Category Archives: Health & Fitness

Running Part-3

This is Part 3 in continuation to my last post about running. The good news is, I have been able to follow my running schedule religiously over more than a year now. The only time I took a break was for a few days when I had the flu.

I have been able to increase my distance a bit since I started and am running around 18km a week.

My VO2 max has continued its upward trend, but still not reached 2021 levels and probably never will, because of age.

VO2 max from running
1 year VO2 max trend

I recently ran my first formal 10k in Bangkok, which was an exhilarating experience.

The only problem with participating in marathons in Bangkok is that they start very early (approx 2 AM for full, 4 AM for half and 5 AM for 10k). However, the atmosphere is electric, even early in the morning. There are mascots dancing, drones buzzing overhead and a live band playing.

Running among hundreds of people is a completely different experience compared to running alone. The distance goes by very fast and before you know it, the race is over.

Running Part-2

This post is a continuation of my last post about running, back in 2020. After I moved to Bangkok, I stopped exercising. For a few months last year, I started going to the gym, but couldn’t sustain it long enough, as it was too time-consuming. Looking to get some exercise while not spending too much time, I started running again. In the beginning, it felt difficult due to the heat and humidity, but I was able to get used to it soon.

After doing it for a few months, I developed severe ankle pain. In the beginning, I would recover during my rest days, but then it continued to extend over my rest days to the next workouts, too.

The cryptmaster kindly educated me on the importance of good shoes. Turns out, my running shoes were dirt-cheap and 8 years old. And that was not acceptable. I promptly ordered some new shoes. Thankfully, my ankle pain reduced considerably, thereafter.

I have now been continuing my runs 4 days a week, 4km each time for more than 6 months now. Although I have steadily made progress with my pace, unfortunately, my VO2 max has plateaued. Try what I may, I am not able to reach my VO2 max levels from 2021.

Overall, though, I am very happy that I am keeping healthy and exercising is definitely a great mood elevator for me. It boosts the mood for the rest of the day. The only problem is, I have been losing weight consistently and need to improve my diet to make up for lost calories.

Weight Loss
Weight Loss

Anxiety Medication Withdrawal Fail-3

Continuing my series about my battle with anxiety, this is a new year special. My latest medication withdrawal fail and third in a year.

So I planned a vacation to Hua Hin for new years. I am anyways not completely at ease while travelling, but this time I topped it by forgetting to take my medication with me. Epic fail! when I realized this, I considered scouring the local pharmacies, begging for prescription medication like a junkie. But since it was only 2 days, I decided to swallow the pill.

Night 1/Day 1

I had a decent amount of alcohol to numb me down and delayed my sleep as much as possible. Once I was really sleepy, I went to sleep. Luckily I fell asleep relatively easy. However, I woke up after a few hours drenched in sweat with my heart trying to escape my chest. I tried going back to sleep but the rest of the night I was in an out of sleep. While being acutely aware of my heartbeat.

Woke up the next day tired. The day was better than the night but was jittery throughout. Sometime during late morning, my hands started shaking. After having some Coca Cola and chilling at the beach, I felt much better. By evening I was almost normal.

At night we went to a New Years Eve party on the beach and I consumed alcohol to distract myself from the impending time I have to go to sleep.

Night 2/Day 2

I went to sleep at 11. Luckily, I fell asleep without much issues, but the fireworks at midnight woke me up. I spent the first few hours of 2023 tossing and turning in bed. I was tired and I was sleepy. But I just couldn’t fall asleep. It was like a brick wall. Eventually I fell asleep but most of the night I was in and out of sleep.

Next morning I woke up tired but otherwise OK. Drove back home and went for a run to clear my head as soon as I came back. Feet felt like bricks while running. Resisted the temptation to pounce on my medication immediately.

In the evening, I figured that I am likely already past the worst phase of the withdrawal so why even go back on my earlier full dose? I had half a dose (0.5mg, compared to 1mg original dose) and went to sleep very tired.

Sleep Changes

One thing I noticed is that my sleep had turned very light, especially in the second half of the night. I was able to fall asleep and sleep well for the first few hours, but for the second half, I was in a strange state. It felt as if I am awake, but I am not because time passes too fast. But I have awareness of things around me, daylight etc. I was miserable, but decided to stick to it to avoid another medication withdrawal fail.

