Category: Thailand

A red painted elephant on the side of the Ping River with a small boat in the background

An expat in Chiang Mai, Thailand

January 5, 2019

We spent 5 months living in Thailand in the winter of 2016/17. I had just retired from teaching and wanted to see what it would be like to live somewhere else, especially during the cold of our winter at home. We decided to become an expat in Chiang Mai, Thailand.

Why Chiang Mai?

I have a friend who had spent some time teaching and living in Asia. She suggested Chiang Mai as an easy place to learn about some Asian culture and recommended a serviced apartment for us to live in. Since we didn’t have any other advice, we booked the room and the flight. If we hated it, we decided we could always come home.

We loved our time in Chiang Mai. I was sad to leave when spring arrived. We wondered if we liked this city because of all it had to offer to expats, or because it was new and was the first place we had visited.

What is there for an expat in Chiang Mai, Thailand? The answer came from all the other expats we met from around the world, from Australia, England, USA, and Canada. We also met several local Thais.

The Chiang Mai expat club  meet a few times a month and are a great resource to find out about all the things that are available to do in the city. We found a choir to join and met several people that we continue to stay in contact with. We found a group of people playing pickle ball 3 days a week, a Zumba class twice a week and I found a photography club to join that met once a month. Often we just sat and watched the world go by. It was hard to leave all those people and activities when we came home 2 years ago.

Back to Chiang Mai

We planned a trip to Viet Nam for this winter since we had not been to this Asian country on previous trips. The first leg of this journey was to Chiang Mai. We hoped to satisfy ourselves that there was more to the city than just newly-retired excitement. We had a week to visit and booked a hotel in our old neighborhood. One morning we spent watching some workers weed whack the gutters and clean up the plants for flood control. It took 4 of them altogether! I can’t say enough about watching the world go by in a new place.

It was easy to fit back into our life there. We walked through the old city and stopped for food and drink at some of our favorite restaurants. Things had not changed as much as I was afraid they might have. We visited the apartment where we had stayed and found many people from our first visit back there escaping the cold of their homeland.

The people we still know

The crew at pickle ball were happy to see us. We had continued to follow this group on Facebook so were able to pick up where left off. Our paddles even found their way into one of our bags.

3 adults sitting on a bench and laughing at a joke
Catching up with a good joke.
5 adults playing pickle ball on an outdoor court in Chiang Mai, Thailand
Pickle ball courts

After some rousing games and much talk and laughter, we went for lunch with a Thai couple we know. They took us to a local restaurant and helped us place the order for their specialty dish. It was a glass noodle soup with meat, vegetables and a little bit of heat called sou-ki. Sawit’s recommendation was just to point to the biggest picture on the menu and order. It will probably be the item they do the best.

Chicken, vegatable and glass noodle stir fry served with a dipping sauce.
Sou-ki
chicken and glass noodle soup with vegetables and coconut milk served with chopsticks and a spoon.
Sou-ki in soup form

I did some shopping in the markets and attended a Zumba class with my former teacher. On my walk there I saw a group of people in front of a store line dancing for their activity. I went to a nearby restaurant after class, and ran into a woman from Canada that I knew from the photography club 2 years ago!

A group of people line dancing in a parking lot of a shop in Chiang Mai, Thailand
Line dancers moving to all kinds of music.

Lannacapella

We joined Lannacapella, an expat choir, on our previous visit and sang at some Christmas events in Chiang Mai. We were also invited to sing at the 100 day of Remembrance for the King of Thailand in January, after his death in October. I chose a song that the King had written and arranged it for 4 part a capella choir. Singing in front of thousands of Thai’s to honor their former King was something we will never forget.

The current choir invited us to join them for an afternoon of music as they rehearsed for an upcoming Christmas performance. It felt like we had never left. We also had the opportunity to sit in the old Chiang Mai Christian Church. Enormous posts support the roof and has very dark wood floors and walls. The singing sounded wonderful inside.

