Hiatal hernia + 3 fractured vertebrae = pain/fear for life

[teddog]

Surgeons remove 30 inches of man’s bowel after rare condition caused constipation to build up over 22 years - Mirror Online.htmSurgeons remove 30 inches of man’s bowel after rare condition caused constipation to build up over 22 years - Mirror Online.htm

 

How long have you been a constipated sailor?

[NancyL]

Has the chronic constipation been discussed by a GI specialist?  For example, there is a test that seems like it would be helpful in this situation, a colonic marker transit study  http://www.aboutconstipation.org/colonic-inertia.html

 

Of course, just the process of getting cleaned out for a colonoscopy and endoscopy would clean out the GI tract, temporarily, and could rule out some possible causes of the problem.  But this colonic marker transit study looks like it would be a less expensive way to start an evaluation.

 

I wonder if Sheryl or others with  experience could comment?

[jpinx]

There's so many things to be resolved that the OP is possibly getting quite confused between the symptoms.  Chrons disease,  Colitis, etc, etc but without a decent diagnosis which is not always looking at a price-list the whole diagnostic process becomes a lottery.  I've been suggesting relatively simple blood tests and scans to at least give pointers for the OP to explore further, without breaking his bank account and without getting sucked into a vortex of inter-related problems.  I walked into a private hospital and asked for a short consultation, a simple X-ray, and a simple blood sampling.  It cost about 2000Baht and I got copies, printouts, CD of the Xray, etc and I walked out to have a good look at the results, do a lot of reading and then decide on the next step.  The radiologists report was invaluable - he spotted the lesions before anyone, the blood samples supported his view, a bit of reading and I was able to get a more tightly defined consultation with a urologist next time -- so the process goes, and meantime make the biggest efforts of your own to clear your body of the (literal) crap which has been adding to the confusion.  You don't put diesel in a petrol car, do you??   -- so treat your body in a better way than you have been doing! 

 

 

[sailorjon]

UPDATE: thank you for the comments and advice all.  I will look closely at them and reply shortly...

 

I went to Vejthani hospital yesterday.  Spoke with the cardiologist that gave me the heart check in May and said things were fine with heart.  Explained that in Malaysia I was advised to see cardiologist and he said I should have an angiogram to check for blocked arteries which would account for the shortness of breath and fatigue symptoms.  That this test was the most important one to do.  Showed him the results from Malaysia Calcium blood test I did in the machine pre-angiogram indicating a lot of calcium in blood.  Told him that the cardiologist there felt certain enough from that evidence that I had blocked arteries to prescribe medicines as if I had arterial blockage.  He also suggested I should confirm this by getting a standard angiogram.   I could not do that in malaysia, insurance will not cover.   Back to BKK.  

 

So, I'm asking his opinion at Vejthani since he said my heart was fine and probably not connected to the breathing problem and why no angiogram and how does 'your heart is fine'  relate to 'you probably have blocked arteries'...  He said, because if there was arterial blockage there would be painful angina.  And that is right, I have had minor heart/chest pains but not very painful intense pain.  

 

Which is why he recommended I see chest doctor [test the lung to see if that is causing the shortness of breath, etc.]     

 

With the new evidence he does think I should have an angiogram.  It's possible I do have blockage, however it might not solve the breathing problem.  There may be another cause for that or a contributing cause.  And he spent time giving me a scary long list of possible complications with an angiogram.

 

I said Ok, great.  we are on the same page finally, maybe narrowing in on an accurate diagnosis for one of my many afflictions.  Praise be!  Let's get it done asap.  We must get confirmation the insurance will pay first.    And then, it all began again.  it is clear now i am to be left circling the drain in pain and discomfort daily while the last of the money goes without any treatment whatsoever, month after month.    He said before an angiogram can be done, you have to do the other procedures because you will be on anti platelets? for six months and if you have some gastrointestinal problem requiring a procedure or a skin biopsy etc.  , I don't know, there would be some problem with the angiogram post medicine situation.  It's all a little unclear.   Bottom line.  First see lung doctor and get tests, then gastrointestinal doctor and get tests, then skin doctor and get tests. Then, we can check the heart with an angiogram.

