…And Not A Bad Way To Start Off The New Year

“Certainty? In this world nothing is certain but death and taxes.”

Benjamin Franklin

It’s pretty damned hard to argue with Ben’s well expressed sentiments. Not withstanding the possibility of benevolent space aliens bestowing on us mortal humans an Elixir of Life, we are all eventually headed to the grave. I also think it’s safe to say that not even E.T. and company could ever deliver us from the long arm of the tax man.

I’ve dutifully, if not enthusiastically “rendered unto Caesar” my share of taxes since my first part time job at age sixteen. Most of this has gone to good old Uncle Sam. Moving here to Thailand did not end my life as a taxpayer. No, a portion of my meager salary still is being deducted for taxes, only now they are headed for the coffers of Loong Somchai. I can’t even begin to imagine what happens to the billions of baht that are collected each year. To be honest, I don’t really want to know, because I’m fairly confident, it’s not a pretty picture! Still, I am delighted to report that at least a tiny portion of Thailand’s incoming revenue is going to a worthwhile endeavor. I am referring of course to the health and well-being of yours truly.

Yes I’m sure you are all happy to know that your humble scribe, Old Sawadee, is being ministered to by a legion of Thai doctors, nurses, therapists and other health professionals. Well, at least I am happy about it, and I am even happier that all this TLC isn’t costing me a single blessed baht!

In my last submission of 2010, Not A Bad Way To End The Year, I related the story of how I was receiving free physical therapy at Lampang Hospital. It turned out that being over sixty, a tax payer in good standing, and knowing some fine folks who were willing to guide myself and my wife through a maze of paperwork, I was able to qualify for free medical care. In that story I also touched on briefly some of the various techniques being employed to help alleviate my recently diagnosed Fibromyalgia. A lot has happened since then in this continuing story which may be of some interest.

Up until now I had been paying upwards of 5000 baht per month on medicine. Luckily there are many generic forms of popular medications, or I would have been paying much, much more than that. Would the Thai medical system help pay for a portion, even a small portion off that? Well there was only one way to find out. I needed to make an appointment with a doctor. So it was off to the hospital.

How can I describe Lampang Hospital? Picture this: Take a place the size of Mor Chit bus station. Paint the interior a ghastly shade of institutional green, and then never, ever touch the walls again. Cover the floors of the endless corridors with dingy tiles. Make certain that there are a bewildering set of signs that are designed to get you hopelessly lost. Under no circumstances should there be a directory to, either tell you where you are, or the location of where you want to go. At any given time there literally thousands of people sitting waiting often for hours at time as they move from one enormous waiting room to another. It’s a damned good thing that I have cultivated the art of waiting, because I was going to be doing a lot of sitting around, along with everyone else. Bringing a nice loooong book along is never a bad idea.

Eventually I was able to make an appointment with a cardiologist, but before my appointment I needed to have some preliminary lab work done. I needed to show up to the lab the next morning, fasting, and with the requisite urine and stool samples.

The lab opens at 7:00 AM, so I thought I’d be smart and get in line no later than 6:30. I actually arrived at 6:15, along with at least two hundred other people who all had the same brilliant idea I had. All I could do was deposit my paperwork in a box and wait for my name to be called. All around me a host of elderly people were wheezing, sneezing and coughing with abandon. I know it seems silly to sate the obvious, but a good reason to avoid hospitals is that they are full of sick people! If you aren’t sick when you walk in, you very well might be by the time you leave. The lab staff started showing up at 7:00, but didn’t start calling anyone until 7:30. Amazingly I only had to wait half an hour to be called. Unfortunately that was only to assign me a number in the line. Still, the line did in fact begin to move along, and by 8:30 I was sitting down and having a liter or so blood drawn out. Apparently the doctor wanted to run a lot of tests. After presenting my two “specimens” I was out and on my way, but not in my way home.

The next stop was the radiology department to have a series of X-rays taken. Once again, the waiting area was packed. Eventually it was my turn, and after a short wait to have the film developed, I left with X-rays in hand and was on my way…..to have an EKG done. I lucked out here. I was the first in line and the procedure itself only takes a few minutes. Now I was really and truly on my way home.