A group of men and women sitting in an old Thai church singing choir music.
Lannacapella rehearsing

More tours and shopping

We found a driver with an electric tuk tuk. He offered to take us to a village on the outskirts on Chiang Mai where they make painted handmade umbrellas and weave silk. Even though we lived there for a winter, this was an area we had not visited before.

The silk makers had an interesting demonstration on how they feed the silkworms until they make a cocoon. Before they open, they boil the whole thing and pull the silk threads off and unwrap the pupae. The threads are dyed and woven into cloth. The boiled pupae are surprisingly tasty. I even ate 2 of them!

The umbrella makers use split bamboo for the frames and make rice paper with and without added silk or cotton for the tops. They also made wood and paper fans. Many had elaborate scenes painted on them. One of the painters did a design on the back on my phone cover for about $2. It has not scratched or peeled off after 3 weeks of use.

We visited a shop that sold pashmina scarves and rugs from Kashmir. I’m not sure why they are working in Chiang Mai. He was very convincing, but you only need 1 Indian Rug, which we purchased in India last spring. A tour of a jewelry factory and salesroom was the last stop.

More local food

After the success of our local lunch earlier in the week, we asked our driver to take us to a place where he might eat. We pulled up to a couple of tents set up along the main road. There were several scooters parked in front and our driver waved to several of the other drivers he knew.

He recommended some bbq pork that came off the grill and was chopped into bite size pieces. It was served with a dipping sauce with Thai basil and cabbage on the side. He also suggested a kind of catfish that was rubbed in spices, wrapped in banana leaves and roasted on a grill. It was a whole fish and being from the prairies, where we don’t eat much fish, I didn’t look at its face and focused on the flavor. Delicious! Our driver ordered a beef salad that had cucumber and lots of herbs and lemongrass with a tart, spicy vinaigrette. Along with 3 large local beer the bill came to $16 for everything.

  • Local B B Q

More expats

We made friends with a couple of expats at one of the Expat Club breakfasts when we first arrived in Chiang Mai. They had invited us for drinks a couple of times and talked about how they found themselves moving from the United States to Thailand permanently. When I emailed them that we were coming back to the city, they invited us again for a visit.

It felt very festive with several decorated Christmas trees. Even though we had only known them for a short time we felt so welcomed. Jim commented, “You are someone we didn’t think we’d see again.” For those expats who welcome the strangers who visit, then leave, it must be difficult to remain open to meeting new people. They did say, however, that it took them 8 or 9 visits of varying lengths before they decided just to stay.

Should we become expats in Chiang Mai, Thailand?

This Asian city is a very easy place to live. There are many other expats from around the world who are open and welcoming and many opportunities to get involved in a variety of activities. There is lots to see and experience in a foreign culture but also lots to do that feels like home.

We looked at some local condos and apartments on-line. Chiang Mai is still a reasonably priced country in which to live. The infrastructure is improving, and we noticed more cars than scooters this time, which would suggest the middle class is continuing to grow. The local people are kind and respectful to “farangs” and don’t seem to hold it against you for coming into their lives for awhile and then leaving.

Thailand is a country ruled by the military, even though the new King is in place. It floods in the rain, swelters in the heat and has a couple of months when the farmers burn that air quality is like living next to a British Columbia forest fire. The rules for visas for retirement change often and in order to stay long term, you may need to deposit several thousand dollars in a Thai bank.

And the final answer…

I don’t think we are ready to decide yet. We know that there is more to Chiang Mai than just the excitement of our first place. Six months in Phnom Penh last year was long enough to know that it is not the place for us. We don’t know if there are other places we have yet to discover that might meet our needs even more. Stay tuned.

Packing for a Winter in Thailand…What did we really need?

April 15, 2017

It was difficult packing for a winter in Thailand.  What did we really need?  Having never visited Asia before, we weren’t sure what was essential, what recommended and what would be nice to have. We only had 28 sq. m for living space so we couldn’t take too much.  As we packed to come home, I made some notes for next time.