 

Ok, I would love to do that. I'm trying to get an answer if insurance will cover or else I cannot.  Hospital can't really help there.  Trying to reach the agent who sold me the insurance.  

 

Let's assume I can do this then I want to move on it.  Sounds good.  Lung check will maybe give an answer about the breathing.  let's rule everything out first before we just go check the heart and see if its blocked, right?  gastro - i definitely urgently need as you know.  I want endoscopy and colonoscopy.  upper g.i.  Let's solve the torture from the gastrointestinal area.   over 5 months now and still no confirmed diagnosis there either, so no treatment just 5 months taking laxatives and eating and exercise advice.   

 

One more piece of info.  Yesterday, they did one more test that they couldn't do when I had the 'complete' heart check in may because my back was too painful too lie down.  Blood pressure test on all four limbs.   the printout says:

stiffness CAVI   right [5.10]  'CAVI is extremely low.

                             left   [3.6]

 

BLOCKAGE ABI    right / left both say:    OCCULUSIVE ARTERIAL DISEASE MAY BE PRESENT

 

So, I don't know.  We didn't have time to discuss that test yesterday.  but there's obvious confusion and conflict in the diagnosis....  Doesn't seem like 'your heart is fine' was correct, which is why I went to another doctor.

 

And, blood pressure yesterday was very low! I mean 80/62  pulse 89.     

later, he tested it and it was 90/ and something ...

 

I believe that is dangerously low, right?   Before it was dangerously high.. although I realized some of those high test results were because they were not waiting until my heart settled.  I would have just walked to the room, etc and even getting up from a chair has an effect, they take the test and it is 179, 190...   so now i say let's wait 20 minutes

 

I asked why so low, maybe because of the hypertension medicine im taking is working he said.

 

 

 

 

 

 

 

 

 

[sailorjon]

Jpinx.  I sincerely want to try to clean out the g.i.   I had the doctor prescibe more forlax and I'm willing to try your '8 packets at once' idea.   What else do i need to know?  stop eating and drinking water first?  empty stomach?  etc.  

 

Anyone have experience with the various colon cleanse products? with psyllium, senna, etc... they make some big claims about cleaning out impacted colons...

 

[teddog]

4 hours ago, sailorjon said:

Jpinx.  I sincerely want to try to clean out the g.i.   I had the doctor prescibe more forlax and I'm willing to try your '8 packets at once' idea.   What else do i need to know?  stop eating and drinking water first?  empty stomach?  etc.  

 

Anyone have experience with the various colon cleanse products? with psyllium, senna, etc... they make some big claims about cleaning out impacted colons...

 

 

 

You are going to get thrashed on the prices here in Thailand,just 2 hours away finest care and cheapest in the world.  This place   all--in- one,.many like it

 

 

Welcome to Suraksha

Suraksha is a name people readily associate with diagnostic quality and convenience. The largest diagnostic chain in eastern India, it today ranks among the top 5 nationally with nearly 25 centres across West Bengal, Bihar and Delhi NCR. All diagnostic centres are owned and operated by the company to maintain strict quality protocols. Suraksha also operates a centre in NRS Medical College & Hospital in Kolkata on PPP (Public Private Partnership) basis with the State Government.

Suraksha diagnostic services span Pathology, Histopathology, Molecular Diagnostics and Radiology and include the latest tests. It is the first in India to receive the coveted CAP (College of American Pathologists) certification and is also NABH accredited. Apart from diagnostic services, Suraksha has a number of polyclinics with senior consultants from disciplines such as Cardiology, Gastroenterology and Neurology. It also runs Super Specialty Clinics for diabetes, hypertension, back pain, etc.

Online reports download    |    Customer Care Timing : 6:30 A.M - 8:00 P.M     |    The most advanced pathology lab in Eastern India    |    The largest array of tests in Pathology    |    Fully automated with bar coding    |    Door step collection available    |    SMS alert

 

 

[NancyL]

Sailorjon, I'm amazed that you still haven't resolved the constipation problem.  Whenever I'm on pain killers, I up my normal daily dose of one Mucilin packet.  It's fiber.  If I didn't take at least packet daily (with a large glass of water) I'd probably be as constipated as you.  I read where the normal dose is one to three packets daily, with a large glass of water or fruit juice, best taken after a meal.

