I'm booked into Bangkok International Samui...
I first started considering this and doing my online reading about six months ago, and after sending photos to the surgeon in Thailand (I'm based in Sydney, Australia), we/he/I decided on a breast lift with no implants and no reduction. I'm pretty happy with the actual size of my boobs, just wildly unhappy with their droopiness. This has come about because of weight gain/loss/gain/loss over the years as well as time/gravity - I turn forty in two weeks time and this is my birthday present to myself. I'm single, and I feel that my boobs have been causing me to feel embarrassed to start anything with a new partner - I had a brief liaison just before Christmas last year and, honestly, I felt so shy about getting naked in front of another human being that I thought, hell, if **I** don't find myself sexy, how can expect anyone else to find me sexy?! And so I decided to do something about it. And now it's tomorrow. Eeeek, but also aaaaah. Pics to follow!
The day after
The surgeon, who looks like tintin and is much gigglier than you would expect from a medical professional, also touched my tummy roll and said 'this too must do', smiling. I said 'next time', also smiling. It was a friendly little exchange, not critical.
Then an orderly arrived and I was wheeled out to the OT - amazing and weird to be conscious in there while they were setting up. Anaesthesiologist - lovely pregnant woman in purple scrubs - explained about antibiotics and pain meds after. Then I was standing, robe off, while an older lady nurse fashioned a sarong for me, low on my hips and attached with masking tape. Then, lying on the gurney, arms strapped down, and they started putting anaesthetic thru the drip hole in my hand, so so painful - so they gave up and gave me gas in a mask. And I was out.
Woozy waking up. All a bit of a blur. No idea where I was. Not in the OT but somewhere else. Woozy. Then wheeled to my room - very nice, right down to the towel shaped like a swan, as if this is a fancy hotel. I have a private room, air con that gets a bit over enthusiastic and cold, and I keep asking them to make it a bit warmer (ironic, in such a warm island - but they set it to cold). I have my own bathroom, a tv on the wall, tons of natural light (a whole wall is windows), and a bed that reclines or sits with a button. I also have a call-for-help button, and a sofa, side lamp, little table etc - it is a luxurious setup indeed.
I feel basically ok. I threw up a bit earlier. The tip of my tongue is numb. I can lie on either side or my back. I'm a bit queasy but not too bad, considering. Contrary to what I'd thought/been told, I can lift my arms about my head and my mobility is mainly limited by my IV drip and wooziness rather than any real pain. I guess I'm on some pretty strong pain meds, as well as antibiotics as a precaution in case of infection.
My boobs feel very tightly packed. Like they're compression wrapped. I have no idea what they look like in there as I'm swaddled in bandages.
Nice conversation with night nurse. - I asked if she always works nights, no sometimes days. She asked - how many times you peepee? Two. Poopoo? Zero. Hilarious combo of medical professional and cutesy thai girl - one of the other nurses has a winnie the pooh pen around her neck. Then she said - you no pain? Hmm, a little bit. She said: like you no pain, no fever, you fine. Very good, very strong girl. Nice. In Western medical systems, being a bit overweight is always scorned; here, it seems to be a sign of being a bit stronger. Quite a breath of fresh air, really.
Two bits I forgot
Friendly, caring nursing staff
Day 2 after the op
I had a shower today - careful not to get my boobs or bandages wet. This meant using the shower head for everything south of there and a washcloth for everything north. Easy. I'm much, much more mobile than I had expected,and in much less pain. The tip of my tongue is numb from the breathing tube during the op, I'm tight across the chest as you'd expect, and (perhaps less predictably) my back and shoulders really hurt when I get up or lie down. But I'm perfectly able to raise my arms, lie on either side or on my back, and lift things (though obviously I'm not doing much of any of those things, but the thing is - I can). I'm on Tylenol for pain, nothing stronger, and I'm not in agony - this is the most surprising thing.
I haven't had a poo since the op but don't feel especially constipated. Weird. Three days now. It's like my body is in shock. I'm not very hungry and I haven't eaten all that much. And although I've been making an effort to drink plenty of water, I'm probably not drinking as much as I could/should be.
And, so, yes. I'm getting out of the hospital today after they've changed the dressings again, and will be taking a cab to the little guesthouse I'm booked into. I stayed there one night before the op, so I know what it's going to be like there, which is one less thing to worry about. It is a lovely little privately run series of small bungalows in a tropical garden, and as there's no pool or whatever (because I can't use one anyway), there's no noisy party/family groups there. It's a small oasis.
The hotel is just a ten minute cab ride from the hospital which is good as I have to come back every day for four or five days after being discharged to have the dressing changed and everything checked again. I'd though I would have to organise cabs but the hospital said yesterday they would organise transport for me. Either way, it should be pretty easy.
The "before" pictures
I lost and gained and lost weight pretty much all my adult life,and these droopy boobs were the result. It's strange to see these pics, now, and know that they are no longer with me. They are no longer the cause of the shame that I felt when getting naked with someone for the first time. It's funny - overweight bodies are one thing - there's a certain source of pride and fierceness there if you look hard enough - but droopy boobs are never going to get their own 'movement' saying they are beautiful. But here they are, as they were. Adieu, droopy boobies!
Droopy boobs, with markup ink
Out of hospital!
I'm in much less pain that I'd prepared for, and I'm much more mobile than I'd thought, although I'm forcing myself to take it easy (when really, all I want isvto go out and explore, have a pedicure, get my hair cut etc - soon, I will do...)
The marketing lady at the Bangkok Samui Hospital has been great - she speaks good English, has explained everything, and apologies every time I see her about the mixup over my appointment date. All good, really - these guys are impressive. They're not the cheapest hospital in Thailand, not by far, but they're about 1/3 of the Sydney cost. Worth it, I think. And although the hospitals in Phuket and Bangkok handle a lot more cosmetic surgery, these guys do enough of it to give me confidence in them. I feel good, generally. More updates to follow...
Two steps forward, one step back
The surgeon cut one of the stitches on the right vertical incision to see if there was a fluid buildup issue ... And suddenly there was something of a small geyser happening - it didn't hurt, but I could feel a lot of fluid running down my side. Damn. So he's had to put in a drain (a rubbery plastic tube that prevents the incision from healing but which allows the excess liquid to drain out). This delays healing, as it all has to come out again before the area can be re-closed and can start to heal again. Depending how long this takes, it may be that I'll have to get the stitches removed back home in Australia, although that's still ten days away so lets see how it all goes between now and then. Until yesterday I was the teacher's pet for fast, pain-free healing, so maybe I can make another minor medical miracle happen? We shall see. In the 16 hours since going to the hospital this morning, righty has managed to seep through a centimetre or so thickness of gauze, making a stain about 8cm across - that has to been good drainage, right?
But its a bummer if i have to involve medical folks in Australia (who don't know what I'm doing here for complicated, boring reasons to do with insurance for a different medical issue entirely). I really had wanted to just deal with everything here and arrive home 'fixed', but I guess it's not a simple mechanical procedure and unexpected things can happen.
In other news: I have a sore throat and a cough and I feel quite rundown - I guess this is a combination of, firstly, time off work after a hectic six months and finally having a bit of downtime in which to let myself have a rest, and, secondly, the after-effects of major surgery. So I'm trying to lie low but there are only so many trashy movies a woman can watch in a day and only so many Kindle books I can focus on. Luckily, a friend (who knows what's going on) gets here tomorrow and is aware that I'll be needing cups of tea and lazy hanging-out times. I hope he's good with that (think he is). I've also been skyping a bunch of other friends quite a lot, though the sore throat things does limit the amount of nattering I can do. But when my buddy is here I'm hoping we can hang out, watch some movies or whatever together, and time will pass more quickly.
One silver lining in all this talk of drains, though - they tested the liquid that came out and it's not infected. This is something to hold onto. This could easily be different and worse.
But, in general, I'm a bit bored and restless now and a bit antsy to get this recovery happening PDQ and get my new fabulously-boobied life a-happening! Patience, dear Panda, you need patience :-)
Friday and the sun is shining :-)
Anyway, the stuff drained out really well from righty, the doc said, and both incisions are now looking much better. And so the drain can come out tomorrow, assuming everything is still as is. This is great news.
One small issue that has come up is that at some point, during the removal of surgical tape, a small new abrasion has appeared, just a shallow skin graze from pulling off the tape but it bleeds off and on and so the dressing for it to be covered as well extends up above most of my shirts. Previously, I'd been able to hide all the white surgical gauze under clothes and now I have a little telltale flag of "check this out" going on. I mean, I'm not here for fashion, obviously, but it was better when I could hide everything within a bra and then a top. It's as if my breast operation is saying, 'ahem, not enough attention down here!'
Still no news on when the stitches can come out, and there's still the possibility of me taking them home to Australia with me. But as newname reassures me below (thanku, sweetie!) this is not the end of the world that it felt like yesterday. It's interesting, both the physical healing but also the mental/emotional 'journey' that this process is involving. I'm enjoying watching it all unfold.
Still nothing like any of the pain I was promised - I think I've been let off really gently. The sorest thing is when I cough, which I do a little as its hot and humid and then I stupidly drink something cold and then: hack hack hack. No more cold drinks. On the way back from the hospital today I went to the pharmacist and got a cough remedy made, it seems, of eucalyptus and honey, which promises to help (the doc suggested this and wrote down the name for me; I was cautious as I didn't want anything to interfere with the veritable cabinet of other meds I'm taking post surgery). But apart from the pain induced at the injury site when I cough, there's really not so much at all. Certainly, as I sit here (on my little terrace, in a tropical garden - really, life is pretty tough...) I feel no pain at all. A bit of discomfort at the swelling and the tightness of the support bra, so I can certainly say I feel my boobs and their presence (and very high and wonderful they are too - even at this stage, they are so, so much better than the droopy balloons I had to scoop up and hide before), but there really isn't any pain to speak of. This may, of course, be because of the meds.