Prepared for action

Clothing

As almost every travel site will tell you, pack your bag and then take half of it out.  I did that initially, but could have done it again.  Thailand is hot and humid.  It is also very casual.  The only people dressed up were the tourists from China.  I took dresses, shorts, skorts, and wicking t-shirts as well as some stretchy shorts and light t-shirts to use in the gym.  I added a couple of swim suits and a cover up.

Here’s what I found.  The laundry lady on our street washed, dried and folded our clothes about every 10 days for $7.  She usually had them overnight.  That meant I took too many t-shirts.  I also preferred wearing dresses with the stretchy shorts underneath.  The rayon dresses they sell in Thailand for $10 each are perfect for this climate.  They hang loosely and were the coolest, most comfortable option for me.  I had one nice sun dress I brought and a couple of other dresses that were also cool enough.  I would recommend buying dresses on arrival and a long wrap-around skirt to keep packed to use as a skirt or a wrap to be respectful in the temples.

Thai dress

The skorts were useful as they are appropriate for any occasion.  The black one was good when I needed black and white for a choir uniform. I had a white t-shirt but bought a dressier white top when we were performing. I rarely wore the shorts.

The most important item I took was a big white sun hat I purchased at MEC before we left.  I wore it every day.  The chin string seemed a bit uncool until I was riding in tuk-tuks and boats when it became essential.

swim cover and hat locked on

Travelling Clothes

Since we planned to visit the Great Wall of China during our Beijing layover on our flight there, we had a bag of clothes for layering.  We wore zip off hiking pants that were also very practical for our visit to Nepal.  I took a toque and mittens as well as a wind jacket and light fleece jacket.  As it was just around freezing with a light breeze, these clothes were perfect for the stopover.

The coldest high temperature in Chiang Mai was 23,  and only for a couple of days.  I wore my hiking pants once, just because I had them.  I wore a light sweater that I did buy there.  It was also useful in the movie theaters when we sat in the air conditioning for a couple of hours.  A scarf or skirt as a wrap would probably do. Most restaurants were open air with fans so we didn’t experience the chill I feel when sitting in A/C here.  We brought umbrellas and rain jackets.  It only rained twice and was too hot for a jacket.  The umbrellas could have been purchased at 7-11 for a small amount and then left behind.

Brisk day in Beijing

Footwear

For footwear I took flip-flops for the pool, hiking shoes, runners and sandals with good support.  I could have managed with just the runners and sandals but they both were pretty new and I wasn’t sure if they would feel good with all the walking we were going to do.  We had planned to do some hiking, but we didn’t, so I would take the same choices again another time.  There is plenty of footwear for sale, but with my feet I wanted to be sure I had what I needed ahead of time.

Toiletries

As far as toiletries are concerned, you can buy most of what you need.  There are many recognizable brands in the drug stores and grocery stores.  There were a few challenges.  Peter found the toothpaste tubes looked the same as at home, but the taste of Colgate was not the same.  Deodorant is either spray or roll on and contains whitener, as does almost every skin product in Thailand.  They want their skin lighter and we are all trying to make ours darker!  If you like solids, take lots because you will need it in the heat.

I wasn’t able to find 3 products.  I use a hydrogen peroxide solution to clean my contacts.  It is considered “dangerous” and is not sold in Thailand. I had to have some brought from England and Canada.  Blonde hair colour is also not available, which is to be expected in a country where everyone has beautiful black hair. I also had difficulty identifying antacids like Tums in the stores so my sister brought me some from home.

We took towels, but our apartment provided towels for the bathroom and for the pool.  I found some beach size quick dry towels that pack very small.  They were good when we went to the beaches in Krabi.  We also bought full face snorkel masks for the ocean, but there were places to rent them if we had wanted.

Games and Activities

I took a crib board, some cards and a couple of puzzle games.  We did use them, but there was lots to do in the evenings, or we were too exhausted to do much besides watch a little Nat Geo channel.  I took a couple of books with me, but there was a book exchange in our building and a couple of used book stores where I could find lots to read in English. Peter took his guitar and golf clubs.