[teddog]

Sailorjon,

 

   Remember the injectable plastic holder I wanted to send you?  the one with the 4 inch long tit on it, well was doing bit of research,you see gravity will not let it seep into your innards, you have to stand on your head (feet in the air) and get someone to squeeze the contents into your anus,  guaranteed to hit the spot,just like WD 40

[Sheryl]

8 hours ago, sailorjon said:

UPDATE: thank you for the comments and advice all.  I will look closely at them and reply shortly...

 

I went to Vejthani hospital yesterday.  Spoke with the cardiologist that gave me the heart check in May and said things were fine with heart.  Explained that in Malaysia I was advised to see cardiologist and he said I should have an angiogram to check for blocked arteries which would account for the shortness of breath and fatigue symptoms.  That this test was the most important one to do.  Showed him the results from Malaysia Calcium blood test I did in the machine pre-angiogram indicating a lot of calcium in blood.  Told him that the cardiologist there felt certain enough from that evidence that I had blocked arteries to prescribe medicines as if I had arterial blockage.  He also suggested I should confirm this by getting a standard angiogram.   I could not do that in malaysia, insurance will not cover.   Back to BKK.  

 

So, I'm asking his opinion at Vejthani since he said my heart was fine and probably not connected to the breathing problem and why no angiogram and how does 'your heart is fine'  relate to 'you probably have blocked arteries'...  He said, because if there was arterial blockage there would be painful angina.  And that is right, I have had minor heart/chest pains but not very painful intense pain.  

 

Which is why he recommended I see chest doctor [test the lung to see if that is causing the shortness of breath, etc.]     

 

With the new evidence he does think I should have an angiogram.  It's possible I do have blockage, however it might not solve the breathing problem.  There may be another cause for that or a contributing cause.  And he spent time giving me a scary long list of possible complications with an angiogram.

 

I said Ok, great.  we are on the same page finally, maybe narrowing in on an accurate diagnosis for one of my many afflictions.  Praise be!  Let's get it done asap.  We must get confirmation the insurance will pay first.    And then, it all began again.  it is clear now i am to be left circling the drain in pain and discomfort daily while the last of the money goes without any treatment whatsoever, month after month.    He said before an angiogram can be done, you have to do the other procedures because you will be on anti platelets? for six months and if you have some gastrointestinal problem requiring a procedure or a skin biopsy etc.  , I don't know, there would be some problem with the angiogram post medicine situation.  It's all a little unclear.   Bottom line.  First see lung doctor and get tests, then gastrointestinal doctor and get tests, then skin doctor and get tests. Then, we can check the heart with an angiogram.

 

Ok, I would love to do that. I'm trying to get an answer if insurance will cover or else I cannot.  Hospital can't really help there.  Trying to reach the agent who sold me the insurance.  

 

Let's assume I can do this then I want to move on it.  Sounds good.  Lung check will maybe give an answer about the breathing.  let's rule everything out first before we just go check the heart and see if its blocked, right?  gastro - i definitely urgently need as you know.  I want endoscopy and colonoscopy.  upper g.i.  Let's solve the torture from the gastrointestinal area.   over 5 months now and still no confirmed diagnosis there either, so no treatment just 5 months taking laxatives and eating and exercise advice.   

 

One more piece of info.  Yesterday, they did one more test that they couldn't do when I had the 'complete' heart check in may because my back was too painful too lie down.  Blood pressure test on all four limbs.   the printout says:

stiffness CAVI   right [5.10]  'CAVI is extremely low.

                             left   [3.6]

 

BLOCKAGE ABI    right / left both say:    OCCULUSIVE ARTERIAL DISEASE MAY BE PRESENT

 

So, I don't know.  We didn't have time to discuss that test yesterday.  but there's obvious confusion and conflict in the diagnosis....  Doesn't seem like 'your heart is fine' was correct, which is why I went to another doctor.

 

And, blood pressure yesterday was very low! I mean 80/62  pulse 89.     

later, he tested it and it was 90/ and something ...

