September 16, 2017

Bangkok





How to survive another pterygium surgery (part 2)

The story continues...
I had a follow-up on the 1st post-op day. Yee-haw, the dressing, which was most annoying and itching all the time by then, was going to be removed. I couldn't wait to see what was underneath.
I left at least two hours before from the hotel and went to Starbucks in the Sky Lobby. 
I couldn't wait to get the dressing off.
I had gone for breakfast in the morning. Thank God I had had breakfast there two days before, so I knew where to find the toast, fruit and coffee. I even managed not to break anything or spill the coffee... but I had taken Tramadol just before breakfast. Mistake. I think I could have managed without it. The whole breakfast was an out of body experience. The relief was huge, when I returned to the room and went straight to bed.

Anyway, the follow-up: I was still very much affected by Tramadol. I knew where I was and what was happening (oriented x 3, GCS 15/15). My speech wasn't quite clear.. somehow. The doctor, that very same cute one (yes, I saw that even with one eye), removed the dressing. That tape is the world's stickiest tape, better than any superglue. The best possible quality. At first I couldn't open the eye. Then when I did, I couldn't see much. The right, healthy good eye, was ok, but images near and far were blurry. We tried eye drops. I couldn't see much better. The eye chart still looked blurry. The eye looked bright red. A monster eye. The doctor showed me the image of the eye. Interesting- was that really my eye? It was better than I had expected. Taking the image involved a bright light and it felt as if the flashes of the light went all the way into my brain. The most painful procedure was removal of the dressing. What a relief to be able to wash my face. I left the clinic with several bottles of eye drops and ointment for the night. 

I walked home- well, back to the hotel, wearing sunglasses in the darkness of the evening. I walked slowly and popped into 7-11 on the way home. I had an early night. There was no way I could have gone out partying and shopping. So instead I went to bed, listening to Buddhist chants on YouTube.
Then I just had to decided how to spend the remaining four days in Bangkok. On the 5th post-op day I would have one more eye check-up.

The eye looked and felt better each day. Pterygium excision and graft, which I had in 2010, was probably as easy as this one, but something about the latest operation felt like I was going to recover a lot better and faster. The eye drops and the ointment helped a lot. Sleeping helped too. Getting out of the hotel helped. Listening to the Buddhist chants was one of the highlights of my day. Good food especially at the hotel breakfast was godsend.
I went to the spa, hairdressers and to the Grand Palace.

The final check-up was encouraging. My eyesight was probably very close to where it had been preoperatively. The graft had healed nicely. I was very very pleased about the result and the doctor's skills and commitment. I wanted to give him a hug so badly, but didn't. 😂
He did a great job and I don't think anything could have gone better. The standard of healthcare and professionalism of the healthcare personnel at Bumrungrad are excellent. I would have no hesitation in recommending the hospital- of course do your research and ask for a second opinion. As I said earlier, I don't know exactly how much money I spent, but  it was worth every cent.
There is a nevus at the back of the left eye too. Without that very thorough eye exam I wouldn't know about it. I didn't even know a nevus could be found on the surface of the eye. That's another story then.

Now, almost two weeks later I feel great. I am very very careful with the operated eye. You could almost say I am overly protective of it.
Horseback riding lessons start next week and I'm going to wear an eye patch to protect it. 
I always have sunglasses on now.

I am very very grateful of having had the opportunity to visit Bangkok, have the surgery there and meet this great doctor, whose skills and knowledge are extraordinarily good.. not just the skills, but his kindness, compassion and respect were a real blessing.






How to survive another pterygium surgery (part 1)

After a long break, Blogger is back. I don't know what happened, but I needed a break.

I went to Bangkok for an eye surgery earlier in September. I had never even been in Bangkok, but in this day and age booking hotels, finding places, paying for stuff online becomes so much easier.
Within a day or two I had everything booked: flights, hotel, surgery.

The hospital, Bumrungrad, is a super cool looking structure somewhere in Central Bangkok. I went for an outpatient appointment and had my eyes checked. It must have been one of the most comprehensive eye exams I have ever had in my life: pterygium in the left eye, smaller one in the right, nevus in the back of the left eye. I think I had already decided on having the operation, no matter what, but I thought about shopping and sightseeing in Bangkok. What if...? Maybe I could have the best of both worlds?
Waiting area
I had to have some pre-op work done, all in the same building: chest X-ray, EKG and blood tests. Al of them were more of less normal, even the thyroid function tests, which I thought would not be anywhere close to normal and might cause the operation to be cancelled. EKG showed the same 1st degree heart block, which I have always had and I was not concerned about it. I was asked if I want to see a cardiologist? Noooooooo! At this stage I wasn't really thinking about money and to this day I don't know how much I really spent. But I really didn't feel I needed a cardiology consult- God only know what they'd have discovered.
So the operation was scheduled for the following day.


