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  • hardie karges 2:42 pm on March 10, 2017 Permalink | Reply
    Tags: , Bumrungrad, , , kidney stone, ,   

    Medical Tourism in SE Asia: This is Spinal Tap… 

    IMG_2193Continued from previous…

    Fast forward to Bangkok and I arrive on schedule, 10:00 hours, no wait at immigration on these early regional flights, too early to check in at my hotel, and feeling better after a half-stream piss at the airport, so walk the back road from the ‘Airport Rail Link’ station at Makkasan to my hotel near Bumrungrad hospital, waving—but not flipping—off the tuk-tuk drivers who only love me for my fare…

    I decide to wait another day for the medical care, though, since I’ve been granted a minor reprieve, and since it won’t be cheap. I bite the bullet the next day, though, since this could gone on forever, and is the silliest of servitudes, impairment is. That means sonograms, again, telling me what I already know, that I have kidney stones—duh. They haven’t dealt with the obstruction, since that is not viewable by ultrasound…

    IMG_1302Doc says I’d need a camera shot up my little thingie for that, and that’ll cost $4-6K, and to grab it, too, or nuke it, adding in the same breath that it could be a fraction of the cost elsewhere, ‘after hours’, specifically the police hospital, then I notice he’s a police colonel himself, so got it, hint hint, just call this number and talk to Nurse Ratchet, and don’t let her ratchet up the price, I tell myself accordingly. Bumrungrad is the all-English ex-pat hospital of choice BTW…

    Sounds weird to me, though, so I decide to make the rounds of other hospitals before making any decisions. Chulalongkorn is well-known, so I visit, but not really to my taste or liking, too busy, must be a government hospital. I don’t much like crowds, especially in hospitals. Ever heard the word “Bedlam?” That was a mental hospital, though, I believe, or ‘lunatic asylum’ as they say in Mississippi. Still, I don’t like people screaming down the hall, for any reason, including pain…

    So I make an appointment to meet with a urologist, two days away, then continue on my way, next stop Sukhumvit Hospital–bingo. They make a quick estimate of the ‘cystoscopy’ at a favorable price, then tell me to come back the next day to meet with a urologist. So I do. He has a better idea: do a CT scan, which would show a stone in the urinary tract, no matter where (since he can’t just take my word for it). So why didn’t they suggest that at Bumrungrad? Good question…

    IMG_2196And Bam! There it is, bigger than sh*t, and not that large, either. So we schedule the ‘surgery’ (sort of) for the next day, with one night in the hospital, all for a couple thou USD—I sign. You can’t do this in the US, by the way, or do I have to mention that? I should mention, though, that I had a stone twice that size stuck in the same place last year, did the CAT, still nobody told me I had a stone the size of a bread truck lodged there…

    To quote my LA urologist, as he talked on the phone to ER (he never viewed a scan, X-ray, or even sonogram): “If there’s one there, it can’t be very big,” quote unquote. ER must have seen it, though, and again I quote: “You’ll have to piss them out.” Only one problem: a 10mm stone won’t necessarily pass, though mine finally did, after six weeks. I’m still considering a lawsuit. I won’t even get into the Primary Care-ER-Insurance-Specialist runaround, in which referrals are sent by MAIL, as in SNAIL!!

    And next day at Sukhumvit Hospital goes like clockwork, nothing weird except the spinal tap—ouch! No anesthesia, just a curtain so I don’t freak, and it’s all over in less than an hour. Doc’s even got a plan for a permanent fix, maybe, fingers crossed. And it all comes in at a cost of two grand and change, for which I get my life back, after a week with Cathy—my catheter. I think I love her…

    IMG_2194Did I mention previously that I hate the US healthcare system—no matter the price, whether it’s Obama’s or whoever? Okay, so I did. Let me re-count the ways: 1) It’s overpriced, 2) It’s mediocre quality, 3) It’s Byzantine, 4) They can’t estimate costs accurately, and worst of all: 5) They don’t communicate with you. That’s one reason I’m here. Most ‘medical tourists’ fly over for the surgery, then fly back. Some of us just stay. I guess I’ve backed myself into a little corner of the universe, but I think I can live with it…