 

I believe that is dangerously low, right?   Before it was dangerously high.. although I realized some of those high test results were because they were not waiting until my heart settled.  I would have just walked to the room, etc and even getting up from a chair has an effect, they take the test and it is 179, 190...   so now i say let's wait 20 minutes

 

I asked why so low, maybe because of the hypertension medicine im taking is working he said.

 

 

 

 

 

 

 

 

 

 

What you are reporting makes no sense. You do not need to see all these other doctors prior to having an angiogram. You do need to have your blood checked for any clotting issues.

 

From your BP it sounds like some adjustment is needed to the meds you are on.

 

You need to see a GOOD cardiologist. I have repeatedly tried to steer you to one, you keep going elsewhere and then complaining when the treatment you get is not up to par.

 

Nothing more I can do. I would not continue with this doctor if I were you, but suit yourself.

[Sheryl]

P.S. The bit he told you about being on anticoagulants afterwards is not  from the angiogram. It is from stent placement during the angiogram (done in blockage found). This will cost you about 500,000 baht, more if multiple stents. It is very unlikley your insurance will cover this as it is a new policy and a problem like this takes years to develop, they will spot this as pre-existing in a flash.

 

It would cost about 150-200K at a government hospital.

 

BTW what he told you about always having angina if there is blockage is incorrect. (As is much else you quote him as saying)

 

Again, I urge you to change doctors, though I am frankly starting to get the impression you prefer to see inept ones and then complain about it than to take positive steps to get the care you need.  You will certainly succeed in having LOTS to complain of -- physical and financial -- if you continue in this way.

[sailorjon]

re: teddog article on impacted faeces.   Teddog, I saw that article.  Holy crap! What are the chances this is what is happening to me?  A lifetime of meat eating and bad food choices.  Surely though, that would have been seen in the Ctscan I had done of my abdomen,.  In fact, I'm thinking now to see g.i.  Doctor get colonoscopy and endoscopy of upper g.i. to get a clear picture of what's what if the insurance can pay.  This is ridiculous going so many months with no clear diagnosis!  And an xray or another ctscan should be able to identify any serious blockages in the colon that is the problem.

[sailorjon]

Re: NancyL - thanks for that reference.  The only discussion with a g.i. has been at rhamthibodhi teaching hospital with a young doctor and it was kind of passed over as we tried to focus on what to do about the hernia, thinking that was the urgent concern.  And he was pushing for an endoscopy.  

 

Sheryl, I tried to get an appointment with the g.i. you suggested at chula but couldn't.  Some of those recommended doctors I asked for I was told didn't come to the clinic.  I could try to get appointment directly through his ? Office perhaps if insurance will cover.

 

I'm really thinking endoscopy, colonoscopy and some kind of imaging of g.i. / colon should give some answers.

[sailorjon]

 re jpinx comment.  Yes, I start to do research, find possible causes for sympoms like croyns, colitis, blockage etc.  And realize I could be reading for months without being closer to the truth or knowing what's what.  I need the proper tests and highly competent medical professional and, true, always looking at the price list is a hindrance.   So, if the insurance won't cover endoscopy / colonoscopy and imaging of g.i. / colon looking for blockage and a diagnosis and I have to wait for months and save money… I will think about the tests I can get like you recommend and then order them and see if they bring results. 

[sailorjon]

re: Nancy comment:    Thanks Nancy, I am amazed also,, I've just been running ragged from the back pain to the stomach pain, then to the heart crisis , now back to the colon / constipation.   I know it looks crazy but it is a little crazy making being assaulted in all these areas at once, feeling these are very serious conditions, being in danger of having no treatment options because of funds, and then finding the experience with the doctors and hospitals not improving the situation greatly.  Granted, I've switched to different doctors and hospitals but I think for good reasons and if I didn't I would't have the certain results I now have.

