I am a 66 year old Englishman, living in Thailand, with no health insurance and I had my aortic valve replaced in a Bangkok government hospital on 8th June. As far as I can determine, I was fitted with a 21cm SJM. Although as a foreigner I had to pay for the operation, it was still much cheaper that having it done at a private hospital, which I could not afford.
I have no complaints about the treatment at the hospital, which in all respects was excellent, and is in fact the leading heart hospital in Thailand, but being a state hospital – and therefor free to Thais – it is extremely busy and it is simply not possible for them to provide the kind of postoperative after care that one would normally get in the west.
The hospital is over 100 miles from where I live and I went back to see the surgeon two weeks after the operation where I had a very brief consultation and my next visit is not scheduled until the end of August – 2 months after my last visit.
I am also insulin dependant and have been monitoring my own blood sugars and blood pressure for many years.
I have a number of issues arising from my operation, but by far and away my chief concern is my high blood pressure.
I have had high blood pressure for many years and have been able to control it with an increasing amount of meds (statins, beta blockers etc) until about 6 months ago when even my ever increasing mountain of meds failed to control it properly. I was diagnosed with severe aortic stenosis and post op, the surgeon told me that my valve had a congenital defect – 2 cusps instead of the normal 3 – And was badly calcified. A routine angiogram, prior to the AVR, showed no serious narrowing of my arteries.
Immediately after my operation, my blood pressure was quite low (120/70) but after I returned home it has been consistently high, with the systolic rarely dropping below the 150’s , and my heart rate is very high – usually high 85 - 95). I told the surgeon about my high BP and showed her a record of my daily readings, (I always take at least 2 readings to ensure a reliable result), but she didn’t seem too bothered and suggested that I take amlodipine, 10mg daily.
I understand that it takes the heart quite a while to settle down and there may be many reasons for my high BP, but I am now in my 6th week, post op, and my BP is getting no better. I have even resumed taking Cardura for my enlarged prostate (which I stopped taking before the op), which also has BP reducing effects, but no change in my high BP.
I am not due to see the surgeon for another month and am wondering if I should self-medicate and start taking some more BP reducing drugs – such as Ramipril, or maybe go back on beta blockers; or should I not worry about it too much and wait for my next visit.
Any comments and advice would be appreciated.
I have no complaints about the treatment at the hospital, which in all respects was excellent, and is in fact the leading heart hospital in Thailand, but being a state hospital – and therefor free to Thais – it is extremely busy and it is simply not possible for them to provide the kind of postoperative after care that one would normally get in the west.
The hospital is over 100 miles from where I live and I went back to see the surgeon two weeks after the operation where I had a very brief consultation and my next visit is not scheduled until the end of August – 2 months after my last visit.
I am also insulin dependant and have been monitoring my own blood sugars and blood pressure for many years.
I have a number of issues arising from my operation, but by far and away my chief concern is my high blood pressure.
I have had high blood pressure for many years and have been able to control it with an increasing amount of meds (statins, beta blockers etc) until about 6 months ago when even my ever increasing mountain of meds failed to control it properly. I was diagnosed with severe aortic stenosis and post op, the surgeon told me that my valve had a congenital defect – 2 cusps instead of the normal 3 – And was badly calcified. A routine angiogram, prior to the AVR, showed no serious narrowing of my arteries.
Immediately after my operation, my blood pressure was quite low (120/70) but after I returned home it has been consistently high, with the systolic rarely dropping below the 150’s , and my heart rate is very high – usually high 85 - 95). I told the surgeon about my high BP and showed her a record of my daily readings, (I always take at least 2 readings to ensure a reliable result), but she didn’t seem too bothered and suggested that I take amlodipine, 10mg daily.
I understand that it takes the heart quite a while to settle down and there may be many reasons for my high BP, but I am now in my 6th week, post op, and my BP is getting no better. I have even resumed taking Cardura for my enlarged prostate (which I stopped taking before the op), which also has BP reducing effects, but no change in my high BP.
I am not due to see the surgeon for another month and am wondering if I should self-medicate and start taking some more BP reducing drugs – such as Ramipril, or maybe go back on beta blockers; or should I not worry about it too much and wait for my next visit.
Any comments and advice would be appreciated.
