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MountainFun

Heart Disease diagnosis

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Hello everyone, thanks for having me in the forum. 

 

After having some heart issues over the last year, mostly random palpatations and a few pretty scary episodes of wild heart flutters, we had a holiday a couple of weeks back and whilst in the hotel one night I was unable to sleep lying down, I couldnt catch my breath properly and had realy wild palpatations when flat.  I had to sleep in a chair all night.  Actualy thats not the first time over the last year I have sleapt in a chair all night, either.  I have been to three different hospitals about this since August (and one heart clinic) and have had blood tests, ultrasounds, x rays, and the obligatory ECG.  Each time I was told I am fine, probably too much coffee or something (despite always telling them I only drink one cup a day in the morning).

 

After this holiday recently I went back to my local cardiologist at Bangkok Hospital, Udon Thani and had an ECG.  He told me everything appeared fine and suggested changing my BP medicine.  I put my foot down a little, told him I could feel something serious was going on and demanded a battery of tests.  So I had the lot - a full heart check up includiong echo, CT, BP/ECG, Blood, 24H holter, stress test, Xray.  I have no insurance and the tests cost me 27,000 baht. The blood test showed a high colesterol and lipd count but more alarmingly the CT scan showed actual heart disease (although they didnt tell me it was heart disease at the time).  I have a calcium score of 120, and 75% stenosis (narrowing of vessel) in one vessel, and 25% stenosis in another.  According to the CT report, this places me in the 89th percentile - meaning I am in the bottom 11% for people of my age group.

 

The Doctor told me, and I quote 'not serious, not serious, can give medicine to help, come back in 1 month'.  I thought oh well ok, not serious thats great!  But then a retired British GP who I got chatting to in a cafe the following morning purely by chance told me actualy, this is very serious - its Coronary Heart Disease.  How could the cardiologist not tell me that the day before and just say 'not serious'?  The CT report clearly states in English that without lifestyle changes, a major cardiac event/stroke could be expected in 3 to 5 years.  is that not serious enough???

 

Anyway, I was prescribed some medicine: Atorvastatin 40MG, Asprin 81MG, Atenolol 50MG and Losartin 50MG all once a day after breakfast.  I have radicly changed my diet for the last 10 days, leafy greens juice with a little fruit in mornings, im eating seeds, nuts, berries and salads for lunch and fresh salmon/mackeral/tuna with salad for dinner.  I was a smoker, but quit cold turkey 10 days ago.  Im not expecting immediate results of course, but plan to stick with this liefstyle change for years to come now.

 

I am nervous about my condition though.  I dont know actualy how dangerous this is.  I went back to my cardiologist a few days ago and asked him, do I actualy have Coronary Heart Disease then?  he said yes.  So I asked him, why did you not tell me that and say it is not serious?  He said it isnt too serious and the medicine should fix it because the 75% blockage/narrowing is "only in one vessel".  But I dont know, I mean this retired GP seems to think I could keel over at any moment.  He said "you probably wont, with medicine, staying off the smokes and healthy diet, but yes im not going to lie according to your report you are in dangerous ground right now"

 

I dont know who to believe.  I have been trying to set up a virtual consultation with a cardiologist in the UK but it has been problematic.  I paid 320 GBP for a cardiologist in Cambridge, UK, to look at my results and have a 60 minute zoom call with me but after spending a really stressful week trying to get my reports over to her clueless secretary (she couldnt open CSV files and then Google drive links) and lots of messing around (46 emails swapped in 5 days), the meeting has been rescheduled three times and I eventualy gave in, threw a bit of a wobbly with her and cancelled the whole thing.  Im in the process of looking for someone else and hope they will refund my money.  I would like someone to look at the results and just simply tell me, yes this is really quite serious - you need a stent fitting right away, OR dont worry, medicine will help, stay with the diet and off the smokes and you will be fine.  Im just looking for concrete advice.  

 

I am begining to worry here quite a bit.  10 days into the medicine and lifestyle changes and I still have heart flutters, occasional palpatations and sometimes feel just a little short of breath.  I want to start excersising but worry I will drop dead half way around the jogging track.  I am only 46, but worry I might only have weeks/months or a few years to live.  I really havent been told quite how dangerous this is.  My cardiologist seems popular with the local ex pats here (one guy on a local forum reporting that this doc saved his life when other cardiologists failed him) so he must know his stuff.  But I cant get out of my head the fact that he was so nonchalant about it all, saying it is 'not serious' and not telling me I had CAD for a full week untill I went back and asked!  Compare that to the British GP who although it was only a casual chat seems to think it IS serious.

 

Should I pursue finding a cardiologis back home in the UK and look at my results remotley?  Or should I find a Thai cardiologist with a good reputation to look over my results and offer a second opinion?  Apparently there is a great heart hospital in khon Kean but it is government hospital, which means sitting around in a waiting room for hours and hours being shuffled from pillar to post, with poor English skills (and my Thai is terrible).