I went to McDonalds. Really enjoyed my burger and fries. That feeling of having the last meal ever. After that I walked back to the hotel and thought I should get some sleep.  I should. The sleep never really came: I worried about waking up in the morning, but I should know myself better than that. I am practically never late. I wake up well before the alarm clock. I worried about missing my taxi at 5.30am. I was expected to be in hospital by 6am. I counted sheep, cows and horses and the sleep never came. It was probably close to 2am when I finally drifted off. It wasn't a good quality sleep, but all I needed to do was get dressed, brush teeth and apply lipstick. I wasn't looking too good that morning, but lipstick would surely change it all.
The hospital admission procedures are pretty much the same all over the world.
Pay the bills, get taken to Day Surgery, pre-op checks and IV cannula. When did I last eat and drink? Any allergies? Lots of questions, pre-op eye drops, extreme tiredness- but I still couldn't sleep. I was alone in Bangkok and in this strange place, yet I felt I was very well looked after and safe here. 
The ophthalmologist and anesthetist both came to see me. I think at this stage I was fine and after that everything just happened so quickly that I had no time to consider escaping from the OR. I didn't start crying hysterically. I didn't feel like anything was going to go wrong. I remember the lyrics "It's gonna be ok" by Robin Schulz feat. James Blunt and I felt I was going to be ok. Both of the doctors had this professionalism in them...  and kindness, something that I don't "feel" so much in some other individuals. They both did an excellent job looking after me.So did the nurses, who were all some of the most polite and kind people. There was nothing at all that the team could have done better for me. They were excellent.
I could have had the surgery under local anesthesia, but I think I would have freaked out and started crying. I guess it can be done under local, but I'm probably not the right candidate. To be honest, I can't even imagine what it would be like: would I be able to see the scalpel and see all the other instruments and feel something... weird. Would I feel the sutures? Would be able to breathe?
I didn't think this was the right time and place for such experiments... at the same time I think I could have done it. There is still another pterygium in my right eye, so who knows...

So we decided to do the surgery under IV Propofol and gas, laryngeal tube and  painkillers. All I remember then was being wheeled into the OR. On to the OR table. I saw the scrub nurse and some of the instruments. After that I was given something by IV and I started feeling great. Happy. Not worried about the lack of sleep. Desperate to talk, but nothing to say really. I wanted to know what that clear liquid was. Whatever it was, it was awesome. Even better after the Propofol went in. The last thing I remember was an O2 mask. 

Then I woke up in the Recovery. Once, twice. I feel as if many people came to ask me how I am doing. I didn't know how I was doing, to be honest. Something on the left side of my face was bothering me (that dressing) and I could kinda tell that the surgery was done, but I was feeling dizzy and tired and dozed off several times. At some stage the eye surgeon popped in to see me. Someone was holding my hand. Then I felt sick. Like sick, you know. Head of the bed up, someone handed me Kleenex, but I didn't feel sick anymore then. Well, I did, but didn't want to throw up on the good old doctor. Poor guy, he wouldn't have deserved it. Someone gave me Zofran and I can't remember what happened then. I slept wondering where I was and who was the kind person, who held my hand? The surgery had started at 8am and when I finally had a chance to check what time was, it was 1.30pm. Had I really spent almost four hours in the Recovery? 
I remember having some juice and Tylenol. I remember feeling very very sleepy, but I was ok. Then I was being wheeled back to the Day Surgery and went to the toilet and got dressed. 

"So tell me now
When every star falls from the sky
And every last heart in the world breaks
Oh hold me now
When every ship is going down
I don't fear nothing when I hear you say
It's gonna be ok."
- Robin Schulz feat. James Blunt: Ok 

The dressing... OMG I don't look too happy there. This is on the following day and I was drugged up with Tramadol, Panadol and found myself very unhappy with just one eye.

This the the hotel room service table and the broken pepper container. I also kept bumping into walls, doors, tables and chairs. I don't know I managed to to get to breakfast in the morning. I recall going to Starbucks too. How did I do that? Hotel concierge looked suitably impressed by my dressing, which I couldn't cover by sunglasses, hair or pretty much anything. The main thing was that the surgery was done, but was it successful?



