Thailand 2013: Starting Off on the Wrong Foot

Part 1 of 3

Before I get to the tales from my latest trip to Thailand, I have to explain something I’ve discovered about myself. I have a very unlucky right leg. It wasn’t always like this. Until recently, I would say that my entire body was very lucky. I could abuse it in all sorts of ways and then get up early the next day, run a few miles, and then do it all again the next day. But time catches up with the best of us and I am no exception. My catch-up time was 2008 when I was playing a friendly game of racquetball. I went backward for a shot at the same time my right foot stepped in a small pool of sweat on the floor. My legs went out from under me and I landed square on my shoulder and broke my collarbone. Who breaks bones playing racquetball? After that there followed a series of stress fractures and pulled muscles, all on the right leg. Last year, during a marathon run, my right leg went completely numb at mile 18 and I had to stop. When the feeling came back, I discovered I had torn my right plantar fascia. Finally humbled by these insults and injuries, I did a serious re-assessment of my body, especially my right foot.

I found that my problems were a result of over-training, which I freely admit I had been doing. Superman was finally dealing with his kryptonite. To get back in shape, I didn’t do any training for two months. I took up yoga to cure the pinched femoral nerve in my lower back that made my leg go numb. I massaged my right foot daily to heal my torn fascia. But the big change I made was to my style of running. I started to use Jeff Galloway’s run-walk-run method of long distance running. This basically delays the point of when your body breaks down from running so that you are able to finish a long race. I later discovered that a ratio of 3 minutes running with 1 minute walking worked the best for me.

I decided to try this technique out in my next race of 11 miles to qualify for another marathon. At first, everyone, even the short, fat ladies, waddled happily past me. Then, at about mile 5, I started to pass these fatties and by mile 9, I was passing some in-shape, but obviously very tired runners. I finished in a respectable time a couple of minutes behind my Thai wife, who was in better shape and ran continuously. After a couple of hours recovery, I was actually quite refreshed; something that was very different from my other runs. In the weeks that followed the race, I increased my runs to 15 miles with the same result – good times and no exhaustion. Hey, maybe my luck had changed.

A quick question to my readers: I have always thought that when I retire to Thailand, the tropical weather would really curtail my running. I am wondering if this run-walk-run method works in the tropics. Any comments would be greatly appreciated.

While on a subsequent long run on a forest trail, my right foot (again) tripped on a rock and down I went on my side. There was little pain at first, with my ego being hurt most, but I finished the run. The next day my side was on fire, so I went to the doctor who took an x-ray that showed I had a broken rib. Not a big deal normally but I would be leaving for Thailand in four weeks and ribs take at least six weeks to heal. Also, my wife was already in Thailand visiting her mother, so I couldn’t really delay the trip. Worst of all, I could not exercise at all during this time, not even stretch. All I could do was wait for my intercostal muscles to repair themselves between breaths.

I come from a long line of male German beer bellies that I have been able to avoid through frugal eating habits and exercise. Now, my weight started to balloon. I try to diet more but it doesn’t help very much. When I board a plane that would take me first to my nephew’s college graduation in Los Angeles, I am in the worst physical shape since breaking my collarbone five years prior. In the arid climate of southern California, I help prepare for the party, drink a lot of beer and eat some really rich food. The next day we go on a long and hot walk on the beach. That afternoon, I board a China Airlines flight that will take me to Bangkok. It would have been a pleasant flight except an 80-year old Chinese man kept poking me to help him with his English. He seems to be some sort of professor in Taipei who is working on an engineering publication. I spend the LA – Taipei connection drinking wine and correcting English on a technical paper I barely understand. The Taipei to Bangkok connection is super-crowded so when I land at 2:30 AM, I feel like a liberated soldier from a POW camp. My darling wife is waiting for me and together with her friend G, we drive to her condo where I have a nice long sleep.

In the morning I notice my right foot is sore, like I had stubbed the big toe. I didn’t give it much thought and go about our various errands the day. The next day, we start our journey south to visit my wife’s mother. We first stop at a condo in Cha Am beach that belongs to G’s sister. It is a really nice place, just off the beach in a development of low-rise condos. We spend the next morning in the complex’s wonderful pool and my foot feels much better. But by evening, my foot is swollen and red. I tell my wife I should see a doctor so they drive me to Bangkok Hospital in Hua Hin. There is a group of attendants waiting outside the emergency room entrance, so when we arrive and they see my foot, they jump into action with a wheelchair and whisk me to the admitting station. My wife answers a few basic questions and within 10 minutes I am processed and in front of a doctor. For those of you not familiar with America’s medical system, the usual time to do this in my country is more like 2 hours, at best. I am very impressed. But when the doctor confirms my worst fear, that I had all the symptoms of gout, I am devastated. How does a fairly robust and healthy person get gout?