Meds-wise, for people that are interested in such things, I'm taking:
Mobic meloxicam 7,5mg, 2x/day - anti inflammatory
Reparil aescin 20mg, 3x/day - oedema-mobilising (whatever this actually is)
Tylenol (paracetamol), 500mg, 4x/day (actually, now I read this in detail on the label it says to take two tablets, i.e. 1000mg, but I've just been taking 500 and seems fine) - for pain/fever, neither of which I really have.
Dicloxacillin 500mg, 4x/day, antibiotic, to reduce/reduce risk of infection.
Lorazepam 1mg, 1x/day - sleeping pill, heavenly :-)
This is more medication in one hit than I have taken in the last ten years straight, so this world of meds is a new one for me (and Australia is not a place in which meds are advertised directly to consumers, unlike the US, so I'm not all that meds-literate, but I'm learning as I go along, reading online about it all and so on. It's quite interesting). The only med I take normally is 50mg/day of Zoloft, to manage anxiety, and if this is your case too you'll be pleased to know that none of this stuff above interferes with Zoloft, and vice versa- I'd been concerned about this before surgery.
Ummm, yes. That may be all for today. In other news: a friend form home is arriving today and I can't wait to hang out with him and shoot the breeze, be normal for a while rather than think/talk about boobs all the time. I had my first post-surgery glass of wine last night (red, French, with the owners of the guesthouse - it was divine). I get that I'm not supposed to be drinking booze, but one glass of red is medicinal in both body (antioxidants) and spirit (I chilled the fuck out a little, and it was great).
Fingers crossed to the drain being removed tomorrow, the whole messy shebang healing quickly and continuing to be pain free, and the stitches doing their magic and staying in Thailand rather than coming to Australia with me in eight days' time. Is this too much to ask for y 40th birthday, which is on the 18th??! ;-)
One week post surgery
Things are healing, but slowly. The drain is out of righty, now, but there a bit of pus and general yuck that is preventing either new stitches (where the drain was) or fast healing (in general). I'm still popping the meds but, as of today, I'll be down to painkillers as necessary (paracetamol) and the antibiotics only. I still have a week to go in Thailand but it does most likely look like I'll be bringing stitches back to Australia with me. Oh we'll. worse things happen.
I'm a bit more active than last week but forcing myself to take it easy. A friend from home joined me here -wonderful- and yesterday we zoomed around on a moped, me clinging to his back like a baby koala. The fact that my sore boobies even allow for this is a minor miracle, really. We've also been out having dinners, hanging out yapping about this and that - and although it is wonderful, really, it is also ugh more tiring that I had anticipated. I guess I'm still quite weak, post-operatively. Despite what I try to convince myself. So yesterday afternoon I had a great, three hour nap and felt better, and last night, late, when my friend came into my room as asked if I wanted to go see Muay Thai boxing, I declined. And then I had an earlyish night, after writing a looooong email to a guy in Sydney with whom I think there may be something starting romantically and who I like a lot (but its early days and I hardly know him; our emails are beautiful and heartfelt, though). So in general, I need to keep taking it easy - reading and naps and drinking Fanta rather than beer (so. Annoying!) and letting myself have some time and headspace to get better.
The Sydney guy doesn't know what I'm doing here, as its not really first date material for conversation. I'll tell him when I see him, of course. It's not an easy thing to present in the right way, though, as it involves a lot of other sharing around weight, body, self confidence, etc. But OK, I'll figure it out.
The context: Koh Samui, Thailand
The restorative power of sleep :-)
Looking back again at the photos from this morning I'm slightly concerned with righty, and the hole left because of the drain site. I spoke to the surgeon about it this morning and he said it was 'not bad' (as opposed to good, but also as opposed to bad, I guess - glass neither half full nor half empty, just the wrong size of glass). He said that, soon, he will put in another stitch or two (under local anaesthetic) to ensure it heals properly closed, but that it wasn't a good idea to do this while there was still pus and fluid coming out of it as this would simply seal all the mess inside and cause more problems down the line. Faultless logic. I wish I had longer to spend here, so to be certain of resolving everything before going home. But ok, if the worst comes to the worst, I'll go and see a doctor in Sydney and get the rest of the healing done there. Either way, I will be fine, I'm sure - i feel that I am in good hands. And I still love the shape, size, elevation, and roundness of my "mad cans", as my great friend Sam called them, having seen a photo the other day.
On the thing of sleeping a lot, and generally taking it easy - I kind of get it now. I know that's what I've been told and have been saying, at least in theory, all along. But I now realise I had still been trying to do too much and it was taking its toll. For instance, I'd been told 'no booze' and one night had a glass of wine and then the next night had two beers and then the night after had one beer. Ahem, Panda! This is not 'no booze', this is 'fuck with your antibiotics and wonder why you don't heal as quickly as you would like to'. And so I am in a much better headspace now - I need sleep, lots of it; I need rest, lots of it; I need protein and good, healthy veggies (OK, this part I have been doing all along, and plenty of water too). And when they say 'no booze' they don't mean 'just a couple of drinks'. They mean: no booze. And faffing around on the backs of mopeds and the like - probably not such a good idea either. I'm kind of torn between not wanting my friend to have a boring time and wanting to spend time with him doing the stuff he wants to do ... And resting and healing and taking it easy. Today, after a sleep and a bit of soul searching, I resolve to look after me and what I need, and to spend the time with my buddy (who totally gets it, and it more than understanding and, in fact, keeps telling me to take it easy) - the time I spend with him will be low key. And,with all of that in mind, here's to a sane, safe, speedy recovery - I raise a glass of lychee juice ;-)
Two steps forward, one step back - some complications
So I went in to the hospital this morning, as per, to get the dressings changed but also to ask the doctor what is going on. And the truth is - all is not going as well as it might and he doesn't really know what is going on. This is not to say that I am dying, or that my boobs are, or any other melodrama, just that I'm slower to heal than I should be, there is a bit of unexpected 'activity' (he is not using the word infection yet) around my stitches on the vertical incisions, and, in short, I will not be healed enough to go back to Australian next weekend. I know he has been quizzing the other doctors about it too. I have confidence in him, but I also just want to get everything sorted out and moving along. The stitches around my actual nipples are healing beautifully, it's just the vertical (sweatier, hotter, tropical and more humid, maybe??) incisions that are the problem. He says that, depending on how things are looking tomorrow, we will try some kind of locally applied cream.
So. He gave me a medical certificate explaining that there have been post-operative complications and I've just spent an expensive, stressful couple of hours changing flights on two airlines ($130 and $250 fee/ fare difference, respectively; total extra cost $380 - not too bad, but annoying), writing an email to my boss including the medical certificate and explaining the situation (when I really, really had not wanted to tell anyone at work - of course, I have said 'in confidence' to her, but the medical certificate specifies 'mastopexy' and I'm certain she will google it - wouldn't you?), emailing the cat hotel where my kitty is in hock in Sydney to extend his stay for a week (at another hundred and fifty dollars' cost or so), and checking that its cool to stay on here in my lovely bungalow which, thankfully, it is (though obviously there's a bit more cost involved there too). From memory, the small print on my travel insurance excludes trips whose express purpose is medical tourism - as you would expect - but I'll double check and see if it might be possible to recover some of these expenses from them. I'm not holding my breath. Luckily, we're almost at tax return time in Australia and I should be due a refund, although I'd kind of earmarked it for other stuff (paying off the feckin credit card bill from the hospital, for instance), its good to now that the wolf is not actually at the door yet*). But, gah, this is annoying, and I'm most stressed about my boss knowing about it, and perhaps making the assumptions that many women make about "cosmetic" surgery, and the fast that my job is not really one in which time off is all that easy (teaching, admin, and research - I'm an academic, so time "off" doesn't exist, as such). Hmmmm.
Is it that Thailand is too hot for successful, speedy recovery? Should I be spending up big on aircon (but I hate aircon, and ended up turning it off in both the hospital and the hotel in Singapore during my brief stopover there, because it is cold, noisy, yucky recycled air). Should I be lying yet lower than I already am, when I am now practically immobile? I don't know. The good thing is that today is crazy windy, which means both that my buddy has gone kite surfing (so I'm not worried he is bored) and also there is a wonderful, natural through-breeze, as well as the fan above my bed, and I'm not hot, sticky and sweaty. If anything, I'm a little chilly, and it's lovely.
So yes. That's today's news. I have booked another week onto my flights and that's the absolute maximum time I can spend here, as semester starts the week after and I have a couple of big lecture classes I'm teaching. Fingers very crossed for a full, speedy recovery from now on. I wish there was something I could do to make that happen, but I feel very powerless (apart from maybe nipping down to the buddhist temple and lighting some incense...!)
*actually, there kind of IS a 'wolf' at my door. One of the loveliest things about the guesthouse is its resident pets, a couple of dogs and cats. One of the dogs, called Wolfie, seems to live on my terrace; I'm just borrowing the space from him - he's often crashed out on my top step or outside my door. He's a gentle soul who sits and waits with me every morning, having a gentle little lean against my legs, for the hospital car to come and pick me up. Post-surgery, it is nice to have a bit of animal company as well as human. Surgery is such an alien world for me, that I'm finding it helps to be reminded of 'real' life as much as possible; Wolfie and his chums are part of that.
