Beware the Jabberwock

July 1, 2017

One of the first articles I ever wrote was titled “Cobras in My Garden” (Bangkok Post, circa 1980). I told the story about finding a couple of monocled and venomous slithery friends who had invaded my garden. They didn’t fare very well after an encounter with my garden hoe though. I had chopped one in half (a big no-no I later found out), the head flying off into the bushes. The whole neighborhood screamed at me for being such a fool. About a half hour later their fury was corroborated when the head part, with its fangs flaring and cobra viscera trailing, and still very dangerous, came wiggling out of the shrubbery.

And ever since then I have had to answer the question about how dangerous snakes are in Thailand; the latest being an email telling me that a perspective female retiree to Thailand had decided not to migrate here because she was afraid of the snakes.

Personally, I love snakes. Maybe because of that I see snakes often. Most are harmless and non-venomous. Some are dangerous but sadly all snakes usually run away from me as fast as they can. In fifty years here I have never heard of anyone I know being bitten by either a venomous or non-venomous snake. So are snakes a reason for not coming here? I think my emailer is making a mistake.

Yes, you should be careful if you see a snake although most will be harmless. But there are lots of other things lurking here that, on the danger scale, rank much higher than the 200 or so species of snakes.

Before I get into things to “beware” of, I should emphasize that none of the following “Jaberrwocks” would stop me from a move here.

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The tiny danger

The most dangerous animal in Thailand (besides humans that is) is not a snake, or a tiger, or a water buffalo in heat, or a rampaging elephant. All are dangerous, but nowhere near as dangerous as the tiny mosquito.

Dengue fever is a real threat, although for adults it is usually not life threatening. I’ve had it. Painful as hell, worse headache I ever had, 104 temp, lasted about 4 days, but I am still here. It wasn’t much more of a bother for me than a trip to Immigration. Others have had more severe cases.

Children can be hit hard by dengue and recently one of Thailand’s biggest movie stars caught a lethal strain, ended up in a coma and later died. This was a big deal here not only because of the victim being a celebrity but because it is so rare for an adult to die from dengue.

Mosquitoes also carry the much rarer Japanese encephalitis. As the name implies, it attacks the victim’s brain. There is a vaccine for it but unless you are living way out in the boondocks you won’t probably ever see this. It is also known as “sleeping sickness” because many children who get it lapse into a coma which they rarely come out of. I know of only one Expat who contracted Japanese encephalitis. He lived way upcountry and he later had severe psychological issues due to it. Since the Japanese encephalitis mosquito’s life-cycle includes time spent in a pig, if you don’t live near or around pigs then you’ll probably be fine.

And of course there is malaria. I haven’t heard of malaria up here in the north. There is some down in the south though but I have never met an Expat who caught malaria here in Thailand. If a reader knows of someone please let us know, and tell us the story. There are malaria pills but I don’t know anyone here who takes them. It just isn’t a problem that concerns most Expats.

So what does one do about mosquitoes? Screens on your house would be a good idea. I lived in a non-screened house for about 3 years and slept under a mosquito net (When I wasn’t sleeping under a net was when I caught dengue even though the dengue mosquito is most active in the daytime.) There are many insect repellents available here. The best ones use “deet”. Mosquitoes are definitely “repelled” by it, but many people have side effects using it so be careful. There are also mosquito coils which you burn and do keep the little buggers away. But I don’t like breathing in the fumes.

There are also lots of other little buggers that hang around trying to eat us. If you get a scratch or a scrape or break the skin in any way, be sure to quickly wash it out with soap and water and use an antiseptic. You may not be able to see these bacteria but you are now in the tropics and they will find you. A friend of mine almost lost a leg when he got a simple scratch which got infected and it took some serious antibiotics and weeks walking with a cane before the infection was gotten under control.

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They’ll eat you out of house and home

Probably the most destructive insects here are the termites. If you have any wood in your house, even door frames, or book cases, or books for that matter, they will find them, and eat them. They won’t physically hurt you but your bank account might get eaten away after paying for house repairs. I have some climate-change-activist friends who tell me that if we don’t stop the destroying of our environment immediately then our species doesn’t have much longer to live on this planet. I hope they are wrong, but if that is the case, then I think the termite will be crowned the new “King of the World”.