February 20, 2017

Insomnia in 2017

Sometime this evening I realized that I had lost my ID. Both the national ID and work ID.
I was scared out of my mind. I recalled leaving work the ID safely in my bag, but after that I'm not sure really what happened. Fast forward 6 hours: the ID (both of them) are almost in the middle of the road leading to my house. I just couldn't believe my eyes. It was already dark, 10pm and it was pure luck I found it and not just that, God was really and truly there looking after me.

I called my friend right away and told him I found the ID's (both!), thanks be to God. He told me a story about a guy, much less fortunate than we are, no money and he has not received his salary for four months! My cool and awesome friend sounded more than upset, when he was telling me all this and me, not ever having had met the guy, I was speechless. We all need reminders how lucky we are, how much God has given to us, but we just don't see it. We do, but at the same time we don't. My friend.. he has become like a brother to me, a lot more than a friend to me and when was the last time I actually told him I'm so happy to have him in my life? When did I say thanks to someone for something they helped me with? Was I grateful when I saw my horse earlier today or did I just take it for granted that she's "always" there? There could be a day, when she is no longer there.. what do I do then?
What do I say to another friend, who upon hearing about my lost ID, asked me "what can I do to help"? When did I last call my mom and tell her how much I care about her? and my brother and all my other friends? Was I grateful of my latest appraisal, even after receiving a kind of a mediocre performance rating? Did I even attempt to understand it? When did I last smile, when I saw the sun?
Did the words of my colleague, who said he almost welcomes death, get me thinking? When was the last time I was I compassionate toward myself?

I should be asleep, but I'm not because I'm thinking why I have lost the skill of awareness, being in one moment, not multitasking and being absorbed into another Instagram world, when I should be paying attention to where I'm walking, what I'm seeing, who I am talking to listening to them. Previously, many moons ago when I had a regular yoga practice, I was fully present, slept well, ate well, but it's very different these days. Sometimes when I go for a walk, I find myself being transported from one place to another, but not really remembering how I got there. From the passage of time, I can tell I have spent an hour walking/exercising, but I don't remember any details. Did I see anyone I know? Did I stop to say Hi? Did I stop and look at the flowers and trees? I don't believe I did. I remember nothing.

I do believe we all have the power to change. Make those changes into our lives, gradually first. They don't need to be huge changes and no one needs to know about them. People will notice though, soon. Even if it's just changing your thinking into a bit more positive. Self-esteem grows almost instantly. Negative energy dissipates. It works! I spent a week in the French Alps once, in a very unique yoga retreat (if you can call it that) and when I returned home, the effects were long lasting. For the first time in years, I saw my image in a bus window and I was smiling. At home, I noticed changes. I was a lot more confident, approachable, less angry and overall harboring less anger. I loved myself.
Things gradually changed and I became.. myself. Again. That old person I had never really liked, but with whom I would have to live for the rest of my life. It was up to me to change for good. I have kept parts of the yoga and spirituality in me all the time, the concept of God, giving thanks, empathy, trust and confidence too, but I have a lot of work ahead of me. It's never a good idea to become a multitasking super robot, who can handle any amount of work, stress and pressure. The cracks will appear in the core soon enough and some of us fall apart. I have been there. Someone once said that anger causes cancer. Yes, I would agree with that. It does not ever need to go that far: a common cold is more than enough sometimes. Wouldn't it still be a sign to slow down a bit?
My problem right now is that I am trying to do too much, please too many people, not being able to say No, never accepting or even considering a failure as an option, insomnia, all or nothing attitude, poor self-esteem, loneliness, anger- which probably isn't anger as such, but a feeling of mixed emotions of inadequacy and frustration, which all make me want to crawl under my bed and cry. My studies, work, voluntary work, late nights, travel, meeting friends, horse riding- all fine, but not when they all pile up and the deadlines are getting closer and closer. Something needs to go. Studies. I need a break and I want my life back. My life, which I could start building again piece by piece.
I do need to tell my friends and family how much I appreciate them. I need to get myself out of the house and stop making excuses and procrastinating. I could also tell myself that I'm ok, I like myself, I can kick myself (just like my friend does when we are having dinner) once or twice for failures, but not make it an eternal punishment. I'm not ugly either. I'm actually just fine, but I need to get up and shape myself into a person, who I would like to be, without plastic surgery, Botox etc.