Electronics

My computer got lots of use.  I bought an ASUS zenbook because it runs on a solid state drive so it is fast and is more durable if (when) it gets bumped around.  It is also powerful enough to run photo editing software. I used it to write my blog, edit photos, watch movies on Netflix, call home on Google hangouts and video call on occasion.  I also had a couple of external drives that I used for picture storage. Pete took his laptop and our tablet.  We also took along a small Bluetooth speaker that we used quite often. We did have a TV in our room that had many English channels, including a movie channel, National Geographic, History, and CNN International.

Phones

Our phones were old when we took them.  After a few weeks of trying to keep them charged or plugged into external batteries to enable Google Maps to keep working to help us find a location, we started looking for something more efficient.  Once Uber became an option, it was essential to have a working phone.  We ended up buying the first new phone in Laos.  It was 2.25 million kip!  This is only $350.  Peter bought another of the Huawei gr5 2017 phones when we returned to Chiang Mai.  They last about 1 1/2 days on a charge.  What a relief.

Chargers and Adaptors

Thailand works on 220V and North America on 110V.  We took a plug-in adaptor with us as well as a small power bar.  We found that our phone and computer chargers work on multiple voltages.  This is printed right on them.  Even my camera battery charger worked.

The cords in Thailand have 2 round pegs and no grounding plugs, however the slot plugs from home would fit into the outlets which had an extra slot for the third peg. They often had to propped up to stay since the plugs had to be inserted sideways, and they weren’t gripped as tightly as we are used to.  The power bar was useful but we didn’t need the adaptor for our plugs.  I didn’t take any other appliances.  I bought a small blow dryer when I arrived.

Money

Thailand, and most of South-East Asia for that matter, is a cash economy.  We rarely used our credit cards, and if we did there was at least a 3% fee added on.  The ATM worked well for taking money from our Canadian account and giving it to us in Thai Baht.  There was a $7 fee for the withdrawal on that end and a $5 fee from our account at home.  We always took the maximum amount possible to minimize the fees.  Next time we would be sure to have a larger limit for withdrawals.  We also needed American dollars to pay for our visas in other countries.  It would probably be cheaper to take some of that currency with us.

We paid our rent with a global e transfer from our bank to the hotel account.  This had a smaller fee than 2 withdrawals would have and worked easily.

Packing

Air China allows 2 free checked bags of 23 kg on their international flights.  When we came, we brought 2 large rolling duffel bags, 1 smaller duffel bag and Pete’s golf clubs.  I had a 40L daypack for my camera/computer equipment and Pete had a similar daypack for carry on as well as his guitar.  We also used the daypacks as luggage for our trip to Laos.

Daypack and hat went everywhere

To return, we were doing well with only buying a few small items for gifts and had decided to replace the smaller duffel with a larger pack from the market.  Luckily we sent the golf clubs and few other items home with our daughter, Melissa, in March before we went to Nepal.  The “made in Nepal” outdoor gear was too tempting.  In the end we brought home our 2 big duffel bags and 2 large North Face waterproof bags full of outdoor clothing that will be great additions to our truck camping supplies.

Things We Left Behind-maybe for next year?!

Supplies
Our kitchen supplies
My cozy chair and computer table
Left this for the neighbors

Thank you for all your interest in our travels.  I will share a few more pictures and shorter stories now that we are home and have time to look through them before we head off on whatever comes next.  I appreciated being welcomed back to church last Sunday with, “We thought you were in Nepal!” since that is where my last post referred to.  It let’s me know people were following us closely.  We never felt lonely on this trip.  Let me know if I can help if you decide to just go to see the world.

 

Krabi and Ao Nang…A holiday from our holiday

March 16, 2017

Krabi and Ao Nang

I will get back to our visit to Siem Reap shortly but for now we are in Krabi, Thailand. Our hotel is in the Ao Nang area.  We came here to experience the beach life of Thailand, to escape the smoky air of Chiang Mai and best of all to meet with our daughter, Melissa, who came for a visit. It’s a 2 hour direct flight from Chiang Mai and cost us about $175 return for the flight.