Lollipop incision versus inverted T
Suture abcesses and new stitches today
So there are a couple of things to note here. The first is that I'm glad I'm doing only this operation and did not go for any other, more major, procedures (tummy tuck or inverted T breast lift or whatever). The second is that I think I made the right decision to change my flight by a week and stay on in Samui to try to get this all sorted out here if I possibly can. And I'm glad that the message has finally got thru: I'm lying really low, sleeping a lot and generally doing everything I can to get well (this kind of sucks as I thought I'd be on holiday more than I can actually be, but there we are; getting well is what matters now). My body has a fight on its hands and I really don't want to tax it with too much other activity; exhaustion is not the goal here.
As for the breasts. The surgeon said that if the internal sutures are getting spat out and the wound is reopening there is a good chance that the results will not be as good as the might have been - there will be a bit more sagging than if all the internal architecture was properly in place. However, rather than let that become too much of a problem, the work-around now is to make sure that at least the external strength of the breast is there, i.e. the skin, by ensuring that the incision on the surface at least closes properly. (I'm not sure whether this means there will still be abcess mess happening in the meantime, thru the new stitches, but looking at the outside of the gauzes 8 hours after the hospital this morning, it seems there's still a lot of toys being thrown out of the pram down there).
So, with all of this in mind, the surgeon set things up today with lights and green cloths and masks and gloves, gave me local anaesthetics into each breast, and re-stitched both vertical incisions with much stronger and much more obvious dark blue suture. I'm OK about more obvious scarring if it means 1. healing and 2. better shape overall. This suture, he says, is stronger and will hold the whole construction together with more integrity than the existing external skin sutures (which relied on support from the internal Vicryl, which has been compromised). And so my vertical incisions now look like there is a single file line of dark blue mosquitoes standing on them, but OK, one does not apply sutures for how they look. Here's hoping this all works, that the abcesses get done with their spewing soon, and that the whole thing needs up healing together properly thanks to the new stitches.
I'm feeling a mixture of disappointment and resignation at the moment, with an underlying sense of excitement and optimism that, surely, everything will be all right in the end, this is just a slightly more convoluted process than I had expected. Knowing everything I know now, I would still opt to do it. I don't think this is a Thailand thing or a this-surgeon thing; this simply seems to be something that can happen, and has happened, in this case. There an article about suture abcesses here that makes the issue sound fairly common: http://www.realself.com/question/allergy-vicryl-sutures-tummy-tuck So I'm still not overly worried - I'm lying low, have stopped drinking booze entirely, I'm enjoying the presence of my friend from home until this coming Saturday, and I'm watching a lot of trashy movies on my iPad. I'm in beautiful surroundings, I'm not spending too much $$$ here because although Samui is expensive for Thailand it is still much cheaper than Australia just to buy everyday necessities like food (and the food is amazing, also!) And although I'm fretting slightly at the sheer amount of work-related stuff I'll have to catch up on when I get home (research/writing, mainly), I'm also aware that I'm powerless to do anything while I'm here - I thought I was coming on holiday for two weeks, knew I needed a total break, and didn't bring anything work-related with me. So I'm trying to just enjoy the enforced rest which, ultimately, will probably make my research and writing all the better, as I'll be returning to it refreshed. (But I'm ENTJ, and I find that 'relaxing' is just not always that relaxing!)
Anyway, I think things are looking up as of today because I feel we're now doing something about the small volcanoes erupting on my chest, rather than just watching them and wondering, as before.
Another useful article about this issue - 'spitting stitches'
This article compares the issue of the body rejecting stitches to having a splinter - you cannot get on with healing until they're gone. OK, so perhaps the blue stitches today were premature (though it does feel better to have done something rather than nothing), if it means the spitting out process cannot now happen properly - I don't know. But I trust the surgeon, Dr Charlemkit, to know what to do. He does seem very capable.
Exchange rates :-(
Ah ha! Progress at last :-)
After the appointment this morning, I went with the very lovely Pete (a woman, whose nickname is Pete - it took me a while to get used to calling her this!) to get my hair 'rebonded', i.e. the Japanese-origin permanent straightening process that I've been doing every five or six months now for ten years (my hair is a bit dry but not too bad). My hair is naturally hideously frizzy, and it gets worse in humid places; rebonding was the best damn thing I've even discovered, to the point where I would not, now, consider living in a city without a decent Chinatown as I know I'll be doing it for the rest of my life - it is wonderful. I first got it done in Shanghai when I was living there in 2003 and since then have done it every six months at least either in Australia (expensive) or whenever passing thru HK or wherever. In Asia it's a bit cheaper, though not necessarily better or worse; the quality depends on the materials they use, with a roughly descending order in quality from Japanese to Korean to Chinese stuff, and the time they take to iron the hair out in between relaxing it and putting on the straightening solution. Here on Samui, at the hairdresser that Pete recommended, it seems to have been excellent, although you can never tell for sure until you wash it, which cannot be within three days of having it done. Given that, because of having to keep my boobs and dressings dry, I've had trouble washing my hair in the shower anyway, this is no great hardship. In fact, I've had my hair cut (about a week ago) and now straightened (today) in part because both involve someone else washing my hair, which is just so much easier than faffing about in the shower with plastic bags over my bra!
So yeah. Things are looking up today - boobs are finally healing, hair is straight and amazing, and I turn 40 tomorrow. And now it is time for lunch :-)
How to sleep with new boobs!
12 days post
Anyway. Onto brighter things. My two regular and favourite nurses at the hospital are Gop (real name Prontip) and Amy (real name Penpak)*. They are sweet and very smiley and lovely - big, nice fuss today over my birthday, and lots of friendly smalltalk (in limited but mostly functional English) about their families, what they do on their days off, and so on. I'm being really well looked after here, both in the post-surgical sense but also in the sense of feeling like they care. Plus, of course, Pete (real name Utawan*), who is the international marketing person for the hospital and who liaises with international patients, has been more than amazing, helping me out with all manner of things as well as being there at pretty much every follow up appointment.
So. Nine days to go here until I fly out of Samui but, as I keep reminding myself, it is still only 12 days since the operation itself, so there is still almost half the recovery time left here in Thailand in which (come on body!!) I would like to do some proper healing, please. I've changed my return flight by a week but really can't take any more time as I have to be back to teach and to get caught up with a bunch of writing and other work stuff, but also it just gets too expensive to be away for so long (hotels, flight changing, cat hotel, and the likes). So, hmmmm, it does look at this stage like I'll be taking at least some of the stitches, infection, and gooey mess back to Australia with me (though nine days is a long time in post-op recovery, so this could still all change), but OK, it is what it is, I guess. Annoying, but cannot be helped.
Now, a confession - to make myself feel better, I read a bunch of real horror stories online last night about plastic surgery post-op complications, botch jobs, disaster nose jobs gone wrong, etc. It was a bit schadenfreude of me to do this, and I'm not for one second making light of anyone else's experiences, but strangely it helped me put things into perspective. In the grand scheme of things, what is happening to me is very minor; all I have is a bit of yucky infection and my incision is not healing as well or as quickly it might. There will be a lot of scarring. And this whole experience is/has been quite exhausting. But I am perfectly fine in both emotional and physical health, and my boobs are by no means a disaster, not at ALL. So, yes, Panda. Perspective required.
* Penpak's nickname is Amy. Everyone at the hospital (and in Thailand more generally? I don't know) seems to have a nickname that is quite different from their real name, and everyone knows each other's nicknames rather than real names - it's nice.
Today, though, the doctor was busy with an emergency when I got to the hospital, which gave me a nice chance to take some dressings-off pictures of me standing up in between the nurses taking off the dressings and the doctor coming in to have a look. When he arrived (and the nurses also said this), he made good, positive sounds - better, better. Some progress. This is good. But, oh, still very slow. I'm feeling impatient now although I don't think there's really anything more anyone, including me, could or should be doing to heal any faster. I think, now, it is a waiting game.
But! This was the first time I'd really had a chance to look at my boobs while standing up and without dressings in place since the operation. Looking at these pictures, it would be very easy to take a perfectionist position and be hyper critical: are the nipples too high? Isn't there still quite a bit of sagging going on around the crease? What about that prominent 'tuck' in the stitching on one of them? And aren't they a little uneven at the cleavage? Plus, of course, there is going to be a lot of scarring, and there is still a lot of post-surgical carnage going on right now. All of this is easy to say and yet I'm not saying it. Even with all the post-op complications, even with all these possible criticisms (and remember, it is not even two weeks post, yet - there will be a lot of change, still, from here on in, for both good and bad), and even with the hyper-critical gaze towards female bodies that we are so used to ... I am not saying any of this. Instead, I am thinking: it is all, already, way, way, way better than it was. Compared to the hanging sacks of sadness that were there before, these pert, round, confident boobies are a breath of fresh air. I can imagine running with these new boobs without having to stop constantly and tuck everything back into layer upon layer of support garments for simple comfort of movement. I no longer fear getting naked in front of someone new (in fact, I have been naked in front of strangers more this past two weeks than ever before, although I don't think medical professionals really count in this respect, hahaha). I am walking differently: head up, shoulders back, boobs forward - already I feel different; more confident. In clothes, they look great already. Out of clothes, there is still a lot of healing to do but they are always going to look better thn they did before. And so, with that, today is a good day. Still slow healing progress but positive things are happening and many of those things are happening in my mind.
