When you run into expats abroad, who are usually grumpy old men, there’s one cardinal rule for interaction: never ask them how they’re doing.
With that simple question, you risk opening up the floodgates of a whinging and whining marathon where they tell you every intimate detail of their gout, varicose veins, or erectile dysfunction, all while gumming their scrambled eggs and sipping beer at 9:30 in the morning.
I’ve learned to avoid that question (and to avoid them) altogether because, to me, there’s nothing worse than when someone starts telling you about their health problems.
That being said, let me tell you about my recent health problems.
With that simple question, you risk opening up the floodgates of a whinging and whining marathon where they tell you every intimate detail of their gout, varicose veins, or erectile dysfunction, all while gumming their scrambled eggs and sipping beer at 9:30 in the morning.
I’ve learned to avoid that question (and to avoid them) altogether because, to me, there’s nothing worse than when someone starts telling you about their health problems.
That being said, let me tell you about my recent health problems.
It started a week before Christmas, when I was so lightheaded and dizzy that I almost passed out every time I stood up. Everything I ate made me queasy. I was full after a few bites but my stomach felt bloated no matter how little I ate. I was completely sapped, like my energy dial had been turned from ten down to two. It felt like something inside of me was stealing my nutrition.
This isn’t unexpected in the Philippines. I've traveled to a lot of countries, but this is one of the filthiest. Don’t get me wrong, it’s also one of the best, but the lack of cleanliness I encounter on a daily basis would make a medieval peasant go, “That’s nasty.” It’s also hot and insufferably humid most of the year, essentially making it a big Petrie dish.
Still knocking me out after a few days, I visited a “reputable” doctor, who diagnosed that I had just a bad hangover (despite the fact that I hadn’t touched a drink.) A day later, I nearly fainted. I grabbed a taxi to the nearest Korean medical clinic where they did some tests, but found nothing. They did hook me up to an IV for an hour, which made me feel better for about twenty minutes and let me take little nap, but my malady didn’t go away.
Was it worms? Tapeworms are a common in the Philippines because of bad water.
I remember meeting these twins from England; really nice guys who were tall, strong and in good health. One of them told me that earlier that year, his brother had fallen ill with a stomach problem that wouldn’t go away, too.
In the end, the doctors realized it was a tapeworm. It had grown unchecked for so long in his stomach that they had to remove it surgically, cutting a hole in his belly and pulling it out. With his healthy twin brother watching (and videoing), the doctor removed a three-foot yellow tapeworm from the incision. Even the doctor started gagging and almost lost his lunch!
After that, there was no way they were going back to local Filipino food. So, their concerned mum in England sent a huge crate of canned, boxed, and non-perishable food, which cost a small fortune but kept them eating safely for six months.
I didn’t have the luxury of a pallet of food from home, but I did suspect that the Loch Ness monster was lurking in my gut.
This isn’t unexpected in the Philippines. I've traveled to a lot of countries, but this is one of the filthiest. Don’t get me wrong, it’s also one of the best, but the lack of cleanliness I encounter on a daily basis would make a medieval peasant go, “That’s nasty.” It’s also hot and insufferably humid most of the year, essentially making it a big Petrie dish.
Still knocking me out after a few days, I visited a “reputable” doctor, who diagnosed that I had just a bad hangover (despite the fact that I hadn’t touched a drink.) A day later, I nearly fainted. I grabbed a taxi to the nearest Korean medical clinic where they did some tests, but found nothing. They did hook me up to an IV for an hour, which made me feel better for about twenty minutes and let me take little nap, but my malady didn’t go away.
Was it worms? Tapeworms are a common in the Philippines because of bad water.
I remember meeting these twins from England; really nice guys who were tall, strong and in good health. One of them told me that earlier that year, his brother had fallen ill with a stomach problem that wouldn’t go away, too.
In the end, the doctors realized it was a tapeworm. It had grown unchecked for so long in his stomach that they had to remove it surgically, cutting a hole in his belly and pulling it out. With his healthy twin brother watching (and videoing), the doctor removed a three-foot yellow tapeworm from the incision. Even the doctor started gagging and almost lost his lunch!
