I must apologise to followers of my ‘novel in progress’ who did not have the anticipated dubious pleasure of reading the latest chapter this past week.
I did complete the first draft last Monday and was fully expecting to have it in a sufficiently advanced state to publish it by the end of the week, but unfortunately, events overtook me on Monday night, and I am still struggling to revert back to my ‘normal’ routine.
I must have been a little prophetic in last week’s blog when I speculated on my own bionic mortality, and even commented on the heart palpitations that I had been experiencing of late.
In future, I’ll know better than to temp fate as on Monday evening, I started to feel my heart going into overdrive for extended periods and by the time I went to bed, it was racing like mad. I tried to take my blood pressure with my ever reliable home BP machine, but it kept coming up ‘EE’ – (error)!
There didn’t seem to be anything wrong with the machine and after repeated attempts I finally obtained a reading which showed a pulse rate of over 140 beats per minute. I could feel my heart beating very fast and very irregularly and over the next hour, and although I continued to come up with numerous error messages, I succeeded in getting a series of readings, which showed that my heart rate and BP (blood pressure) was all over the place – with my pulse ranging from the low 100’s to the high 140’s and the BP showing high in one reading and then ridiculously low in the next, and so on.
I was also starting to feel distinctly weird and tired. It was clear that my heart had gone into atrial fibrillation (cardiac arrhythmia), which a friend of mine, who also has a heart condition, had warned can quickly lead to heart failure or a stroke if not brought quickly under control.
Noo was fast asleep beside me and I lay there for a while, hoping that my heart would somehow settle down and the emergency would be over – but on the contrary – it seemed to be getting worse, with no sign of any let up. I continued to monitor my erratic BP and pulse readings (in between the multiple error messages) and pondered what I should do, stuck as I was in the middle of nowhere, at least 30 minutes drive from the nearest hospital.
If I went to farang/tourist orientated Bangkok Pattaya Hospital, the chances were that I would find a cardiologist on call, but the fear was that they would bankrupt me before they cured me. I just don’t trust those mercenary bastards and I decided that I would rather die than let them get their hands on my money. But if I went to any other hospital in Pattaya, I knew for sure that there would be no cardiologist there – not even in the day time – let alone the middle of the night!
I woke Noo and told her I was in a bad way and she duly called the two ‘lesser’ private hospitals in Pattaya and confirmed what I already knew – no cardiologists. We ‘hummed and harred’ on what to do and eventually Noo made the sensible remark that if I got any worse and something happened to me at home, there would be nothing she could do, but at least if I was in a hospital there was a fighting chance they could do provide something approaching professional medical assistance.
Hmm, we will see how accurate that assumption was.
So eventually, at around 3 a.m., Noo drove me into Pattaya and I was admitted to the E.R. at Pattaya Memorial Hospital. I had a ‘crib sheet’ with me that was provided to me by Rajavithi hospital which contained full details of my operation, my meds and any other relevant mediacl information, in the event of an emergency. We showed them the paper and explained that I was suffering from a-fib.
They put me on one of their beds and took my BP, which was high, and the pulse was in the 130’s. They then ignored me to deal with other patients and returned after 15 minutes or so and took my BP again. This time the BP was very low but the pulse was up to 140. The doc looked at my low BP and smiled and said:
‘There it is much better now’
‘But what about my pulse rate?’ I asked plaintively, but he ignored me and walked away.
There was then a major disturbance while a road accident victim was hauled in and after a long while a nurse returned and took my BP again. This time it was high and the doc came over and told me to calm down and not to be so excited. I tried to tell him that my pulse rate was very high and my heart was in a bad state but he just wasn’t listening and walked away.
I had enough of this and decided that I had better go elsewhere, and got up from the bed and went to consult with Noo in the waiting room. The doctor must have overheard what I was saying and for the first time since I had arrived, he produced a stethoscope to listen to my heart. He agreed there was indeed ‘something wrong’ and persuaded me to return to the ER and have an EKG. – this after more than 2 hours after I was admitted. When the doc opened my shirt to clip on the EKG leads, they saw the 16cm scar down my chest and said to me in surprise:
‘Oh, have you had an operation recently?’
‘Oh my God! I’ve been telling you over and over again, and it’s also written on the paper I gave you – in Thai – that I had valve replacement surgery 7 weeks ago! Doesn’t anyone listen to patients or read anything in this fucking place?’
The EKG print-out was very scary – a mass of very high spikes– I have never seen anything like it.
The doctor looked at it and said:‘Your heart is very unstable, something is seriously wrong.’
(Really? Tell me something I don’t know)
He said he would give me a beta blocker to try and slow down the heart and I expressed my doubts whether it would have any effect. I was still attached to the EKG machine and an hour later there was no change, so he gave me another drug which he said was designed to slow the heart down. He said the drug was very powerful and after I took it he would monitor me for a couple of hours to observe the reaction and to ensure that there were no adverse side effects.
