August 15, 2024
Day T9: Finally the Doctor Visit
This was probably the best time to do the checkup after having recovered as best as possible from that earlier covid exposure in Armenia or wherever it came from. Based on the last visit six months ago and how I feel now, there is the likelihood of further reduced red blood cells. Maybe there is a link between covid and anemia? I wanted to see the same doctor as he was quite the expert on this. He mentioned something like this study at the time.
Regardless of what he would say or the results of any tests, I slept well. This trip was bringing together a community of supporters, like a cheerleading squad. All strangers of course, and nobody on the team really knew each other either. Yet they had converged to bring in an abundance of great advice and encouragement. Their approach was entirely respectful and completely on point. It felt like they all had my back. It was really quite remarkable to see all this in one trip. The magic came from a simple rule: they are all neutral third party independent observers.
The beliefs at the core of this midlife crisis had proven to be completely irrational. Yet not one person said anything to belittle me, well except for that ex-friend from high school who got the boot. That was another source of incremental progress to move forward. Part of minimalism is, like it or not, getting rid of these kind of people.
So as for the doctor visit, everything was standard at first. Unfortunately there was a new guy who gave me the consulation. The same revolving door pattern with Thai people in jobs also applied to doctors apparently.
He said, "We have serious concerns about your low heart rate and enlarged heart size. Even after you're drinking a coffee your heart rate is so low."
I explained, "Well yes, I drank a coffee just now after all the tests were done and they asked me to wait for the results. So I went downstairs with the food coupon they gave me and also got a coffee on the third floor right beside you guys. This was all after I did the EKG test"
Yes it's true, the Thai hospitals will have a food center, coffee shops, and a 7/11 downstairs.
He then checked my heart again and said, "It's still too low. This is not good. That coffee you drank did nothing. We recommend you consult a cardiologist. You also have enlarged heart size. This could mean your heart isn't pumping enough blood to all your organs and they are lacking oxygen."
I told him, "Maybe, but they asked me to come fasted, not eat food or drink water for at least 16 hours before the tests which I did. So that might have affected the results. As for my heart rate, I realize it is very low. It is because I do HIIT classes nearly every day as well as ride bicycles for a long distance. This result has stayed the same for years. People have told me, including other doctors at this hospital, that I have athletes heart and this isn't something to worry about."
He said, "True but even then your heart rate shouldn't be below 50. It's sitting at 43 which is dangerously low. Do you feel faint or tired often?"
I said truthfully, "Yes it happens occasionally in the morning or if I get up too fast from bed."
He said, "See what I mean, this is not good. Your heart could stop, you know."
Was this a joke or something? I couldn't believe he would talk like this. That comment really scared me coming from a doctor. I was pretty sure I had athlete's heart but the occasional feeling of lightheadedness was a concern. Nothing serious, or so I thought. Just to be safe I booked an appointment with the cardiologist the next day anyway.
Meanwhile this same doctor also thought there were serious problems with my kidney function. I then also consulted a nephrologist. The whole thing was only 4100 baht, or just over $100. His game was of course to run up the bill on purpose with extra consulations but the price tag wasn't exactly breaking the bank.
It was a long wait for the nephrologist so I got out the laptop and started learning about how to circumvent the restrictions in my brokerage account in order short stocks. I was mainly looking for how to recover the losses from the ridiculous Trump stock that was bought after he nearly got shot.
But I first wanted to practice this technique with another crap stock that was cheap and likely to go down. Even better, it was Ford Motor Company, the antithesis of a bike lover. All this learning and research was an effective use of half an hour, it sure beats scrolling. By no means a foolproof plan, it had potential to make a net profit and correct my mistake.
The nephrologist took a look at my results and said, "This is all within the normal range. What happened is that the kidneys released a trace of protein, but it's only a trace. This is because you came in fasted for the tests and didn't drink water. So let me guess, the doctor told you to drink more water, reduce your sodium intake, and reduce the fatty diet."
I said, "Yes he did."
He went on to say, "I agree, you should do all three of those things but it's nothing to worry about. Everything else is in the normal range. The doctor you saw did everything by book. If the system flagged something as red because it was out of the normal range, he thought it was a serious problem. For example let me guess, you have a high protein intake as an athlete right?"
I said "Yes for sure. And the doctor told me not to eat chicken, duck, or anything with wings on it."
He laughed and said, "So what that does is it increases the creatinine level. You're sitting at 1.17 mg/dL which is on the higher side of normal. The other thing the doctor flagged is the eGFR (kidney filtration rate) at 74 because the system said it's supposed to be over 90. But anything over 60 is OK since you have no obvious kidney problems. It's because your kidneys are doing more work to filter out the excess creatinine from the protein. So that might also explain the trace of protein in the sample. Of course all the sodium you're taking in, the excess cholesterol and the lack of water isn't helping. So definitely change those three, I think you know that."
I thanked him for all this advice and decided not to do any further tests. I appreciated the knowledge this guy had and how he could teach me something.
All in all it was a fruitful visit. Friends all over social media thought there was something wrong with me for visiting a hospital. Well actually no, it is simple preventative maintainance done twice a year.
Unfortunately all these delays meant I had to cancel my last counselor appointment, but it was probably better to reschedule to next week and take a break from all this by going to Pattaya. The counseling had been very intense and it opened up several entirely new thought and action pathways. This guy had an amazing style where it was simple conversations and he acted as a facilitator. He made it look so easy, like anyone could open up their own counseling business, rent a cheap office, grab a water, pull up a chair then just talk to people all day while raking in cash. But in fact no, he had some serious skills.
It reminded me of another famous Chinese proverb that if you really want to help someone then you teach them how to fish, not just give them fish.
The successful morning done, finally it was time to shop for a new phone. That was actually the easy part.
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