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There are lots more biters and stingers here who can make life painful and itchy. I’ll just mention the ones I have encountered personally.

 

The stingers

There are many species of bees in Thailand. The jungle produces lots of illegal honey (which sometimes finds its way into our kitchen), and bee keepers produce a good quality legal kind. We once had a hive of tiny bees living inside the walls of our house. They entered and exited the hive from the outside so we weren’t concerned. Their stings are only bothersome unless you are allergic.

It’s the wasps and hornets that can knock you out with their stings and there is a buzzing, hairy bumble bee whose sting feels like a gun shot. Avoid these guys if you can.

Scorpions are just about everywhere. You’ll often see the large black ones, sometimes frying in a wok in the market as they are considered a delicacy. They are huge and look like black lobsters, but their sting is more or less just a bit of a bother. It is the little red ones that give the big stings. Just turn on the lights, as scorpions are usually photo-phobic, and, like New York roaches, they’ll scurry away.

I can’t fail to mention the one time I was walking through my garden and my arm brushed along the underside of a leaf. POW! I thought I had been bitten by a cobra the pain was so intense. I turned over the leaf and there was this hairy caterpillar looking up and smiling at me. It took hours for the pain to go away. Moral of the story, if it is hairy, stay away.

The biters

You will get bitten by ants, that’s for sure. Little black ones hurt, the big red weaver ants, the ones that make those cool woven nests and whose eggs and larvae are so tasty, can give a painful bite. But it is those tiny red ones, the ones that the Thais call “mot khan fai”, the “ants that itch and burn” that can really hurt.

After a heavy rain ants sometimes like to move house. One rainy season morning I went downstairs, eyes still closed, and stepped right into a moving parade of the “itchy burning ants” going right across my living room floor. They flew up my leg and started biting. I looked down and saw what was happening but it was too late. There was so much pain I thought I was going into cardiac arrest. After getting all the ants off my leg my heart was still racing, my leg felt like it was being cut off, and if I wasn’t flat on my back, and if I had a phone, I would have called 911 (nothing would have happened anyway because emergency here is 191). I survived though, and ever since then, no matter how sleepy I am, I open my eyes wide before going downstairs.

Other biters are centipedes, the big long 8” variety that can put you into the ER (Note: Those huge millipedes are harmless and are in fact good for the garden.); during the rains there are tick invasions, especially in houses with dogs; leeches you’ll discover on your jungle trekking experience; and there are little bugs you can’t even see, like scabies. I caught scabies once in a hill tribe village. Little red dots on the skin, the insect is microscopic, that itched like crazy. Made me feel dirty. If I got them in one night in the village what must it be like for the villagers?

But the bites you want to avoid are from our best friends, dogs. Rabies is endemic to Thailand and a large percentage of the dogs here go unvaccinated and are prone to this virus. If you are bitten or simply scratched by a strange dog then to the doctor you must go and you will probably be in for a series of the rabies vaccine. It is a series of shots over a number of days. They are costly and chances are you wouldn’t even have needed them, but peace of mind sometimes costs a bit. To paraphrase Cercei Lannester, the Mad Queen in Game of Thrones, “If you play the game of rabies, either you get vaccinated, or you die.”

Note on soi dogs or dogs you meet on your walks or runs. They will sound really aggressive but they are just doing what dogs do, protecting their territory. Some people carry sticks or stones with them. That just makes the dogs angrier. Here is what I do. When I pass by a yapping pack of soi dogs, I just stop, arms hanging low, palms out, non-aggressive, and I speak sweetly to them and say, “Please let me pass. I know this is your territory and I promise I won’t do anything to mess it up.” And they quite down, sniff my palms, and then let me go on my way. Amazingly this works almost every time, and I have never been bitten.

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So you like it raw?

Do you like sushi and sashimi, raw fish? Live tiny shrimp, still wiggling are favored by many beer drinkers. Lots of people here will eat raw meats including pork. I suggest you go onto YouTube and search for “intestinal parasites pictures”. I would normally put the link here but the sites are not for kids or the squeamish so I’ll let you do it for yourself if you can take it. After seeing them, tell me you still want that nice raw salmon or tuna.