The next day I was sitting in yet another waiting room the size of a football pitch for my doctor’s appointment. After an hour or so it was my turn. It was a good thing my wife was with me, because this doctor did not speak very much English, and my Thai simply isn’t up to snuff for a technical conversation. The lab results were about what I expected. Everything was pretty much nominal. Through diet and a slew of drugs I wasn’t doing too badly. Nothing bad showed up in the X-rays or EKG. The doctor then went over my current medications, wrote up some prescriptions, and sent me on my way.

This time, “my way” led me through a long series of corridors and rooms, and eventually to the hospital’s main dispensary. After the now familiar sit and wait routine, my mane was finally called. The wait turned out to be well worth it. A smiling young, extraordinarily lovely woman, apparently thrilled to have a chance to practice her English, was there to go over with me the many boxes of drugs she was putting into a plastic shopping bag. Some of them were exactly the same drugs I was currently taking. A few were the same class of drug, but had different names. One was a completely new medication. Some medicines which I had been taking in the evening were now to be taken in the morning.

It all sounded great to me, because the total cost to me was……zero! I didn’t have to pay a single baht for the next month’s medicine! Even back in the USA I couldn’t have gotten this wonderful a deal. The lab tests alone would have been hundreds of dollars, and there is no program which would provide 100% of my medicine for free. The elderly are often forced to make an agonizing choice between buying the medicine which helps keep them alive, and buying food. Finally I can say with a genuinely delightful smile on my face, “Welcome to Thailand!” While there are many very serious problems here, even the poorest of the poor can get basic medical care. While some of the hospital facilities may not be fancy and a simple doctor’s visit may take some time, no one is turned away because they can’t afford medical insurance. Queuing up for major surgery might be a long process, and I hope I will not need to “take a number” anytime soon. Still, the hospital is in the process of building a state of the art cardiac surgery unit, so perhaps the next time I have to “go under the knife”, I may actually be able to have it done right here, without having to rob a bank or make a deal with Mephistopheles.

Old Sawadee, because of “pre-existing” conditions, can’t get any medical insurance. I therefore have had to pay for everything out of pocket. When your pockets aren’t exactly overflowing with cash, you have to get creative to find ways to pay for medical care. It’s for that reason I consider myself damned lucky to qualify for any program! Apparently while my bank account isn’t overflowing, my “good karma” account” is. Over the past years all the volunteer work I’ve done in Lampang has borne some unexpected benefits. A number of parents who work in the hospital, and whose children I’ve taught went out of their way to get me into this program, for which I am profoundly grateful.

So, what types of treatment have I been getting lately? That my friends leads us to the interesting part of this particular tale, so those of you who have been nodding off should wake up.

In January I met with a doctor in the hospital that specialized in Chinese medicine. After a through examination she asked me if I was willing to undergo a traditional Chinese course of treatment. This would not just address my immediate symptoms, but would instead treat my general health, taking into account my heart problems and my diabetes. I was quick to say yes. Conventional western medicine had so far done little more than keep me alive. I did not feel healthy. My energy levels were at rock bottom. Where only a year ago I was happily biking all over town, I was now barely able to shuffle one foot in front of the other. I wasn’t sleeping very well either which didn’t help matters any. In short I was ready for a new approach.

I am no New Age wannabe by any means. Don’t talk to me about the “healing power of crystals”. I likewise think that many “alternative therapies” are pure bunkum. Homeopathy? Reiki? Psychic Surgery? Magnet Therapy? None of these (plus a plethora of other so-called cures) can pass anything approaching rigorous scientific tests. As far as I’m concerned, if you can’t prove the validity of a claim through double blind objective experiments, repeatable by anyone, anytime, anywhere, whatever you’re promoting is just so much snake oil. That’s not to say that science can always explain why and how something works. There is still a lot left to be discovered about how the human body works. No doubt many gaps in our understanding will be filled in with each new generation, but, if nothing else, it should be able to be demonstrated that a technique or a substance does in fact work, and work every time.

Why then would I consider trying traditional Chinese medicine? For starters, there are mountains of anecdotal evidence, accumulated over thousands of years which seem to indicate the efficacy of the two main branches of Chinese medicine; acupuncture and herbal treatments. In other words, at least for some conditions there is strong evidence that they do in fact work. I was also unaware of any ill effects from either therapy. All in all I felt I had nothing to lose, and since I wouldn’t have to pay for treatment, I thought, why the hell not give it a go!