Amazing wound-cleaning job by nurse Suda
My two favourite nurses, Gop and Amy, were both away today, as was Pete and Dr Chalermkit, so it was just me and a nurse I hadn't met before called Suda. And she did an amazing job of picking away with tweezers at a million tiny bits of yuckiness, including the blackish scabs that were now ready to come off arund the areolas and a lot of the yellow pus that had hardened into a kind of plug in a couple of spots. She also managed to extract four more rejected Vicryl sutures, which must be good for healing as it is them causing the allergic reaction. Then she spent at least half an hour cleaning everything out with syringes (no needle, just the tube and nozzle) of betadine and saline, and generally making the whole sorry mess look much, much more presentable. And, to entertain me during this whole hour-long process, she gave me a pink Mickey Mouse mirror with which to watch everything she was doing - so cool! By the end, everything looked pink and clean rather than yellow/black and scary. Obviously, it's not that presentation is exactly a criterion I'm going for yet, but all of a sudden I believe that healing is something that can and will happen here, and this is such, such a relief. I fly out of Thailand one week from today and I'm really, really hoping to have some proper healing going on by then on the vertical as well as the circular incisions. Fingers very crossed.
In other news, I'm thinking now about how and whether to talk about of of this, and with whom, when I get home. My close friends know and some of them follow this thread, but people in my outer circle - work colleagues/friends and the like - they know nothing about any of this and think I'm just having a tropical Thai time of it all for my 40th. However, as I've had to change my return flight date, the colleagues who are handling my workload while I'm away will doubtless ask why I changed the flight date. To a certain extent this can be handled by getting online next week and dealing with all my work emails, so that they don't even necessarily notice I'm not physically back as I'll be cyber-back; Monday morning I will do so. But I don't want to tell them anything and, knowing myself, I do tend to overshare my own intimate details with people. I think I do this in order to create -or perhaps to force- an easy and too-quick intimacy. I've moved around a lot in my life and this is a habit borne of having to make friends quickly in each new place; spilling one's own secrets and details is a shortcut to becoming friends with someone, even though it then makes you unnecesarily vulnerable later if they turn out to be psychos. My work colleagues are not psychos (well, one woman totally is, but the majority are lovely), but I'm in a good, professional job and I really don't want tongues to go a-wagging, as they doubtless would. I'd rather my colleagues thought of me mainly as professional and capable rather than mainly as a bubble-headed idiot who went and got cosmetic surgery. Of course, *I* know that this is more a confidence-restoring, reconstructive, exercise-enabling boob job than any desire to look like Pamela Anderson, but that's not necessarily how others may see it.
On that: cosmetic surgery (and maybe boob jobs in particular) really is still very stigmatised, especially in intellectual, hyper-educated, hipster, feministy-type circles like the world I inhabit. Cosmetic surgery, still, is seen as something that ditzy, blonde wannabe Hollywood types do. Now, I've made peace with why I'm doing this and although one well-meaning friend tried to convince me not to, the vast majority of the good friends I've told have been super-supportive and totally on my side. The doubting friend (who has worked in healthcare, and has doubtless seen her share of post surgical complications, which may explain her position) said the problem was more in my head, that she didn't "like the psychology of what I was doing", and that any surgery was too risky for a 'cosmetic' procedure. To be honest, since then, I've really been feeling a gulf between us; that she said this at all tells me she is not really hearing me or acknowledging the emotional and psychological anguish involved in having the droopy non-breasts I had until two weeks ago. But ok. Most people have been either neutral or positive and, honestly, it doesn't matter one little bit, really, what anyone else thinks. I'm secure in my decision to do this, and I'm framing it as "reconstructive" rather than "cosmetic" surgery, just as I would if I'd been burned in a fire or had a masectomy or some other disfiguring trauma that reconstructive surgery could improve after the fact. My trauma that caused the problem was a lifetime of disordered eating and all the anxiety that goes with that; I've fought bloody hard to lose the associated weight and get to a point, physically and emotionally, where I'm starting to be happy and confident in my own skin. And, crucially, I'm now solving problems in ways other than stuffing them down with food and so the root cause - the disordered eating - is now much, much less of a problem. So I'm damned if I'm going to let the stigma of droopy, saggy boobs get in the way of my happiness, confidence, and intimate relationships after all this. We live once, after all. This is the inner reality of "cosmetic" surgery - or, at least, it is in my case. I think in some ways the field is a lot closer to psychology than it is to medicine/beauty. Yes, there is still plenty about my body that one could argue "needed" to be "fixed": I have a saggy tummy, bingo wings, chubby thighs, and all kinds of stretch marks. And I'm really quite fine with all of it - these are my battle scars from having fought, and won, against the demons of my teenage/twenties years; I'm a curvy, feisty woman of forty and I like very much who I am. I feel confident and sexy in my body, and so much more so for the new boobs. And so while I don't think most/many people (=muggles) may really get this if they have battled different demons in their own lives (because we all have the shit that we have to deal with), the easy solution is simply choosing not to share the story with them. It is none of anyone else's business, after all.
There's also a very new guy who is almost-maybe-kind of in my life, and telling him is going to be scary but also I want and need to do so (in person, when I get back to Sydney, I think). His response will be interesting and I don't know him well enough to predict what it is going to be. I thought of simply sending him a link to this thread so that he has time to process the info in private - might still do that, to allow him to save face and consider his response/reaction rather than feeling under pressure and having to arrange his facial features into something supportive while actually feeling shock? Surprise? Distaste? Judgement? I don't know. But, gah, it is so recent and so raw, and while, years from now that 'story of my 40th' will be just another thread in the complex tapestry of life, right now it is what I am going through, and I just don't want it to define me for him. There is, obviously, so much more to me than either boobs or boob surgery, as there is for all of us here. But on a forum like this, where what is shared is the stories of breast surgery, it is easier to see in tightly-framed close up and much harder to pan out to the widescreen view of life, context, complexity, and the location and minor, cameo-role status of breast surgery in every other aspect of our lives. And so, today, post-hospital here I am trying to make sense of this angle on the thing; the emotional and psychological 'journey'. How very frikin' reality TV, eh? ;-)
Suda the wonder nurse, part 2
However, Suda is off for the next three days :-(
Her boyfriend is a policeman on the next island over from Samui and she spends her free time there, she says. Her mum and dad are in Bangkok, which is where she's from, and she has come to Samui for this job. I love these small insights into the lives of the Thai people around me here, it is a lovely way to get to know a place slightly better than just being a tourist. Of all the people I've met here, the one I've gotten to know best is probably Pete/Utawan, who is super-lovely and with whom I've talked about a few normal things besides boobs/healing etc. Of course, I'm aware that I'm a paying patient and that these are staff employed, in part, to be nice to me. But I'm enjoying the time I spend with Thai people more generally - this is a lovely, gentle, friendly, Buddhist culture and people seem to be nice to one another in general and to put fun and smiles at the centre of their lives. For instance, as I walk down the road from my guesthouse, the people in all the little shops now wave and say hello as they've seen me every day for two weeks, even though these include shops I'd never need (such as a car mechanic and the reception staff from another hotel). The woman who runs the little laundry where I take my clothes chats to me about her cats (she has five, all black, and all related to each other in complicated ways: mama, baby, brother, brother from first baby group, etc). The guy in the neighbouring house sometimes sits out on his balcony for a smoke, and he waves and says hello when I pass by. And the guys in the cheap, good restaurant I go to every day or two (I have a few regular places that I go) treat me as a regular. Yesterday, there, for instance, I was writing an old-school paper letter to a mate in Scotland and the envelope I had wouldn't seal properly, so before I could ask the restaurant staff were running around finding tape and a new envelope for me. Sweet. And I'm getting used to speaking very simply to be understood by the majority of people, whose English is minimal but functional - so, for the laundry lady, for instance, a litter of kittens becomes a baby group of small cats. And for the hospital receptionists that organise my transport every day there is lots of gesturing, smiling, and the odd specific bit of info written down, just to make things clear. It works :-)
Anyway, having watched exactly what Suda has been doing today and yesterday, I now have some idea of what Amy and the others could/should be doing in terms of cleaning (and if they don't do it as well as Suda, I'm not above being all bossy and directive, as that's how westerners in Asia are thought to be anyway, hahaha). Today, again, Suda did a full hour of minute picking and cleaning, extracting three more rejected Vicryl stitches and generally flushing everything out again, removing a million more tiny pieces of yuckiness and dabbing everything with betadine before she patched it all up with gauze. Once I was patched up, she also took cotton wool and acetone (or maybe alcohol? It smelled pretty strong anyway) to the small black lines left by two weeks of daily surgical tape; the result of this is my skin outside of the actual incision sites is now back to normal and is no longer sticky and picking up fluff from my clothes. Good one, Suda. (I also thanked her on behalf of my mum, who emailed me and told me to do so!)