But not to worry. If you cook your foods well and unless you are extremely careless about what you eat, get really drunk often and don’t know what you are eating, or are just addicted to Japanese sashimi, you’ll probably never get a picture of your intestines posted on YouTube. Many old-timers here will do a series of deworming pills once a year as a prophylactic (ask you pharmacist), just as you would for your dog or cat. I used to, but now that I am more careful about what I eat I don’t see the need.

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In Nature, it is always a war. Either something (big or small) is trying to eat you, or something is afraid you are trying to eat it and will throw up protection. Because Thailand is in the tropics, is hot, and damp most of the year, and is blessed with so many and varying species of plants and animals, we tend to come into contact with these battles more than if we lived in the more moderate regions of the world (although if my climate-change-activist friends are correct then every place may soon become tropical).

But is that a reason to avoid a retirement here in Thailand? I mean, America has black widow spiders, alligators, rattle snakes, gila monsters, the zika virus, lime disease, its own share of parasites, the Kardashians, Chipolte, and now the U.S. even has dengue fever. I might be afraid of moving THERE.

For some, maybe there are good reasons for avoiding Thailand and the tropics; they simply want to avoid the Jabberwocks. For others, Jabberwocks just make life a little more interesting, and that is one of the reasons I love it here.

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If you see a snake and want to ID it, first stay back, and then this link might help.

See an insect you might want to identify? Here’s a link.

Deet and other mosquito repellents.

 

And you just had some kind of mushroom

And your mind is moving low

Go ask Alice

I think she’ll know

The White Rabbit, Jefferson Airplane

Thailand is a good place for mushroom lovers. Normally when we think of mushrooms we think of the edible kind. My two favorites are the shiitake, in Thai called “black mushrooms”, a basic ingredient of lots of Chinese stir fries and soups, and the wonderful rice-straw mushrooms (also called paddy-straw mushrooms), named for the rice straw they are grown in. These are often found in the Thai restaurant favorite “tum yum” soup.

Shiitaki Mushrooms

Rice-Straw Mushrooms

I remember way back in the 60s, during Chinese New Year’s dinners at our house in New York, the feast’s show-stopper would be that plate of shiitake mushrooms cooked in oyster sauce. Shiitakes were a delicacy and we would have it only once a year because back then, pre Nixon’s visit to China,  there was an embargo against Communist Chinese products into the U.S. They had to be smuggled in from Canada and were very expensive, but they were worth the price and the wait. Even today, when they are cultivated almost everywhere, I still consider them a special treat.

The first time I encountered rice-straw mushrooms was my first or second day in country. I thought I had found a heavenly food. My wife Pikun tells me not to order them when we are out at a restaurant now because they are getting expensive and we can make them so much cheaper at home. But I still order “tum yum het” (mushroom tum yum) just about any time I can.

Lately Thailand cultivates lots of other mushrooms. The oyster mushrooms are popular as are those little Japanese ones, enokitake, we find in soups. And every rainy season the hunters and gatherers, of which there are still a few left, go up into the mountains and return with baskets full of wild mushrooms and bamboo shoots. Next time you are driving from Chiang Mai to Lampang (on the way to Bangkok maybe) there is a market at about the 50K mark from CM. You’ll find all kinds of “forest” foods there, bugs and birds, and creepy crawlies, along with lots of mushrooms you’ve never seen before.

For our more adventurous friends, there are the buffalo-shit mushroom (it’s where they grow). Also called cow-dung mushrooms but probably best known as “magic mushrooms” or “psilocybin”.  I think this is the kind that Grace Slick and the Jefferson Airplane are singing about (check out the link to “White Rabbit” above).  They are technically toadstools, or poisonous, and it has been a long time since I have been that adventurous, but I do have fond memories of drinking “sky juice”, psilocybin tea, on the island of Jamaica and encountering ”kaleidoscopes” when I closed my eyes.

Our experiment in raising Oyster Mushrooms

Enokitake Mushrooms

Magic Mushrooms growing in buffalo dung

But now, since the latest visit from my son Darin, I am  getting familiar with medicinal mushrooms, popular where Darin lives, and also becoming quite popular here in Thailand, although the Chinese have known about their healthful properties for centuries.  Darin lives on Orcas Island, in Washington State up near the Canadian border in the great Pacific Northwest, aka The “Left Coast”. And there is nothing more “left”, both geographically as well as culturally, as Orcas Island and btw, it is also one of the more beautiful and enchanted places in America, where live more deer and rabbits than people, and where Dungeness crabs and Pacific salmon, and orcas, and whales, and elephant seals, and the huge Stellar Sea lions, and giant octopi, make the waters around Orcas Island a living soup.

