OznAsia

I have been asked by a friend for information on my experience with traditional medicines. As there are a few, I decided to write it as a blog. May be useful information for others too.

As a traveller I try to keep the weight of my packs down as much as possible. So I don't carry this stuff unless I believe in it. There are medicines I started using in Australia that I can't easily find in Asia so whenever I return to Australia I top up my supply.

Cold sores don't seem to bother me much these days but if they do, I always have tincture of calendula handy. Even in Australia this is not easy to find. I pick mine up from a pharmacy in Stones Corner, a Brisbane suburb. The pharmacist keeps it in stock for his wife (and me). Tincture of calendula is antiseptic but apparently has healing qualities too. If I get it onto a cold sore as soon as I feel the first itch it doesn't go any further. It's also good for mouth ulcers if you can stand the taste. I use it on any little skin sores or cuts too. When I was first working at Mahasarakham University a few years back I had friends teaching in the pharmacy department. They checked to see if it was available in Thailand. It wasn't.

If I have dry lips or any other minor skin irritations I dab on some pawpaw ointment. Never seen it anywhere but Australia.

I also carry tea tree oil as a general disinfectant for cuts and scratches.

I use citronella oil as an insect repellant. You have to reapply it regularly but it doesn't do any harm as far as I know. In the past I've brought this from Australia too but recently I picked some up in Penang at a much better price than I pay in Australia. I can also get it here in a spray pack for household use but I've never been able to find out if this product contains any other ingredients.

Years ago I started using rock deodorant in Australia. It too is an antiseptic and can be used in the early stages of cold sores or on other cuts such as from shaving. I've discovered I can pick up this product more cheaply in Asia than Australia. It is readily available in markets in Thailand. It's cheaper still and in a much rawer form in Cambodia.

I sometimes get skin rashes which seem to respond to nothing. Once when travelling with some friends in the southern part of Thailand we visited a hospital where they offered natural therapies to outpatients—mainly traditional Thai massage. They were selling a preparation that was suggested might help my rash. It did but somehow I lost the container. In those days I couldn't read Thai and I never knew what it was called. I've never found it again.

I have tried traditional Thai massage myself. Another Westerner teaching at Mahasarakham recommended a masseuse who practised it. My colleague highly recommended this person so I had her come and work on me many times until I had eventually to acknowledge that the treatment gave me more pain than I had without it. This made me quite wary of traditional massage (as against Western style massage). Recently while in Cambodia I was suffering from backache. There were a few massage places near where I was staying. I decided to give one a try. I thought I'd be able to explain that I wanted a Western-style massage but they spoke no English and my Khmer was very basic. The treatment was in some ways similar to what I'd had in Mahasarakham but in many ways different. The young woman who performed it was quite small and she even walked on my back. Yes at times it was a little painful but the end result was that I felt much better. I returned a few times. I've since had another massage in Thailand and this was something between what I had in Mahasarakham and what I had in Cambodia but no walking on the back. I'm pleased, she was quite a large woman. And once again it was OK. I felt better after the experience. Maybe the first woman was not doing a standard traditional Thai massage. Perhaps I'll approach traditional massage with a more open mind in future.

Other than as mentioned above, I have had very little to do with traditional medicines here in Asia. I know they are quite common and it is one of the courses available to students at Mahasarakham University.

Labels: Asia, Mahasarakham, pain, thailand

To put these present tooth issues in perspective I'd like to go back to the beginning.

I had teeth that were giving me lots of twinges, thermal aches and such. This dentist in Mahasarakham was recommended. He removed a couple of old fillings and replaced them and told me to come back in three months. Up to that point everything was fine.

Apparently most Thais don't come back for follow up if they feel fine. He was surprised to see me back. The teeth were not bothering me, at least way less than before. In retrospect, I think he saw this as an opportunity to 'make business'. He told me that the second tooth had a crack and that I should get the root canal treatment and a crown or I would end up with continued troubles. He's the expert, I thought, I took his advice.

After all the troubles (see earlier blogs) I got a second opinion from a dentist who said that my continued pain was coming from the tooth next to the one that had been treated. She suggested I not go back to the first dentist but return to the specialist in Khon Kaen.

I did. She checked it all out and I put my case that I wanted either her or her husband to put the crown on the tooth and also to do the root-canal treatment on the next tooth. She called her husband to take a look, for a second opinion. He was reluctant that they should do this for 'ethical' reasons, ie I had been referred to them by the dentist in Mahasarakham and it was unethical for them to take his patient from him. I've encountered this before in Australian medical practice. The ethics towards colleagues are higher than the ethics to the patient.

