Pre Surgery and Work

[Unicusp]

The getting done is slow going here for two reasons
1) I have to pay for everything
2) Not sure where to get it done

It appears that it's "slow" because you've been stuck in consideration/decision mode for several years. You have evaluated all options and potential locations. You need to execute the decision.
Cost we have discussed. Your total out of pocket in Thailand is equivalent to deductibles in the US.
TAVR - Has your Dr. confirmed that you are a candidate? I wasn't.
I can't imagine you going thru this entire process again in 5 to 10 years if you go Bio on round 1.
Good luck!

 

[Superman]

The getting done is slow going here for two reasons
1) I have to pay for everything
2) Not sure where to get it done

In my world, you’re stuck in what we call, “Analysis Paralysis”. At some point one has to either sh*t or get off the pot, as they say.

 

[Unicusp]

In my world, you’re stuck in what we call, “Analysis Paralysis”. At some point one has to either sh*t or get off the pot, as they say.

Funny as I thought the same exact two things earlier today. At work, I often heard the phrase and witnessed analysis paralysis quite often. And my father used to always say sh*t or get off the pot!
Too much data can be daunting. Another great phrase: "eat the elephant one bite at a time".
I love analysis but equally love execution and completion. And move on to the next challenge.

 

[Chuck C]

I can't imagine you going thru this entire process again in 5 to 10 years if you go Bio on round 1.

Good point, but if he goes mechanical he has to deal with the ticking. It does not seem to bother most, but he has shared that he is terrified of it. Can you imagine him dealing with the ticking?

 

[pellicle]

In my world, you’re stuck in what we call, “Analysis Paralysis”. At some point one has to either sh*t or get off the pot, as they say.

personally I think I've seen enough sh*t here.

This appears to be the decision process

 

[Unicusp]

personally I think I've seen enough sh*t here.

This appears to be the decision process

View attachment 888813

I agree. My money is on that he never makes a final decision.

 

[Unicusp]

Good point, but if he goes mechanical he has to deal with the ticking. It does not seem to bother most, but he has shared that he is terrified of it. Can you imagine him dealing with the ticking?

Agreed, but if he goes bio then the ticking will be the theoretical clock to redo time. I'd guess he'd worry about that more and think "what if it fails today" thought process, every day.
Easier to put ear plugs in. Ha.

 

[pellicle]

My money is on that he never makes a final decision.

personally I'm in that camp. I think the only way it will happen is if he's out cold (because its pretty clear that all his second opinions are he's in severe) and an ambulance takes him to an Emergency Department and he's operated on as an emergency patient. He'll then wake up with whatever he gets.

Then the whinging about that outcome can begin (probably prefaced with "I never got to make a choice").

I have no idea (well that's being polite) as to why @newarrior fails to act on any of the advice given here ... perhaps its because we don't understand that he has no insurance, isn't living in the USA (neither am I FWIW), has nobody to care for him and would prefer to sit this one out.

I think he needs to stop being so optimistic ...

 

[pellicle]

but if he goes bio

I would normally advocate for mech valve in his situation, however (you'll probably find my post where) I've argued that for him the anxiety of managing his own INR (required in Thailand) and deciding on what his INR is (from the 23 blood samples he got today) and what he should do about his INR being 2.8 (should I hold, should I decrease, did I eat too little lettuce) would be such a stressor for him (and us) that realistically a bio is the best way to go.

Hopefully then he'll get his (volunteer) job back at the Cat Shelter (after he's rebranded himself after "the event").

 

[newarrior]

Absolutely not true. I just got diagnosed as mild moderate 3 years ago I just got diagnosed to severe a couple of weeks ago. I'm living overseas and the insurance doesn't cover pre-existing conditions. I thought when my valve was going to need to be replaced I'd either have about twice the net worth that I have now but the stock market crumbled so I can't go to a private hospital that easily. Doing it in America does not seem to be as logical or make as much sense as I thought it was going to period on top of that the government hospital I was going to go to is not working for various reasons. Imagine if you were living in a foreign country and you had to pay 100% of all your cardiac related cost. On top of that because the surgery is having to be done at an earlier stage and because I'm now thinking about not getting a mechanical valve I'm worried now about having at least one or two more surgeries before I die versus maybe one surgery with the mechanical valve.. I think I found a government hospital that I could do it at I'll confirm everything next week. I disagree with everything else you're saying.

 

[newarrior]

Agreed, but if he goes bio then the ticking will be the theoretical clock to redo time. I'd guess he'd worry about that more and think "what if it fails today" thought process, every day.
Easier to put ear plugs in. Ha.

I've got really bad tinnitus ringing of the ears so putting earplugs in it is a nightmare I'm supposed to keep as much outside noise as possible so I don't hear the tinnitus. And having to deal with tinnitus plus a ticking valve would be a nightmare.

 

[newarrior]

I have free insurance in California so the surgery would not cost anything I'm covered under a government plan. So you're wrong about deductibles. Did you read my original message? I've got free government insurance in California however I wouldn't have anybody to take care of me in California and I have to pay for somewhere to stay I'd have to pay for somebody to take care of me Airline etc etc so I'm probably going to do it at a government hospital here. I'm hoping to nail things down next week unfortunately Thailand has endless holidays so I can't go back to the government Hospital the new one that I found until next wednesday.