There are lots of beach towns and islands to visit in Thailand.  We talked to many people before deciding on Krabi.  It is not as popular with the party folk and is fairly well-developed for those of us who can backpack, but don’t necessarily want to.  It was easy to get to for a 5 day visit.

Accommodation

Finding a place to stay was more challenging than I expected.  Agoda, the Thai on-line booking company, showed lots of places as not available, although word is that they had limited rooms, not the hotels.  The majority of places only have beds for 2 people, either 2 twins or 1 double.  We would have needed to book 2 rooms for the 3 of us.

We found a place called Oscar Villa that had a family room with sleeping space for 4, a little kitchenette and a pool view for about $65/night. It was about 4 km from the beach so it took us awhile to figure out the transportation.  The hotel provided free shuttles to and from the beach 3 times a day.  You could call the office and go or be picked up any other time for 200 baht (about $7.50) per family.  They had a restaurant at the main office which was a couple of blocks away.

Customer Service

We didn’t take advantage of their activity planning until later in the visit.  Peter and Melissa went kayaking the last day. They arranged the booking for them, the transportation, stored our luggage for the day and picked us up at the beach for our trip to the airport in the evening.

Oscar Villa
mystery bug

The customer service was very good.  They really want you to have a good experience.  Pete got bit by some caterpillar thing that was sharing the back of the bench with him.  The gardener made a big show of killing it with his shoe, then brought over some ointment to rub on his arm to prevent any itch.

Ao Nang Beach

The Andaman Sea is warm and clear.  A peninsula protects the beach at Ao Nang from the Bay of Bengal. Phuket is on that peninsula. The area has recovered from the tsunami, although many big resorts rebuilt along the coast and took over some of the nicest public beaches.

The view is dotted with limestone cliffs, stone karsts and longtail boats.  It really does look like the views you see in the travel books.  The islands that you can visit may have promotional pictures of their beaches from 10 years ago but they are considerably busier now.  They are still so beautiful though.

Things to do in Ao Nang

  • Sit on the beach.  There are trees to provide shade until afternoon.  There are hawkers for bamboo mats, cold drinks, dresses, jewellery, massage deals, and even fresh cooked corn.  That man even had a charcoal bbq with him.

 

  • Swim in the ocean.  It’s sandy on the bottom and clear.  Watch for jellyfish. Someone thoughtfully fished one out with a big palm leaf and left it up on the sand where it was easily seen.  Roped off areas protect the swimmers from the boating area.
  • Take a long tail boat to another beach.  You buy the tickets at the beach access.  Railay beach is about $7.75 or 200 baht return and takes about 10-15 minutes in the boat.  It was low tide when we got there so the beach wasn’t that nice, but the cliff views were worth the trip.  There are lots of shops and eating/drinking spots there.

  • Find a rooftop bar for happy hour.  That’s all day for many places.  We really liked the Tom Yum restaurant near the big sailfish statue.  It’s upstairs on the roof next to the Family Mart.  The staff made sure we had cushions to sit on, shade or a fan and the view of the water is through the trees that give the shade.  Their mojitos are delicious and are on sale for 90 baht or less than $3.50 each.  They put fresh-cut pineapple on their Hawaiian pizza.  The places on the beach that are south of the main drag are more expensive.

  • Have a massage or mani/pedi along the beach.  Head south along the beach and keep going until you find the row of massage places.  They are open to the beach and most have mattresses on the floor.  We had picked up a flyer earlier in the day on the beach so we went looking for #12, Jan’s Massage.  Peter had an hour aloe vera massage plus his nails trimmed.  Melissa and I had a mani-pedi which included having our feet scrubbed and nails painted.  The entire process occured with us lying down on the mattress.  The women moved themselves to where our nails were. We spent 1100 baht which is about $40 for an hour of bliss for the 3 of us.

mani/pedi by the beach

  • Book a table at the Hilltop Restaurant.  It is at the northern end of the beach up in the hills.  The food was quite good, the service was fine and the sunset views behind the islands were spectacular.  We also enjoyed the live music. One other highlight was witnessing a wedding proposal while we were there.  They offer a free shuttle service to/from several local hotels.  Ours was not in their zone, but they picked us up at the Sailfish statue by the beach.  Sunset from the beach is pretty nice too.