Let’s start with acupuncture. For two, and lately three times a week I’ve been going in to see Dr. N. for acupuncture treatment which usually has lasted for 60-90 minutes. Dr. N. is a lovely middle aged woman with a sweet disposition. She speaks excellent English, and is pleased at my inquiries about my treatment. The fact that I’ve volunteered to help any hospital staff with their English, was well received, and “raised the value of my stock” a few points!

One point I’d like to clear up immediately. Acupuncture, despite the fact that the needles (always new ones which are disposable) are extremely fine, it is not pain free!

Over the last fifteen years I’ve had to endure getting poked with countless needles. Many have been for drawing blood. I must have had gallons of blood drawn. Some nurses and lab technicians have a delicate hand when inserting a needle….. others much less so. I don’t think getting an IV stuck into your hand is anybody’s idea of a good time!

Other needles have been full of medication, from anesthetics at the dentist. Isn’t it amazing how many “manly men” are reduced to a quivering lump of jelly at the mere thought of a visit to the dentist? I can’t say that I enjoy it, but I am able to endure a considerable amount of pain quite stoically. Being diabetic I’ve gotten used to injecting myself twice daily with insulin. Let me tell you, the first time I had to stick a needle into my stomach I was more than a little nervous!

I couldn’t have a discussion of needles without touching briefly on the joy of having an angioplasty. Believe me, having a catheter shoved up through your groin and then snaked into your heart is an experience that you’re not likely to forget. What’s worse is when blow up the little “balloon” and prior to inserting the stent! Oh, did I mention you are wide awake during this little procedure? No worries though, after the first time I had it done here in Thailand, the other five times over the years were a piece of cake….sort of. Believe me, when the doctor says, “this is going to hurt a little”, he ain’t kidding!

Dr. N. made no such warning as she proceeded to stick the first needle in. It did not tickle, believe me! Before long I resembled a porcupine, with over twenty tiny needles sticking out from head to toe. Some needles hurt for just an instant as she stuck them in. Others however, sent what felt like electric shocks coursing through my body. Wow! Dr. N’s explanation? These were “sensitive” trigger points. I don’t know about the trigger part, but I agreed whole heartedly with the sensitive bit!

Once everything was in, I lay there for about half an hour, “resting”. Whether because of the treatment or not, I soon found myself relaxing. Hell, considering the bizarre circumstances, I felt pretty damned good indeed. After what seemed not more than ten minutes subjectively, Dr. N. was there removing the needles, and asking me to get up and have a seat. I then needed to lean forward onto a set of pillows. It was time to undergo the same treatment on my back. These needles didn’t seem to hurt as much. After another thirty minutes my first acupuncture treatment was done. This was followed by a one hour heat pack treatment in the rehab department. This may not have cured anything, but it sure did loosen up some tight muscles in my back and neck. My step was definitely livelier than it was earlier in the afternoon.

I can’t honestly say that I noticed anything profoundly different. That of course was par for the course. This wasn’t going to be any overnight “cure”. This was going to be an ongoing therapeutic process which would attempt to correct long standing conditions. No problem though. I was in for the whole game. I remember seeing a report many years ago about people undergoing open heart surgery in China with acupuncture being used as the sole method of anesthesia. That made a pretty powerful impression on me. As for other reported benefits, at least for me personally, I will have to wait and see. Each time I’ve come in for treatment, the basic process has been the same, although the number and location of the needles has varied. So much for the first phase of my traditional Chinese treatment.

The second phase was herbal medicine. The history of Chinese herbal medicine goes back thousands of years. There is no doubt that many plants contain powerful pharmacological substances. Take aspirin, whose active ingredient, salicylic acid is found in the leaves and bark of the common willow. Digitalis, a powerful heart medication was first derived from foxglove. Alkaloids such as quinine come from the bark of cinchona are still used for treatment of malaria. Many anti-cancer drugs, such Taxol, Vinblastine, and Topotican, have been derived from rain forest plants. St. Johns Wort has proven to be useful in treating depression. Let’s not forget the pain relieving opiate compounds which come from the poppy flower.

This does not mean to say that all herbal folk remedies are any more than placebos. For years Saw Palmetto was touted as a means to treat an enlarged prostate. A recent study in The New England Journal of Medicine showed no discernable benefit. Garlic has been touted as a cholesterol reducer. This has nor been substantiated in clinical trials.

