Saturday, June 4, 2016

The End of the Tour d'Borneo and New Beginnings

I have a chronic disease for which there is no cure. It's called psoriasis and I've suffered from it for 20 years. Every few years, I give the medical world a chance to treat it, but almost without fail, what the doctors have proscribed has had no effect.

Mind you, psoriasis is not a dangerous condition. The swaths of skin I have which are covered by pustulous, white, placquey lesions may itch a bit, but they don't hurt me otherwise. I've learned to live with people staring at my shins when I walk by while wearing shorts. I've come to accept being disfigured.

To make things worse, psoriasis is extremely rare amongst Asians, and so as I walk down the street in Yangon, no one has ever seen anything like my psoriatic skin. 

 photo legs_zpsyep9pnja.jpg
My psoriasis

 Yesterday, I decided to give Myanmar medicine a chance to help me out. I went to what I had been told was the best dermatologist in the country. I mentioned that doctors have never really been able to help me out with my condition, but there's been one exception. Two and a half years ago, I became a patient at the Thailand Dermatology Center in Bangkok. Over the course of a few months, with a combination of topical steroids and phototherapy, my symptoms were reduced by 95%. The psoriasis was practically gone. 

Phototherapy is the treatment of skin conditions with ultraviolet light. The symptoms of psoriasis can be reduced by exposure the UV light in some patients. I am one of those patients. 

This method is preferable to other recently developed treatments to psoriasis, i.e., pharmaceuticals. See, psoriasis is essentially a hyperactive disorder of the immune system. The psoriatic dermis, AKA our skin, thinks it's in constant need of replenishing itself because its been damaged when it hasn't. My skin is constantly replacing itself when it doesn't need to. So, drugs have been developed which suppress the immune system and this helps with the skin's hyperactivity. As you might imagine, there's dangers involved with suppressing one's immune system, and so drug-based psoriasis treatments require constant monitoring to make sure you're not subjecting yourself to lots of other diseases while making your skin more pretty. 

Furthermore, anti-psoriasis drugs are really hard on the liver. Anyone with a shaky liver shouldn't take them. 

So, when I went to the dermatologist yesterday, she ordered the full assortment of blood and urine tests. She needed to know how healthy I was before proceeding with any treatment. I haven't had a full panel, a full assessment of my health in several years. I was a bit nervous about the results which I picked up this morning. 

I have high cholesterol and my liver function report was well well outside (on the dangerous side) what is acceptable. 

I could have guessed that was coming. I know I'm fat, eat too much red meat and fried food. I probably drink too much too. 

Anyways, the pharmaceutical path towards alleviating my psoriasis is out of the question. My liver is a beaten pup; it can't take much more. 

There are two upsides to these last couple days. 

First, I feel, for the first time in years, that I need to pay attention to my diet. No more massive quantities of meat and cheese (cholesterol). I gotta cut back on the drinking (liver).

The second upside was that I learned from my dermatologist that there actually is a phototherapy facility here in Yangon. She's on the staff of the clinic there. See, these phototherapy machines are outrageously expensive and given that Myanmar is, well, Myanmar, I didn't think there'd be anyplace in town that had these machines. Unfortunately, the clinic is all the way in Downtown, but at least I know the one thing that's helped me in my life with my skin condition is available here in the backwaters of SE Asia. 

I start treatment on Thursday. 


In addition, the Tour d'Borneo is ending with this blog. Please watch the final episode of what was an incredible journey. 



I thought I was going to retire there. I was the senior staff member. I'd been there longer than anyone. It. Is. Not. Fair.  But on the ...