Category Archives: Medical

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.

Eyesight Chronicles Part 2: Contact Lenses

One fine day, me and my roommate Whoreko decided that we had had enough of eyeglasses and we would wear contact lenses from then on. We were in second year of college then and funds were short, so we went to an optometrist at Dharampeth and asked for the cheapest contact lenses they had. He gave us 1-year hard lenses and taught us how to put them on and take them out. Happily, we were on our way, with tears streaming down our faces from discomfort.

To say that these contact lenses were uncomfortable would be an understatement. They were uncomfortable all the time & dried up after a few hours. While riding motorcycles, they would shift from the wind and the eyes would turn red. Eventually, me and Whoreko both stopped wearing them altogether and went back to our shitty glasses.

contact lenses
Not my eye, PC: Signature Eye Care

Try as I may, I couldn’t adjust to life with glasses again & was miserable all the time. Eventually, when I was visiting my parents in Kolkata, my mother took pity on me and took me to GKB Opticals at Gariahat. The optometrist was very kind and patient with me and explained to me that the cheap contacts were not meant for extended use. She also explained to me that I have Astigmatism and the cheap contacts don’t address that. She prescribed me with monthly disposable toric soft contact lenses. They were very comfortable and provided me with perfect 6/6 vision. I could wear them for extended periods of time with no discomfort.

These lenses changed my life and were probably the most significant upgrade to my lifestyle ever. For the first time ever, I had perfect vision with incredible comfort. I was incredibly happy and looked forward to waking up in the mornings to put on my lenses. The only times I had issues were when dust got into my eye(s) while riding my motorcycle. I occasionally wore them for upwards of 36 hours straight & slept in them with only minor dryness.

However, like all good things, it didn’t last long. After 13/14 years of using them, I started to experience more and more frequent spells of dryness & discomfort in my eyes. I went to my optometrist but he was of little help, just stating the obvious. Eventually, it became so bad that I couldn’t wear contact lenses at all.

I decided that I couldn’t go back to wearing glasses again and would need a permanent surgical resolution yo my Myopia.

Eyesight Chronicles Part 1: Eyeglasses

I was diagnosed with Myopia when I was 2 years old and have been wearing eyeglasses since. Both my parents were Myopic, so the genetic gamble was never in my favour to begin with. I don’t remember how it was like, wearing glasses all the time as a 2 years old kid, but it couldn’t have been pleasant.

I wore glasses all through primary & secondary school. My mother used to be furious because I frequently broke my glasses in the playground. Funnily enough, my glasses broke most often during exams. Then it would be a mad rush between studying and ordering new glasses from the optometrist. I specifically remember enjoying visiting Tosh Opticals at Paschim Vihar. They had nice modern looking equipment and air-conditioning. I remember us waiting for them to make the glasses while mother quizzed me on the topics for the exam next day. Since we spent most of the day at the optometrist, she didn’t have time to cook. We ended up ordering food from somewhere, which I enjoyed.

Broken Eyeglasses
Not Mine, PC: Just for my boys

In the years that followed, I also dabbled with photochromic eyeglasses, rimless eyeglasses and gunmetal frames. That being said, at the end of the day, they were all eyeglasses and sucked balls.

During high school and college, I started realizing that the glasses were not doing my face any favours. I realized that I looked silly with them and started hating them more and more. Also, their weight would leave sores on the bridge of my nose where they rested. North-Indian bullies were not very friendly with glasses, either, calling me “chashmish” or “chamakkha”. I also realized that glasses provided inferior vision, as they didn’t correct the entire field of vision.

By second year of Engineering, I had made up my mind that I didn’t want to wear glasses anymore.

A Note on Mental Health

I have documented my struggles with mental health on this blog before. Considering the focus of the media on the mental health of famous people these days, I decided to write a longer rant about my own struggles.

During my college days I was a happy-go-lucky kind of guy. Although I did get depressed once in a while, I was never-ever worried about things. After college, while working a job I didn’t like, I also went through bouts of depression, but got over it quickly once I found a better job.

My second job was the best job, mentally, of my career. I had friends at work, I enjoyed what I was doing and I never even thought about work outside office. It was a shift-job where you could switch off completely after work.

It was in 2012 that I realized something was wrong. I suffered from IBS for almost 2 years. During this time I also turned lactose intolerant. I did read about the close connection between the gut and the brain, but I couldn’t figure out which affected which. After 2 years, I suddenly got better and didn’t think about it again.

Things started to go south again around 2016-17, when I wasn’t able to handle non-stresses from my work. I would lay awake at night thinking about trivial things from work, lost weight rapidly and couldn’t concentrate on non-work things. I tried things like meditation and mindfulness but nothing helped much. The mind just won’t stop racing and over-thinking.

This was the first time I decided to go see a shrink, at a hospital. I was hoping for a quick solution to all my troubles, but she prescribed me with very-expensive counselling sessions. The cost of the sessions made my issues worse, so I never went back. Thankfully, the shrink did give me a diagnosis, that of Generalized Anxiety Disorder. Eventually, this phase also passed and I forgot all about it.

I switched jobs again in 2020 and this time anxiety came back to attack me with a vengeance. It was clear that this time it was worse than before. It was so bad that I couldn’t sleep for more than 3 hours for a week straight. Sleeping aids didn’t help either.

Eventually, I decided to go to another shrink. This one was in a busy market popular with people I knew. I was ashamed to go see him. This doctor also confirmed the diagnosis of GAD and decided to prescribe me medications immediately. Within a few days, I was feeling much better. Although anxiety never went away completely, it is now quite under control, thankfully, to this day.

What I do

I use the following techniques to keep my anxiety under control

  1. Medication, which I am slowly weaning myself off of.
  2. Exercise – Even a short run helps a lot. Even walking is better than nothing.
  3. Listen to music I love everyday, without fail.
  4. Writing (Blogging)
  5. Whenever I have too many thoughts at night, I write them on a piece of paper before I go to bed. Next day I action all the items on that piece of paper and then tear it away. I found this strangely therapeutic.
  6. Stay as far away from Social Networks as possible.

I know many people have found relief with mindfulness, but for me it tended to make things worse. Maybe I was not using the tool correctly.

The Rich

On the news, I repeatedly hear stories about the struggle of famous people with mental health, especially sportspersons. Although I am happy that they are raising more awareness for mental health, the impact of mental illnesses on them is much different than it is on regular people like us.

For them, quitting means an outpouring of support and being called “brave”. For people like me, quitting would mean being called a failure, losing my house and not being able to feed my family. So no, I don’t think these sportspersons are brave for quitting. They quit because they are filthy rich & can afford to.

Not everyone can.