Thailand Update: Bangkok Hospital Hua Hin Responded—Now I Need a Date

Well, that was fast.

After writing about my plans to potentially spend about 30 days in Hua Hin, Thailand, I emailed the Hua Hin location of Bangkok Hospital to ask what I would need to do to continue my hemodialysis treatments while I'm there.

I expected to wait.

Instead, it took only a few hours for Bangkok Hospital Hua Hin to respond.

They sent me a detailed list of the medical records, dialysis information, and laboratory results they want me to provide before arriving in Thailand.

Suddenly, this little Thailand experiment feels considerably more real.

What Bangkok Hospital Needs From Me

The hospital wants my current hemodialysis prescription, including information such as my dialyzer, dialysate settings, blood-flow and dialysate-flow rates, dry weight, treatment duration and temperature, vascular access and anticoagulant. The prescription needs to be from within three months of my dialysis appointment in Hua Hin.

They also want my recent dialysis information, including any complications I've experienced during treatment, my blood pressure before and after dialysis, and medications administered during or after treatment, such as IV iron or erythropoietin.

Then come the labs.

They require recent testing for HBsAg, hepatitis C antibodies, hepatitis B antibodies, hepatitis B core antibody IgG, and HIV. Most of those results need to be from within six months, while the HIV result can be from within one year.

They noted that if I arrive without the required information, they may need to repeat blood testing before my first dialysis treatment—and there would be an additional charge.

They also want a list of optional information, including my medical history, recent dialysis treatment information, medication list, and additional lab results such as CBC, BUN, creatinine, electrolytes, calcium, phosphorus, and other tests.

It looks like a lot on paper.

Fortunately, I shouldn't have to assemble all of this by myself.

I Talked to My Dialysis Provider

Most Mondays, either my nephrologist or his Physician Assistant checks in with patients at the dialysis center.

Today, I told him what I'm planning.

I think he was a little surprised when I told him where I was thinking about going—and that I was considering staying for about a month.

Thailand wasn't exactly the answer he was expecting.

I showed him the information Bangkok Hospital Hua Hin requested. He told me that my dialysis clinic should be able to obtain most, if not all, of it.

That's a pretty big hurdle potentially taken care of.

And that's exactly why I contacted the hospital before booking a trip. A beachfront condo with an ocean view sounds wonderful, but none of that matters if I can't safely continue dialysis three times a week.

The Pieces Are Coming Together

In a relatively short time, I've gone from thinking about Thailand to working through the logistics.

I've connected with an expat who may be able to help me find a furnished beachfront condo, work through the visa process, arrange transportation from Bangkok to Hua Hin, find temporary accommodations while I get settled, and potentially help arrange a caretaker for Mom.

Now I've heard directly from Bangkok Hospital Hua Hin about what they need for my dialysis.

My dialysis provider believes they can supply the medical information.

So what's the next major item on the Thailand checklist?

I need to pick a date.

That's where I am now.

No plane ticket yet. No condo lease yet. I'm not packing a suitcase tomorrow.

But each question I answer removes another reason this couldn't work.

A few days ago, dialysis in Thailand was one of the biggest unknowns.

Today, I have a list.

And apparently, my dialysis clinic has most of what's on it.

Now I just need to figure out when I'm going to Hua Hin.

The Ankle Report: My Low-Tech Fluid Monitoring System

Lately, I’ve found myself spending more time looking at my ankle.

I mean, why wouldn’t I?

It’s a great-looking ankle.

More importantly, it’s the only one I have left, so it gets 100% of the ankle-related attention around here.

But lately, I’m not admiring it purely for its aesthetic qualities. I’m checking it for edema and fluid retention.

My Built-In Fluid Gauge

As someone living with End-Stage Renal Disease (ESRD) and receiving dialysis, fluid is something I have to pay attention to.

My kidneys still have some function. I still urinate normally, so I don’t retain fluid in exactly the same way as someone whose kidneys have stopped producing urine altogether.

Still, I can retain more fluid than I should.

And one of the easiest places for me to notice it?

My ankle.

Gravity is very dependable. Fluid can settle into the lower part of the body, so I can look at my ankle and get a visual clue that perhaps I've been a little too enthusiastic with the beverages.

Apparently, my ankle has become a medical instrument.

No batteries.

No Bluetooth.

No subscription.

Just look down.

The Other Fluid Gauge: My Residual Limb

My ankle isn't the only place where fluid retention becomes noticeable.