Darin and Pikun going out crabbing

Deer population on Orcas Island

The catch

But, as usual, I digress.

I now am learning about reishi, cordycep, and monkey-head mushrooms, as well as jiaokulan, and stevia leaves, all now cultivated in Thailand.

Reishi (Ganoderma lucidum) 

Reishi from a tree trunk in our backyard

Reishi mushrooms have been a staple in the traditional Chinese pharmacology for centuries. They are wood mushrooms that grow on the bases of trees and fallen logs. They are hard like wood and inedible although they can be boiled down and the bitter tea made from them can be drunk.

Formerly they were quite expensive but the price has fallen since the Thais have learned to cultivate them. I have visited a number of reishi farms and research centers in northern Thailand and the hilltribes are raising them and selling them to distributors in Chiang Mai.  I get my reishis from the Kings Project markets.

Modern studies on reishi’s effects on our health have been carried out in Japan, China, USA, and the UK.

Health claims for reishis include enhanced immune systems, anti-tumor effects, improved liver function, and lowered blood pressure. Also, reishis are thought to alleviate common allergies by inhibiting histamine release. And of course ingesting them will lead to a longer life, or so it is said.

No side effects have been noted in long-time use of reishis.

Reishis have become a big hit in Thailand and are considered a life lengthener by those who imbibe. They are referred to by the Thai rendering of their Chinese name. In Thai they are called “het lin jeur”, reishi being their Japanese name.

Corteceps (Cordyceps militaris)  

Cordyceps. The caterpillar, or what’s left of it, is under the ground.

Cordyceps, aka caterpillar mushrooms, have a very peculiar life cycle. All the things we call mushrooms are really only the flowering part of the organism. The real stuff of mushrooms is called the mycelium. The mycelium usually live underground in long strands looking very similar to a nerve bundle. When it is time to reproduce they send out their “mushrooms” which will open up and spread their spores.

A spore of the cordyceps will find its way on to a caterpillar, embed itself, and the mycelium will start to grow inside the little caterpillar host. It eventually kills the host and a mushroom will sprout from its desiccated body, usually the head.

It may sound creepy but these medicinal mushrooms are hunted in northern China and Tibet and can fetch big bucks. Since the 14 hundreds they have been a part of Chinese medicine.

They reportedly have anti-cancer properties, improve renal function, reduce cholesterol levels, increase energy and testosterone levels but are mainly prized for their aphrodisiac potential (energy). There are even claims that they increase a woman’s libido. I take them of course because they reportedly just make you feel “well”; believe me.

The big drawback to cordyceps is their price, as much as hundreds of dollars an ounce. So for years people have been trying to cultivate these, and they finally they have been successful. I visited the Chiang Mai University mushroom labs and saw their products growing under glass; no caterpillars were harmed in the YouTube video linked to above.

Although the specific species that is cultivated is different from the expensive ones collected on the Tibetan plateau, it is still believed that they have beneficial effects on our health. And the cultivated ones, although a bit pricey, costs way less than their “wild” counterparts.

 

Monkey head aka Lion’s mane aka  Yamabushitake (Hericium Erinaceus)

The Lion’s Mane Mushroom, aka Monkey Head

I don’t take these regularly. You can find them in many markets, sold for food, and they are used in soups, and are also sold as a dietary supplement in capsule form. I have included them here because I really like the name, Monkey Head. But they are supposed to have real medicinal qualities like enhanced memory, nerve growth, and longevity and may someday be used in treating Alzheimer’s.

 

Jiaokulan

A leafy plant originally from China, aka Fairy Herb, Southern Ginseng. Claims about Jiaokulan are that it lowers cholesterol, and blood pressure and improves heart function. It is supposed to be an anti-aging agent, an antioxidant, and is a detoxifying agent. Supposedly it also improves memory and prevents hair loss. If the last is true then I’d buy stock right now.

Jiaokulan leaves can be bought at many large markets and are now sold in tea bags.