Sleep. Insomnia can sometimes be cured by sleeping. Those who know me, know how much they mean to me and how much I love them even if I don't always say it, but maybe that's exactly what I need to do. To begin with, maybe tell it to myself first. Be a bit more more kind, loving and understanding toward myself.

February 09, 2017

How to survive your dentist visit Part 2

After my last visit to the dentist three or so days ago, I thought I'd need more time to process the news of two cavities and the overall condition of my teeth not being so great.. and having to resort to the inhalation of nitrous oxide to get through a simple dental cleaning.
I got over it, no major traumas and self-preservation kicked in: I do still like to keep my teeth and look after them. Email the dentist, try to recall the email, which failed and then I was still hoping that he would not be at the clinic today. Next thing I know: he replies and says c'mon in. Seriously? The whole cycle of anger, bargaining, sadness, acceptance and finally "ok, I'll go then", but not before researching every possible website of inhalation sedation, dental phobia, pain etc. Then I came across this website:
http://www.dentalfearcentral.org/help/sedation-dentistry/laughing-gas/
Some of the stories about nitrous oxide were not just informative, but entertaining too, that I was encouraged to just go ahead and try it once more.

My blood pressure was 150/90 so I was undeniably anxious. As I was sitting in the lobby, I thought I could still walk out, but as I was thinking about it, the dental nurse  was suddenly standing next to me (oh I bet you never thought you'd see me here again) and I no choice.. Sure, I could have made my excuses and left, but it would have been way too embarrassing.
I'll spare you from the details of what happened in the restroom. I already mentioned what the anxiety did to my BP. The same as it always does (madam, do you suffer from hypertension?)...

...and then, because it is easier to explain everything in order as it happened, here goes:

1. A chat with the dentist, whilst plotting the best escape route. He explains what he is planning to do.
2. Before I know it, I am sitting on the chair and can't escape. I look at the tray of the dental instruments, but can't figure out what each of them are used for.
3. They start administering the gas/oxygen mix via nasal mask. It feels weird at first, but then I get the "taste" of the gas and feel a lot more relaxed. I don't necessarily need to escape.
4. More gas.
5. And more. My legs feel heavy, I stop clenching my jaws and relax my grip of the dental chair armrests.
6. Anesthetic gel goes on and what else, I feel nothing.
7. Next moment the dentist says we will start drilling- but no wait, I'm still conscious and he has yet to give me the dreaded injection. He shows me the empty syringe and proves me wrong: he already gave it.
8. More gas please. Drilling goes ok, it just sounds funny. The drill is not a power tool, not the one they use in drilling oil or that Black&Decker you use in some DIY stuff at home.
9. At any time, I didn't feel like choking or drowning or being unable to swallow. I didn't taste blood or any other weird stuff. The local anesthetic gel  tasted something nice though: strawberry, raspberry, cherry... I'm not sure, but the effect of the taste made me see "red" shapes, which I think resembled Valentine's Day gifts and hearts.
10. Once the drilling was over, then they filled the cavity with a filling and some medication, because the cavity was quite large. Not the largest the dentist had seen, I asked him about it afterward.
11. At some stage- after drilling I think, they discontinued the gas and just let me breathe oxygen for a while. I was actually ok,  felt myself tensing up at times, but I was still feeling okay.
12. The dentist always asked me from time to time if I'm okay and let me clean my mouth with Kleenex. The dental nurse gave me a towel to hold, kind of for comfort you know, and it worked.
13. I'm not quite sure of what happened next- I kept hearing the dentist telling me multiple times "nearly done". At that time I started feeling I could leave.. soon.
14. Then it was all over: I got to rinse my mouth. I felt a bit dizzy, but the chair was elevated quite slowly so I managed to adjust. My mouth felt like rubber as if I was wearing a clown mask or something. It was almost impossible to speak at first.
15. I recalled some fun bits and pieces I had said inbetween the local anesthetic, drilling and all: "are you worried I'm going to bite your fingers off?" (to the dentist).
"I gave the local" to which I replied "show me the syringe". When he did, I said something along the lines "oh s**t, really, lol".
After he had indeed given the local,  he had said "you are doing very well, you won't need a general anesthetic" and me not realizing that he had had the Lidocaine syringe+needle in my mouth all this time.
16. Now almost 3.5 hours later I'm at home, eating ice cream, thankful I survived without pain and further embarrassment. The numbness and rubbery feeling have almost gone. I don't know what the new improved tooth feels like- I'm afraid to look or even touch it. I don't think there's any need to look at it at this stage.
17. Lesson learned: never underestimate the power of N2O. One of my favorite gases for sure.
18. The next step is to find a dentist, who can remove the remaining wisdom teeth under heavy IV sedation or general anesthesia.
In all honesty, I didn't expect anything to be wrong with my teeth and I got a shock of my life when I learned about the cavities. Almost at 40 I've never had cavities! No fillings, nothing. Anyway now I know better- there are always dentists and other healthcare professionals who treat their patients with respect and listen to you, help you to overcome your fears so you can get this done.
I came across this dentist in Facebook, where someone had posted an introductory video of him. I thought it might be a good idea to see a dentist, especially because I had missed my previous appointment in 2016 and because I knew I would have to get a thorough cleaning done. Now I'm glad I went.

