Friday, October 16, 2015

I've Had Back Surgery

If you've been a regular reader of this blog, you know I've been struggling with a herniated disc in my back these last 16 months or so. Seems like every third blog these last couple years has been about my back. Well, hopefully, this will be the last 'back blog' I'll be writing for the foreseeable future. See, I've gotten it fixed.

I left Naypyitaw at noon on Friday. Six hours to Yangon by bus. 90 minutes to go 2 miles in Yangon traffic from the bus station to the airport. International flight to Bangkok, and I finally got to my hotel near midnight. As I was checking in, one of Thailand's notorious ladyboys barges in the lobby, humongous tits hanging out, and proceeds to buy 3 condoms and a bottle of lube from the other clerk at the desk and sashays on out again.

I picked this hotel because it was an inexpensive 2-star hotel near the hospital where I was going to be treated. What kind of hotel had I checked into?

My 5 nights at the Atlas Hotel in Bangkok were weird. Yeah, the hotel was in the heart of (one of) Bangkok's party zones, but it was comfortable enough and it was walking distance to the hospital. My friend Anthony came to visit me from Northern Thailand, and he stayed with me while I got the preliminary stuff done before the surgery. It was great seeing him again and we had fun on Sukhumvit. We did a little bit of touristy stuff and he helped me make a uke video for the Seasons of the Ukulele.


On Saturday, I had an MRI and an examination, but not from the main back surgeon guy, the one recommended for me in Yangon. Nothing was decided on Saturday except that there were two possible surgical options for a ruptured disc: repair, i.e., shaving off the extruded part of the disc so that it no longer impacts the spinal cord; second, disc extraction and fusion of the two discs.

On Monday, I came back at met with Dr Verapan Kuangsongthem. We looked at my new MRI, and wow, even though I wasn't in any particular pain at the moment, my problem had gotten a lot worse since my last MRI in 2014. I had practically no disk left between the L5 and S1 vertebrae!  All of it had burst out into my spinal column. Dr Verapan made no bones about it; I needed the fusion surgery. He called it a permanent fix, but it's a more intensive surgery requiring a longer recovery time. 4 to 6 weeks. We scheduled the operation for Wednesday.

Well, I was scheduled to teach again next Thursday! I'd need to do something about the class I'm teaching in Naypyitaw. I wrote to my company telling them what's going on and my need for extended rest. I proposed a couple solutions.

Tuesday was tough. By the afternoon, my insurance company still had not sent their guarantee of payment to the hospital. There'd be no surgery without that letter. I know asking them to turn around and approve a $20,000 surgery in one business day is a lot to ask, but they had received a preliminary cost estimate, my full medical history and had already agree that surgery was a medical necessity. They said they would expedite their assessment procedures. By evening, the guarantee still had not come, and the surgery was postponed.

More bad news from my employer. Given the length of my recovery time, they were sending a new teacher to Naypyitaw to finish the class I was teaching. I'd be doing my recovery in Yangon, returning to teaching in mid-November. Well, I suppose that's for the best in that it gives me the full recovery time, but I liked Naypyitaw. I wanted to go back there in November and finish up the course. I'm going to miss it. I'll be going back there in December to sell my motorcycle. I'm also worried that they're going to try and dock my pay for the time off; I've been reviewing out paid sick leave policies carefully.

Very surprising to see this blatant
criticism of Thailand's military junta
At the same time, if I'm going to be just lying around doing light rehab, I'd rather do that in Yangon. I liked the environs of NPT better; but I liked my apartment in Yangon more than the dinky hotel room in NPT. There are some things I look forward to getting back to in Yangon.

By Wednesday, I didn't know what was going on. How long was this insurance approval going to take? The hospital wasn't just going to let me make appointments for major surgery and then postponing them. I couldn't continue to stay in the relatively expensive hotel near the hospital. Anthony went back to Chiang Mai, and I checked into a hotel further out. Back to the Nasa Vegas Hotel a bit more on the outskirts of town. It was like returning to an old lover. I've stayed several times at the Nasa Vegas; it's where my adventure in Asia began some 2 1/2 years ago.

AS I checked in, good news. The insurance approval came in; I was going for surgery on Thursday morning.
Checking in

I've never had real surgery before. I've never been put under anesthetic. I've never spent a night in a hospital. This was all new to me and I was a bit nervous.

Bumrungrad International Hospital is a world class facility and visited by people from all over the world. Lots of Arabs, Caucasians, Indians and Asians fill the hallways of this busy hospital.  I got a private room, and it was nicer than most hotels I've stayed in!

12th floor. Quite a view!



They put a mask on me to loosen up the phlegm in my smokers' lungs so that I wouldn't cough during the surgery. OMG... This was actually happening.

The last thing I remember was the anaesthetist saying, "you're going to sleep now..."

Waking up five hours later, I was groggy, disoriented and in a bit of pain. Not much, but a little. Eventually I got sent back to my room where I spent a night on lots of pain killers, fuzzy headed and unable to either stay awake or stay asleep.

By Friday morning, I was feeling better. I wanted a shower and a cigarette.