    …and on the surface it might seem that my travel career is over, too, since who knows when or how many times this might happen again. I can’t travel much if I have to stay close enough to a hospital to make sure that I can empty my bladder twice a day, minimum. Curses! I hate old age! I hate the accumulation of repeated mistakes all packaged together and presented to me as evidence of my failure as a human being. I hate karma…

    There is another way, of course: just carry a catheter and learn to use it. They’ll love that at Customs. They’ll see that rubber tube and naturally think I’m tying up in the bathroom, and I just might be! It seems so sinister, so unattractive, so self-consumed and dangerous. And still, that would only buy me a few days, at most, not all that much better than just making a run for the border if and when disaster strikes, like I just did. I’ll figure something out…

    I’ll have to. Living life cloistered and cashiered is hardly thinkable, though not inconsistent with my recurring desire for the Buddhist monk-hood. Now I won’t pretend that the Universe planned it this way, and for a reason, because that would be silly and superstitious. But it’s good narrative, and it might as well be that way, because that’s ultimately the package that I’ll buy. Welcome to the future. It’s been a rough week…

     
    • Esther Fabbricante 4:00 pm on March 10, 2017 Permalink | Reply

      Decisions, decisions. Making changes is not easy.

    • davekingsbury 11:08 pm on March 12, 2017 Permalink | Reply

      Blimey … hey, is that why you call us Limeys? … what a roller-coaster ride! Glad you had a good outcome but as you say, the future’s unclear. Devil and deep blue sea come to mind. I have to admire the sang froid of your writing, though, do you find meditation helps?

      • hardie karges 1:32 am on March 13, 2017 Permalink | Reply

        Meditation helps with everything. Sang froid is part of the culture, called ‘jai yen’ = ‘cool heart’ in Thai. I think ‘limeys’ refers to the practice of sailors carrying limes to prevent scurvy, or so I once heard… 🙂

    • davekingsbury 3:44 pm on March 13, 2017 Permalink | Reply

      ‘Cool heart’ is, well, cool … best wishes, anyway!

  • hardie karges 2:03 am on March 9, 2017 Permalink | Reply
    Tags: , , , , , Sen Monorom   

    Mondulkiri, Cambodia, part II: Self-Evacuation—in a Void, Asteroid… 

    IMG_2168

    Continued from previous…

    Now here I am in the remotest outback of Cambodia, but not THAT remote, and so entranced by the landscape, and my linguistic tribulations, that I’d forgotten that simple requirement of quality medical care. Now my kidney-stone drama of the previous year is back, first in Mandalay, Burma, a month and a half ago, then at the border in Mae Sot, Thailand, about a month ago—and now…

    Part of my undefined gut problems of the past week, I finally realized there was a kidney-stone, ANOTHER one, large enough to cause some pain exiting the kidney, and block some urine flow, before finally passing. But that’s not all. There must have been two. And the second one won’t pass, stuck at the taps, just like the one that caused me so much anguish last year in Tucson and LA. But this ain’t LA… (More …)

     
    • Esther Fabbricante 2:41 am on March 9, 2017 Permalink | Reply

      OOh Myyyy.

    • kc 4:02 am on March 9, 2017 Permalink | Reply

      good luck getting rid of that barbed rock, or few.

