Medical check up in Bangkok

[Harry2]

I had a health incident/crisis last Friday when shopping. I suddenly felt queasy, began sweating heavily and felt faint. I tried to sit it out but eventually had to lie down for 15-20 minutes to recover enough to get a taxi home. I then basically spent 2 days in bed before I had recovered sufficiently to go out again. I am early 50s, no serious health issues but high blood pressure (lazily untreated), since the incident I have felt some chest pain - noticeable but not severe. I am wondering whether I need to book a check-up programme or begin by consulting a 'named' doctor at one of the English speaking hospitals in Bangkok & taking it from there before booking say a heart check-up package that may be superfluous. I am quite happy to pay for better quality advice. If anyone has recommendations for a doctor or hospital, or dealt with a similar experience - any suggestions would be very welcome. Thanks.

[tonray]

Your symptoms sound like you had a heart attack. you should not wait...go and get a workup soon.

[Ahab]

Seek medical advice as soon as you can. It is better to be safe than  sorry.

 

[Sheryl]

Yes, see a cardiologist at once. This is a serious situation and not the time to be getting check up packages.

 

Recommendations:

 

Prof. Taworn  Suithichaiyakul at Bangkok Christian Hospital, call for his hours as their website is only in Thai now Tel : 0-2625-9000, 0-2235-1000  Might only be there on Saturdays in which case I don't advise waiting, see:

 

https://www.bumrungrad.com/doctors/Visuit-Vivekaphirat

 

Both are excellent. Expect to have blood samples tested, EKG done and, if based on these you are stable enough, a stress test. If that confirms ischemic heart disease (or if the lab work & EKG confirm a recent heart attack) your next step will be a cardiac angiogram and possible stent placement. At that point you are looking at big money so if uninsured, Prof. Taworn at BCH is better option.

 

If prior to getting in to see a doctor you develop such symptoms again, go immediately to an Emergency Room, do not wait for your appointment. If uninsured I suggest Chulalongkhorn or Siriraj ERs, whichever is closer. If insiured, more options but Chula and Siriraj are still good choices, or (if you are well insured) Bumrungrad and ask specifically for Dr. Visuit.

 

Do not delay, act fast. Even tonight - the least twinge or shortnrss of breath, taxi to ER.

 

I am assuming your issue is cardiac based on what you describe. If by any chance it is not, let the cardiologiost refer you to the specialist he thinks most appropriate.

[al007]

You have been given some excellent advice above, PLEASE follow it

 

For years I have always had the standing instruction, to my wife, if in any doubt at all get me to the nearest A & E as quickly as possible, generally go by car do not wait and die waiting for accident

 

If you are lucky and A &E say you are OK just apologies, but you are still alive, if the same thing happens two days later do the same again, I have lost a couple of friends because their wives said don't worry it will pass, well yes it did pass but so did they !

 

Sad and unnecessary

[SaintLouisBlues]

4 minutes ago, al007 said:

For years I have always had the standing instruction, to my wife, if in any doubt at all get me to the nearest A & E as quickly as possible, generally go by car do not wait and die waiting for accident

My standing instructions are the opposite - DO NOT RESUSCITATE. I'm thinking of having it tattooed on my chest in English and Thai.

[al007]

1 minute ago, SaintLouisBlues said:

My standing instructions are the opposite - DO NOT RESUSCITATE. I'm thinking of having it tattooed on my chest in English and Thai.

 

I love your reply, the thing we have in common is that we both have specific instructions

[SaintLouisBlues]

Just now, al007 said:

I love your reply, the thing we have in common is that we both have specific instructions

Yours sadly are much more likely to be followed. I doubt there's a hospital in Thailand that won't continue to treat a farang patient until their wallet runs out

[Harry2]

Thanks to all particularly Sheryl, I am on my way to hospital now, having gone through the options.

[Cook my sock]

Just to say I've been quite impressed with Bangpakok 9 international hospital (Rama 2). Had a couple of thorough checkups last year and this year and not expensive IMO. Yes, they did try to charge me above the package price I chose, saying there was some extra they had to do but all in all v good.

[al007]

On 11/1/2016 at 0:53 PM, SaintLouisBlues said:

Yours sadly are much more likely to be followed. I doubt there's a hospital in Thailand that won't continue to treat a farang patient until their wallet runs out

 

Ah but my wife is under strict instructions to sign no documents or papers whatsoever, if I am admitted unconscious, so I might just be left to die, but somehow I doubt it, she has assets in thailand I do not so I do not want a hospital pursuing her if I am dead, so Saint louis blue I too might die !!!

[al007]

On 11/1/2016 at 2:12 PM, Harry2 said:

Thanks to all particularly Sheryl, I am on my way to hospital now, having gone through the options.

 

Good luck my friend, let us know the outcome, wishing you well

[Harry2]

Update. Well thanks to everybody for shaking me out of my complacency. In particular Sheryl's analysis & suggestions were extremely helpful and I went straight away to the Cardiology unit at Bunrungrad. I saw a doctor explained the circumstances and he put me through the process of EKG and echocardiogram. The result of which was there were no indications I had not had a heart attack. But he said I needed to urgently reduce blood pressure and started me on the appropriate meds. So it did not become clear whether this incident was due to hypertension or another cause, but whatever it finally got me to do something about the blood pressure.