They see us rollin...
Now, it's Saturday, I'm able to walk around pretty well with a back brace, and I'll be checking out soon to return to the Nasa Vegas for a couple more days of recovery before returning 'home'.

They gave me a card to show at the airport when I set off metal detectors. I was actually quite surprised to see how big these screws were. Those are going to be with me the rest of my life.

One good part of this was that through the battery of tests I was given in order to prove that was healthy enough for surgery, I found out that I don't have any heart or kidney problems, my blood sugar levels are normal, my blood pressure is okay and I have neither HIV nor Hepatitis. These are good things, but still, I feel more inspired to get more fit. I lost about 20 pounds when I first moved to Asia; I've gained all that back. The doctor told me that the disc above the one removed is showing some initial signs of deterioration and if I didn't lose some weight, I'd be back having the same procedure in another 5 to 10 years.

I endeavor to do so.  
Here's my post-op x-ray. Look at the size of those screws! They even gave me a special card to show at the airport when I set off the metal detectors.

Sunday, October 4, 2015

The Taungdwingyi Loop

I've been hooked on motorcycle touring ever since I was in Thailand. Riding a motorbike through the roads of a developing country can be tiring at times. Perhaps even a little dangerous. It's worth it. Getting away from where the foreigners usually are allows me to see the country more as it really is, as opposed to how it's presented.

As I've said before, having the motorbike has been the best part of moving to Naypyitaw; motorcycles are banned from the city streets of Yangon. My travel companion Chris and I were planning our first multi-day journey. The goal was to visit Taungdwingyi, a small city about 100 miles west of Naypyitaw, visit the ruins of 2000 year-old city called Beikthano, get a hotel there and then drive back via a different route the next day.

I was interested in the ruins, but the real thrill was going to be the drive itself. You can see the route we'd planned on the map above, but let me expand on it by explaining a bit about the geography of Myanmar. As you can see on the topographic map, the country is bounded on either side by tall mountain ranges.

 The center of
the country is a big valley, but the lowlands themselves are split down the middle by a range of hills. They're not that tall, but we were expecting them to be scenic. Naypyitaw sits in the eastern half of the valley. Taungdwingyi is just on the other side of the hills in the western half, the Ayerwaddy River valley. The cool thing about this trip was that we had a boundary to cross; an obstacle to overcome.

We left early in the morning and as soon as we got out of the sprawling metro Naypyitaw area, the beauty, the intense greenness all around, and eventually, the rolling contours of the Bago Hills just had us smiling ear to ear. This is why we're here: to explore a new country.

The people we passed, sat with in tea shops and interacted with were very curious about us. Full of smiles and often dumbstruck when we appeared, this was obviously just as new for them as it was for us. If you think about it, Myanmar has been closed to outsiders for 45 years before opening up in 2010. Up here in the capital, most of the foreigners here are older than Chris and even I, so on the whole, they're not the kind who go out and adventure. Our Taungdwingyi Loop certainly isn't on any tourist guidebook or website. Despite being close to a
Was that a caucasian driving by?
UNESCO World Heritage Site (the Beikthona ruins), Taungdwingyi doesn't have a page on Witkitravel.org, isn't mentioned at all on TripAdvisor or Lonely Planet. Even go-myanmar.com ignores it. It's certainly within the realm of possibility that we were the first westerners the hill-dwelling locals had ever seen in their entire lives.


Myanmar is a nation of lots of different ethnic groups. One of the largest is the Karen people who mostly live in the mountains on the east side of the country as well across the border in Thailand. I found it interesting that I noticed lots of Karen-style costumes on the people of these hills. After looking at a map of the ethnic groups of Myanmar, I saw that these hills west of Naypyitaw are inhabited by Burmo-Karen people, i.e., a mixed ethnicity. The woman in the picture above has very Karen-like facial features, but her grandson is wearing thannaka, a wood-based facial sunscreen that is traditionaly Burmese.  

My friend Chris had recently purchased a new toy: a GoPro video camera. These miniature cameras record in HD, are rugged and durable and come with a variety of accessories that allow you to do things like attach it to the top of a motorcycle helmet. I so want one. 

The video I made uses clips from my camera as well as new perspectives made possible by the GoPro.  I'll share some screen grabs before the video. Please watch and comment on YouTube!

The Bago Hills had a big sky.



Getting to ride on the top of a truck and seeing foreign tourists in your area for the first time makes for a happy occurrence. 


We filled up three times on our journey. Up in the hills, this is a gas station. 


Funny framing on this one. Toddlers now available in convenient plastic containers!  


Rush Hour on Myanmar's Highway 2.


The gas pumping committee.


A lovely young lady whose job was to collect the toll for the road to Taungdwingyi. Mind you, the toll was 100 Kyats, i.e., 8 cents. 


I was worried about the roads, this being the tail end of the rainy season. We've been foiled by ruds-turned-to-mud before. There was only one small stretch of that on the journey to Taungdwingyi. 


And here's the video:



PART TWO yet to come...

On the Go in Manado 15: Where to Next? Pulisan!

By this time in the journey, I was still very far ahead of schedule, and not really sure where to go next. My last night at the Tangkoko ...