 

[newarrior]

Tavr..not a candidate

 

[newarrior]

I think the biggest thing to think about regarding valve choice is that if I'm living in Thailand when I do my next surgery in about 10 years then I'll have to pay for a Tavr.. then another 10 years later I'll have to pay for a valve in valve.. however the price is might come down significantly for some of these procedures or I may simply drop dead before I end up getting a second or third procedure. And if that point I'm still living in Thailand it won't really matter because the cost of living is so low here as long as I've got enough money to cover my expenses until I drop dead of whatever kills me then it doesn't matter. And I don't have children and I don't own a home anywhere so I don't have to worry about those sorts of things I just rent out a cheap condo for a couple hundred dollars a month here till I drop dead of old age

 

[newarrior]

In my world, you’re stuck in what we call, “Analysis Paralysis”. At some point one has to either sh*t or get off the pot, as they say.

I am researching my options...Are you living overseas ? Paying for your own surgery ? Considering doing surgery in a foreign country that does speaking primarily English ?

 

[pellicle]

I am researching my options...Are you living overseas ? Paying for your own surgery ? Considering doing surgery in a foreign country that does speaking primarily English ?

hey, I'm really sorry you are living overseas, were you kidnapped and held against your will or are you there of your own choice?

I notice that in March 2021 (more than a year ago) you discussed this issue of being overseas at length and apparently decided going back to the USA was your best option

Going back to America when my aortic stenosis becomes severe or stay in Asia? What sayeth my valve peeps ?)

Dear All,, I'm in Bangkok; I like living here in Thailand/Asia and have no interest in moving back to the USA. However private health insurance in Thailand will NOT cover pre existing i.e. for me cardiac. There may be a few plans that will cover pre existing conditions but the cost may not be...

www.valvereplacement.org

back in 2020 you apparently got good advice that encouraged you to return to the USA as well:

Doing valve replacement overseas without insurance

Dear All Hello and good day. I am sending this message to all my heart valve related groups so if you are on more than one of my groups please accept my apologies as my intent was not to spam. My name is David and I am an American living overseas in Bangkok Thailand. I have moderate aortic...

www.valvereplacement.org

you also made it clear back then you were living overseas as well as almost every second post on this (and your other) thread since. Perhaps you should remind us again that you are living in Thailand again?

I lived in Japan for about 3 years and there was nothing that pissed me off more than a Gaijin (which would be ชาวต่างชาติ in Thai) who after years in the country could barely function in Japanese. I understood that the Japanese had a lower opinion of these baka too.

Perhaps you think everyone on the forum is from the USA? Sadly you'd be as mistaken in that assumption as you are assuming that you need to remind us at every turn that you are not living in the USA and that you are paying cash.

I'd suggest you contact other ExPats (like moddedyhoo) living in Thailand but I know you already have and have successfully burned through them and any sympathy they may have had.

Why do you keep doing this?

Why don't you just get the surgery done and begin recovery. The longer you wait the worse it will be.

Just get it done mate.

Best Wishes

 

[leadville]

Tavr..not a candidate

Dave, not for the first time I might add;
I'm perplexed by your post...

Here #33 you say :
" Tavr..not a candidate "

( I infer from this you mean you are not a candidate? )

In post #34 you go on to ponder that you'll pay for TAVR in your redo, can you see the paradox ?

You do realise that if /once you do your 1st surgery this perpetual cycle will start over regarding the inevitable redo?

 

[Superman]

I am researching my options...Are you living overseas ? Paying for your own surgery ? Considering doing surgery in a foreign country that does speaking primarily English ?

Wait, what? Why didn’t you say something about all this earlier!?!

You’ve been harping on this for three years (at least). If you simply had moved back to the US then, you’d be settled, likely have a job (assuming you could hold one down) or disability. You’d have your free insurance that covers everything (I’ve never heard of this in the US, but congrats). You might have even made some friends.

But you don’t DO anything. You just complain about circumstances that you chose. You complain about not having family, no job, and being alone, yet that means you have nothing keeping you tied there other than cheap living. No spouses job to consider. No kids school to consider. No extended family to worry about moving away from. You can live anywhere you want and yet still can’t make a move.

A person continues to just turn over information, continues to seek information to validate information they already have, tries to find why even that might not be the best information, but that same person can never bring themselves to take action. That, my friend, is Analysis Paralysis.

 

[pellicle]

I’ve never heard of this in the US

Obamacare? (isn't that AKA the affordable care act?) Or doesn't that cover this?

Affordable Care Act (ACA) - Glossary

Learn about the Affordable Care Act by reviewing the definition in the HealthCare.gov Glossary.

www.healthcare.gov

 

[Superman]

Obamacare? (isn't that AKA the affordable care act?) Or doesn't that cover this?

Affordable Care Act (ACA) - Glossary

Learn about the Affordable Care Act by reviewing the definition in the HealthCare.gov Glossary.

www.healthcare.gov

Affordable Care Act just makes healthcare coverage available for those who don’t have it through work. What it does is prohibits an insurance company from denying coverage based on pre-existing conditions. It also subsidizes premiums based on income level. But subscribers still have to pay some level of premiums. It offers four levels of coverage, between 60% and 90% of costs. I’ve heard it can still be quite expensive out of pocket to use.

If memory serves, the OP did some acting in the US and may be a member of SAG (Screen Actors Guild), so possibly has insurance through that association? I’m not familiar with California having a state run health plan (aside from Medicaid for people living close to poverty level) that would cover everything. But they are one of, if not the highest taxed states in the Union. Without any income, it’s possible the OP would qualify for Medicaid. I don’t know if there’s a means test (for net worth) or if it’s just income driven.