So yes. All good here and although I'm a bit bored - there's only so much to do in Samui if you cannot get in the sea and cannot drink booze: these are the main reasons people come here. To be honest, it isn't really the kind of place I'd normally choose -a bit of a party island and very touristy in many places- although I've been LOVING watching a lot of tropical storms, and the garden around my bungalow is amazing, with lizards and flowers and tons of glorious green lushness. But admiring weather and nature aside, I'm rather limited in the stuff I can do. Proper massages are out, although I had a glorious foot massage the other day, as I can't lie on my front yet. I've been entertaining myself with hair cutting and straightening, a couple of pedicures and a foot massage, plenty of amazing food, a bit of zooming around by moped when my buddy was here (he left yesterday and I miss him, but quite excited about how much sleep I'm now getting; last night was 12 hours!) and generally making attempts to lie low - I'm reading, watching movies, writing a bit including the first long paper letter in years, loving writing my daily blog entry, and generally keeping myself occupied. I really like the family that runs the guesthouse and we have little chats here and there throughout the day. There are also two cats that take turns to sit on my lap when I'm on the terrace. It is nice, all of it - an enforced rest and the first time that my time has been this unstructured for years. In many ways it's like the freedom and spontaneity of backpacker travel and in other ways it is utterly unlike backpacker travel as there are so many limitations on what you can't and must do, and no instant, like-minded community to share experiences with (which is why this cyber community is such a godsend). In a lot of ways, surgery is far more challenging and risk-taking than a lot of the artificial 'adventure' peddled as part of the backpacker 'experience', and in other ways it is deeply suburban and quite out of the realm of the adventurous, as surgery, and particularly cosmetic/plastic/reconstructive surgery is associated with such a different set of values and individual from the earthy, free-spirited, down-and-dirty, function-over-form community of Lonely Planeteers. I dabbled for years in this identity as a "traveller" (scare quotes are essential, as there is so much identity bullshit in this little subculture). But I think I can honestly say that even though this trip does not feature any of the "adventurous" stuff I've done on previous trips (wreck diving, wild hiking and camping, off-road driving, dodgy hitchhiking...) in many ways what I'm doing here is far, far more adventurous than any of that stuff, as it's a journey into the self.
Thai food is amazing
Good news, bad news, good news
The bad news is that, as predicted yesterday, the tenuous skin connection that was only just holding together my vertical incisions like crochet lace (on lefty) and the biggish hole that had appeared in the incision (on righty) - without the additional stitches I asked for yesterday, both incisions had opened up again today and each had acquired biggish holes with very raw flesh visible through the skin. Hurrah (not) - back to square (more or less) one. This is getting extremely frustrating. I really do seem to make a bit of progress and then it all slides back again. Bad news, right there.
Dr Chalermkit is not back until Wednesday morning, 48 hours from now, and I do wonder whether the issue really was just the continued bits of infection or whether there was also an element of the other surgeon not wanting to do anything much while my own doctor was away. I don't know Thai culture nearly well enough to understand the nuances of this kind of thing, but I've lived, worked and travelled extensively elsewhere in East Asia and I know there can be a tendency to do nothing rather than doing anything (and, so, risk do the wrong thing; by doing nothing you cannot then be blamed for getting it wrong - it is this kind of thinking that paralyses business and local government all over China). There is also a reluctance to make anyone else 'lose face' by stepping in and solving "their" problem for them. So the other surgeon's inaction yesterday could indeed have been infection-related, perhaps it was only that. But I did also have to perform a bit of loud-nagging-face-losing Westerner today with the nurses even to get the other surgeon to come and look at the mess, and also to a lesser extent with him to get it all stitched back up properly again (he is more senior than my doctor and I flattered his expertise and talked mainly about my worries and lack of expertise in this area; nothing untrue there, but I was aware that I was using every last bit of intercultural skill I've ever learned or taught. Of course, I'm not a doctor (well, I am, but not a medical one. In fact, my area is intercultural competence stuff - remarkably relevant, here, but not in the obvious way!) so I don't know whether this as the right thing to do or not -check out the pictures and judge for yourself. However, as it was painful, blatantly hanging open, had stopped most of the oozing of pus, and also because it really, really needs to start healing before I leave here in five days' time, I made the judgement call to nag the doctor until he stitched it back up for me. Which, in the end, he did. I really, really didn't want to waste two days of possible healing time by leaving the incisions gaping open to wait for Dr Chalermkit to come back from his conference trip. For the first time in a while, as well, it was properly painful - no surprise, really, when they took off the gauze this morning and I saw just how much of a mess things were in: red-raw flesh exposed beyind the skin and rubbing against blood-soaked gauze. Yuck.
And so yes, the other bit of good news, after a fashion, is that I'm now all neatly and strongly stitched back up again, with small (5mm) drainage holes built into the incisions in case there is any more volcanic/Vicryl-rejection activity still to come. The replacement surgeon, Dr At, is not a plastic surgeon but an oncology/general surgeon (irrelevant when it comes to sealing up a wound) and I'm hoping that he has been thorough and tough with the new stitches; it certainly seemed so from watching it (local anaesthetic again, and we chatted about his time as a visiting surgical resident at the Royal Melbourne while he stitched. Weird to chat to someone who has your own blood on his hands but, as he pointed out, a lot of blood is a good sign as it means there is not goin to be a problem with flesh necrosis; I like this guy's optimism!)
So yes. As I write this, I'm not in pain, my boobs feel comfortable again, and I'm optimistic that things might, finally, start healing now. Today is a big, important Buddhist day and I'm actually going to go to the temple straight after this and light some incense and say some prayers. Because even when the body is not cooperating, the mind still gets to be hopeful.
Lighting incense at the Buddhist wat
I've lived in Catholic and Buddhist countries (and one Muslim one, too), and while I don't have religion at all in my life, I like and respect the rituals that go on in these two faiths in particular. And while, yes, it's very easy to make rational critiques of both faiths as superstitious, pre-modern, male-dominated, money-hungry, bullying and cynical setups (the Buddhist rather less so than the Catholic, but you can find it in both) - I love the peace and calm of both faiths' religious spaces. I love the rituals and the gathering of peaceful people; I love the pause in the rush of real life and watching the smoke from candles and incense rise up, taking my hopes and prayers with them.
I'm not sure that what I do is pray, though; it's more a mantra. Today, as I watched the smoke rise from my bundle of incense, I just repeated over and over to myself "make me heal". Repeating a mantra, I find, is amazingly efficient at silencing all the other monkey-mind white noise that goes on between my ears. Maybe my body is listening, too. Maybe this will help me heal. Certainly, it cannot hurt.
A toothless monk in saffron robes came out of the compound to see what I was up to - there was no-one else around. He smiled when he saw me lighting incense; we made the 'wai' sign to each other (this is everywhere in Thailand), and he gestured for me to kneel in front of the display of Buddha statues. Then, he wrapped himself in a bit more saffron-coloured cotton, sat on a wooden bench off to one side, dipped a kind of bamboo whisk into holy water and splashed a tiny bit of water onto me three times: left, middle, right. Then he tied a thin, saffron-coloured string around my wrist and trimmed off the ends. I don't know the significance of these rituals and we didn't have any language in common at all. I wanted to tell him that I have been ill and that my body now needs to heal. I wanted to say that I'm struggling with feelings of powerlessness, of not being able to do very much to help with getting better. Who knows, maybe he guessed? Or maybe he thought I was lovesick or wanted to get rich or some other thing, I don't know. But healing was firmly in my mind as I took part in this small communion-like ritual, and the saffron string is around my wrist as I type. Maybe holding healing in my mind, alone, is enough to start healing. Or maybe I'm just trying to make myself feel better.
Third time lucky?
On choosing to see the glass as half full - this is something I've consciously been working on in the last 18 months or so, after many wasted, damaged years of "what if" catastrophic thinking, the illusion of trying to control things by throwing money and plans at them, making complex arrangements for every eventuality, and being paralysed by anxiety as a result (and/or as a cause). What I have learned is this: some things cannot be controlled. And some things -perhaps most things- are not about the practical arrangements and plans at all, but about emotions and feelings, to whch logic cannot necessarily be applied. And, further, trying to control things in too much detail leads to much more stress, ultimately, than simply trying to lean into the unknown: I try to embrace the uncomfortableness and just let things be what they will be. This is not to say I'm going to spend the rest of my life on the sofa waiting for good things to come to me; there is certainly plenty of time and place for being proactive, and sometimes you do just have to chuck a bit of money and planning at something to get it to happen. (Healing is not really part of this category, though.) Yesterday, for instance, when I wanted the doctor to just stitch me up already, I got proactive and a bit nagging - a useful, directed bit of trying-to-control-things. But in a situation like this, more generally, instead of running around like a headless chicken panicking and trying to make arrangements to deal with every unknown "what if", I'm choosing to make myself feel better by saying, simply, "we shall see". Whatever happens, I'm sure I'll be ok. I don't want to change my flights again but if there's still a big mess going on in my bra by the end of this week then maybe I'll have to; but I'm not worrying about it at the moment because it is still part of the unknown, and it makes me less happy to worry about, plan for, catastrophise about, and lose sleep over the never never of "what if" than to just go with the flow as much as I can.
Going back to Sydney on the weekend is just as plausible an option, after all, and would mean not having to shell out any more money to change flights again, extend guesthouse/cat hotel stays and all the rest. I live one block from one of the best teaching hospitals in all of Australia, I have a good GP (=family practice doctor) who will, if need be, refer me to the right hospital unit. I have government and private hospital insurance cover. And at this stage what I need is not plastic surgery but wound care. My friends and home are in Sydney, I'm a bit bored here now and I feel like real life is utterly on hold. Obviously I won't throw myself back into 12 hour work days until I'm ready, but I also feel that I don't want to have to delay the start of my next-semester courses (but will if I have to). I knew all along that there would be an extended healing period after major surgery in which I would have to lie low; I've got my gym membership on hold for exactly this reason, and my boss is being incredibly supportive with time off as needed. But this does not mean I have to stay on in Thailand indefinitely (indeed, my visa is only good for another week after this week, and while I could extend it, I'm walking wounded - I can easily get home and keep healing there). But, obviously, this is a judgement call I will make later in the week when I have a bit more info; the point, now is neither to overplan nor to stress out.