 

Stevia

I have a bit of trouble with artificial sweeten drinks, especially those that use aspertame. I don’t know if aspertame causes any health problems but when I have used it it has made me feel lousy. And there is that terrible aftertaste. So I have avoided artificial sweeteners.

Stevia is not artificial, it is as sweet as sugar, and there is no aftertaste. Stevia is also sold in markets in Thailand.

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With my son’s encouragement I have been using some of these medicinal herbs and mushrooms. I don’t know if they have had an effect on my longevity, but I’m not dead yet so, Maybe.

My morning mushroom concoction (Life Juice)

  1. I cut up about 10 pieces of dried reishi mushrooms into a large pot. Bring it to a boil and then turn it down to simmer for about 3 hours.
  2. After about 3 hours I put in the jiaokulan leaves. I currently use the kind that are in tea bags of which I use 4.
  3. The reishi mushroom tea is quite bitter so after I turn the heat off I add stevia leaves. Normally stevia sweetens the drink but because of the bitterness of the reishi it balances everything out to neutral so it isn’t really sweet but the bitterness is gone.
  4. I strain this concoction into a large bottle which I refrigerate; enough life juice for a week or so.
  5. Each morning I take a large cup, squeeze half a lemon into it and a pinch of cordycep mushrooms with a regular tea bag. Green tea or herbal teas work just as well.  I fill the cup up halfway with boiling water.
  6. When the tea is brewed I take the reishi life juice and add it to fill the cup to the top.
  7. I drink this every morning and if all the literature is right I will be writing this blog for another 50 years.

To learn more about mushrooms (fungi) and how they can save the world you can watch Paul Stamet’s TED Talk here.

 

I have a condition called pityrosorum folliculitis. No it isn’t that Walking Dead viral infection so I don’t believe I’ll turn into a zombie anytime soon, nor is it anything like that terminal disease from Love Story where Ali MacGraw dies in Ryan O’Neal’s arms.  Boy did I hate that movie.  In fact pityrosorum folliculitis, although a tongue twister, is pretty mundane, but it is the focal point of a good story about the quality of medical care here in Thailand.

So, let’s start at the beginning.

About 15 years ago, when I was still a normal working stiff back in Seattle, I began to develop a skin disorder characterized by extreme itching. At first it was isolated to small areas on my chest and it would go away after a week or so. Sadly it would always return. Later the areas affected began to grow larger and the duration of the outbreaks longer.

Not having a very good health insurance policy at the time I tried treating the outbreaks by  checking the Internet, using over-the-counter anti-itch creams, powders, an some Chinese herbal rubs. I even considered prayer. The symptoms would lessen a bit but mostly I would just scratch, and scratch, until there would be a short respite. Soon it would return.

Note on itching: Unless you are also an itch sufferer you probably think this problem is overblown. But if you have one of those skin infections that cause you to itch constantly, scratching until you bleed, then you know what I was going through. The old TV ad that used the term “the agony of psoriasis”, another of those itching diseases, was right on the mark.  There were days when it got so bad that I now feel lucky I wasn’t a gun owner. You start thinking that the itch is so bad that maybe just leaving this life and going on to what’s next might be an improvement, no matter where we end up. That’s when you start looking around for a hand gun. Apologies to the NRA but I’m happy I didn’t have one around.

So what does this have to do with medical care in Thailand? We’re getting there.

Things got so bad that I finally made an appointment to see my doctor. I didn’t want to pay that $100 for an office visit; I had a huge deductible on my insurance policy which meant I would have to pay for it all myself. But since I often still found myself searching the house for weapons, I shelled out the $100 instead.

The doctor examined me and then said, “You have a skin infection.” Right! That was money well spent.  “I’ll have to recommend you to a specialist, a dermatologist.” He hands me the number, gives me a prescription for anti-itch cream and the $100 disappears.

The dermatologist could see me in 3 weeks. Until then she suggested that I continue on the anti-itch cream.

Note on the medication: On a scale of 1 to 10 my itch-agony was at 10. The anti-itch cream brought that way down to about an 8.5.

Three weeks later I check in with the dermatologist. She examines me for about 45 seconds and says, “You have a case of eczema. There is really not much we can do for that, I’m sorry. Here is another prescription for anti-itch cream. That will be $250.”