The emergency room doctor, a young and efficient MD, prescribes anti-inflammatory medication. She then refers me to another doctor at the hospital and an appointment is made for the next morning. The prescription was ready when I pay my bill of 1,200 baht. This is roughly equal to my co-pay for each doctor visit I make back home in America.

When we get back to the condo, I do some googling and find that gout happens in middle-aged, overweight guys who drink beer and don’t take care of themselves. It can also be triggered when this person doesn’t drink enough fluids. Some of this didn’t seem true about me. Then I realized the past couple of days I had been drinking more than usual, in arid conditions, and not taking in enough water. Also, since I broke my rib, I had gained weight and had been mostly inactive. It was a perfect storm of precursors that again made me realize I am subject to the rules of health as everyone else is. I know now that if I want to avoid a recurrence I need to take better care of myself beyond just physical activity and moderate dieting. It was a big cold splash of water of reality on my face.

The next morning at Bangkok Hospital, I meet a Thai doctor who had practiced urology in Los Angeles for 30 years. She had returned to Thailand hoping to retire but the hospital begged her to join them when it opened in 2010. She examines me and quickly confirms the original diagnosis. She orders blood work and it is available in 30 minutes. It shows my uric acid is now normal. She prescribes some different anti-inflammatory drugs and tells me to decrease my alcohol and increase my water intake. The bill this time is a bit more, closer to $100 US. I had been in a Thai hospital for just over an hour and in that time I had blood work performed, met a competent doctor, collected my medicines, and paid my bill. I thought back to when I broke my collarbone in America. Four hours in the hospital, two days to see the orthopedist, and then two more days wait for my first operation. During that entire time, my right shoulder was in terrific pain. Medical care in America is now a big political issue. But clearly, whatever Thailand is doing, America should be learning from.

We then take off for our next destination – Bang Saphan Noi in the south. We are on our way to see my wife’s mom and family. My mother-in-law is a wonderful person, now 91, who lives in an old house with her son and his family. She has lived in the same house for close to 70 years. No air conditioning and she cooks on a stone stove with charcoal every day. We have tried to upgrade her house but she likes it the way it is. She cooks for whoever shows up, friends and family, who always seem to be popping in. Otherwise she sits on her wooden bench in the shade, smiling at the passers-by, napping occasionally. Even though we can’t communicate much, I really enjoy just sitting with her, holding her hand, and smiling back at her. It feels like she has made her peace with the world and now lives in every moment. She is a devout Buddhist, the same as my wife, and I can’t help thinking that after a lifetime living in the Buddhist dharma has brought her to this place of peace.

As the afternoon wears on, everyone starts to pitch in for the big family feast this evening. My in-laws start to arrive, gifts are exchanged, food prepared. The men start in on the beer which I politely excuse myself from. One brother shows me he also had gout on his foot as well. Oh great, I finally have something in common with my in-laws, gout from drinking too much beer in a tropical climate. Later, the guys coerce me into a beer when we do a group toast. I follow it up with a couple of bottles of water. My foot still throbs from all the activity in the day.

That night we sleep at a wonderful little resort called the Palm Gardens Resort. It has four units and is a short walk to the beach at Bang Saphan. These units are very clean
and very well built, with all new appliances and everything in working order. In the front is a very clean salt water pool that did wonders for my aching foot. There’s a short breakfast menu and free coffee for the morning. Later in the
day you can take advantage of some of the restaurants and bars in the area, some of which are supposed to be quite good. The owner, Larry, is an engaging Brit who lives on the property with his Thai wife and daughter. He takes obvious pride in
his establishment, as he well should. Later we meet a German man and his Thai wife who love this place so much they rent a unit for 2 weeks each year even though her family is in Isaan! They are renting scooters from Larry but on this day, they
are doing the local snorkel trip. For Bangkok weary citizens, it’s a rare blend of great location, friendly hosts, relaxation, and interesting things to do. Below is my crazy but beautiful wife enjoying breakfast outside our unit.

We spend another day and night with our family at Bang Saphon Noi, just hanging around, taking pictures, teasing the kids. But now it is time to head back to Bangkok. My foot is no better since I last left the hospital so my wife calls the doctor’s cell phone number and she says we should go to any pharmacy and ask for the steroid Prednisome and take it twice a day for a week. We stop in a small city on the way to Bangkok at a small pharmacy. Without a prescription, I soon had this potent drug flowing through my veins. By the time we reach Bangkok a few hours later, my foot is noticeably better. How easy it was to speak to doctor and to get the right medicine, even though we were traveling in rural Thailand, just astounded me. My Thai passengers seem unfazed. Isn’t this the way it is in America?