Nights 3/4/5

Nights 3/4/5 went equally poorly. I could only sleep for the first few hours each night and woke up mid-way and failed to go back to proper sleep again.

The days also started seeming gloomier and sadder in general. I even gave up alcohol temporarily.

On day 6, I decided to chalk this up as a medication withdrawal fail and upped my dose to 0.75mg, which is still lower than 1mg, my original dose. With 0.75mg, I am doing more or less okay, something I can live with.

Overall, not a complete withdrawal fail, as I was able to reduce my dosage, by a bit. Baby steps, baby steps.

Off with the face masks!

It is now 3 years since the beginning of the COVID pandemic and since we started wearing face masks. Luckily, me and my family haven’t been infected till now. In India, most people didn’t take masks seriously to begin with. But now, masks are a mere distant memory of more inconvenient times. Which is why, it is such a culture shock to see how serious Thais still are about them. 

In Thailand, it seems like masks are here to stay. Although, the government has removed the compulsions of masks, the Thais have decided to stick with them for now. 

Thai students wearing masks
Thai students wearing masks

Almost every Thai wears masks, all the time, everywhere. On the streets, in shopping malls, at restaurants, in pubs and in offices. In offices, they wear masks even when sitting at their desks all day. When eating or drinking something, the masks are temporarily lowered for the bite/sip and then pulled back up. Basically, the exact opposite of Indians. 

I assume Thais take off their masks when they are at home and while sleeping, however I have no evidence for the same. Overall, I think it is commendable how Thais are so serious about protecting their health and of those around them. 

Of course, none of this compares with the Chinese, who have taken COVID precautions to whole new (crazy) levels. I still see people in full hazmat suits at airports everywhere and I know that when I look at their passports, they will turn out to be Chinese. 

Chinese taking masks to a new level
Chinese taking masks to a new level

Samitivej Hospital Loot

Although, ever since my surgery, my sinusitis has been much better, it still flares up from time to time. In Bangkok, it has been more or less fine last 2 years. But last weekend, it suddenly flared up. I suffered from bad headaches for 2 days and couldn’t take it anymore. Normally, I know exactly which spray to use to relieve my symptoms, but in Bangkok, it is not available OTC. This meant, I needed to go to a doctor (hospital) for the medication. Normally I go to Bumrungrad for other ailments, but this time, in a bid to save money, I decided to go to Samitivej Sukhumvit Hospital. Big mistake!

I got an appointment soon enough and went to see the ENT. Didn’t have to wait too long, saw the doctor within 10 minutes. I explained to the doctor that I am a long time sufferer of sinusitis and informed her which medication generally relieves my symptoms.

She said straight away this doesn’t look like Sinusitis and sent me for a CT scan.

For a sinus headache.

Once the CT scan was done, she looked at the slide and said this is not Sinusitis and referred me to a Neurologist. I complained that I just need a steroid spray but she sent me for a neuro consult anyways.

The neurologist ran a battery of tests on me and told me I have a migraine. I told her I have no prior or family history of migraines but she prescribed me a bunch of medications anyways.

Then I was sent back to the ENT. By this time, the formal CT scan report had arrived and guess what it said – “Severe sinusitis”. The ENT asked me to take the migraine medications and on top of that prescribed me some sinusitis medication too. Including the spray I wanted. They also scheduled 2 follow up appointments, one with the ENT and one with the neurologist.

Eventually, I walked out of the hospital with 9 medications (out of which only 1 that I really needed). I paid THB 8500 for this farce of a treatment. The insurance only covered THB2000, so I ended up paying THB6500 from my own pocket.

Samitivej Loot

Chutiya Banaya

After coming home, I threw away 8 medications, used the spray and experienced relief within an hour. Then I slapped myself 21 times and swore never to go to Samitivej hospital again.

Thais have weird requirements from their Dentists

I have found yet another Thai quirk! Recently, I realised that I needed some Dental work done. I asked a few Thais to recommend some dentists. In parallel, I looked at reviews on Google maps to find one.

While scrolling through Google maps, I noticed a disturbing trend : How many reviews mentioned the cuteness of their dentists. This is one example, but all Dental clinics have such reviews.

This pattern has boggled my mind. I can’t seem to make sense of it. Hundreds upon hundreds of such reviews. Why?