Why, then, write about this at all? This is my blog, and it is anonymous, and the whole point of it is to be able to explore feelings by writing about them; perhaps these will be helpful to others going through similar processes but even if not, I find it helps to write them down. I also think that, ages from now, it will be nice to come back and read about how I was feeling day by day in Samui. But day to day here, it really helps to write about what I'm feeling.
However, some of my close friends and family members are reading along, and a couple of them seem to have misinterpreted the purpose of the blog and have come to see having access to it as an invitation to offer unsolicited and partially informed advice on email, couched in the emotional blackmail of "you are making me worry". And so I want to say, clearly, here: I appreciate that you care. I know that you only worry and say such things because you want me to get better. And I know that you love me, and this love is very much reciprocated; I love you very much. But please, please stop worrying and, crucially, stop adding to my stress load by filling my head with your own fretful, circular, "what if" catastrophising and mindchatter that, ultimately, goes nowhere and just makes things worse. This is a situation that cannot be controlled by making more plans and arrangements; obviously I'll do what is right at the time - that will probably mean going back to Sydney on Saturday and, when I do, I'll figure things out when I get there. I'm old enough and worldly enough to make my own decisions about what is best. If the blog gives you sleepless nights, stop reading it (I sleep very well during all of this and so should you). I wanted to address this here because it's that or stop writing the blog at all, and I don't want that. For the record, I have cried only twice during this entire process: with My Adelaide buddy one night during the worst of the infection, when we still didn't know why it was happening and I was scared, and then again yesterday when I was unnecessarily stressed out and upset about having had to tell the well-meaning people who tried to control things on my behalf to butt out. So 50% of my tears have been caused by well-meaning interference - I had prepared emotionally for all kinds of complications but not this. Enough!
One more thing. I told the Sydney guy why I was really here - putting my vulnerability on the line and risking losing him - we were discussing honesty and we had both shared a lot, and so it would have been entirely dishonest not to say anything. And he was brilliant - absolutely brilliant. A long, warm email fluttered into my inbox yesterday with a "you go girl" vibe and a lot of supportive comments. He is excited for me that I feel sufficiently empowered to choose to be happy by identifying and fixing something about myself that would otherwise make me self-conscious and unhappy. He is a good guy; I am glad to have found him. It is very early days but I like him and he likes me. And this time I'm not going to be sharing anything much about any of it with friends and family: it is none of anyone else's business and I do not want to invite comment, well-meaning advice, attempts to interfere, or any such thing. This thing, whatever it is, is mine and his alone. Funny, isn't it, how the self-knowledge and personal growth that has come of this whole process has been around the areas of vulnerability, limiting disclosure, the strategic uses of privacy and secrecy, and not over-sharing. Every day is a school day :-)
No news is good news :-)
After the hospital I went for brunch, for which I had pork green curry and steamed rice. I really don't do sweet breakfast stuff, and Thai food is just so damn good and so healthy that I kind of want to eat it all the time; I'm not sure you're "supposed" to eat green curry at ten thirty in the morning, but where is the "should" in post-surgical recovery? Right, there is none. Thai green curry is a coconut-milk-based, fairly spicy soup with a ton of fresh veggies in it and some good, lean protein in the pork (sometimes I have it with chicken or fish or whatever instead; it is easily my staple Thai dish and it's as much as I can do to limit myself to once a day). I dunk the rice in, spoonful by spoonful, and eat it with the soup. It is delicious, nutritious, and cheap ($3 or so for a huge steaming bowlful in any of the little local restaurants near my guesthouse). And today, with it, I had a mango shake: fresh mango pieces blended together with (bagged, clean-water) ice chips; completely divine. Nothing is processed or packaged; all the ingredients taste of themselves. This amazing Thai food must, surely, be helping me to heal.
Then I came back to the guesthouse and crashed out on my bed from elevenish til about two thirty. This, after sleeping 11-7 the night before. I am eating for England, sleeping for Scotland, and healing for ... Hungary? Usually I don't nap at all, I try to limit what and how much I eat (conscious of the tyranny of bodily surveillance, trying to 'do healthy', yadda yadda), and I'm quite the workaholic. Here, in contrast, I eat when I'm hungry and I eat and whatever and however much feels right at the time. In the week or so straight after the operation I wasn't hungry and didn't eat much at all. Then, when my friend from home was here, we made up for it; we over-ordered and ate loads of amazing food; many different exotic dishes every night. And now back to being here in my own, I've found my equilibrium. This turns out to comprise mostly fruit, veggies, lean protein, a small can of chilled milk coffee most mornings, a beer every couple of days as the sun sets, and a bit of rice and some rice noodles; I've had a few sweet things here and there, including some Raisin Bran and milk in the early mornings where, otherwise I'd really struggle to get moving at all (the hospital car comes every day at 8.30), but no junk food at all and no bread. I feel great! I order more than I think I'll eat at each meal and either pack up the leftovers to take away or push the plate to one side and just stop. It doesn't feel wasteful; there are enough chickens around to eat all the leftovers I can produce, and great food here is so cheap and fresh and readily available that I don't regret not stuffing down every last bite. This is quite new for me - after years of disordered eating, mainly binge/emotional/comfort eating, orthorexia, and a bit of bulimia (hence the weight fluctuations in the first place), I'm only just learning how to respond to, and honour, my body's own hunger cues rather than any socially sanctioned rights and wrongs of eating. Similarly, here, I sleep whenever and for however long I want to. It is such a liberating feeling as there is no "should" of sleep here either. And although I'm checking my work emails every day now and dealing with the urgent ones, the minute I'm done I switch it off and five minutes I'm not thinking about it. Having started a good, careery, "proper" job as an academic 18 months ago, and having worked incredibly hard in the years up until then on my PhD and, straight after, another very intense two-year academic job, I'm finally having the rest I think I've been needing for ages. And I'm also learning how to honour my own body and needs and self-care in a way that I kind of knew in theory before but had rarely put into practice. Amazing how this surgery experience is causing all kinds of other good stuff to happen in my head too (or maybe that's just the thing of turning 40, hahaha).
All of this said, I'm excited about going home on Saturday. It's a longish journey with the most direct connections I could find; one stopover only. Twelve hours flying in total with a ten hour layover in fabulous Singapore, all within more or less the same time zone (only 3 hours difference; not much). In Singapore, if I feel up to it, I'm going to hit Orchard Road for a bit of clothes shopping: they have a whole bunch of chains that aren't in Australia yet - H&M, M&S, Dotty Ps, Gap, etc. If, on the other hand, I'm feeling exhausted, I'll throw some money at a transit hotel in the airport and get a room for the day. Either way: easy. It's funny - when you live in Australia, and the rest of the world seems so very far away all the time, somewhere like Thailand feels like it's just up the road compared to going to, say, Europe or North America.
I'm also looking forward to *being* back in Sydney. Obviously, I miss my friends, and while we've been texting, skyping, and the likes, it's not the same as seeing them. I miss my flat, my kitty, my suburb, my routines. (Even, slightly, I miss the routine of work, though I'm not exactly pining!) And I'm looking forward to seeing 'the guy'. It's a strange thing - so much contact on email, and so little real-life time spent together before that. It's all out of whack. I want to see him and spend time with him; we need to even all of this out. Email forces you into the very wordy and cerebral way too soon, and life (and a human relationship in particular) is about so much more than that. He is nice, it is early days, and I like him. So I'm keen, now, to get back to Sydney and see how it all goes. (As any of the romantic poets would tell you - there's only so far a love letter can actually take you.)
I don't know what the practicalities will be in Sydney, wound-care-wise. If, as I really hope, things are actually starting to heal properly now, this may be as simple as learning how to change my own dressings and then getting my stitches out in two or three weeks' time - I guess my doctor can either do this or send me to someone who can. If, on the other hand, there is still more mess and infection and yuckiness to come - well, I'll cross that bridge when I come to it. Things have settled down a lot today - there is almost no pain now, and nothing seems to be leaking - touching wood as I type this. It rained a lot earlier and the path outside my bungalow is like a skating rink, and I slipped (this happened a couple of weeks ago, too; that time I fell down and cut my foot; this time I balanced myself before I actually touched the ground). As I fell, though, I felt a kind of jerk to my left boob incision, and I do hope that nothing tore or shifted or anything - on bathroom mirror inspection straight after (thru the gauzes I mean), it seems ok. I'm walking around quite a bit in general - have been since just after the operation - in part to keep my circulation flowing and in part for the sanity of my head. And I'm usually so, so careful - but, hmmm, need to avoid that damn path!
Sunny day - both metaphorically and actually
To celebrate, and also because I'm feeling less sleepy than usual, I tried on every bra and every top I have here with me, including the verboten underwires that I'm not wearing yet (I just tried them on; no need to irritate my incisions by actually wearing them). What a difference, seriously, in the fit of everything! This is the first time I've really compared the old with the new, as I never wore the post-op bras before the procedure, so I had little idea just what a difference has occurred. Holey moley, what a change! In place of scooping extra skin and sagging sadness into bras designed to contain and to create shape where I had none of my own, my fabulous, pert boobs now echo the shape of my underwired, contoured bra, filling it nicely but not spilling over, and wow, it looks amazing! I did not have implants or a reduction in this operation - just a lift, plain and simple - and as a result, it appears, I'll be able to wear the same size of bra (dd) just with a whole lot more shape and lift going on in my body. This is wonderful news, as the actual size was never an issue for me, just the saggy droop and embarrassing profusion of skin. (It was like having two tennis balls down at the end of rugby socks or like holding a brace of lifeless pheasants to my chest.) Even with now-minimal gauze still in place to keep everything clean until I heal, my shape within a bra and clothes is simply amazing. I am a happy little camper indeed! Wow.