[Ahab]

3 minutes ago, Harry2 said:

Update. Well thanks to everybody for shaking me out of my complacency. In particular Sheryl's analysis & suggestions were extremely helpful and I went straight away to the Cardiology unit at Bunrungrad. I saw a doctor explained the circumstances and he put me through the process of EKG and echocardiogram. The result of which was there were no indications I had not had a heart attack. But he said I needed to urgently reduce blood pressure and started me on the appropriate meds. So it did not become clear whether this incident was due to hypertension or another cause, but whatever it finally got me to do something about the blood pressure.

Good news, glad it was not a heart attack. Now you need to stay on your medications and follow-up with the doctor to ensure they are 1. working properly and 2. there are no adverse side effects (that you cannot deal with).  Follow-up is key. Good luck.

 

[dddave]

11 hours ago, Harry2 said:

Update. Well thanks to everybody for shaking me out of my complacency. In particular Sheryl's analysis & suggestions were extremely helpful and I went straight away to the Cardiology unit at Bunrungrad. I saw a doctor explained the circumstances and he put me through the process of EKG and echocardiogram. The result of which was there were no indications I had not had a heart attack. But he said I needed to urgently reduce blood pressure and started me on the appropriate meds. So it did not become clear whether this incident was due to hypertension or another cause, but whatever it finally got me to do something about the blood pressure.

I had been having mild chest discomfort for the past year when doing even moderate exercise.  I knew it was heart related but it did not seem severe.  Finally I went to the Cardiac Clinic at Sukhumvit Hospital, had an EKG and cardiac MRI. I was told there was evidence of blockages but it did not appear severe.  He did suggest an Angiogram but I could not afford the cost.  The Doctor felt I could get by with better control of BP, loosing some weight and modifying my diet.  He did prescribe Isosorbide Dimit, 20mg/day. and 82 mg aspirin.

 

Things did not get better, instead slightly worse.  My normal 10 minute walk to the supermarket became 20 minutes with several rest stops along the way, especially if I was carrying anything more than 3kg.  I found myself staying in more and more.  Several times I awoke during the night with chest discomfort extending to my arms.

I was playing with fire and I knew it.

I have mentioned on this forum in the past; I do occasional air courier jobs, often to the US or Mexico and I was waiting for one to come along.  I qualify for both Medicare and Veterans health care in the US.

Three months went by without a job.  Finally, in September I got a run to Mexico, then I got myself from there to Boston where my sister lives one mile from a highly rated Veterans Hospital.  The day after arriving in Boston, I walked into the VA Hosp. and decided to bypass the usual administrative BS and went directly into "Urgent Care"

I told them I was having ongoing chest pain which was true.

A quick EKG and within an hour I was in an Ambulance going to their surgical unit 8 miles away.  Two days of testing and observation followed. It was a Friday so they sent me home and told me to return on Monday for a stress test and possibly an angiogram.  I was fully expecting angiogram, balloon angioplasty and a stent; probably out in two days

Monday came, the stress test showed significant blockage and soon I was being wheeled up and prepped for the angiogram. The last thing I remember is being rolled onto a table.

Not long after, I died.

My death occurred during the angiogram...my heart went into arrhythmia, then  stopped.  Fortunately for me, they got it going again and I was wheeled into surgery.  The surgeon called my sister and told her she better come in, "He might not make it."

 

I awoke the following morning with a breathing tube down my throat, a voracious thirst and the feeling of having been hit by a train.

 "Good morning, sir.  We had to perform  triple bypass surgery on your heart."

The first 48 hours were probably the most unpleasant of my life though things improved immeasurably when the breathing tube was pulled out.  I had an 8" incision down the center of my chest, IV's hanging from my neck and arms and a catheter plugged into my best friend.  My left leg also had several long incisions where veins used in the bypass had been harvested.  I felt as weak as a baby. Coughing was frequent and very painful.  I was taught to clutch a little stuffed pillow to my chest each time so the incision wouldn't burst.

By the third day I was able to get up and walk 50 yards, clutching an elaborate walker with a convenient hook for hanging my always attendant pee bottle.  Things got progressively better over the next three days and I was discharged at the finish of day six carrying a big bag of meds.  My fantastic sister had made an enclosed cubicle with a bed in her ground floor living room so I would not have to negotiate stairs.

Unfortunately, after three days, I developed a nasty Cellulitis infection in the leg with the incisions.  Back into the hospital for 5 days of antibiotic drips morning and night.  It was a very bad infection and I came close to loosing the leg but the antibiotics finally began working and I dodged yet another bullet.

Now, three weeks later and I'm walking 2 miles a day and getting my strength and wind back.  I'll return to Thailand at the end of November.

I wrote all this because I want anybody reading this who is experiencing any kind of chest discomfort and shortness of breath not to play with fire as I did. Get it properly checked out and go the extra mile and get all diagnostic procedures done.  Too many guys attribute their chest pain to reflux and indigestion and don't pursue further diagnosis. Not infrequently, reflux and cardiovascular disease are both present, one disguising the other. 

