(s).

[muskoka]

On 6/10/2559 at 1:28 PM, Sheryl said:

Go to the Special Medical Services Center of CMU Hospital (AKA Sripat),  it is a quasi-private channel through which you can consult senior specialists from CMU.

https://www.google.com/search?q=Chiang+Mai+Sripat&ie=utf-8&oe=utf-8&client=firefox-b#q=Chiang Mai Sripat Special Medical&tbs=lf:1,lf_ui:2,lf_pqs:EAE&rflfq=1&rlha=0&rllag=18789430,98974755,54&tbm=lcl&rldimm=7946673953630867207

 

Ask for Prof. Thanawat Benjanuwattra

 

Before doing this, get a copy of your records from Rajavej Hosp to bring along as well as list if all your meds to show the doctor

 

From the meds you were given sounds like the doctor you saw suspected the chest discomofrt was angina due to ischemic heart disease (but if she was not a cardiologist that may not necessarily be correct diagnosis).

 

You will likely need an Exercise Stress Test. Make sure the doctor knows you are taking the current meds as it will be necessary to skip taking some of that on the day of the test, maybe even a day or two before.

 

Prof. Thanawat can also be seen at Rajavej on Saturdays only, but everything will cost more there.  IF you do actually have ischemic heart disease you could be looking at a possible stent placement or bypass which runs to big money so worth going through Sripat to begin with.

 

 

 

 

It seems things are rapidly changing. Went to Sriphat Medical Center CMU yesterday and discovered that Prof. Thanawat Benjanuwattra is no longer associated with Sriphat and has 100% moved to Bangkok Hospital CM. This just happened in the past few days, 3 different sources confirmed this.

 

Saw Dr. Naranut Prasertwittayakit (sp? handwritten for me) at Sriphat as he was the heart specialist on duty. Staff referred to him as "teacher" according to Noi. All in all a happy outcome. Since the hospital is under construction for another month and Mai Rim is too backed up to accept any more patients for the more invasive tests (something to do with injecting chemical dye into the vein) after some conversation he suggested we do an "extra stressful treadmill test" and see how my heart responds. If I am ok after he pushes me to my limit we will stay with just meds for 3 weeks and meet again to review. If I pass the test with no chest pain (in 3 weeks) we could lower the amount of meds and sub some of the brand names for generic brands if available for much lower costs.

 

I have never been on a treadmill before, and this one was slanted uphill!!!. He pushed me until I nearly collapsed (couldn't get my breath anymore). No chest pain, in fact 10 minutes later my chest/heart area felt really really good.

 

I am totally at fault for being a lazy bum for the past +6 years. No exercise at all, smoking a lot, not even going for regular walks. Veins over time get sludged up and this is what happens.

 

All in all I am 100% satisfied with Sriphat & Dr Naranut Prasertwittayakit (sp?). A change in lifestyle is what is needed, and some meds, at least for a while, until I reverse the self-induced damage due to personal neglect & lazyness.

 

Sriphat seems very organized and well run, highly recommended - thanks Sheryl and others!

 

TOTAL COST: 2,340 Baht (no meds, I have enough for 3 weeks).

TOTAL TIME: UNDER 3 HOURS IN AND OUT

 

Doug

 

 

 

 

 

 

 

[chiang mai]

4 hours ago, mankondang said:

With ref to the cardiologists in Chiang Mai, as anyone had first hand experience with Dr. Pattarapong of Chiang Mai Ram hospital, for Stent and/or Coronary Bypass procedure.

Preferably advice relative to the Professors at Bangkok Hospital Chiang Mau, and Siripat CMU.

I have heard mixed reviews, and found that he prefers NOT to medically operate on patients recently.

 

Dr Pat as he likes to be called is one of the best cardiologists in the North, very experienced, excellent English and a very pleasant demeanour - he talks to you and not at you and is not rigid, very easy to get along with. He's performed angioplasty on me twice, both times were a relaxed and pain free experience - highly recommended.

[ajnamoon]

I also  took the treadmill test  and like you pushed to the limit 20 minutes  ,and  no chest pains at all ,I then went for heart scan at Ram with injection  chemical contrast   which showed up 40% blockage in heart artery (not nearly enough blockage for op)

However   I was still experiencing chest pains but never during physical exercise   Turns out I have variant  angina  ,unlike normal angina   chest pains only when relaxed

so take small amount of meds for that ,but was glad that I went for the heart scan at Ram as it identified   the root cause of chest pains

 

[Sheryl]

Glad to hear all went well, Doug.  And thanks for the update re Prof. Thanawat.

[Cook my sock]

Taking aged garlic extract might be a good idea
https://www.ncbi.nlm.nih.gov/m/pubmed/26764322/

[mankondang]

On Saturday, October 08, 2016 at 9:45 AM, Sheryl said:

 

A number of TV literallyn positive feedback on Dr. Patarapong...but of  course,. for something lik this, a private hospital is a very expensive route to  go unless insured.

 

Dr. Patarapong is a specialist in intervention cardiology (stent placement, balloon angioplasty etc) so I very much doubt he has suddenly developed a "preference" not to perform these procedures. More likely he had reason not to do so in a particular case(s).

 

Thanks Sheryl. Your remaks about Dr Pattarapong being specialized in "intervention cardiology (stent placement, balloon angioplasty etc) may have clarified the issue, as the discussions i listened to involved two disgruntled ex pats, who both required complex tripple bi-pass (cabag) and said he would not be performing such. I took them litarally.