And for the next 10 years the anti-itch cream and I got real close. I would have an outbreak of the “eczema” every few months and it would last from a few weeks to a few months. During that time sleep was difficult and during the day I would make those around me uncomfortable enough to take a few steps back hoping not to catch what was making me scratch so hard. I went from applying the anti-itch cream to looking for a lethal weapon to sending up prayers to whoever would listen. That lasted until I got to Thailand.

I was reluctant to go to a doctor here in Thailand because I had already been diagnosed by an American specialist who said there was nothing to be done. But maybe I could get something that would bring my itch-agony down to a survivable 6 or 7. So I walked into Chiang Mai Ram Hospital.

I told the admissions clerk my problem and she said, “Would you like to see a dermatologist?” Sure. The wait was more like 3 minutes than 3 weeks like last time.

I walked into the Thai dermatologist’s office and met up with a guy who looked young enough to be in middle school, with spiked hair, and dressed like a Korean soap opera star. Turns out he was a genius.

I said to him, “I have “eczema” and I was hoping that you could give me something to help the itching.

He told me to take off my shirt, looked at my skin and finally said, “Take a look at this.” And he shows me a picture book of hundreds of kinds of skin diseases. He opens to a page that says “eczema” and asks, “Does that look like what you have?” And I say, “Not in the least.” “You don’t have eczema.” He says.  He opens to another page and asks “How about this?” It’s a picture that could be of my own scratched-down-to-the-bone rib cage. “That is exactly what I have.”

“You have pityrosorum folliculitis.” (He had to write this down for me because he couldn’t say it and I can’t remember anything longer than 2 syllables.) “We all have micro organisms on our skin; it is normal and the organisms are usually harmless. But in some people these organisms get into the pores and hair follicles and get infected and the result is intense itching. That is what is happening to you. We can treat it with some oral anti-fungal medication and some cream and in a few weeks it should clear up. It will return because you will always have the problem but as soon as it starts up again you can take the meds again. And don’t worry. It is not contagious.”

I know what you are thinking, but hey, you got those microscopic creepy crawlies on your skin too. Mine just get into places they are not supposed to.

The pharmacy downstairs gave me the meds. Doctor’s fee 400 baht, or about $12. Three weeks later I was itch free.

Now every time I feel a pore or follicle start to itch I scrub the area down with a loofah (always wanted to use that word in a sentence) and an herbal soap to clean out the pores and then I put on the meds and the itch goes away within hours. I have not had another serious outbreak for the last 5 years. And I have stopped looking for weapons around the house, considering suicide, or praying; and people have begun standing just a little bit closer than they used to.

Needless to say I was very happy with my Korean soap opera star of a doctor and have other thoughts about my (expletive deleted) expensive American specialist.

You’ll hear good and bad stories about the medical care here in Thailand. But you can hear similar stories about medical care just about anywhere. I have written about some of my health care adventures in Thailand before, doing so in order to give my readers as much information as I can so that they can make good decisions about their health and health care. My personal experiences here have almost all been positive.

My recommendations: Find doctors and hospitals you can trust. That will be easier in the larger cities. Eat well, don’t overindulge in food and drink, and exercise, and you won’t have to visit that “trusted” doctor very often.

Just in case you are interested in pityrosorum folliculitis.

Good health to all.

In these posts I usually don’t share too much of what personally goes on with me since I want to spend as much time talking about general retirement and retiring to Thailand as I can. But for this post I wanted to share some personal stuff that might be important for my many retiring readers, especially men, and women who have men in their lives, to know about.

The National Football League has a week each season to increase awareness of breast cancer. All the players and coaches and even the referees wear pink, pink ribbons, pink shoes, pink socks, pink wrist bands, pink penalty flags. This is a very good thing and I am sure that the increased awareness about breast cancer has saved many lives. But maybe they should also have a week where we work on the awareness of a problem that is solely that of men. Prostate cancer. Everyone could wear blue.

So I thought I might do my part to help my readers become more aware of a condition that many of us feel uncomfortable thinking about let alone talking about. Try to get as much info about this condition as you can because just about every man on the planet, if he lives long enough, will be faced with it someday. To aid in that I have included lots of links in this post. And, although I am still cancer free, I thought I would tell my story.