[sailorjon]

re: sheryl
thanks.  This is what I'm dealing with.  It seems the doctors want to keep referring me to other doctors and more tests.  How am I supposed to know?  
He didn't say 'always' have angina, but he said I would have angina, intense pain which I haven't.   So, you believe that's not true either?   Maybe he mentioned the anticoagulants because if they do an angiogram and find they must then use stents right away, the other possible procedures should be done first...
And, please, it's not necessary to suggest I wish to see inept doctors so I can complain about them.  That's unfair and, frankly, insulting.  I'm doing the best I can to make choices and take positive steps to get the care I need under difficult circumstances.    I went to Maylasia and found a very good heart doctor, his advice was sound, he was cognizant of the reality of money issues, and he actually prescribed medicines that helped.    I tried to get an appointment with the doctor you recommended at the night clinic and couldn't.  
I didn't start this thread in order to complain.  I'm not an immature drama queen in need of attention.  I came here seeking help and advice because this is a bewildering and serious situation.  If the comments read to you as just unwarranted complaints I don't understand.  I may not be proceeding in the best possible way, but it seems like I have somethings that are legitimate and serious 'concerns' that I am trying to get information/ answers to not just complain about.  And you, and everyone else here have been great at helping to fill in those gaps with valuable information from your experience.     Everyday, I wish that these multiple injuries and ailments were treated, healed and gone so that I could get stronger and move forward with my life in a healthier way.  It has been six months of pain and severe limitation.  I look around me and see many hospitals, millions of dollars of high tech equipment and, surely thousands of doctors with high expertise and know this could be done, and quickly.  I don't know why I am not getting correct diagnosis and treatment.  I don't know why the doctors opinions differ so widely.  I don't know why I spend all day getting a heart check as you advised, thank you, and the doctor tells me my heart is fine and then I go to another and he says i probably have arterial blockage.  I don't know why the doctor then insists I see three other doctors first and, what, lies about angina?  How am I supposed to know?  Am I complaining too much about it?  I don't think so.  i'm trying to find a route to survival.
 

[Sheryl]

It is not that you are complaining too much, it is that you are insisting on sticking with a doctor who has demonstrated a low level of competence and who was nto selected through any sort of research but rather by chance.

 

Coronary artery occlusion can be completely asymptomatic until it is total (at which point of course you have a heart attack).

 

The cardiologist I recommended can also be seen privately at Sukhumvit Hospital on Saturdays, which is tomorrow.  I suggest you see him and when there ask if it is possible for him to arrange to do the angiogram and stents (if needed) at Chula. It is indeed impossible to make appointmets etc at Chula on the phone but if he is able he might be able to set t up for you.

 

http://www.sukumvithospital.com/en_doctorprofile.php?id=32

 

He is of course not the only good cardiologist in Thailand, but others whom I could recommend are either only available at government hospital (hard to book in advance) or at very expensive private hospitals.

 

Dr. Taworn trained in the US and I have taken many friends, relatives etc to see him with consistently good results. He has done angiogram and stent placement on several TV members who were likewise pleased with him.

[sailorjon]

Got it. I called sukhumvit yesterday.  I will go today, they told me register at 2pm and wait until he sees regular patients.  That's fine.   I will give him the story including the conflicting ideas from different doctors and ask for advice.

[sailorjon]

UPDATE:  Good doctor, excellent English. Some of the advice confusing.  Some of the conversation weird. Next step depends on insurance.

 

Thank you Sheila.  I met with Dr. Taworn.  Impressive doctor.  I had a good feeling about him.  Excellent English. And seemed to be really trying to find some answers for me.  He even gave me his telephone contact number at the Christian hospital to contact him Monday after I talk with the insurance agent to try, once again, to confirm coverage.

 

The strange part of the conversation was the sense of him, like other doctors not wanting to make a decision, but to leave things vague or unknown rather than take a risk.   What I mean is, I started by asking him to clarify the conflicts of opinion of the other doctors:  1.  severe heart pain necessary for blocked artery diagnosis.     He said no, not necessarily.  Later,  while asking when you would think arteriosclerosis is present and recommend angiogram he said there should be symptoms.   Like what?  Heart pain, he said.    So,,  confused me there.    He talked about the CAC scan showing anatomy and not physiology but I didn't get his point about that.