 I came very close to being on the loosing end.  When the cardiologist in Bangkok said "It's probably OK.", I really wanted to believe he was right, ignoring his angiogram recommendation.  It turned out I had 90+% blockage in two arteries and 60+% in the other. The fact I made it as far as I did as long as I did may be proof that my late mother was right: I did inherit her guardian angel just as she said I would.

 

To any Americans reading this who qualify for Veterans health care, I want you to know that the level of care I received was outstanding.  The nursing staff was as attentive and accommodating as they could have been.  I was monitored constantly and any time I pushed a call button, the response was immediate.  Doctors went out of their to answer questions and explain my condition.  Never, ever did I feel like I was in a second rate institution.

I know some VA Hospitals are better than others and some are not up to standard but if money is an issue and you need medical care, give them a try...you could end up being as surprised as I was.

 

Edited November 4, 2016 by dddave

[wpcoe]

16 hours ago, Harry2 said:

I saw a doctor explained the circumstances and he put me through the process of EKG and echocardiogram. The result of which was there were no indications I had not had a heart attack. 

 

 Can you clarify?  The double-negative seems to indicate that you might have had a heart attack?

[Sheryl]

I assume he means he had not had a heart attack.

 

But I am concerned that this post does not mention a stress test.

 

EKG and some blood markers can rule out a heart attack but they cannot rule out ischemic heart disease and partial blockages that may mean an incipient risk of one in future.

 

Chest pain/discomfort can also be due to angina, pain from inadequate blood flow but short of a heart attack.

 

OP if you did not have a stress test (running in a treadmill with the EKG attached) you definitely should.

[wpcoe]

My sister in the USA is a candidate for hip replacement and needs to get a cardiologist's okay before they agree to surgery.  Because she cannot do anything on a treadmill, they did a "chemical stress test," which I'd never heard of.  Apparently she lies on a table, they inject chemicals and her heart races.  Do they offer such stress tests in Thailand?

[Harry2]

17 hours ago, wpcoe said:

 

 Can you clarify?  The double-negative seems to indicate that you might have had a heart attack?

Yes it was a double negative, I tried to edit it when I re-read it but couldnt work out how to. 

I see an edit button now on this but maybe it disappears later on?

Edited November 5, 2016 by Harry2
Explanation

[Harry2]

13 hours ago, Sheryl said:

I assume he means he had not had a heart attack.

 

But I am concerned that this post does not mention a stress test.

 

EKG and some blood markers can rule out a heart attack but they cannot rule out ischemic heart disease and partial blockages that may mean an incipient risk of one in future.

 

Chest pain/discomfort can also be due to angina, pain from inadequate blood flow but short of a heart attack.

 

OP if you did not have a stress test (running in a treadmill with the EKG attached) you definitely should.

Thanks again Sheryl for your extremely pertinent advice. I did not have a stress test and the doctor I saw at Bumrungrad (your reco was who I aimed for but was not available) was frankly pretty indifferent. I was relieved at the time that there seemed to be no heart attack but as I reflected on it I became more concerned that the original incident was left unexplained and there was no suggestion of seeking other advice. If it wasnt heart/hypertension related then it potentially might be something equally serious - in particular I still feel woozy & my balance is not 100%. So I will most likely seek a second opinion next week from the other one of your main recommendations. Again thanks for spurring me into action, I am very prone to complacency & cant afford to be in this context.

[lopburi3]

1 hour ago, wpcoe said:

My sister in the USA is a candidate for hip replacement and needs to get a cardiologist's okay before they agree to surgery.  Because she cannot do anything on a treadmill, they did a "chemical stress test," which I'd never heard of.  Apparently she lies on a table, they inject chemicals and her heart races.  Do they offer such stress tests in Thailand?

Yes - at least at Bangkok Hospital they do.  I had prior major (6 hour) surgery - another hospital had done echocardiogram as there pre surgery check.  Much more pleasant experience than physical stress test where I can never get beyond a few minutes without becoming breathless (and may or may not get heart into target range).  

[al007]

Some observations, from my personal experiences

 

A little over a year ago, after an annual check up,( also done in the previous 4 yrs),  then 3 days in the local ICU unit after haemorrhaging 2/3 litres of blood, a month later. I left the hospital without the right answers

 

I was sweet talked by doctors into doing nothing, should have known better but took the easy option

 

Today I probably have a strong case of medical malpractice

 

If I had posted on this forum my symptoms, or gone for second opinions promptly, which eventually after a year I did, and then uncovered not only prostrate  but also colon/rectum cancers, I might just not have my current problems, and they would have been much more treatable

 

Medical care in Thailand can vary phenomenally, from excellent, that I believe I am getting at the moment to awful

 

So to be safer we need to follow up, when in doubt, or get second opinions,(not expensive)  and listen to Sheryl's and the advice of others who are either suitably qualified or can talk by experience

 

We do not want to have potential malpractice claims we want to be well

 

The old saying a stich in time can save nine, is so true, if I am lucky I will wind up with many stitches but hopefully still alive !  !  !