 

Should I fly home to the UK and put myself through the system?  My sister seems to think that is a non starter as there is a massive back-log of patients waiting to be seen there owing to the pandemic?  I also dont have property in the UK which means having to stay at expensive airbnb's.

 

I really dont know how to proceed and im really quite worried here.  As I said, I am only 46 - not ready to keel over and die just yet!  I just wish someone could look at my results and confirm as a second opinion, if this is a serious issue that could kill me in the short term, or not.

 

Any advice greatly appreciated, I am very very worried here!

 

Thanks!

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11 minutes ago, MountainFun said:

I also dont have property in the UK which means having to stay at expensive airbnb's.

Why ? Plenty of B and B's around the UK for long term workers, etc. I'm stuck in the Uk now and I can get a room £70 a week - though I pay £90 for a larger room. Which is little more than a Thai condo or house. Course, you may have to stay in a city town that you don't like if on a budget

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I would do immediate changes as you did. And I would also planned a visit of home country for proper examination. But I wouldn't stress about it. I would plan it within ~1 year from now.

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2 minutes ago, RichardColeman said:

Why ? Plenty of B and B's around the UK for long term workers, etc. I'm stuck in the Uk now and I can get a room £70 a week - though I pay £90 for a larger room. Which is little more than a Thai condo or house. Course, you may have to stay in a city town that you don't like if on a budget

Hi Richard.  I couldnt see much on airbnb in the way of value to be honest.  I have a budget of 2000GBP for 6 weeks, looking under monthly rents on airbnb all I could see for that money was small rooms in shared houses.  I tried looking at a few different areas, within 50 miles of cambridge (good hospital there) and within 30 miles of Watford (friends there) and seen nothing in the way of 'entire place' for that budget.  There is nothing wrong with just a room only of course, but I just dont want to lol.  Its been a naff year, lost my business in March because of covid and now have heart disease - I dont want to be stuck in a room with a shared kitchen for 6 weeks on top of it all.  

 

I could stay with family, but that would be a nightmare after 5 days.  I have friends I could stay with also, but again I just dont want to for different reasons.  Not being picky or anything, there are genuine reasons why it sbetter I stay at my own place.

 

That is assuming I even need to go back.  Hopefuly I wont have to.

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I have similar problems to you and take similar medications .. I am 62 and had a calcium score of 137 . I had catheter ablation for palpitations which did not really work and then later had a cardioversion which was more successful . I take cordarone 200mg along with 2.5mg concor  which slows the heart and keeps the palpitations under control , although recently I have noticed a few flutters .

 

I think you need to get your palpitations under control , they can be very stressful .

 

I am sure this can be managed in Thailand , I don't think you should worry .

 

I do regular exercise classes and push as hard as I can ... however I did crossfit previously and found this too much .

 

Good luck 

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It would seem obvious that gathering all your test results and consulting with a top rank cardiologist, perhaps in Bangkok  would be your first option but whether or not that would provide a more definitive diagnosis and prognosis is questionable. 

There's an old trope that says the more watches a person has, the less certain they are of the time.  That wisdom can also apply to having too many consultations; which opinion does one chose to follow.

I experienced what I called "pressure" in my upper chest any time I exerted myself for a year, totally in denial. A friend who is a former physician visited for a few days.  When we were on a quiet walk and I had to stop and sit because of "pressure", he basically dragged me by the ear to a local hospital for some tests.  Similar to your experience, I was told I had a "mild" blockage; less than 30%, was given nearly the same meds as you and sent on my way with the admonition to loose weight, eat better food and exercise.

I did ok on taking the meds, not so much with the weight loss and diet.  I did try to walk at least 1km a day.  

Things were tight financially for me at the time. Though the local cardiologist did say a stent would probably be a good idea, I couldn't afford it's B300K-500K price tag and waited an additional six months before I was able to return to the USA where I get free veterans health care. 

I went directly into an "Urgent Care" unit at my local Veterans Hosp. and complained of chest pain.  I was in a ambulance within 15 minutes going to their surgical center.  Several days of tests later, I was on the table for a stent when I kind of died.  I was resuscitated and awoke the next day, having had a triple by-pass.   My blockages were much more severe than had been indicated in any of the testing and as a result, I came very close to checking out.

This was all three years ago.  I recovered from the surgery and have had a normal life since.  I'm in my 70s.

 

All this to say that testing only reveals so much and doctors can only make educated guesses as to what is really going on.  If you feel something going on inside that doesn't feel right and aren't 100% confident in what the Doctors are telling you, then you need to educate yourself as much as you can and advocate for yourself.   

If you think you need a stent, then push for it and make them explain why not.