 

   About the Vejthani dr saying first do lung, stomach, skin etc.  he didn't think that necessary.   He talked alot about angiogram and angioplasty risks vs benefits suggesting that sometimes artery blockage is not responsible for blood flow decreasing which is what is dangerous.  Connecting narrowing of the arteries to eschemia [blood flow] … that some patients could have 75% blockage and he wouldn't do angioplasty but leave it.   ok. why?  the procedures injure the blood vessel, they ? scar I guess and thicken and could end up being more than 75%....  also, mentioned possibility of 'acute closure'  happening which sounds like death follows because the blood vessel collapses..  

How to connect narrowing of the artieries to eschemia?  1: tighness in the chest, pain   2. heart attack.   If the narrowing causes the eschemia - then the angioplasty is called for.   If not, he said, leave it.   Something about can't check the blood flow?  Only in the lab?  I don't know.

 

 

 So, the conversation was fruitful but strange in the sense of:  he said 'but if you want an agiogram we can do it.   Hmm but  as I told him, it's not that I WANT an angiogram so badly..  I would like a diagnosis.  Firstly, to solve the problem of what is causing the shortness of breath.  Secondly, even if the heart is not the direct culprit of SOB, the testing thus far indicates a possiblity of heart disease and isn't it wise to get a look and see??  yes?  or no?  there is or there isn't?  rather than just sit around and guess and wonder?  I asked what other way is there to check?  none.   Angiogram is it.

 

I told him about the CAC scan in malaysia that revealed the calcium resulting in that doctor suggesting artery blockage that should be confirmed by angiogram.  He wanted the test number and I didn't have it because I brought the CD of the test scan.  But he couldn't play it, something about his computer and I didn't have a hard copy... but.. I searched by notebook and found it.     The malay dr. said anything over 400 is very high and my score was 500.

Dr Taworn said well, he didn't think 500 was very high.  He had a patient with 800, then after angiogram.. or angioplasty?  He was clear.    

 

Next important issue he brought up is if there is a need for angioplasty found during angiogram, its done right then and his concern emphasized the risks very strongly.  .. I thought these procedures were relatively low risk and done by many people everyday without problem but in this conversation there was a real dark shadow of ... we could do it but....  this or this or this could happen.    and the alternative is what?  Not knowing?  Wait and see if heart attack?  I’m just trying to understand. 

 

Another piece of information he revealed looking at the tests from Vejthani when I did the 'complete' heart check, echo, blood, etc.  Was that there was no stress test, maybe because of back, and the results were all 'resting' results.   So, I guess that means they would be misleading , perhaps inaccurate for giving a diagnosis.  Resting test is not conclusive.

 

Near the end of the conversation he looked at the printout from blood pressure test down on four limbs simultaneously at Vejthani earlier this week which said:  'occlusive arterial disease may be present'  next to two of the test numbers and said 'I think you have blockage.   Or artereoschlerosis  I don't remember the exact word.   

 

I got him to write a medical certificate and we decided I would call him after talking with the insurance agent Monday to decide how to proceeded because obviously if this begins with angiogram it could escalate to angioplasty, stents etc..  And I don't have the money for that.

 

 

… so he's obviously struggling with risks vs benefits of doing these procedures and I am struggling with multiple afflictions with no clear diagnosis or treatments leading to healing..

 

 

… only two possible causes he said of sob, heart or lung… although later he mentions the hiatal hernia which seems to me likely also to have pressure on the lung…   I said why not put both recommendations on medical cert.  Angiogram and lung test and I'll try to get insurance confirmation.   But he didn't put the lung dr. referral.

[Sheryl]

But you already saw a lung specialist, didn't you, and nothing found?

 

Did you ask him about the possibility of doing the angiogram at Chula? (In case you have to pay yourself).

[sailorjon]

No, I have not seen a lung doctor yet.  So, perhaps should try this first see if that reveals anything responsible for the s.o.b.,  if not, that leaves the heart.  If yes, I can get treatment probably and then follow up on the possible heart problems.

 

I mentioned the Chula option if insurance wouldn't cover.  He gave no definite answer but I will follow up if need be.

 

His telephone he gave me on paper with Bangkok Christian Hospital written on it.  Perhaps that is the hospital number but maybe I can see him there in the future.. because if you search google for sukhumvit hospital and then look to the right capsule and click 'google reviews' you can read some real nightmare stories about Sukhumvit hospital.

 

 

[sailorjon]

Did you have an idea about the good lung doctor to see?