Apparently after the radioactive iodine treatment, something changed and my mouth became dry, exposing my teeth to dental caries, higher risk of cavities etc so yes, I should have been more careful.

It's never ever going to be a walk in the park, visiting your dentist, but at least the "event" can be broken down into a manageable pieces and it can be done and we all survive somehow. If I can do it, anyone can.

If you are ever in Dubai needing dental treatment, see Dr David: http://valiantclinic.com/ourphysicians/dr-david-donelson/

 

February 07, 2017

How to survive your dentist visit

I went to a dentist yesterday and I have to say I am glad I did. On the previous day I was very close cancelling the appointment, because I thought there is nothing wrong anyway. I might need a check-up and cleaning, true, but there are no other issues for sure. I was so certain of that.
My appointment was in one of the private hospitals/clinics in Dubai (Valiant Clinic) and I was super anxious hoping the taxi driver couldn't locate the place. Well, he did...

I have never had "real" dental treatment for anything really; no cavities, no fillings, no root canals, nothing but regular check-ups and cleaning. This time it seems they found two cavities, one in a wisdom tooth and one in another permanent tooth. I was NOT expecting that. The dentist and the dental nurse were so great, polite, kind and fun too that I forgot to be scared. I was a bit though... I had x-rays done, which was fine. That's how they discovered the cavities. I declined to have the filling done and the tooth extracted without an IV sedation or general anesthesia, but agreed to have the cleaning done. Someone mentioned nitrous oxide..? Yes, they do provide it for anxious patients and yes, maybe I could have done it without the gas, but why not make things more comfortable? Application of local anesthetic gel into gums made it even better and I think I fell asleep. It certainly did not feel like 45 minutes of cleaning, I did not feel like I was choking on blood and saliva at any stage, I didn't panic and I didn't feel I needed to escape.

So glad I went. It may cost a lot (!), be uncomfortable, inconvenient etc but your teeth are precious and I will never neglect my dental visits again. If I had to choose between going for mammogram, gyn visit or dentist, I'd go for the dentist any time.

1. Do your research, compare prices, get recommendations, even if it's an emergency.
2. Ask for sedation if you need it. If they say "no, you don't need it, we are awesome, we are professionals etc" don't take no for an answer. If you can get the cleaning done without sedation, ok fine, but anything more than that, tell them what you need and want.
3. Don't go to dentist every three years. Go at least once a year, maybe even more. After I had the radioactive iodine treatment, my mouth sometimes feels dry, and I think that may have contributed to the dental caries and stuff that's going on in my mouth right now.
4. Clean, really and truly clean teeth feel great. It's not something you can do yourself.
5. Don't expect the worst kind of news about your teeth. It may not be as bad as you think it is and you may get a clean bill of health.

As for me, I guess the next step is locating a dentist, who agrees to remove the two remaining wisdom teeth under general anesthesia and fill the cavity at the same time.
Maybe during the same surgery they could fix my ankle, which I sprained yesterday morning.. but that's another story.



January 25, 2017

The Cove-Taiji

Just say No to dolphin and whale shows. Wouldn't you rather see them in their own environment?
This is why I said No to a "swim with dolphins" and chose another place to stay, rather than watching and swimming with dolphins in captivity.
I recommend checking out some videos about Taiji, dolphins etc and watching the movie The Cove. It will upset you, it will make you cry, but it does open your eyes and you will know what captivity does to dolphins.

In all fairness, some animals end up on our plates as our dinners, but how they are killed, that matters. See what happens to the dolphins in the movie and decide then if you still want a piece or meat of an animal that experienced an awful death. Practically hacked into pieces.