After that, there was no way they were going back to local Filipino food. So, their concerned mum in England sent a huge crate of canned, boxed, and non-perishable food, which cost a small fortune but kept them eating safely for six months.
I didn’t have the luxury of a pallet of food from home, but I did suspect that the Loch Ness monster was lurking in my gut.
Hoping it would pass soon, I stuck to my normal routine. Of course, I still had to work, but I’d need three or even four naps a day just to drag myself through.
I remember going to the gym and having difficulty making it up the two flights of stairs before even working out. My boxing trainer laughed at me and said that I always looked so tired.
Luckily, I had a trip scheduled to Thailand, where the medical care is first-class compared to the Philippines. There, I had high hopes as I booked my first appointment at the sparkling and modern Bangkok Hospital.
Over a three-week span, I think I went to Bangkok Hospital about fifteen times, as well as several other clinics and various pharmacies.
Staying at a condo near where my buddies Judd and Scott live, every morning I’d drag myself up to the street to get a motorcycle taxi, which zoomed me through traffic under the blistering sun, delivering me to the hospital’s gate sweating and even dizzier.
It became so routine that the taxi drivers would see me coming and spring into action, knowing exactly where I was going. When I returned to my condo, they’d give me a thumbs up or thumbs down, not out of concern but because they were taking bets if I’d make it to another day.
I started with a gastrointestinal specialist, but after a week of appointments and tests, they found nothing. So, I was referred to different departments, visiting specialists in Gastroenterology, Radiology, Haematology, Cardiology, Microbiology, and Neurology, where I consulted with doctors named Bundit Leetanapon, Thitma Vutivivatanakul, and Sompote Saelee.
Each day, the nurses made it a point to measure my height and weight (as if that changed overnight), take my blood pressure (that did), checked for a fever, and registered other vitals.
They also took blood; a lot of blood. Most days, I had fresh Band-Aids on the inside of my elbows or the back of my hands. I’d rip them off on the motorcycle taxi ride back home so that people didn’t think I was a junky. After a while, the nurses had to search for veins that hadn’t been tapped the day before.
In total, I estimate that they took a dozen blood tests, sometimes filling up two or even three vials.
I remember going to the gym and having difficulty making it up the two flights of stairs before even working out. My boxing trainer laughed at me and said that I always looked so tired.
Luckily, I had a trip scheduled to Thailand, where the medical care is first-class compared to the Philippines. There, I had high hopes as I booked my first appointment at the sparkling and modern Bangkok Hospital.
Over a three-week span, I think I went to Bangkok Hospital about fifteen times, as well as several other clinics and various pharmacies.
Staying at a condo near where my buddies Judd and Scott live, every morning I’d drag myself up to the street to get a motorcycle taxi, which zoomed me through traffic under the blistering sun, delivering me to the hospital’s gate sweating and even dizzier.
It became so routine that the taxi drivers would see me coming and spring into action, knowing exactly where I was going. When I returned to my condo, they’d give me a thumbs up or thumbs down, not out of concern but because they were taking bets if I’d make it to another day.
I started with a gastrointestinal specialist, but after a week of appointments and tests, they found nothing. So, I was referred to different departments, visiting specialists in Gastroenterology, Radiology, Haematology, Cardiology, Microbiology, and Neurology, where I consulted with doctors named Bundit Leetanapon, Thitma Vutivivatanakul, and Sompote Saelee.
Each day, the nurses made it a point to measure my height and weight (as if that changed overnight), take my blood pressure (that did), checked for a fever, and registered other vitals.
They also took blood; a lot of blood. Most days, I had fresh Band-Aids on the inside of my elbows or the back of my hands. I’d rip them off on the motorcycle taxi ride back home so that people didn’t think I was a junky. After a while, the nurses had to search for veins that hadn’t been tapped the day before.
In total, I estimate that they took a dozen blood tests, sometimes filling up two or even three vials.