I can also retain fluid in my residual limb, which creates an entirely different problem.

My prosthetic socket doesn't suddenly become more accommodating because I'm retaining extra fluid. If my residual limb changes volume, getting into the prosthetic can become more challenging.

The prosthetic basically says:

“Sorry, we're at capacity.”

So fluid management isn't just something I think about during dialysis. It can affect something as basic as putting on my leg and getting on with my day.

Then Winter Joins the Party

Winter brings another issue.

When the air gets dry, my skin tends to get drier too. Add fluid-related swelling and stretching into the equation, and I've noticed my skin can start cracking more.

So apparently my body has seasonal programming.

Summer: Watch the swelling.

Winter: Watch the swelling AND the cracking.

Excellent.

Learning to Pay Attention

Living with ESRD has taught me that sometimes the useful signs aren't dramatic.

Sometimes it's simply noticing that my ankle looks a little puffier than usual.

Or that my residual limb isn't fitting into my prosthetic quite as easily.

Or that my skin is behaving differently.

None of those observations replaces what my dialysis team measures or tells me. They're simply ways I've learned to pay attention to my own body between treatments.

And since I only have one ankle left, I might as well put it to work.

For now, I'll continue monitoring it.

Part ankle. Part fluid gauge. Still pretty good-looking.

Thailand Is Starting to Feel a Little More Real

For a while, Thailand has been an idea. Lately, that idea has started turning into actual planning.

I've been in contact with an expat in Thailand who can help me work through the logistics of getting to Hua Hin and figure out whether this could realistically work for me—and potentially for my mom as well.

There are a surprising number of moving pieces.

He's offered to help me find a condo in Hua Hin. I've already started looking at what is available, and my wish list isn't exactly small. I want something furnished, preferably three bedrooms, beachfront with an ocean view, and reasonably close to the hospital.

I'm discovering that those places actually exist without necessarily costing what a comparable beachfront condo would cost in the United States.

He can also help me figure out the appropriate Thai visa. That's one of those things where I'd much rather have someone familiar with the process help me than spend hours bouncing around the interwebs trying to figure out what is current and what was accurate three years ago.

Then there are the immediate arrival logistics.

He can arrange transportation from Bangkok airport to Hua Hin, which matters because I'd prefer not to land after a very long flight and start negotiating transportation in a country I've never visited.

He can also help arrange a temporary place for me to stay while I get situated and look at condos in person.

That makes a lot of sense to me. Pictures on the internet are wonderful, but I'd rather walk into a condo, look out the window and confirm that "ocean view" actually means I can see the ocean—not that if I lean over a balcony, look between two buildings and squint really hard, there's a tiny patch of blue in the distance.

There's also Mom.

We've discussed the possibility of eventually having her in Thailand, and this expat may be able to help arrange a caretaker. That would require more research and planning, but knowing resources are available makes the idea less overwhelming.

He even mentioned helping me get a Thai driver's license.

I'll pass.

I don't have an urge to drive in Thailand. I think I'll be perfectly happy using ride-share services, taxis, and other transportation. Somebody else can navigate the traffic while I sit in the passenger seat and look out the window.

Then There's the Big One: Dialysis

Everything else is secondary if I can't work out dialysis.

Today, I emailed Bangkok Hospital Hua Hin to ask what I'd need to receive hemodialysis there during an approximately 30-day visit to Thailand.

For me, this isn't optional travel planning. I need hemodialysis three times a week, so before I start getting too excited about beachfront condos and ocean views, I need to know that my medical care can continue safely and reliably while I'm there.

I want to know what records they need from my dialysis provider in the United States, how far in advance treatment must be arranged, scheduling, costs, payment requirements, and anything else an international dialysis patient needs to do before arriving.

Now I wait for their response.

If Bangkok Hospital Hua Hin can accommodate me for a month, that's a pretty significant piece of the puzzle.

Maybe 30 Days Is the Right Test

I'm not talking about getting on an airplane tomorrow and permanently moving to Thailand.

A roughly 30-day stay would give me a chance to experience Hua Hin as more than a vacation destination.

Can I comfortably get around without driving?

Can I find a condo I'd actually want to live in?

How easy is it to get groceries, go out to eat, and handle normal daily life?

Most importantly, what is it like going through my normal dialysis routine in Thailand?

Those are questions that YouTube videos, Facebook groups, blogs, and beautiful real-estate photos can't completely answer.

I need to experience it.