I explained that I'd been upfront with the dentist in Mahasarakham and told him I was going to get it finished in Khon Kaen and that he should call him and get his OK before he went ahead.

He spent ten minutes on the phone and came back in to say they had agreed that I should return to Mahasarakham to finish the treatment.

During this discussion I mentioned something about them having treated the second tooth and I was corrected. No they had treated the first one. It took me a little while to wake up. It seems that somehow they'd got the wrong tooth. I didn't think of it while I was there or I would have asked to see the original referral document (if they still had it). Did he tell them the wrong tooth? Did they get the wrong tooth? Or am I still confused?

But one thing they all seem to agree on is that the second tooth is the one with the crack and that is the one from which I am getting pain at times (thankfully not now).

Someone recommended another dentist in Mahasarakham. I caught a sorngtheau into town one night to pay her a visit but I backed out. I found the clinic but I changed my mind. Somehow all of this has undermined my faith in dentists. The temporary crown is still in place. The tooth is not bothering me. For the moment I have decided to leave well enough alone.

About a week later I was riding my bicycle home from the night market. My phone rang. I stopped and took the call. It was the wife of the dentist in Mahasarakham. She told me my crown was ready could I come in and have it fitted. I said that I didn't want to do that. 'OK. Thank you,' she said. And that was it.

Labels: Asia, dentist, pain

This follows on from my previous dental report.

I needed to go back a few times for the dentist to make and fit the crown. The next time I returned he said he would give me an injection. I said OK. I wasn't concerned if I had an injection or not. I had decided that I would use some relaxation techniques and control the pain on my own.

He jabbed me several times but I wasn't aware of any numbness. He didn't seem to take too long before he started working on my tooth, preparing for the crown. There was some pain as he worked but I did not complain. I used my own techniques to keep it under control. He took a cast to prepare the crown and then put on another temporary crown.

On the way home I could feel a little pain and I was aware that there was no wearing off of the numb feeling. There was no numb feeling! Had he put any anaesthetic in that injection or was it a placebo?

By the following morning the pain was quite intense. It lasted for about a week. I wasn't sure what to do. I didn't want to go back to that dentist, not if he believed my pain was psychosomatic. If that was the case, he'd discounted the possibility that there could be some dental reason for the pain.

I decided I needed a second opinion but I had a complication in that my throat was also sore. A friend had H1N1 swine flu and was in hospital. (Perhaps an overreaction.) On Friday we were chatting online and he said that his symptoms were just a sore throat and a temperature. We've had a lot of hot, humid weather lately and it feels like you have a temperature whenever you are out in it. I decided I needed to be sure. On Saturday I went into town to do my shopping and I bought a thermometer. When I came back I checked and it was exactly normal.

I went to see the doctor on Monday and he said he thought the throat problem was caused by the tooth. He recommend I see a dentist who comes to the university clinic on Tuesdays. She was able to demonstrate quite convincingly that the pain was coming from the tooth next to the one that had been treated. She tapped the treated tooth, I felt nothing. She tapped the next tooth—intense pain. She shot a burst of air at the treated tooth—nothing, the next one—intense pain. She squirted cold water on the treated tooth—nothing, the next one—intense pain. It was pretty convincing.

So, how incompetent is my dentist? Has he been treating the wrong tooth all along? I have no way of knowing but I'll give him the benefit of the doubt. What I'm sure of is that he certainly wasn't able to diagnose the real source of my pain this time. The clinic dentist advised that I go back to the root-canal specialist in Khon Kaen and get all the work done by her and that's what I'm doing. The pain has since subsided I might add.

I wasn't able to get into my usual Sunday morning appointment this weekend as the dentist is going to Bangkok. I took a Saturday afternoon slot. But I didn't make it. This morning when I took a sorngtheau to the bus stop there was a bus there when I arrived. But they wouldn't let me on. It was already overcrowded and there seemed to be a quite a few students waiting already for the next one. I joined them. When it arrived about half an hour later it was seriously overcrowded already and there were about 20 or 30 students who were attempting to get on too. I decided to give it a miss. I rang the dentist and booked my usual 10 am Sunday slot next weekend.