Anxiety Medication Withdrawal Fail-2

To continue the series of posts about my battle with anxiety, I bring the latest medication withdrawal fail story.

As I wrote here, after my last misadventure with SSRIs, I stopped taking them altogether. Since I felt fine for the next few weeks, I assumed that I don’t really need them and forgot all about them since.

PC: Verywellmind

However, ever so slowly, my anxiety started to creep up back on me. There weren’t any drastic symptoms. Just things like worrying too much about work, thinking about work at night or during weekends. Also, the ever present feeling of dread that something will eventually go wrong.

I was very proud of myself for having successfully(?) given up this medication and wanted to prevent another medication withdrawal fails. So I decided to continue without it.

After I spent 3 successive weekends obsessing over work and dreading Monday, I decided I would keep my mind open about resuming the medicine and gave myself 1 month to decide, till my next doctor appointment. I didn’t last 1 month.

Last weekend, after dreading work all Saturday and most of Sunday, I decided to give up and go back on the medication there and then. I called the hospital & requested to see the doctor the same day. Thankfully they were able to put me on the waiting list and I saw the doctor within the hour. He took pity on me and put me back on Lexapro.

After bagging the medication, I immediately felt better. The world looked brighter and life seemed more beautiful. Of course this was a placebo effect as the medication takes up to 2 weeks to work. Over the next day or so, the placebo effect wore off, but a week since starting the medication, I already feel better.

Second reminder to myself, to not mess with medication that work well.

Also, it’s not worth avoiding medication (and for what?) if it works for you and makes you feel better

The Serotonin Misadventure

Recently, I had a misadventure with my serotonin levels. As I posted earlier, I have been on Neuris 1mg- An Antipsychotic & Lexapro 5mg- An SSRI for my Generalized Anxiety Disorder since I moved to Thailand.

Now, the Lexapro, in Thailand costs 15 times what it cost in India. Always one trying to cheap out, on my last doctor’s visit, I asked him if he could prescribe me a cheaper alternative. He prescribed me Fluoxetine 20mg instead and I happily went on my way chalking this up as a win.

After a few days, I started noticing signs of heart palpitations and sweats through the day. I had recently joined a gym so I chalked this up to the workouts. However, the palpitations became worse with time.

It was not until my family left for vacation leaving me alone with my dog at home that the symptoms hit hard.

I was in a state of constant anxiety. My heart felt it was going to burst out of my chest. To make matters worse, I took a Lexapro, too. It really pushed me over the edge and after suffering all day from a constant state of agitation I dumped my dog with the neighbours and went to the ER.

Serotonin Misadventure
Saw many such alerts throughout the day

They said I have Serotonin Syndrome, from an overdose of SSRIs. They shot me up with a sedative and sent me home with a few pills of Ativan. Ah! Bliss!

I slept for 11 hours and woke up the next day feeling much better. Things didn’t go back to normal immediately, but I could feel the improvements over the next few days; all I had to do was not take the SSRIs.

Lesson Learnt : Don’t mess with medication that work, just to cheap out.

PS: On SSRIs, I used to have vivid movie-like dreams. After stopping the SSRIs, the dreams stopped, too.

Anxiety Medication Withdrawal Fail

As discussed before, I have been on medication to treat my GAD for the past few years. I was lucky to have found a doctor who prescribed me medication instead of sending me to therapy. The medication had been working beautifully, but I always assumed that I won’t take them forever. When I moved to Bangkok, I decided to quit, as I won’t find a doctor here to continue the prescription. I put it off for many months fearing medication withdrawal. Running low on supplies, few weeks ago, I decided that that time was here.

I had been on the following medication to treat my GAD

Medication withdrawal

With high optimism and hope in my heart, I started the process of quitting, one medication at a time.

Levowave

Getting off Levowave was relatively easy. First I halved my dose for a week and then changed it to 3 days a week, then stopped completely. I had some confusion, irritability, anxiety, tremors for a couple of days but after that I was back to normal. No impact on sleep at all.

I assumed that the withdrawal for the other medications would be as easy. How wrong I was!

Buspin

I assumed this one would be the easiest to stop, but I was dead wrong. I halved the dose and in just 2 days, shit hit the fan.