  • Watch the clam diggers at low tide…moms, dads and kids.

Muslim clam digger
A boy digs up his own clam
Like father, like son

Island Tour

The highlight of most people’s trip to Krabi is a day trip to some of the islands.  There are many options so I am glad we talked to others who had been here.  You can book a tour to the closest 4 islands, a tour to the Hong Islands or a tour to Phi Phi Island. You can travel by long tail boat or speed boat.  To read more details on the pros and cons of the tours and the mode of transportation, check out these two sites.  Travelfish boat and kayak tours and YourKrabi.  We found them quite helpful.

Although this is still high season here, it was not as busy as we expected.  We didn’t want to spend our island tour day on someone else’s schedule so we opted to book our own private long tail boat to the Hong Islands, just for the 3 of us.  It cost 3000 baht which converted to $114 CAD for the day.  The group tours cost 700 baht each but include lunch. We came into town early, had breakfast, and bought a couple of take away sandwiches for our lunch. We bought our  boat ticket when the booth opened at 8 and were taken to our boat right away

Thoughts for next time

Although the day was fantastic, I know a couple of things I would do differently.  I understood that the drivers travelled the same route as the tours, just on our time schedule.  I should have been more familiar with the tour route as I would have liked to spend a little time snorkelling at one of the off shore stops instead of just along the beaches.  When I asked what was next, he just replied, “whatever  you wish, madam.”  I should have known better what I wanted.

The other thing we learned for next time is that we could have bought our boat ticket the night before.  Then we could have left even earlier and beat all the crowds. Regardless, the day was terrific.

Hong Island

It took about 45 minutes by long tail boat to get to Hong Island.  The water was like glass so it felt more like a lake than the ocean.  We saw other long tails and speedboats as well as some dive boats and large catamarans.  We had benches to sit on under a shady cover.  The motor is loud but the ride was smooth.

Our boat was the 3rd to arrive for the day.  We paid our marine National park fee of 300 baht each and ogled the smooth white sand and teal water.  The cliffs were steep around the bay with a large rock formation splitting it into 2 parts.  The background was all jungle.  Areas for the swimmers had ropes and there was a big boat parking lot.  The driver told us to stay as long as we wanted and let him know when we wanted to go. He recommended about 3 hours if we wanted time to see the other areas.

Hong Island Facilities

This is the largest area on this tour so the facilities were good.  There were lifeguards and parks people to remind the idiots not to feed the fish.  Toilet facilities were clean and included a water filled area to walk though to remove the sand from your feet. There was also a restaurant and a place to buy snacks and drinks.  You could rent kayaks to travel around the island, or into the cove.

Although we stayed for 3 hours, I was pleasantly surprised to find that the dock had people coming and going, but the beach or swimming area never felt crowded.  It was a good place for families with children.

We swam and snorkelled.  There were bottles of vinegar in posts along the beach to use as an antidote in case of a venomous jellyfish if necessary.  There were also signs with warnings of what to look for.  The water was clear and I saw several varieties of fish.

sdr

Other stops

We left about noon and travelled around the island to a lagoon that is in the center the opposite side.  It was high tide so the boat could enter.  The water was a beautiful green color with high cliffs all around.  We toured around the inside at a nice slow pace and took lots of pictures.  At low tide you can only enter in a kayak, but apparently, the colour is even more intense.

Cliff walls inside lagoon

We travelled to 2 more islands.  One had a small beach with more cliffs and more fish to see.  The other had a long sand section joining 2 rocky sections.  There was a mushroom looking rock in the bay that had a lot of coral just past it.  The textures and fish were worth the sunburn I got on the back of my legs.  Much of the other coral I saw was dead.  I don’t know if this is still a result of the tsunami, or from development and all the boats in the area.

It took about an hour to return to the beach in the long tail.  It was 4 o’clock and we so appreciated our tropical paradise.