Still, herbs and other plant derived medicines that have been used for so many centuries seem to be at least worthy of serious scientific study. Amongst the hundreds of substances used in traditional Chinese medicine, I wouldn’t be surprised if there weren’t a least few that are effective.

In any case, effective or not, I agreed to try taking a tea made from a list of ingredients Dr. N. wrote out on my “prescription”.

I had passed by this little shop dozens of times on my way to a local market, but never knew what was inside. You would never in fact guess that it was a shop. I had always thought it was someone’s house. There was an accordion-like metal grate in front of it, and all I couldn’t see anything within. The fragrance wafting out to the street though was powerful and exotic. I thought it would be interesting to know what exactly was in there, but I never had an occasion to find out until the afternoon I rapped on the gate, prescription in hand.

An older Thai woman opened the gate, probably wondering why a Farang was standing there, but as I held out the list of ingredients from Dr. N. she smiled and ushered me in. After a few minutes looking over my prescription over, she began purposefully opening drawers set into an enormous wall unit. From floor to almost ceiling were dozens of wooden drawers, each one full of Chinese medicinal ingredients. On top of this were dozens of jars of yet more mysterious items. Each drawer was divided into small compartments, containing things I was utterly clueless about.

Carefully this woman, who I suppose one might call a pharmacist, took out small amounts of this and that and placed them on a well worn scale.

Some ingredients she crushed using a mortar and pestle.

Others she sliced

As she finished preparing each ingredient, she carefully placed it on a piece of paper, which she would use to wrap everything. Here is my finished prescription.

Oh, and I was impressed with the deft way this woman added everything up using her Chinese “computer”!

I had no idea what all of those things were, let alone what they were supposed to do, but I had a funny feeling this was not going to taste very good. It turns out my intuition was unfortunately correct. After soaking the whole lot for 30 minutes, and simmering for 20 more, my concoction was ready.

I wish I could say that it smelled delightful. It in fact smelled dreadful. It didn’t taste any better than it smelled either! I was prepared for a bitter tasting brew, but this witch’s concoction was waaaay over the top! In searching for just the right adjective to describe this stuff, the word fetid comes immediately to mind. Oh well, isn’t medicine supposed to taste bad? It’s always better to get these things over with quickly, so after waiting for this stuff to cool down, I chugged the whole mug down in one long gulp….and then just as quickly ran to rinse my mouth out. Yuck! “See” my “wife said, that wasn’t so bad was it”? Ha! Why then did she adamantly refuse to taste a single damned drop?

In any case, I had made a commitment to “stay the course”, so it looked as though I was going to be drinking an awful lot of this stuff for an indefinite period of time.

Not surprisingly I wanted to know what I was drinking, but didn’t know what any of the ingredients were. Luckily a good friend of mine is a Chinese teacher. She translated the whole list for me into English. The next step was to look up each one online. I didn’t do an exhaustive search, but found references for all but one. What follows is a list of what was in my prescription, along with the web addresses I found.

Radix Aconti Preparata

Ephedra Sirica

White Peony Root

milk vetch root

asarum

water plantain

turmeric

ginger

rhizome atractylodis

honey fried licorice root

radix stephaniae tetrandrae

perrin:

I’ve been unable to find any information on this.

earthworm

scorpion

Of course it was the last two ingredients that made me sit up and take notice. Sweet Jesus, why do I suddenly feel I want to want to hurl? So that’s what was in the little bag! Why didn’t she throw in some eye of newt and toe of frog while she was at it?

Does anyone else out there remember their Macbeth?

“Eye of newt, and toe of frog,

Wool of bat, and tongue of dog,

Adder's fork, and blind-worm's sting,

Lizard's leg, and howlet's wing,–

For a charm of powerful trouble,

Like a hell-broth boil and bubble."

So then, did I suddenly chuck out my little “cauldron”? I surprised myself by continuing to drink this “hell-broth” twice daily. The million dollar question is though, has drinking it improved my health? Subjectively I do feel more energetic, but I am waiting for another round of lab tests to see if there are any demonstrable changes to be seen.

I do intend to keep up both aspects of my treatment and see how things get on. If any “miracle cure” has happened I’ll let everyone know. All things considered, my initial foray into this program in December wasn’t a bad way to the year, and this new treatment not a bad way to start of the new year.