I know I am bad-mouthing the American medical system a lot but let me give you another comparison. A week after my wife returns from Thailand, she finds she had picked up a bladder infection. It’s a very common ailment for women, but it took 2 days to get a doctor’s appointment. She tests positive (of course) and we get the prescription right away. But a week later, she still had some slight symptoms (these bladder infections are persistent little devils). So, I go to renew the prescription on a Saturday morning. Sorry, we have to wait until Monday when the doctor can be reached to approve the refill. Sure, we could have gone to the hospital emergency room, waited 4 hours, and then paid through the nose because non-emergency hospital visits have little deductible. Instead, my wife’s infection became a little worse over the weekend until she got her medicine on Monday morning. It’s not the doctors in this system that doesn’t work, it’s the system.

Now back on the road heading towards Bangkok, I notice an old and familiar pattern starting to develop. My wife and I are in the back seat of her friend’s car, her two friends are in the front seats, and all Thai people are talking Thai at a rapid rate. No worries, as I’ve learned over the years how to deal with this situation by just tuning it out and looking at the Thai landscape as it passes by my window. Sometimes, in more desperate moments, I have to resort to sucking some Thai beer to numb my brain. So far on this trip, I am dealing with this quite well. But there's a new twist. The driver and best friend of my wife, G, had recently bought a new CD with all of “today’s hits”. But the songs were re-created by a Filipina band and not very well. Like the road trips when my kids were little and we used to pop in a Barney CD for entertainment. But unlike my kids, who would tire of these songs after a while, G would listen to this CD over and over again. Now, listening to the CD for the 10th time, I start to realize why people become crazy and go on a killing spree. Without the soothing effects of beer, I did something that shocked my fellow travelers in the car; I put on ear buds and listen to music on my iPhone. I get worried glances from all around. I guess they couldn’t understand why I wouldn’t be interested in listening to Thai women quacking through the droning of monkey music. After a while, everyone relaxes and we continued our journey through the rain to Bangkok.

At some time during the trip it is decided my wife and I will not be spending the night at G’s condo, but instead in a hotel nearby. The reason is not given so I just let it go. The hotel seems a bit strange as the main building is a big restaurant and around it are individual Thai huts. Each one is a separate room and they are scattered around the edge of the parking lot. Our room is not too bad and after being on the road so long, all I want to do was sleep. Later in the evening, around 2 AM, a group of Thais who had been partying in the dining hall, continue their loud party in the parking lot outside our door. They did not disperse to their rooms until 3 AM.

The next morning before the wife wakes up I decide to take a little walk in the neighborhood. In the two blocks I walk, I see a couple of abandoned houses, a large modern one halfway constructed, shop houses, and a small but new looking condo complex. I know that having no zoning restrictions makes Thailand communities look haphazard, but it sure makes for interesting walks. I stop at a 7-11 for coffee and bread and return to our room. The wife is now awake and expresses amazement that I had survived this dangerous sojourn. I explain that except for a few noisy, but cowardly soi dogs, my walk was very pleasant. I don’t know why Thais believe that a farang walking Bangkok’s streets is a life-risking endeavor. Maybe it is, but I have never had a problem before and I have walked like this in weird parts of Bangkok for over 15 years.

G arrives after breakfast to pick us up. The owner of the hotel came by at the same time to collect the bill. My wife speaks the owner in Thai and pays the bill. She later told me she complained the room was not good because of the loud partying. I have never seen my wife react like this to anything, so she must have been more pissed than I thought. After we load our stuff in the car, G announces that before we embark to her family home in Korat, we will make a quick stop to a dermatology shop so that G can have some discoloration spots treated. I thought about this for a few moments and asked if I could also have a small bump removed from my nose. Surprisingly, a quick call to the clinic and my appointment is confirmed right after G’s.

When we arrive, what I thought would be a clinic turns out to look more like an upscale beauty salon in a modern mall. The clinic attendants were all young and very attractive women in short skirts and pink tops. But the real knockout was the doctor herself – Dr. Air. She expertly lasers the bump in a few short minutes. Her English is excellent and she tells me her brother owns a Thai restaurant in America. Turns out it is close to our home and we have actually been there a couple of times. What a shrinking world we live in. When the bill arrives it is less than 600 baht. Now I really am astonished. I have just had minor surgery by a very competent doctor after making a last-minute appointment on a Sunday afternoon for less than $20 US. Amazing.

Now with our business complete in Bangkok, we are ready to start our journey to Isaan and the city of Nakhon Ratchasima, or Korat as most people call it. I start this trip with mixed feelings. It has been over 10 years since I was last in Isaan with my ex-girlfriend. These memories are bittersweet. Now we are planning to revisit some of the same places we used to go to. What I didn’t know then was how true those feelings turn out to be, as I am about to have the best and worst of times on my Thailand trip.

Next – Thailand 2013: To Korat and Beyond