Half an hour later he went off shift and the new doctor walked straight over to me, pulled off all the EKG leads and told me to go home and monitor myself! At this point there was still no change in my condition but I had had enough of this bullshit and felt pretty exhausted, so I had Noo drive me back home.
By the time I got home it was past six a.m. and although I was still in a-fib, I fell asleep, exhausted. When I woke about three hours later, my heart had finally stabilised and the pulse rate was much lower. The meds had obviously kicked in. I did some internet research on the drug the hospital had prescribed and found that it was indeed drug for such situations, so maybe I would live after all…
The hospital had advised me that there was a cardiologist who would be there the next day to hold a two hour, weekly clinic, so I duly returned on Wednesday to see what he could do for me.
It started out pretty bad, as just like the doctors in ER, he seemed to be programmed not to listen to anything I told him. I told him about my heart operation and what had happened the previous Monday. Then I showed him a full print-out of my BP, pulse rate over the past 36 hours including details of when I had taken various meds. He gave it a quick glance and put it to one side.
It took much cajoling before he begrudgingly read the Rajavithi hospital crib sheet, and then at long last, he started to understand my problem and take me seriously. I showed him the medication I had been given in ER on Tuesday morning and he shouted at me:
‘No, No, you mustn’t take that it is the wrong medicine!’
‘But it did work,’ I protested.
‘No it’s wrong, don’t take any more! Where’s your EKG? I don’t see it in your records,’ he barked.
He called the nurse and asked her why my EKG had gone ‘walkabout’, and they went off hunting for it. He then told me to have a new EKG.
When I returned to his office half an hour later, they had found my original EKG and he showed me the two side by side.
‘You see? On Monday your heart was very bad, and now it is much better.’
‘So the meds worked…’ I insisted…
He showed me his computer screen where he had obviously been Googling, and found the details of the drug he planned to give me.
‘Read this,’ he said, you will see that THIS is the right drug.’
I read the text and agreed that it seemed to fit the bill. He smiled and then handed me back the print-out I had earlier given with details of my BP readings etc and said:
‘This is very good, please keep it up to date it and bring it with you next time.’
(It was only half an hour ago when he had pushed the paper away with a gesture bordering on contempt.)
After he had seen my two EKG’s and re-read my information sheet, his whole attitude seemed to change and we sort of became friends….(well, we smiled at each other)…He seemed to finally get it through his head that I wasn’t some ignorant, drunken, pot-bellied farang holiday maker with a head ache, but was a long term resident who had a serious problem and actually understood a little bit about my medical condition.
We forged an unlikely partnership and discussed my warfarin levels and he asked me to make sure I arranged for a blood test to check my INR, (the time it takes my blood to clot), before my next appointment. (This can’t be done at the hospital but I know a lab that can do it.)
I was sent back to ER to have the drug intravenously administered to kick off the treatment and was kept there for a couple hours while they monitored my reaction to it and then I was sent home.
Since then I have been in a reasonably stable condition, yet in spite of the new drugs and the reintroduction of some of my old BP reducing drugs, my BP is slowly rising again. So yesterday, I increased some of my BP drugs – I figure I can’t do much worse than these incompetent docs with whom I am beset.
And today, Sunday, my BP and pulse rate seem to be finally under some semblance of normalcy.
Touch wood folks.
After a couple of day’s respite, I have started my daily exercise again and for the past two days I have introduced a little jogging into my afternoon walks – not a lot – as I can feel my calf muscles tightening and I need to get them stretched properly before I become too adventurous.
All being well, I will see the new cardiologist next Wednesday and see what he has to say about my progress. I have Googled him and find that he is based at Queen Sirikit hospital at Sattahip and he does a couple of hours a week at both of the smaller, private hospitals in Pattaya.
It is highly unlikely whether this guy has ever been involved in valve replacement surgery – or in the after-care of such patients – so it will be a case of the ‘short-sighted’ leading the ‘blind’.
Never mind, it’s better than nothing, and there still seems to be a bit of life left in the old bionic Mobi yet.
So after completing the first draft of my latest chapter back on Monday, I have not even looked at it since – what with my medical emergencies – and to be honest, my distraction with the Olympics, which I have been avidly following on radio, the internet and even the occasional bit of live TV.
But next Monday should see me back in ‘novel mode’ as I really want to push ahead and get it finished within the next couple of months.
Last Friday was the first day of Khao Phanser, (Buddhist Lent), which was preceded last Thursday by Asahna Puja Day, which commemorates the Buddha’s first sermon in the Deer Park in Benares and the founding of the Buddhist sangha.