FYI, Another conversation, they said Prof. Thanawat is leaving Sripat CMU to work at Bangkok Hospital, Chiang Mai.

I am on heart medication myself via Australian cardiologist. Hence have a vested interest. I'm not in this as a busy body.

[Sheryl]

Intervention cardiologists are not surgeons and cannot perform CABG and other open heart surgeries. These require referral to a cardiothoaracic surgeon.

[meatboy]

glad you found out a bit of what you have been doing,or should i say what you should have been doing.

a good exersize bike would be a good idea,and try and cut down on the FAGS.

the test of having the dye injected into your veins is also a must,when having it done if you can see the monitor it shows up clearly any blockage.

good luck doug.

[muskoka]

Past couple days dropped from 30 cigs per day to 10 or less. Walking morning and night (hate the mid day heat) about 1-1/2 - 2 hrs total, will increase time & intensity as I strengthen up. Already breathing deeper and easier, feeling pretty damn good. Tightness in chest area gone.

 

 

[Cook my sock]

My stepmum smoked like a chimney/enjoyed a bottle of wine every night but also ate well/healthily and worked out at the gym until her late 70s(!). She also swore by a metabolic cold bath in the middle of the night..
She didn't worry too much put it that way

[muskoka]

Any recommended Pharmacy in Chiang Mai?

 

UPDATE: All is fine & stable health wise. Still do morning or evening walks most days. Bought an adjustable work-out bench and a set of dumbbells which I use a few times a week.

 

Met with Dr. Narawudt Prasertwitayak on Dec 2. He reviewed my blood test results and he said they looked good (improved) but wanted my Cholesterol a bit lower even tho I expressed concern about taking statins over an extended time period. My research over the years indicates the entire cholesterol/statin discussion is very controversial. Anyway, he insisted I take them until our next meeting in 3 months then we will review. I agreed. I did some research on statins after I was first prescribed them and discovered that CoQ10 helps offset most negative effects of statins so I bought a Jarrow brand from iherb.com

http://www.iherb.com/Jarrow-Formulas-Ubiquinol-QH-Absorb-100-mg-60-Softgels/7883

 

The meds I am now taking (1 ea daily for the next 3 months) are:

 

Prenolol 50mg (blood pressure) - cost 90 tabs B270

ASPENT (aspirin) 81mg (blood thinner) - cost 90 tabs B270

Apolet 75mg  (blood thinner) - cost 90 tabs B3,240

Atorvastatin 40mg (SANDOZ) (Cholesterol) - cost 70 tabs B3,920

 

These prices may or may not be fine, but that is not the issue. See below.

 

I asked the Dr for some Sidegra 50mg which I have been taking occasionally for a couple years. He looked it up and said they only had 100mg but prescribed me an alternative - Revatio 20mg (take 2 each time). I paid the bill, was surprised it came to B18,260 so when I got home I went over it in detail.

Shock!

30tabs of Revatio came to 9,660 Baht, which works out to B322 per tab, or B644 per time (taking 2 tabs each time as prescribed). The  Dr. is fully aware I am on a budget (supporting a Thai family) and need lower priced meds when available. We discussed this in detail on 2 occasions.

 

The next day I went to Dr. Smith's Pharmacy and bought a quantity of Sidegra 50mg at a price of B25ea / 4pk= B100 !!! then proceded to the hospital to get a refund on the Revatio. Not so simple. They gave me a form that I had to get filled out and signed by the Dr (he is available only on Fridays) which I did, submitted it to the pharmacy and they said they would call me in about one month to pick up a check if this was approved.

 

I feel pretty ripped off and have decided to find a pharmacy in Chiang Mai where I can buy the above meds and any other meds I may need in the future.

 

Can anyone recommend a CM Pharmacy that supplies all the above.

 

Do I need to submit paperwork to the Pharmacy before they can sell to me?

 

Thanks!

 

Doug

 

 

 

 

 

 

[Sheryl]

The Sidegra is prescription-only, all the rest no need.

 

As you are on a budget I suggest you ask the doctor whether you can switch from atorvastatin to simvastatin which is available in many inexpensive locally made brands, you will save a  lot of $.

 

For pharmacies, try Fascino located near the Univ Hospital.

[muskoka]

Thanks Sheryl!

 

I see  Fascino is located directly across from the Faculty of Pharmacy. Much appreciated!!!

 

Doug

 

[Prbkk]

On 06/10/2016 at 5:29 PM, lopburi3 said:

isordil -  Angina: 30-120mg daily in divided doses

 

Actually Plavix is excellent at keeping the blood thin and slippery to avoid blockage - you do not have to have had a heart attack to be prescribed them (but it is expensive so often not).

 

Aspirin is the cheap blood thinner that most with known or suspected issues take - may be too much with plavix and it does cause bleeding for many people.

 

Lipitor is expensive but not the same type of statin as Bestatin.  It is generally considered a better choice if money is not an issue.

 

Plavix (Clopidogrel? SP?) is also available as a generic in Thailand ( Apolets, significantly less expensive and identical). 

Edit: now I see the OP has the information re Apolets. 

[Prbkk]

On 10/10/2016 at 2:59 PM, muskoka said:

Past couple days dropped from 30 cigs per day to 10 or less. Walking morning and night (hate the mid day heat) about 1-1/2 - 2 hrs total, will increase time & intensity as I strengthen up. Already breathing deeper and easier, feeling pretty damn good. Tightness in chest area gone.

 

 

 

Maybe try an electronic one as a step to giving up