In those dark weeks, I was subjected to more medical tests than I’ve had in the rest of my life combined. They took MRIs, chest x-rays, organ x-rays, antibody tests, glucose tests, hormone readings, and abdominal ultrasounds.
They counted my nitrogen, counted my testosterone levels (concluding that I’m somewhere between a prepubescent ballerina and the Hulk, but leaning more towards the former), and counted my white blood cells.
They poked, prodded, and did things to me that should require dinner and a movie first.
But the scariest of all was when they sent me to the basement of the hospital to the Medical Imaging Department, where I was given a CAT scan. For those of you who have never been through this, Computed Tomography scans your brain, providing a detailed map of any abnormalities.
It’s also an intensely frightening process, as they situate you on a conveyor belt that rolls into the bowels of a big machine. An arcane apparatus locked my head in place, making it impossible for me to move – or escape. There, a virtual prisoner in the hot, airless tube for almost an hour, I fought off panic—the most claustrophobic I've ever felt since I was locked in the trunk of a car while tripping on mushrooms back in the day (that's another story, altogether.)
To inject some much-needed levity into my days, I took selfies wearing the hospital gown and sent them to random people with no explanation, or invented a game show where I won prizes for correctly guessing the diseases of the other patients in the waiting room.
"Yes, I'll take elephantitus for $400 please, Alex.”
Of course, I had to pay handsomely for this privilege of being a human lab rat. After each visit, they had an attendant walk me down to the billing department and supervise the transaction, making sure I paid without running out the front door (which definitely crossed my mind.)
I visited the ATM every day, taking out my daily limit to pay off bills for 4,500 Baht, 9,200 Baht, and even 16,500 Baht. After a while, I didn’t even bother checking the statements for accuracy, just forking over all the Thai Baht notes in my pocket.
(I’m looking through this stack of bills now and see that they once included a Midwifery Charge!)
While even a fraction of these hospital visits would bankrupt me in the U.S., the total for all of these appointments, tests, procedures, and medications was $3,600 - a testament to the Thai healthcare system (and how bad ours is in the U.S.).
They counted my nitrogen, counted my testosterone levels (concluding that I’m somewhere between a prepubescent ballerina and the Hulk, but leaning more towards the former), and counted my white blood cells.
They poked, prodded, and did things to me that should require dinner and a movie first.
But the scariest of all was when they sent me to the basement of the hospital to the Medical Imaging Department, where I was given a CAT scan. For those of you who have never been through this, Computed Tomography scans your brain, providing a detailed map of any abnormalities.
It’s also an intensely frightening process, as they situate you on a conveyor belt that rolls into the bowels of a big machine. An arcane apparatus locked my head in place, making it impossible for me to move – or escape. There, a virtual prisoner in the hot, airless tube for almost an hour, I fought off panic—the most claustrophobic I've ever felt since I was locked in the trunk of a car while tripping on mushrooms back in the day (that's another story, altogether.)
To inject some much-needed levity into my days, I took selfies wearing the hospital gown and sent them to random people with no explanation, or invented a game show where I won prizes for correctly guessing the diseases of the other patients in the waiting room.
"Yes, I'll take elephantitus for $400 please, Alex.”
Of course, I had to pay handsomely for this privilege of being a human lab rat. After each visit, they had an attendant walk me down to the billing department and supervise the transaction, making sure I paid without running out the front door (which definitely crossed my mind.)
I visited the ATM every day, taking out my daily limit to pay off bills for 4,500 Baht, 9,200 Baht, and even 16,500 Baht. After a while, I didn’t even bother checking the statements for accuracy, just forking over all the Thai Baht notes in my pocket.
(I’m looking through this stack of bills now and see that they once included a Midwifery Charge!)
While even a fraction of these hospital visits would bankrupt me in the U.S., the total for all of these appointments, tests, procedures, and medications was $3,600 - a testament to the Thai healthcare system (and how bad ours is in the U.S.).
So, what was the result? After a forest of paperwork, lab results, and consultation records, they still couldn’t find anything conclusive.