  • hardie karges 1:21 pm on March 6, 2017 Permalink | Reply
    Tags: , , , Saen Monorom   

    Mondulkiri, Cambodia, part I: And the wind cries, “… (three ominous tones rising)…” 

    img_2177

    Saen Monorom in Mondulkiri sometimes gets called the “Switzerland of Cambodia”, but in reality it’s more Andean than Alpine, high and dry, at least in this season, more central highland than Himalaya, more Boli­via t­han Burma, more high-plains-drifter than lost-kingdom-of-Shambhala…

    In fact the platitudes of public relations hardly do it justice, simply because it’s sui generis, especially after the sui-genericide self-perpetrated by the misguided Marxists of the Vietnam war era, nowhere safe from its bomb-intensive percussions and repercussions… (More …)

     
  • hardie karges 11:55 pm on February 20, 2017 Permalink | Reply
    Tags: , , Koh Kong, ,   

    Welcome to Kampuchea: Koh Kong, Life on the Border… 

    img_2016

    Sunset at Koh Kong, Kampuchea

    …any border, is weird, by definition, sample TJ (Tijuana), TG (Tangier), TK (Tachilek) and TU (Tecun Uman) for starters, and a few thousand others, where cultures clash and vehicles collide and the simple act of of ‘crossing over’ takes on new meaning, not to mention the modern airline-hub Big Meta-Border cities, e.g. Istanbul, Moscow, Dubai, Bangkok, Singapore, Cairo, Jo-burg, Lima, Delhi and others…

    And Koh Kong on the border of Thailand and Kampuchea is no different, Kampuchea (Cambodia) the bastard big brother of Thailand, long ago fallen on hard times and left to fend for itself against the predations of its offspring, only rescued by the noblesse oblige of the Foreign Legion francais…
    (More …)

     
  • hardie karges 2:42 pm on February 9, 2017 Permalink | Reply
    Tags: , , Mahasi Monastery, , , Rangoon,   

    Ten Days in Mahasi Monastery, Yangon: None flew over the cuckoo’s nest… 

    img_1931

    Mahasi Monastery in Yangon, Myanmar

    Somewhere nearby a gong sounds–loudly. Then someone beats a drum. Then again. And again. Then every dog in the surrounding neighborhood howls in anything but unison, as I smile thinking about Allen Ginsberg, howling, growling, smiling somewhere out there but not Heaven, crazy wisdom incarnate, poet’s blood unrepentant…

    The air is still fresh and cool at night at this time of year in Yangon (Rangoon) and the scene at 0600 at Mahasi Monastery is a bit surreal: monks and nuns float through the monastery grounds in the moonlight, marching weeping shadows creeping. Ruby-robed monks line up in the streets with beggars’ bowls in hand, primed for the pump, while nuns float through on gossamer wings, all dressed in pink, with nothing to think… (More …)

     
    • Esther Fabbricante 9:15 pm on February 9, 2017 Permalink | Reply

      Deep stuff – explained well.

  • hardie karges 1:43 pm on February 6, 2017 Permalink | Reply
    Tags: Mawlamyine, Mon, , , Thanlwin   

    Mawlamyine, Myanmar: Saving the Best for Last… 

    img_1947

    The bus pulls into Mawlamyine after an all-day truck from the capital Yangon and I’m immediately flashing back to Saigon, Hanoi, Viangchan, or Phnom Penh, take your pick, c. 1995 or thereabouts, just coming out of the self-imposed shadows, them not me, but wait a minute, let me think, dirty broke-down funky and authentic, before all the development, all the tourists and the humans from the West, all wanting a piece of the action, all wanting a bit of loose change, hopefully for the better not worse…

    But there are no money changers here, not yet anyway, just banks and ATM’s, and ‘no beer no alcohol’, say all the signs, in the restaurants at least, unlike Inle Lake, there advertising ‘mojitos caiparinhas gin and tonic’ you name it, but here lotsa Chinese and Muslims, and most hotels close at 10 p.m. or 10:30, three red lights and a rush hour inversely proportional to Yangon’s. But the real action is down on the Thanlwin River, with markets both black and white, Mawlamyine’s lifeline and raison d’etre (More …)

     
  • hardie karges 11:44 am on January 30, 2017 Permalink | Reply
    Tags: , Inle Lake,   

    Inle Lake, Myanmar: It’s a Wet Dream…. 

    img_1845

    Inle Lake Fisherman

    For the first time, I’m annoyed at Burma, probably even pissed, at having to pay an entrance fee to the tourist complex at Inle Lake, based in Nyaungshwe. I mean: preservation of an archaeological zone is costly, and expensive, too, but Inle has none of that, and Nyaunshwe is a bit shabby, if you don’t mind me saying, a coat of dust covering the entire affair, tourists included. What are we paying for, anyway?