For now, many questions remain unanswered. But there are also fewer unanswered questions than there were a few weeks ago.

I've found someone on the ground who can potentially help with housing, visas, transportation, temporary accommodations, and care for Mom.

I've contacted the hospital about dialysis.

I've started looking at beachfront condos.

And apparently, someone is even willing to help me get a driver's license that I have absolutely no intention of getting.

One piece at a time.

Thirty days in Hua Hin might tell me whether Thailand is simply a place I'd enjoy visiting—or somewhere I could actually see myself spending a significant part of my life.

Wait… Coke Zero Is Health Food Now?

I recently came across a Facebook video with what might be the best medical advice I’ve ever heard.

Watch the Facebook video here

The video says one way to help with constipation from GLP-1 medications is to drink Coke Zero, and the nutritionist attributes the effect to phosphorus.

My immediate reaction:

FANTASTIC!

Finally, something I’ve been training for my entire life.

Coke Zero is already one of my staple foods. I take Ozempic, and constipation can be one of the side effects.

So when somebody tells me my Coke Zero habit might actually have a purpose, naturally I'm thinking:

Doctor, should I increase my prescription from Large to Extra Large?

And somewhere at Coca-Cola headquarters, an executive just felt a disturbance in the Force.

There Is One Tiny Problem…

I couldn't independently verify the video's claim that the phosphorus in Coke Zero is an established treatment for GLP-1 constipation.

So, sadly, I'm not declaring Coke Zero a medication.

I'm merely saying that if future scientific research concludes that it is...

I was an early adopter.

And yes, before anyone reminds me about phosphorus and kidney disease—thank you for the reminder.

With my kidney situation, I already have to pay attention to phosphorus. I use a phosphate binder to hopefully help keep my phosphorus levels in line.

So this is definitely not me recommending that anyone start pounding Coke Zero as a medical treatment.

This is me discovering a video that seemingly gave my existing Coke Zero habit a scientific-sounding excuse and thinking:

FINALLY. MY MOMENT HAS ARRIVED.

Until then, I'll continue enjoying Coke Zero for the same reason I always have:

I just really like Coke Zero.

And if my consumption happens to help The Coca-Cola Company stock along the way?

You're welcome, shareholders.

I'm doing my part. One bottle at a time. 😂🥤

Recovery Update: The Scabs Are Leaving, the Scar Is Staying

Healing apparently has stages.

First, everything looks terrible.

Then it somehow looks even worse.

Then one day I look at it and realize, “Wait… that actually looks a lot better.”

That’s where I seem to be today.

👁️ The Eye: Boring Is Still Beautiful

My eye continues to look better. There’s still some redness, but compared with where this adventure started after the silicone oil removal, I'll take it.

More importantly, the visual effects are still gone.

No dot. No bubble. No floaters. No horizon. No eclipse.

I never thought I’d be this excited about seeing absolutely nothing unusual.

I'm continuing the drops and watching the eye, but boredom remains my favorite development.

💪 The Scraped Arm: Crust City Is Being Demolished

Now for the arm.

Look at the difference.

Most of that giant, nasty scab that has been starring in these updates is finally gone. What’s underneath is pink, fresh-looking skin with one stubborn darker area hanging around.

And I think we can officially call this one:

I'm going to have a scar.

Considering what this thing looked like immediately after the fall—and then during its glorious Crust City phase—a scar seems like a pretty reasonable souvenir.

I suppose I could make up an impressive story about how I got it.

Shark attack?

Bar fight in Singapore?

Saving a family from a burning building?

Nope.

I fell.

Sometimes reality just doesn't cooperate with the legend.

🩸 The Fistula Arm: Where Did the Stitch Go?

Meanwhile, the fistulagram site keeps healing, too.

The dissolvable stitch appears to be doing exactly what the name advertised. The area is still visible and there’s some discoloration, but it looks considerably less dramatic.

Still waiting on that Hello Kitty Band-Aid upgrade. 🎀

I haven't forgotten.

Three Different Parts. Same Direction.

So today's recovery report is considerably less disgusting than some of the previous editions:

Eye: less red, no dots or floaters.
Scraped arm: most of the scab is gone, new skin is showing—and yes, there will be a scar.
Fistula arm: healing nicely after fistulagram #4.

The scar on my arm will probably stick around long after I've stopped writing these daily updates.

That's okay.

Scars are just receipts proving my body paid the bill and kept going.

And this particular receipt comes with a very simple description:

Fell down. Got back up.