[Sheryl]

Dr. Phichai Namsirikul at St Louis Hospital on Sathorn is a US trained pulmonologist (lung specialist). His hours used to be:

 

Monday :: 09:00 AM - 12:00 PM
Wednesday :: 09:00 AM - 03:00 PM
Saturday :: 09:00 AM - 12:00 PM

 

But call to confirm as their website now is only in Thai. 02-838-5555.  Usually you do not need an appointment at this hospital, just show up and register on the first floor.  But it will be first come, first serve, so arriving a little before the start of  the doctor's hours is wise. Bangkok Christian operates the same way, BTW.

 

Another good pulmonologist is this one but he is  at Bumrungrad so expensive, especially since you may need some pulmonary function tests done.  https://www.bumrungrad.com/doctors/Kasem-Sirithanakul

 

I don't know if it is still the case, but in the past Bangkok Christitan did not have its own cath lab and Dr. Taworn would do the actual angiogram/ angioplasty on patients from there at Chula, so maybe this is why he suggested you see him there.

 

You will find horror stories about any and all hospitals on the web. It is the choice of doctor that is important. but if he still uses the Chula cath lab for angiograms on patients admitted to Bangkok Christian then that is certainly a better option.  I wasn't sure he still had hours at Bkk Christian as I don't find him o ntheir website anymore. His hours used to be Saturday mornings only.

[sailorjon]

looking through my notes and found another point he made at the last re if do the angiogram..  'if put catheter in and no problem, then finished with heart.  if not normal we can make decision on the table.'     hmm.. again,, seems like a lot of dark foreshadowing to me for what I thought was a relatively simple not very risky procedure...

[lopburi3]

Decision is made as to what if any treatment may be required - and treatment could just be expanding or expanding and inserting stents.  It stents to be used choice of non-medicated or medicated must be made.  This can be done in OR when and if required. 

This does not make procedure more risky - just letting you know it could just be an exam or an exam with treatment (which you already know).  

[sailorjon]

Thanks Sheila.  I will follow up on this.  I"m anxious for some real results and an actual diagnosis.  I still can't get straight answers about how insurance works.  I will talk to the agent on monday.  It seems that if you are not admitted it is OPD and then my limit is 2500 baht.  so, what, the limits for surgery, ctscans, lab, etc.  are useless unless they admit so I must get them to admit me for these tests.

 

 

[Sheryl]

Angiogram involves admission, usually 1 night. Even in the west where they sometimes just observe for a few hours afterwards, it is covered as an inpatient procedure. Inpatient cover includes day surgeries and day procedures of the sort that require that you be admitted to a hosp[ital bed for at least a few hours, even if not overnight.

 

That part is not the problem. The problem is that coronary artery disease takes years to develop, so if you have it, it pre-existed the insurance (as did your symptoms) so even though you had not been told you might have heart disease at the point you got the policy,  they may considre it ineligible because pre-existing.

[sailorjon]

Right, I understand.  It's a rigged system.  At this age, every malady will have some connection to the past, pre purchase of insurance except accident or new disease.   So, I live with it until it kills me or I can save or find the money to pay for what's needed.     The hospital called asking for a copy of my insurance card to talk to the Insurance company even though I was there Saturday and they used it and should have it in the computer.  I will wait and see what they say.

[sailorjon]

Thanks Lopburi.  Let's see if I get to the table this year.

[Flustered]

On 2017-6-18 at 1:04 PM, Sheryl said:

Angiogram involves admission, usually 1 night.

Beg to differ.

 

Angiogram is a day admission procedure. The only reason a hospital would keep you in is if there was a complication or to pad the bill.

 

I was in and out within 4 hours and that included watching the procedure on the screen while they carried it out.

 

Any male having an angiogram for the first time has a pleasant experience waiting for them.

[lopburi3]

Actually I have had two done in Thailand and both involved overnight stay for observation - just taking off pressure band from wrist involves about six or more hours and if any procedure involved you will be on monitoring equipment in an ICU/CCU room for the night.  This was at Vejthani Hospital here in Bangkok.

 

Query where in Thailand you were in/out in 4 hours and if this was wrist entry?