    But the main offense is the mere proliferation of tourist amenities, albeit without the aforementioned infrastructure. This is something that has been lacking—refreshingly—so far in Burma, and really the reason to justify the higher prices, like paying a premium bride price for a virgin. And the main marketing pitch seems to be toward millennial malingerers, looking for alcohol and a place to drink it… (More …)

     
  • hardie karges 3:28 am on January 20, 2017 Permalink | Reply
    Tags: Ayeyharwaddy, , Irawaddy, Mandalay,   

    Burma Up North: The Road to Mandalay… 

    img_1773…sounds romantic and all, but it isn’t so much, really, just asphalt and gravel, like anywhere else. Fortunately there are other options, like the train, plane, or boat. I’d like to say that the boat ride to get here from Bagan makes it all worthwhile—but it doesn’t, not really, though admittedly it is more comfortable than pot-holed roads and betel-chewing Burmese drivers…

    At any given moment the average Burmese working stiff is working a wad of chew that would make a Cincinnati Red pitcher green with envy. But don’t startle him or he may accidentally unload a dollop of spittle your direction that just might ruin your day. At least they don’t drive like the maniacs in Thailand. Burma is chilled by comparison—and the roads simply won’t allow it…

    img_1744But the river trip really has nothing much to see, not until you get to Sagaing, and that’s an easy day-trip from Mandalay, anyway. It’s not like there are loads of cool river villages and towns to view along the way. There just aren’t. So I’d say the river trip is optional—at best. Burma is not cheap, anyway, so save your money for something more worthwhile, like paying your entry fee to selected sites, like the archaeological zone at Bagan or the human zoo at Inle Lake—free sarcasm available upon request…

    But I don’t think Mandalay deserves the bum rap that it sometimes gets. Sure, it’s a big busy city, but I’ve seen worse. At least it’s walk-able, something you’d have difficulty saying about Bangkok, Jakarta, or many other places in SE Asia, or the world, either, for that matter. And what it lacks in charm, it makes up in open space, including a massive palace complex and a commanding hill-as-pilgrimage-site like only Burma really knows how to do it—okay, so maybe China, too…

    What I don’t like so much about Mandalay is that the quality of refreshing innocence available elsewhere seems to be singularly lacking here. And of course, that’s most easily measurable amongst the taxi drivers. Whereas in Yangon the first price quoted is pretty accurate and honest, God bless them, in Mandalay that doesn’t hold true, and in fact they can be as rape-atious as anywhere in the world. They beat me on the price from the boat landing to my hotel, so I was on guard after that…

    img_1777After the long walk to Mandalay Hill AND a long confusing walk up to the top, I somehow managed to come down a different path, despite my best efforts. So that kind of disorientation is always a good time to hail a taxi, so I proffered offers to the local moto-boys. The first one asked 30,000 kyat (about $25), at which I sggested he needed psychological help, and responded with an offer of 3000, which I figured to be about right, walking away to make my point…

    …which is what you have to be willing to do, of course, if you want the right price. Anyway, I walked over, so I figured I could walk back, so that helps. Another bike-boy came up and did the trip for 2500. It also helps if you know the name of landmarks in the local tongue, correctly pronounced and with the right tones. The main market is zeigyo, pronounced zay-joe not ziggy-o. Don’t f*ck with me, m*otherf*cker…

    So yes, Mandalay is guilty of the same crimes as Paris and the same samsara pitfalls as Kathmandu, but it ain’t all that bad, really. But no, Mandalay is not a place to fall in love with, more like a place to bide your time, a place for life to happen while you make other plans…

    img_1779Those plans could include excursions in any direction, though Shan state to the east is the big lure for me, with close relations to ethnic Tais in Thailand and Laos and China, too, the Far east of the state arguably more ‘Thai’ than Burmese, and an open question for me as to whether and how well I might be able to communicate, what with my knowledge of standard Thai, Laotian and northern Thai dialect…