Labels: Asia, dentist, pain, thailand

When I was a kid if I needed dental treatment my mother took me to the dental hospital at South Brisbane. Some of my friends went to private dentists. But my family could not afford that. At the hospital you did not get to choose your dentist. Some were good with kids. Some should have been banned from working with kids. I remember when water drills came in. They were so much easier to handle than the old mechanical ones we used to be subjected to. I also remember one cranky old dentist threatening that he would use the mechanical drill if I couldn't keep my mouth open wider. As a kid all of my fillings were done without an injection.

At the age of 18 I went to live in Sydney. When I needed dental treatment I discovered Dr C. He was wonderful. I know it is not common to hear people say they think their dentist is wonderful but compared to what I grew up with I found him to be a kind and gentle man. He would take time to explain what was needed and give me choices about how that was done. He seemed to be impressed that I didn't need an injection for a normal filling. I remember one time he got his nurse (he always had cute nurses) to take a look at how much drilling he'd done without an injection. I had tried injections and I decided I preferred the short-term pain of the drill that stopped as soon as he stopped drilling to the longer-term discomfort and numbness created by the injection.

When I moved away from Sydney I tried other dentists. None of them came up to Dr C. One refused to accept my decision to not have an injection and immediately injected me without waiting for me to disagree. I never returned to him. Nor did I return to others I tried for one reason or another. When I was living in Brisbane I had to go to an annual conference in the Sydney area. I would usually arrange to go a week early so I could visit Dr C for a check up and any work needed. Eventually he said I didn't need to keep coming as at the stage I had reached my teeth should stay good for some time.

When I decided to retire and move to Asia over six years ago, I had one or two little problems with my teeth. I decided to visit Dr C and get them fixed before I did. I didn't know if he'd still be practising but he was. By this time he was about 70 years old. I expressed surprise that he was still practising. He said he had fewer patients these days and it suited him. He'd slowed down rather than retiring. 'And what would I do if I retired?' he asked. I could think of a thousand things but obviously he is happy with dentistry.

He refilled one tooth for me and recommended I get a crown on another. I had a choice of a post and crown or just a crown. He said the post should be better but there were no guarantees. As it turned out I did not have time for the post before my flight to Asia so I settled for the crown.

It didn't last. It fell victim to some sticky rice in Thailand. I didn't do anything about it at the time. I was still able to chew and I found I had less trouble with food becoming trapped. Some time later, when I was living in Cambodia a filling came out. This one was causing some problems so I decided to have it fixed. You can read the story here.

I got the same dentist to replace the missing crown too. I was wary at the time about getting such work done in Cambodia but that was September '06 and I'm happy to say that it is still there and in that time it has been responsible for assisting in the chewing of many kilos of sticky rice.

Having had such success in Cambodia I was not concerned about finding a good dentist in Mahasarakham. The dentist I was referred to was recommended by several people. His practice is clean and appears to be professional. I assume you've already read my previous two posts. Now I'll carry on from where I left off.

Since the first root-canal treatment the tooth stopped hurting and has given me very little trouble. Last Sunday I made my final visit to the lady dentist in Khon Kaen. (Lots of Khon Kaen pics now on my flickr page.) She gave me the final treatment which lasted about an hour and was done without an injection. But I still had to return to my dentist in Mahasarakham to get the crown added. I got someone to ring and make an appointment for me. It can be a little frustrating communicating via someone else who may not understand fully what you want. I usually make an appointment for 6 pm and don't often wait too long. She made the appointment for 5 pm. I made it there by 5.20 knowing that there was no way I'd go in straight off at 5. I waited until 6.40 before I finally got into the dentist chair. I thought they'd forgotten me. Before I left to head into town I noticed that if I bit down on the problem tooth there was a slight twinge there. I tested this a few times on my way to the dentist and sometimes it twinged and sometimes it didn't. I mentioned this to him when I got into the chair. He just said 'Hmmm.' After he removed the temporary crown he stuck his drill into my mouth. I guess he was polishing the tooth but whatever he was doing it was quite painful. 'Relax. Relax.' he said. 'I can't,' I answered. 'It's hurting.' He said it shouldn't be hurting as there was no nerve left in the tooth. I understood that but I know pain when I feel it. And it was painful. So, he put another temporary crown on it and told me to come back in two weeks. I'm not impressed. I wanted to be over it. I've had enough of this. I want to be able to eat whatever I feel like instead of having to eat omelettes and curries all the time. I want to eat sticky rice again. But it seems I have to wait another two weeks—at least. It has been sore to bite on since then but today, not quite so bad. Let's hope it gets better this time.

Labels: Asia, dentist, health, Mahasarakham, pain, Phnom Penh, thailand, tolerance