I wrote a lengthy piece on this subject, and how it affects foreigners, back on 16th July 2011, and for those who may be interested, here is the link: Khao Phanser
Although both days are strictly dry days (by law) in the Land of Smiles, they passed almost unnoticed, by a still sober Mobi.
Tuesday, 31St July marked my 19th month without a having drunk single drop of booze, and for those who wish to follow my example, I can assure you that with every month that passes, the easier it is to stay ‘dry’.
I am finding that weaning myself off alcohol follows the same pattern I experienced when I cured myself of my very heavy smoking addiction back in the early 80’s. When I first quit smoking, it was pretty hard to keep away from cigarettes, but over time, as the addiction faded, it became easier and easier to keep my mind off the likelihood of a relapse. And so it has been with alcohol – time makes the cravings ever easier to keep under control.
I can now chat to my friends in bars for hours on end and not even give second thought to what they are drinking or to having any desire to join them. It just doesn’t cross my mind.
The only time when I feel even a wisp of ’yearning’ is occasionally when watching a movie or TV drama and one or more of the actors open a bottle of wine to relax and ‘cool down’ after a stressful day or some traumatic incident. I used to love my wine and those odd moments on film sometimes evoke fond memories.
But I know with an absolute certainly that I will never drink again – for to do so would be the end of my life. I know that my body can’t handle it anymore, any more than an ageing Olympic athlete can regain the athletic heights of his youth.
Before my drinking became way of control, I experienced many times of sheer pleasure – drinking, chatting and joking with friends – but I can’t turn the clock back and those days are behind me. The challenge now is to find similar enjoyment and pleasure without having to resort to alcohol, and in this, I believe I am making good progress.
Thailand’s very fishy business
For many years, Thai trawlers have been consistently violating the law by annihilating the seabed with their destructive fishing gear, and wiping out marine life from Thailand’s coastal seas?
The law states that fishing with trawlers is prohibited within a distance of 3,000 metres from the shoreline because coastal sea beds are important spawning and breeding grounds for marine life but trawlers routinely violate protected seas.
Complaints by local fishermen in coastal communities who have lost their livelihoods due to the trawlers’ devastating fishing methods have gone unheeded. This illegal fishing has been going on for the past three decades, resulting in many violent conflicts.
Not content with this, when domestic seas are depleted, they then fake the licences of their trawlers to carry out illegal, deep-sea fishing in neighbouring countries’ coastal waters.
Government fishery officials cite a lack of budget to monitor the seas, and they will tell you their hands are tied because the US$4 billion (128 billion baht) fishing industry is backed by powerful politicians. But they will not tell you that many of them have grown ‘unusually wealthy’.
Last year, the European Union and United States jointly announced they would no longer import seafood that comes from illegal fishing in order to protect marine biodiversity and sustainable fishing. Illegal, unreported and unregulated fishing, they said, is a serious threat to the world’s oceans and deprives legal fishermen and coastal communities of up to $23 billion of seafood and seafood products annually.
The boycott warning hit the Thai fishing industry hard because the EU and the US are Thailand’s two top seafood importers, so the trawler industry rushed to the Fisheries Department for help. It got what it wanted – a promise to get an amnesty for all trawlers with fake documents, and to quickly receive new, legal ones.
On top of all this the trawler industry colludes with human traffickers to procure workers who are treated like slaves on their fishing boats. The country’s fishing fleet needs more than 100,000 workers each year. Due to a severe labour shortage, desperate trawler owners depend on human trafficking rackets to supply them with crew, with no questions asked.
Thailand’s deep-sea fishing industry is notorious for using victims of human trafficking on boats and treating them like slaves. Stories abound about young men from neighbouring countries and within Thailand itself who have been drugged, abducted or lured into debt bondage, before being sold to fishing boats. Those who have escaped tell horror stories of forced labour, beatings, enslavement – even deaths – at sea.
Such notoriety is making many countries think twice before importing seafood from Thailand, so to avoid a consumer boycott, the National Fisheries Association wants to set up an independent, self-regulating body to recruit workers for all fishing boats to ensure migrant workers have legal status and receive fair treatment.
The Fisheries Department has shown itself to be totally spineless and corrupt when it comes to dealing with widespread misconduct in the industry and it is highly unlikely that the human trafficking problems will be eased by giving total power to the fishing operators.
As part of the proposed new measures, the fishing industry plans to issue special identification cards to their workers to prevent them from changing employers. This is in itself a clear violation of workers’ rights.
There is much that is good about Thailand and much that is very – very – bad. The fisheries authorities’ plan to whitewash illegal trawlers and give the industry total control over its workforce is a total abrogation of their moral and legal duties to act in a responsible and compassionate manner – which is so espoused by their professed Buddhist faith.
BUTT…BUTT…I don’t give a Hoot!…