    The Burmese and Thai language have little or nothing in common, unlike Khmer and Thai, unless you count the similarities between the Thai and Burmese words for two-wheeled conveyances, ‘mo-to-cy’ in Thai and ‘mo-to-by’ in Burmese, apparently deriving from a common Sanskrit root (cue laughter)…

    Oh well, I guess it’ll have to wait, unless my meditation retreat in Yangon falls through, something Burma has become known for, apparently, though not the inspiration for this trip. But that’s where I’ll go after a brief stop at Inle Lake, and that’s worth more to me than all the travel in the world. Mindlessness or mindfulness? Tough choice, yeah, right…

     

     

     

     
    • Esther Fabbricante 3:58 pm on January 20, 2017 Permalink | Reply

      Amazing insight.

  • hardie karges 12:35 am on December 20, 2016 Permalink | Reply
    Tags: , Mae Hong Son, Shan, Tai Yai,   

    Thailand Outback Up North: Covering Bodies and Bases, Filling Bellies and Logic… 

    img_1362

    They say that life doesn’t always work out like you plan—duh. ‘They’ say lots of sh*t, of course, but ‘they’ seem to have nailed this one. So when I came back to Thailand a couple weeks ago for the many-hundredth time, I assumed that I would likely be an ordained Buddhist monk by now, albeit only seasonally, Thai-style, IF I felt ready enough with my meditation practice, and IF I felt confident enough with my ability to memorize the Pali-transcribed-to-Thai initiation ritual, necessary to seal the deal, and not be a failure nor a joke…

    ‘Nor be a joke’, that’s the crucial concept here, in this fantasy Disney-inspired Thai-land heavily colonized by long-term tourists, short-term customers and random retirees in the late innings of life, all of whom as ‘Farangs’ (western foreigners) constitute the punch-line of many a back-handed compliment or verbal slight, whether they know it or not, usually not. So that’s the reason I learned to dance the lingo, damned torpedoes, for better or worse, usually better, till death do us part… (More …)

     
    • davekingsbury 9:58 pm on December 20, 2016 Permalink | Reply

      As always, enlightening … in the sense of … oh, you know what I mean! May I ask if these pieces are destined for your travel book, in some form?

      • hardie karges 11:39 pm on December 20, 2016 Permalink | Reply

        I guess I was sorta’ joking about another travel book, doubt that will happen, at 62 y.o. my travel days are probably limited, except as metaphor and analogy… Zen and the Art of Travel, maybe? 🙂

        • davekingsbury 3:46 pm on December 21, 2016 Permalink

          I’d buy it! Never was interested in motorcycles …

        • hardie karges 1:56 am on December 22, 2016 Permalink

          Ha! I wish I had the numbers to even consider it; more likely a book on Buddhism, in some way, at some point. But I appreciate your support for my humble efforts. Remind me to bring you a copy of ‘Hypertravel, 100 Countries’, etc, next time I’m traveling direct US-UK…

  • hardie karges 4:10 am on December 13, 2016 Permalink | Reply
    Tags: , radio,   

    Radio Free Tucson: KXCI 91.3 FM, “no static at all”… 

    img_1297In this day on Internet everything, radio broadcasts may seem a bit old-fashioned, but Justin Kesha don’t know it yet, then know it now: community radio is the hottest ticket in town for modern indie vibes and world tribes. Kanye see Beyoncé force-fed smoke-and-mirror music that dominates the Big Biz of Entertainment, Inc? Try…

    Where else will you hear live music on the radio? We all know the answer to that question. So I need to give a ‘shout-out’ to KXCI-Tucson for making life livable there, in what sometimes seems like a redneck cow-town with too many cowboys and not enough hippies. But that could change… (More …)

     
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