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12 minutes ago, churchill said:

I have similar problems to you and take similar medications .. I am 62 and had a calcium score of 137 . I had catheter ablation for palpitations which did not really work and then later had a cardioversion which was more successful . I take cordarone 200mg along with 2.5mg concor  which slows the heart and keeps the palpitations under control , although recently I have noticed a few flutters .

 

I think you need to get your palpitations under control , they can be very stressful .

 

I am sure this can be managed in Thailand , I don't think you should worry .

 

I do regular exercise classes and push as hard as I can ... however I did crossfit previously and found this too much .

 

Good luck 

 

Thanks Churchil, appreciate the advice.  

 

Its a wierd thing with the palpatations, I dont know if you find the same but sometimes I think 'ah ok, thats normal, just my heart working it all out' and other times I think '<deleted>, this is the one that send me to the grave'.  You are right it is stressfull, the amount of times I thought I was dying in the last year, that cant be good for the soul!

 

Anyway, it would be nice just to get a firm, concrete second opinion from a cardiologist here who can say yep, your done for mate... Or calm down you big girl, you are going to be fine.  Just to know, either way, would be good as a starting point to planning all this.

 

Keep up the exercise, well done mate.

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3 minutes ago, dddave said:

It would seem obvious that gathering all your test results and consulting with a top rank cardiologist, perhaps in Bangkok  would be your first option but whether or not that would provide a more definitive diagnosis and prognosis is questionable. 

There's an old trope that says the more watches a person has, the less certain they are of the time.  That wisdom can also apply to having too many consultations; which opinion does one chose to follow.

I experienced what I called "pressure" in my upper chest any time I exerted myself for a year, totally in denial. A friend who is a former physician visited for a few days.  When we were on a quiet walk and I had to stop and sit because of "pressure", he basically dragged me by the ear to a local hospital for some tests.  Similar to your experience, I was told I had a "mild" blockage; less than 30%, was given nearly the same meds as you and sent on my way with the admonition to loose weight, eat better food and exercise.

I did ok on taking the meds, not so much with the weight loss and diet.  I did try to walk at least 1km a day.  

Things were tight financially for me at the time. Though the local cardiologist did say a stent would probably be a good idea, I couldn't afford it's B300K-500K price tag and waited an additional six months before I was able to return to the USA where I get free veterans health care. 

I went directly into an "Urgent Care" unit at my local Veterans Hosp. and complained of chest pain.  I was in a ambulance within 15 minutes going to their surgical center.  Several days of tests later, I was on the table for a stent when I kind of died.  I was resuscitated and awoke the next day, having had a triple by-pass.   My blockages were much more severe than had been indicated in any of the testing and as a result, I came very close to checking out.

This was all three years ago.  I recovered from the surgery and have had a normal life since.  I'm in my 70s.

 

All this to say that testing only reveals so much and doctors can only make educated guesses as to what is really going on.  If you feel something going on inside that doesn't feel right and aren't 100% confident in what the Doctors are telling you, then you need to educate yourself as much as you can and advocate for yourself.   

If you think you need a stent, then push for it and make them explain why not.

 

Thanks Dave, and well done for pulling through.  Blimey that is scary to say the least.  Your story sort of confirms my opinion that I do need a second opinion to be honest - I am told 75% blockage in one and 25% in another but I mean who knows, it could be worse than that.

 

I simply cant afford to have a stent fitted here if it is 500K.  The pandemic wiped out my busienss earlier this year and for 4 months have been living off savings.  I have enough stashed away for me and the wife to live well enough for another year while I figure out my next business move, but with hospital treatment in Thailand that would wipe me out almost.  If I am looking at stents or anything of that nature, I think I need to go home to the UK for a couple months, get in the system again and hopefully get treatment there.

 

Good luck mate, stay healthy

 

 

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I have a history of heart palpitations and atrial fibrillation. One thing I have learnt since the Covid-19 lockdown is that putting stress on body by excessive exercise or stressful situations can stimulate my irregular heart episodes. Since lockdown I have stopped running in the park and stopped swimming, and lo and behold my irregular heart episodes have almost disappeared. I have had a few mild episodes when I experienced some stressful domestic situations.

 

So some of your heart problems are maybe being caused or exacerbated by the the stress and anxiety you are experiencing. That is not to say you do not have other heart issues, but reducing your stress levels can help with the palpitations....if you can do it.

 

Check out the effects of the vagus (vagal) nerve on the heart.

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15 minutes ago, rak sa_ngop said:

I have a history of heart palpitations and atrial fibrillation. One thing I have learnt since the Covid-19 lockdown is that putting stress on body by excessive exercise or stressful situations can stimulate my irregular heart episodes. Since lockdown I have stopped running in the park and stopped swimming, and lo and behold my irregular heart episodes have almost disappeared. I have had a few mild episodes when I experienced some stressful domestic situations.