Eventually, I'll even be able to buy and wear, for the first time in my life, tops that don't have all that much 'architecture' built into them and that can't easily be worn with a bra - slinky strapless things, swimwear that does not resemble a parachute harness, spaghetti-strap tops. I've never been to this land before and don't have a map of its territory or any real sense of how to get around; I feel quite dizzyingly lost amid such things and I look forward to finding my bearings in this whole new place. But I'm sensible, of course - I knew a lot of healing is still to happen and I'm not rushing in buying a whole lot of new lingerie and swimsuits just yet - there's a ways to go yet (and a ways to go before the Australian summer, woohoo!) But, come healing and come summer, I'm going to be all over these halter, bandeau, stringy, god-knows-whats like a teenager first discovering she has a woman's body.
On that - I was a chubby and ashamed teenager, a fat and ashamed uni student, and a very fat (and very lost emotionally) ashamed young adult. Then, when I was 27, I got with the program -WeightWatchers, nothing magical or quick fix- and dieted and exercised my body over a two year period into size 10 (US size 6) acceptability. I kept it there for a several years. And then, in my mid thirties, spending a lot of time at my desk doing a PhD and various jobs I've cared about and worked too hard at (cue: biscuits and inadequate self care), I've slipped and slid back up to a size 16-18 (US 12-14) ... and I'm really quite fine with that now. It is neither the smallest nor the largest I have been, and I feel like I'm myself at this size. I am normal. Average. I very much like, and feel sexy in, my body. I'm learning to dress well in ways that flatter rather than hide. I've stopped being ashamed of who I am and what my body looks like. I'm healthier than many, happier than most, and I like what I see when I look in the mirror. The new boobs have been a huge part of that, but I think this transformation, over the past six months or so (starting with the PS booking and the self worth it took to say 'do it') has been as much emotional and psychological as physical. I feel good!
However, when you shift and morph shape as a woman, there are certain things that remain atypical long after your body reaches the 'acceptable', 'normal', or average. Loose skin is one of them. Another is that I don't know how to shop for the type of tops I'm describing - when you have boobs that actually support themselves, what does that mean for the fashion choices you can make? (One thing I've learned: empire-line waists are a fucking godsend! Picture attached). Another unknown - as a plain, shame-filled, body-terrified and hiding teenager/young adult, I never learned how to apply makeup. To this day, I don't own any and don't wear any (with the exception of brightly coloured toenail polish). If my life depended on applying 'a face' (and its hard to think of a situation in which it might, but bear with me here), I would be like a little girl smearing on garish shades from her grandmother's bathroom cabinet; I simply have no idea where to begin with the paint and powders and liners and twirlers and all the rest of it. (And by the way, how do normal woman afford all that stuff? That shit is expensive!) So yes, today is about starting to heal, starting to celebrate, and also reminding myself that my body's history is never going to be typical and that there's a learning curve in all that we do. Exciting, isn't it?
Dreaming of halternecks
It's been a blast here - three weeks on a tropical island with a ton of unstructured time to heal, read, sleep, write, dream, turn 40, watch trashy TV shows, have pedicures, hang out with my buddy from home, eat great Thai food, and remember who I am when I'm not working all the bloody time. Fantastic! Samui is a bit of a party island and if, like me at the moment, you can't go in the ocean and can't (really) drink booze, there's not all that much to do. There's a couple of Buddha-related sites to look at and a few rocks and natural-marine-park type wonders (which, frustratingly, seem to be all about snorkelling, which I would love, love, love to do at the moment, but cannot until things heal). So, instead, I've been taking it ridiculously easy, getting to know some of the people I've met around here, and thinking a lot about what this whole process means for me, my body, my self confidence, and my future. Writing this blog has helped me process a lot of those thoughts, and I've also had a bunch of great Skype/instant message/email conversations in which I've worked through all kinds of feelings, thoughts, ideas, and dreams. One dream is to wear clothes that don't require hefty, structural, bra-type underwear - see the catalogue picture attached of a fab, fifties halternecks dress - when I heal, I so wanna rock that look!
Bandeau top in Singapore, and a bit more wound separation today
So. I still have gauze and tape all over me and I'm still not nearly ready to shed the sports/post-surgical bras that are holding life and soul together while I heal. There's still a bit of a mess going on with my stitches - more separation of the incision on Lefty today, and it's been a bit painful too - a kind of deep, rolling pain that comes and goes. But I'm focusing, now, on the end result - the way I want my body to look and the way I want to feel in it. Yes, I'm not model-perfect (as so many women who shop for cosmetic surgery are, or aspire to be). I'm far from that (the bandeau top is also quite unforgiving of my tummy roll and chunky arms, for instance). And you know what? I'm ok with all of that. The big confidence destroyer, for me, was my droopy, saggy boobs. With those gone, and with confidence-enhancing 'normal' boobs in their place, I'm feeling emotionally amazing. A bit more healing and a few fancy tops - and I'll be in heaven :-)
"The guy" met me off the night flight from Singapore and we had a lovely morning: picking up the cat from the cattery (kitty was so pleased to be home, much like his owner), going out for brekkie in my cool suburb (me and "the guy", I mean - the cat stayed home - keep up) and, yeah, stuff. Not MUCH stuff, if you're wondering - I still don't know the guy that well/my boobies are still way too sore - pick the likelier reason for my chaste behaviour, hahaha. But, yeah, VERY nice to see him and VERY nice to be home. Aaahhhh. We're having dinner at his place on Thursday - I'm really excited to be getting to know him (but this is not a love/romance blog, so no more details on "the guy" from here on in, sorry).
Anyway. In the afternoon I unpacked slowly, did a load of laundry slowly, spent quality time, slowly, with the cat - we lounged (slowly) about on the bed in a sunbeam; in short, I generally chilled the fuck out. (Slowly, of course). The single eventful thing that happened during all of that was that I discovered, in my sponge bag, a sad, dying gecko that had stowed away and had spent the past 24 hours mostly freezing in hold baggage, poor poppet. He/she was still wriggling quite vigorously when I released him/her onto the windowsill to warm up a little in the sunshine, but I don't think she/he will make it; s/he was rather worse for wear. Besides, there a no mozzies here for a gecko to live on at the moment. Poor, sweet thing. I like geckos and they did a great job this past three weeks of keeping my room fairly mozzie-free (self interestedly, of course. Arguably, indeed, they used me as bait. But anyway, I like them. I like how they wiggle, I like that I associate them with being in tropical places, and I like their loud clicking exclamations, like 'hey!', to announce their presence.) But this littlie had obviously found a little sanctuary in amongst my toiletries and really wasn't expecting to be whisked off to Sydney. Well-travelled gecko.
Also this afternoon I did a bit of online digging and found a long-hours, bulk-bill medical practice, by which I mean they bill direct to Medicare, the Australian government health insurance provider. They're open til 10pm every night including Sundays. Bulk-bill means that you don't pay anything up front - to Brits this may sound like, 'duh, obviously'; to US Americans this may sound like healthcare nirvana (or Bolshie Obama-communism, depending upon your political stripe...), but to Aussies, where some doctors charge a fee -about $30 and up- for a consult and others charge nothing, though you tend to have to wait longer at those, this is just the way it is.
So there I was, late afternoon, Kindle detective novel in hand, waiting half an hour or so to see a very nice lady doctor who did a repeat of the infection-swab that Dr Chalermkit had done previously, just to be sure. She then referred me, with no wait in between, to a very nice nurse who cleaned the incisions, added steri-strips to hold the wound edges together while they heal, patched everything over with gauze and then, in place of the micropore tape that has left my chest/tummy skin in such a sticky, stained, shallow-abrasions mess, used a kind of adhesive patch to cover the gauze in one neat go. The result is kind of like a huge, homespun, white Elastoplast made of a strip of gauze about 20cm by 5cm (vertically, obviously) on each breast, with a self-adhesive edge of about 3cm all round. I don't know if it will be any easier to remove than the micropore tape, which has left my skin raw with all the rippings off, but hopefully it will be no worse. Honestly, I think the use of (and, specifically, removal of) surgical tape on sensitive, tight, post-op breasts has been the single more painful part of this whole procedure. Ouchy. She said I need to change/clean it every two days, which is also what Dr Chalermkit said on the last day I was at the hospital, which gives me a bit of a break in between visits.
So yes. The setup here is a bit less convenient - I drove myself to the medical centre (10 mins), parked opposite at the cost of $1.50/hour (Sunday rates, similar on weekday evenings), waited a while, and didn't get the personal care and attention and lovely little chats as I used to have with Gop, Amy, Suda and the other nurses at Bangkok Samui. But I am relieved that wound care here in Sydney is easy, free, and readily accessible. No problem at all :-)
The story continues (sloooowly)
Still some yuckiness going on, boob-wise, but the second swab they did on Sunday also showed no bacteriological infection - excellent news. So it's just a question, still, of waiting until everything heals and cleaning/dressing/managing the wounds til then. More annoying than problematic, really. And my rack looks amazing, shape-wise!
So yes. No news really is good news. NOW I JUST WANNA HEAL. Is more incense and another temple required here ;-)
Getting better, sloooowly (progress is progress though, eh?)
Huge progress - healing is happening :-)
I'm still covering them with sterile dressings, which is annoying as it means showering is still a real kerfuffle with trying to keep them dry, and that I have to change the dressings daily - or every two days when I really just can't be bothered doing it, but mostly it's daily. But OK. Mostly, when I'm out and about doing other things, I forget about the boob thing entirely - so the fact of wearing sterile gauzes is only an issue at the time of actually dealing with it.