As so many men of my age, I have had prostate problems. Mine started about 10 years ago when I was 58. In an annual physical checkup we found that my PSA (Prostate-Specific Antigen) levels were somewhat high. A high PSA level may indicate an enlarged prostate or possibly prostate cancer – although there is quite a bit of controversy around relying solely on PSA levels. Further checks did show that my prostate was enlarged, a non-cancerous condition called benign prostatic hyperplasia (BPH).

So for the past 10 years I have been keeping track of my PSA levels, taking medication, and doing that annual procedure that most men really hate, the “digital rectal exam” (DRE). Please note that “digital” here has nothing to do with computers, which at first I thought. Digital also means “finger”. Most men my age will know what that means.

For people who believe in “intelligent design” I have a question. Why would you design a gland that encircles your urethra, when you know that gland will eventually become enlarged and block off that nice canal we use for urination? That is exactly what happens as men age. Seems like a design flaw to me.

I was beginning to have the classic symptoms of an enlarged prostate, trouble urinating, getting up lots of times in the night to relieve myself, and urinary tract infections (UTI).  At one point I had an ultrasound of my prostate (This can be done from the outside on the abdomen, or from the inside when something much larger than a finger, called a transducer  gets inserted “where the sun don’t shine”.) They thought they saw a shadow so I was advised to get a biopsy of my prostate. Think being kicked in your butt with a steel-toed cowboy boot over and over again and you’ll know how that feels.

But nothing was found and I was given a clean bill of health.

But the prostate was still growing. And causing me problems. Once, in order to get some sleep, I took an antihistamine on a long plane flight to the U.S. Little did I know that antihistamines and enlarged prostates do not go well together and I wound up in an ER in Seattle Washington not being able to urinate (and for those who ask, that is a condition called “urinary retention” or I like the term “aenuresis”). It is something you definitely want to avoid if you can.

The treatment: can you spell “catheter”? Or to be more precise a Foley catheter. BTW, I was in the U.S. for my son’s wedding. Foley catheters and dancing at weddings do not mix too well but luckily I recovered and was able to get it removed before going out on the dance floor.

One more time a few months ago this condition recurred and I wound up in the ER here in Chiang Mai. I also have had a number of UTIs; the symptoms being blood in the urine. Things seemed to be getting worse. Along with that, my PSA levels had jumped to 30, normal being around 3 or 4.

So my urologist, Dr, Bannakit from Chiang Mai Ram Hospital, was quite concerned and recommended another biopsy, but this one much more thorough than the first. Nightmares of steel-toed cowboy boots circled around my head.

I let Dr. Bannakit know my fears and he said that it would be best if I went under general anesthesia to get the procedure done. Here is how it went.

  • Two days before I began taking antibiotics to make sure that the procedure didn’t cause an infection.
  • The procedure would be done at 6:00 pm on Thanksgiving Day.
  • No eating or drinking after 10:00 am so no worries about overeating this Thanksgiving.
  • I arrive at the hospital at 4:00 pm.
  • The doctor greets me and says, “Ready for a nice sleep?”
  • They set me up with a glucose IV, pump me full of antibiotics, and do an enema.
  • I am wheeled into the operating room.
  • The anesthesiologist attaches the sleeping potion to my IV, and I say “Good night” to what seemed like a dozen nurses surrounding me.
  • Then one second later (by my count) I awake in the recovery room.
  • I have a sore butt and am really hungry but I have to hang around for 2 hours to make sure I can make it home.
  • I am given more antibiotics to take when I get home.
  • We pay the bill, $600.
  • My wife tells me later that the doctor has looked around with an ultrasound and taken 12 biopsy samples, and is certain that I am still cancer free.
  • I whisper a silent “O frabjous day! Callooh! Callay!” and my blood pressure drops back to normal.

This is a few days later and I am feeling fine.

I hope this helps with some info about the mystery surrounding this condition that we older men find hard to think about. And if you haven’t lately, do yourself and your loved ones a favor and get a good checkup.

I am not yet out of the woods and Dr. Bannakit is thinking of entering my prostate into the Guinness’s  Book of World Records as the largest one he has ever seen. So it looks like a little surgery to reduce the prostate size is in my future. Guess I won’t be in the Guinness’s Book of World Records after all.

All in all this was one of the more interesting Thanksgiving Days I can remember. And I have lots to be thankful for. Callooh! Callay!

May you all have a happy and healthy holiday season.

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