  • Night 1/Day 2 – Uneventful
  • Night 2 – On night 2, suddenly I woke up at 01:00 AM with my heart beating fast, for no apparent reason. I was up for an hour, but was able to go back to (restless) sleep afterwards.
  • Day 2 – The entire day I was full of anxiety, irritable and confused. Lost my appetite. There was also a phase where I had to abuse random strangers on twitter for no reason.
  • Night 3 – Night 3 was horrible. I slept at 21:30 but woke up at 23:00. After that whatever I tried, I couldn’t go back to sleep. I either felt too hot (sweating) or too cold (shivering). After tossing and turning for hours and rousing the rest of my family, I think I finally managed to fall asleep at 04:00. Libido was also up 10x. Heart rate was above 90 bpm throughout.
  • Day 3 – Day 3 started slightly better than Day 2. I started running again, which brought back my appetite. But later in the day, my heart rate rose above 100bps doing nothing. A sense of doom & gloom pervaded my brain and I had only negative thoughts.

I Quit

Sometime in the afternoon of Day 3, I realised that I cannot go through with this and decided to go back on my remaining pills. I booked a doctor’s appointment to get a prescription to resume the medication.

Day 4 – I woke up refreshed after 10 hours of beautiful sleep. The world seemed brighter, and life seemed more beautiful.

After resuming my medication, I finally saw a doctor here. Fortunately, he was kind and patient and prescribed me medication to continue. Unfortunately, not all my medication is available in Thailand, so I have to switch medication.

After all this, I am extremely grateful for my medicines and medical science in general. I will never again take them for granted.

Eyesight Chronicles Part 3: LASIK

I had thought about getting LASIK many times throughout my life, but never followed through. By 2016, when I couldn’t wear my contact lenses anymore, I decided to finally take the plunge.

I went to my favourite hospital and consulted an Ophthalmologist. She explained to me the process in detail. I had a Pentacam test which showed that my corneal thickness was in the risky zone. However, the Ophthalmology director gave the go ahead for waveform guided LASIK. I also needed a retina test which involved dilating my pupils and shining a very bright light into my eyes. The most difficult part was not wearing my contact lenses for 3 weeks. This was so that my eyes would go back to their original shape and provide the most accurate correction readings for LASIK.

During this waiting time I also contracted Blepharitis which delayed the surgery further. However, on 13 Dec 2016, the day finally came to get operated on.

I went to the hospital excited like mad, armed with money donated by my mother. They took one final set of measurements and started putting anaesthesia drops in my eyes every few minutes. Soon my eyes were numb and they took me to the procedure room.

The process itself was uncomfortable but not painful. They use speculums to keep your eyes propped open and ask you to look straight. Then they use a suction ring to keep your eye straight. This step feels like enormous pressure on the eye but is not painful. Your vision goes all wonky. Then a Femtosecond laser creates a flap on your cornea. The eyesight at this point becomes blurry. When they lift the flap, you can see only a bright light.

At this stage, another excimer laser re-models and corrects your cornea as per the requirements. You can smell something burning (your cornea). Then the surgeon restores the flap, flattens it and wets the eye. The entire process is repeated for the other eye.

LASIK
LASIK, PC: Wikipedia

The entire process only takes 15/20 minutes and after that you can get up straight away. Your vision is still blurry and you cannot look at lights. My wife helped me go home where I immediately went into a dark room. Even a small sliver of light from the corner of the curtains was excruciatingly painful. I spent the entire day moping in darkness, not being able to do much except listen to music.

The next morning was beautiful. When I opened my eyes, I could immediately notice that I could see clearly without any aids. I took a cab to the doctor and had my first post-op check up. She inspected the flap, gave me medicines and sent me home. At this point, my vision was not perfect, but it kept on improving over the next few weeks and months. I would still see Halos and blurriness around light sources at night for many months.

Eyesight before and after LASIK
Vision Log before and after LASIK

Reading and using the computer for the first few weeks put a lot of strain on my eyes but temporary reading glasses helped with that. I developed a habit to check my vision regularly by closing one eye at a time while driving and trying to read the license number of a car ahead of me.

Slowly but surely, my vision improved and thankfully, now I have 6/6 vision in both eyes without any visual aids. Now waiting for Presbyopia to strike me in the next few years and add a fourth installment to this series.