And I'm still quite run down (or maybe just exhausted because its the first weeks of the semester and I'm doing way too much, again, already, having promised myself to take it easy... It could equally be this!) For instance, I walked home the other day from the beach in Sydney, normally a 20 minute walk - it's uphill, but I usually get a good, slightly-puffed-but-flying-along, pace going. But, oh man - deary me. Post-op and post-rest - it took me half an hour or more of slow meandering, with lots of short stops, a bit of breathlessness, and no real pace just to make it home, and once I did I needed to lie on the sofa for ten minutes to stop seeing stars. So this rather huge surgical procedure has taken it out of me physically and I need to build up my strength and fitness again. So I'm almost looking forward to getting back to the gym (almost...). I'm medical certificate'd off the gym (and, crucially, its payments!) until early Sept, and to be honest I can't imagine doing anything at all bouncy exercise-wise just yet (ouch, ouch, ouch!) But I do feel the desire to start walking a bit more and build up some pace and cardio fitness again - what with eating lots and resting lots I do feel rather sluggish. But I've been honouring what my body felt it wanted to do, including eating tons of protein (as well as generally eating a lot while I was healing), and not racing around all that much. Now I'm getting back to normal - running around like a mayfly doing a million things in a day - but I'm also trying to remember the wonderful calm of those recovery days in Thailand and channel/include some quiet time into my daily life as well. It's not my natural state but I'm finding I need and miss it - so this whole process, as well as giving me new and fabulous cans, has also been good for my head - I'm learning how to slow the pace and take it easy, and it's wonderful.
Healing beautifully :-)
On a deeper and somewhat more spiritual level than the aesthetics of these boobs or any other boobs, I'm feeling awed and humbled by my body's ability (and willingness, after a wee bit of protest!) to heal itself. I've been mainlining protein and good, healthy veggies to the point where I feel I've actually put on a bit of weight. But ok - once I get back to the gym I can deal with that. Meanwhile, my body has done a fucking incredible job and I'm just about healed. I feel ridiculously in awe of Mother Nature - I've never experienced anything medical before -never been in hospital, never dealt with illness, never broken a bone. And here I am, not even six weeks after major surgery, just about healed and sitting on the sofa in my knickers, sort of getting ready for work but actually dreamily writing this, feeling at last that I am in the body of a normal forty-year-old woman: far from perfect, indeed, but no longer burdened by the tremendous shame of the sad, sagging sacks of history that were there previously. It's not that I'm ashamed of my story - I've lost and gained weight and fought some big anxiety demons throughout my life, and I mostly won - it's more that I'd rather be in charge of my own narrative rather than have my body tell the story for me. Now, I feel like I get to be (and to construct and reinvent) myself as I want and need to, rather than being a prisoner of my past. It is quite, quite exhilarating :-) While my boobs are still a work in progress, my happiness is not.
I started off at the specialist and rather swanky Bras N Things (BNT), where the very lovely, and herself fabulously plus-sized, Naomi measured me up and proclaimed 16E (this is Australian size; I think the US/UK equivalent would be 38E). This is gratifying - previously I'd been hauling myself into a compromised, apologetic Target Kirsty (the only style that worked at all) in size 18DD. So to go down a body size and up a cup size - well, there's nothing wrong with that, is there ;-) We chatted as she measured me and I tried on a whole bunch of different styles, and I told her about the surgery. She was fab - she used to work in the Bondi store and has seen a lot of women who have had a lot of work done. She reassured me that my breasts, which feel rather hard and knotty underneath, will certainly soften up in the coming weeks. And she said that although, yes, the nipples *do* look a little high, this is the result of things dropping back into place underneath and is to be expected to some extent. She was great; I hadn't thought of going to chat with a bra fitter about what to expect from breast surgery recovery, but she was one of the most experienced and knowledgeable people I've spoken to yet. And, as she herself was at least a size 20 (UK; American 16, maybe more), I didn't feel at all that I was being body shamed by some skinny Minnie sales chick. In fact, I felt da sisterhood, and it was a marvel.
Anyway, I tried on many beautiful bras and I selected one - the blue and white one in these pics - and handed over my $60. This is my most expensive bra purchase I think ever, though not wildly expensive in the grand scheme of things. But, oh my, is my new favourite thing - seriously - such a good fit, and I feel so confident and feisty and ballsy whenever I put it on. I resisted simply buying an armful of exactly this type in different colours - I'm still shifting, changing, morphing, I get it. But wow. Sexy. Hot. Love it!
So then, armed with an indication of my new size and with a newfound knowledge of the kinds of styles and fits that might work for me now, I took myself off around the mall and picked up Stripey, Flowery, Pink, Strapless, and Black. (Along with Sexy, I just need one more and I'll have a kind of seven dwarves of bras, hmmm. Project!) They ranged in price from $8 (BigW, on special, very nice) to about $30 (strapless, which magically supports invisibly and allows for the wearing of both halter tops and bandeau styles, neither of which I could ever have considered before - roll on summertime!)
I'm still unsure of the naturalness of how things are looking - the base of each breast has dropped quite a bit, causing the nipples to look like they're star-gazing and causing the nipples to sit very high up in bras and tops - I awake most mornings to them peeking out of the sports bra-style crop tops that I sleep in for support (hello nipples! Good morning to you!) But I'm aware, also, that it is early days and that there's a ways to go yet with the recovery. I await.
Meanwhile, my GP has referred me to a plastic surgeon this coming Thursday, to discuss whether this is a normal part of the post-breast-lift process and, if not, what some solutions might be. I obviously don't want to start over with any more surgery, particularly in Australia, which seems to be the most expensive place on earth to do this kind of thing. But I really could do with knowing a little more and so a $250 PS consult is probably worth it for a clear understanding of the possibilities and likely prognosis from here on in. I feel a bit dismayed at all of this, as you'd expect, but even with this 'star-gazing' issue, my breasts are many hundreds of times better than before, and so for that I'm grateful.
Meanwhile, the healing of the incisions is coming along nicely, still. I saw my doctor on Tuesday and I'm no longer bandaged up at all, which means I can shower easily and properly and that I don't have to faff about at the medical centre every two days getting the dressings changed in a sterile environment. I like being able to walk around my apartment with no top on, and I like the feeling that my boobs are holding themselves proudly aloft as I do so. They certainly never did that before, and I used to have to wear a bra, purely for comfort, all my waking hours, including just lolling and reading on the sofa or making a cup of tea. Now, it feels, my boobs are taking care of themselves.
(Almost) a year later
As for the results - pictures attached (apologies, not great lighting, but I hope you can see what's going on). Scarring is there, obviously, but very much better than even optimistic I would have thought after a year - yes, you can see there's been work, but it's not the first thing you notice. Unlike the 'before' pics, they hold their shape up by themselves - this is what I notice. They look like boobs now, rather than sad sacks of longing and shame. This means such simple, important things to me: the postman rang the door the other day at 7am, and I answered in my pjs without having to put a bra on first; I went camping a few weeks ago and was able to get up and wander around in the morning with a top and no bra on - and didn't feel self conscious. Little, important differences like that are why this is all absolutely worth it.
However, yes. It is possible to be critical too. The nipples are way too high. The boobs have kind of bottomed out - evenly, at least - leaving a rather curious shape and the nipples perched high up on the summit rather than mid way up the hillside. Over time, I imagine, the sagging will set in again and the nipples will stay sky high - and eventually this will be too weird. But for now, ok, it's a little odd but it's way, way, way better than before. The trick, I think, is to go for better rather than perfect - no other aspect of any if our post-40 bodies is likely to be perfect, after all. So although I suspect that one day I'll be back under the knife again, sigh, I'm still glad - absolutely glad - I had this done. Weird to think its a couple of weeks til the one-year anniversary - feels like such a long time ago that I had to deal with such awful droopy pre-op shamefulness. The past year has just been easier, on so many levels - bras fit better (no overhang), clothes hang better (higher, rounder boobs), I can go braless without discomfort (though I try not to too much, as I'm aware that gravity continues to exert its effect, sigh!) and I can turn over in bed without everything smushing together. Small, practical, comfort-oriented differences.
As for life more generally - the thing with the guy fizzled - it turned out that he had some druggy issues he'd failed to mention - but ok, it was nice for the time it lasted, and now there's another possibly-maybe guy in my life, but to be honest I'm really celebrating being single now. To get into anything it would have to be much better than singledom, and singledom is very good - so hmmm. In other news: I've put on weight, which sucks. It's mainly due to overwork/not exercising enough/eating on the run/comfort eating to sooth feelings of stress/burnout. Right now I'm away from home and taking some time to reevaluate work-life balance and think about my priorities in the next few months. One of these must be weight/fitness/health.
And: Right now I'm on day one of another long haul trip (Nicaragua this time - I love that travel is still such a big part of my life/identity - this time it's research related, but with a bit of play thrown in too). Out of home/routine, I'm taking time to remember who I am. Updating on this site it something I've been meaning to do for a while and so, jetlagged, here I am. Thanks for reading :)
So far, so good - he took lots of time spent explaining everything and sorting out the practicalities. There had been a bit of confusion with my booking and, as its the weekend, the international marketing staff weren't on site to sort it out - but the doctor did all kinds of getting people to go running around and made phone calls himself, and now it is all sorted out (as I'm only in Thailand for two weeks so cannot delay) - good on him for helping out, he seems to care.