I did learn that I had no gross effusion or pneumothorax, normal echogenicity of the liver parenchyma without focal lesion, and no intrahepatic or extrahepatic bile duct dilation was detected.
It was also told that my gallbladder is unremarkable, to which I took great personal offense. (“F you! YOUR gallbladder is unremarkable!”)
If you think it’s hard to decipher medical-speak, try doing it in Thai! So, it was understandble if a few mistakes were made, like when they listed my ethnicity as Africa-American at one point, or when they documented my symptoms as “Dizziness and giddiness.”
But they still never found out what the hell was wrong with me.
That didn’t stop me from being on a roller coaster of anticipation and stress as I waited for the outcome of the next test, and then the next, and another.
Did I have an ulcer? I was sure of it - until the test results came back negative. But then it must be Lyme Disease, right? It took two weeks to get those results back, but they were inconclusive. Cancer? It must be cancer. Nope. A brain tumor? Nada. Leukemia? Next, please. How about HIV? Oh my God, was I dying of AIDS?
I tried to recall every suspect woman, shared needle, and rhesus monkey from my checkered past. But, of course, the test came back negative.
Each night when I got home from the hospital, I’d Google the disease de jour that I was certain afflicted me. I’d make mental allowances for how my life would change, researching treatment options and reading blogs from support groups.
"Hi, I'm Norm, and I'm living with Lou Gehrig's Disease. Well, no, I don't actually have it yet, but one can really never get started too soon. Now, are those donuts free?"
I did learn that I had no gross effusion or pneumothorax, normal echogenicity of the liver parenchyma without focal lesion, and no intrahepatic or extrahepatic bile duct dilation was detected.
It was also told that my gallbladder is unremarkable, to which I took great personal offense. (“F you! YOUR gallbladder is unremarkable!”)
If you think it’s hard to decipher medical-speak, try doing it in Thai! So, it was understandble if a few mistakes were made, like when they listed my ethnicity as Africa-American at one point, or when they documented my symptoms as “Dizziness and giddiness.”
But they still never found out what the hell was wrong with me.
That didn’t stop me from being on a roller coaster of anticipation and stress as I waited for the outcome of the next test, and then the next, and another.
Did I have an ulcer? I was sure of it - until the test results came back negative. But then it must be Lyme Disease, right? It took two weeks to get those results back, but they were inconclusive. Cancer? It must be cancer. Nope. A brain tumor? Nada. Leukemia? Next, please. How about HIV? Oh my God, was I dying of AIDS?
I tried to recall every suspect woman, shared needle, and rhesus monkey from my checkered past. But, of course, the test came back negative.
Each night when I got home from the hospital, I’d Google the disease de jour that I was certain afflicted me. I’d make mental allowances for how my life would change, researching treatment options and reading blogs from support groups.
"Hi, I'm Norm, and I'm living with Lou Gehrig's Disease. Well, no, I don't actually have it yet, but one can really never get started too soon. Now, are those donuts free?"
This may sound ridiculous in retrospect, but I only knew that something was very wrong with me.
Was it all in my head? What if I was, in fact, going insane? I mean, I know I’m crazy, but maybe I was crazy-crazy?
I tried to will it away, think positive, and just brush it off, but that was as effective as trying to heal a broken arm with your mind.
I reached the fragile and frazzled state where I actually wanted something to come up positive in these tests, just so that I could finally know what I was up against. I remember being strangely disappointed when yet another doctor sat me down and explained that everything looked normal.
I just wanted it to end, but was resigned that this is how I might feel the rest of my life. To reconcile my karma with the Gods, I started spraying donations to various charities, as if that would help. I was desperate.
Soon, my time in Thailand was up, and I boarded my flight back to the Philippines no wiser and with little hope.
Soon, I was back in my adopted hometown of Dumaguete, back in my routine of four naps a day just to get through work, avoiding the gym less someone made fun of me for looking so tired.
One evening, I sat down at an outdoor restaurant overlooking the ocean for some dinner. There was an old, cantankerous expat sitting next to me, a grizzled former logger from Canada who looked just a shade too ugly to play Charles Bukowski in a movie.