 

So some of your heart problems are maybe being caused or exacerbated by the the stress and anxiety you are experiencing. That is not to say you do not have other heart issues, but reducing your stress levels can help with the palpitations....if you can do it.

 

Check out the effects of the vagus (vagal) nerve on the heart.

Thanks, Ill have a read up on that - glad to hear you are doing much better.  

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You are stressing yourself out which does not help your condition.  Do get a second opinion...continue your lifestyle changes.  Get on with your life...

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Keep in mind that if you return to the U.K. for medical treatment, you may not be able to return to Thailand for a long, long time because of Covid restrictions.  It would be a good idea to seek  second opinion here.  Sheryl should be along shortly to give you a good recommendation of who to see.

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1 hour ago, MountainFun said:

I am only 46, but worry I might only have weeks/months or a few years to live. 

I have only read to this part of your post and will read the rest after I send you this. I had my first mild heart attack when I was 47, 2 months short of my 48th birthday, I am now approaching 60 next month, so slow down, don't stress, your lucky you have been diagnoses and are on meds, the aspirin helps to thin the blood so that you do not end up with any clots lodged into your arteries. I gave up smoking 8 years prior to my heart attack, just go slow, eat clean, no smoking, take your meds, I am on Atorvastatin 40mg, Asprin 100mg (purchased overseas) and Irbesartin 150mg. Last visit to my Cardiologist he prescribed me with an extra tablet Ezetimibe 10mg to take with the Atorvastatin at night at night before bed as always as he wanted my bad cholesterol to be under 2mmol/L, it is now 1.2 mmol/L with the additional tablet.

 

If you are overweight, you should lose weight by eating clean food, exercise is good, but you will have to slowly ease yourself into it. I lost 15kg in 8 months, from a clean diet, exercising (treadmill & weights) in my home gym. Try not to get anxious as this will affect your breathing, I do get anxious at times, but then just close my eyes and concentrate on my breathing and am good to go.

 

Once on the meds, you will be on the meds for life, so keep enjoying your life, take your meds, do the above, ease yourself into it and remember, there are no guarantees in life, we can go out with a bang tomorrow, so the long of the short to longevity is to take care of yourself.

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6 minutes ago, NancyL said:

Keep in mind that if you return to the U.K. for medical treatment, you may not be able to return to Thailand for a long, long time because of Covid restrictions.  It would be a good idea to seek  second opinion here.  Sheryl should be along shortly to give you a good recommendation of who to see.

Thanks Nancy.  Yes I agree, that could be a problem.  As it stands right now as you know I would be fine to return (I am married here and have a long term visa), it means staying in a covid hotel for 14 days at 30 to 60,000 baht but if thats what I have to do so be it.  The problem I guess is if the infections spike back in the UK, which is quite likely.  If that happens I could be stuck there for who knows how long.

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1 hour ago, MountainFun said:

I really dont know how to proceed and im really quite worried here.  As I said, I am only 46 - not ready to keel over and die just yet!  I just wish someone could look at my results and confirm as a second opinion, if this is a serious issue that could kill me in the short term, or not.

The best part about this is that you have identified a very common problem, let's not forget that heart attacks are one of the biggest killers to us mere mortals around the world, why so, well, we are what we eat, and of course smoking doesn't help.

 

The above said, it doesn't hurt to get a second opinion if you do not have the confidence in this Cardiologist, and I am sure he didn't tell you that you had CAD because he probably saw you as a worrier and didn't want you to worry further, the meds will do their job in reducing your cholesterol, blood pressure and thin your blood, I get blood test every 6 months to keep a check on things, and they are spot on, always at the lower range, so get ready for some education for yourself.

 

I suppose I woke up and realised what that saying really meant, i.e. 'your body is your temple', treat it badly and it will eventually crumble. You will turn this around, I have had 12 years with a stent and meds and all going great.

 

Sheryl will come along when she can and provide you with a few Cardiologist choices and perhaps give you some solid advice on your situation, she is a valuable asset here on TVF.

 

Try not to stress, it doesn't help your situation, I used to be under a lot of stress from work, but as the Cardiologist said to me back then, either change jobs, or retire early as stress kills, however is not scientifically proven, just his opinion at the time, later a fews years after it was proven scientifically.

 

One day when they cut out all those processed carbs in our foods, or people start to realise we have been poisoned all of our lives with what we eat, then only will we see less people dying from heart attacks and living longer.

 

I do have a question for you, has anyone in your family passed from or had a heart attack, because it can also be hereditary, e.g. my dad passed from a heart attack aged 72 as did all his brothers in their 70's, but mine at 47 was due to over exerting myself, 4 times in one day shouldn't be attempted by any means 🙂

 

Hope my replies have put you at ease a little and offered you some insight.

 

This guy is a legend, subscribe and listen, he covers everything.

https://www.youtube.com/watch?v=WgVJyMsNpQI

  

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