I tried to avoid eye contact. But, when he started complaining about the heat in my general direction, I was too exhausted to protest. It turns out, he’d lived in the Philippines for decades. Sure enough, he soon started a litany of complaints about his health.
“Every year, it’s like this,” he said sipping his beer and holding his distended stomach. “Too tired to leave the house. And don’t want to eat for months. There’s something in the air, or maybe the water. An amoeba, I think. I once knew a Swiss doctor in the ‘80s who carried his own antibiotics…”
“Wait, what? You said your stomach hurts?”
“Bloated,” he said, flagging down the waitress to order another beer.
He went on to describe his symptoms, which were down to the very one that I’d been experiencing for four months.
Son of a bitch – it was a stomach thing, just like I thought, despite the fact that all of the doctors found nothing. But while I was ready to fly back to Thailand and demand my money back, something miraculous happened: I started to feel better.
Gradually and mercilessly, without any more medications or hospital visits, I began to recover.
The next week, I only felt dizzy a few times, and my energy started climbing. The week after that, I woke up one day and felt completely like myself.
I was back, baby! My sky was blue again.
No longer was I dying to be healthy.
So, what's the moral of this story? That health is precious? To count your blessings? That you don't know what ya got 'til it's gone?
Nah, nothing that cliche.
The only thing I took out of this whole experience is that whenever you run into expats, who are usually disheveled and grumpy old men, it always pays to ask them how they’re doing.
-Norm :-)
Was it all in my head? What if I was, in fact, going insane? I mean, I know I’m crazy, but maybe I was crazy-crazy?
I tried to will it away, think positive, and just brush it off, but that was as effective as trying to heal a broken arm with your mind.
I reached the fragile and frazzled state where I actually wanted something to come up positive in these tests, just so that I could finally know what I was up against. I remember being strangely disappointed when yet another doctor sat me down and explained that everything looked normal.
I just wanted it to end, but was resigned that this is how I might feel the rest of my life. To reconcile my karma with the Gods, I started spraying donations to various charities, as if that would help. I was desperate.
Soon, my time in Thailand was up, and I boarded my flight back to the Philippines no wiser and with little hope.
Soon, I was back in my adopted hometown of Dumaguete, back in my routine of four naps a day just to get through work, avoiding the gym less someone made fun of me for looking so tired.
One evening, I sat down at an outdoor restaurant overlooking the ocean for some dinner. There was an old, cantankerous expat sitting next to me, a grizzled former logger from Canada who looked just a shade too ugly to play Charles Bukowski in a movie.
I tried to avoid eye contact. But, when he started complaining about the heat in my general direction, I was too exhausted to protest. It turns out, he’d lived in the Philippines for decades. Sure enough, he soon started a litany of complaints about his health.
“Every year, it’s like this,” he said sipping his beer and holding his distended stomach. “Too tired to leave the house. And don’t want to eat for months. There’s something in the air, or maybe the water. An amoeba, I think. I once knew a Swiss doctor in the ‘80s who carried his own antibiotics…”
“Wait, what? You said your stomach hurts?”
“Bloated,” he said, flagging down the waitress to order another beer.
He went on to describe his symptoms, which were down to the very one that I’d been experiencing for four months.
Son of a bitch – it was a stomach thing, just like I thought, despite the fact that all of the doctors found nothing. But while I was ready to fly back to Thailand and demand my money back, something miraculous happened: I started to feel better.
Gradually and mercilessly, without any more medications or hospital visits, I began to recover.
The next week, I only felt dizzy a few times, and my energy started climbing. The week after that, I woke up one day and felt completely like myself.
I was back, baby! My sky was blue again.
No longer was I dying to be healthy.
So, what's the moral of this story? That health is precious? To count your blessings? That you don't know what ya got 'til it's gone?
Nah, nothing that cliche.
The only thing I took out of this whole experience is that whenever you run into expats, who are usually disheveled and grumpy old men, it always pays to ask them how they’re doing.
-Norm :-)
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