Kayak Tour

Melissa and Peter took a half day kayak tour north of Ao Nang at Ao Thalane.  The trip in the back of a songtaew to the boat launch was uncomfortable, but the time on the water was just what they hoped it would be.  They paddled in a group of 10, led by a guide.  Included were water bags and drinking water.

The current took them along for much of the ride. They travelled through mangrove trees, over a small stretch of open water and into steep canyons that had once been limestone caves until the tops caved in.  Stalactites were still visible.  They spotted some monkeys in the trees, but fortunately none came for a closer look.  This route is only available at high tide.  Coffee and fresh fruit were available after the trip concluded.  At a cost of 500 baht, or $20 CAD, it was a fantastic time.

Holiday from our holiday

It was a great place for a holiday from our holiday.  It was also nice to choose a late flight home where we could get a quick ride home and not have the 2 hour drive through the snow and darkness we usually experience after a tropical holiday.

I have included some photos here in the blog but look for others in the travel menu.

 

 

 

Travel Vaccines and Medical Care for travel to Thailand

March 3, 2017

We didn’t know much about travel vaccines or medical care in Thailand before we left.  After visiting the travel clinic at home, and experiencing medical care first hand, we are comfortable with being in Thailand for a long stay.

Travel Clinic Visit

Before leaving home, we met with the pharmacist at the travel clinic at London Drugs in Red Deer.  We had to pay $40 each for the consultation but we could make our appointment on-line from home and see what fit best with our schedule.  The health unit in Red Deer also has a travel clinic for about the same price.  The following information relates to our experience and may not be applicable to everyone.  Be sure to see a professional before you travel to get the most up to date information.

We filled in our medical history on-line in advance and specified where we were planning to travel.  The appointment took an hour and we discovered that we should have made this appointment sooner in the process.  You need 4-5 weeks to complete immunizations for travel, especially when you are behind on some of the usual ones. She was able to accommodate our schedule, although we will need a booster when we get home.

Thailand Vaccines

You don’t need any specific immunizations to enter Thailand, unless you are coming form a country where Yellow Fever occurs.  We needed our 10 year boosters for diphtheria, tetanus, and pertussis.  The health unit does those free of charge. They also gave us a measles, mumps and rubella booster.  We have probably had all those diseases as children, but if there is a measles outbreak, we have evidence of being protected and would not be seen as carriers of that disease.

Some of the immunizations we chose to get for Thailand I felt were necessary and some optional. Most of these shots last 10 years or more, so we won’t have to go through this each time we travel. Typhoid and Hepatitis A/B seemed obvious for travelling to a developing country.  Japanese Encephalitis is mosquito born and in some cases is serious so we added that.

Rabies

Rabies was one that we discussed for a while.  The pharmacist recommended it because of the stray dogs in Thailand, and the amount of time we were away.  She also said that lots of tourists get monkey bites and scratches because they act so excited when they see this animal, they intimidate the monkey.

We had all 3 shots.  If we do get bitten or scratched, we will still need 2 more doses of immunization.  If someone has not had the vaccine ahead of time, they will require 4 doses as well as Rabies Immune Globulin.  It is a blood product and is not always available in smaller centers.  A flight to Singapore would probably be needed to ensure this product.

The fact that my extended health plan covered these vaccines made the decision easier.  Since I don’t need to use my plan for much else, and I have to pay for it myself now that I’m retired, I felt it was good to go ahead and have the shots ahead of our trip.  Fortunately, so far the dogs are friendly and I have stayed well away from the monkeys.

Malaria

This is the first disease I think of when imagining travelling to a tropical country.  I learned that it is not common at all in urban areas.  We received copies of maps of all the countries we thought we might visit showing where there was the greatest risk of being bitten by a malaria carrying mosquito.  It’s hard to know where you might end up when you have 5 months to decide where you want to spend each day, or week.

We brought a supply of anti-malarial medication with us that you only take when you expect to be in a higher risk area.  You begin them 1 day before you leave, while you are gone and for 7 days after your return.  I had heard that this treatment made you feel as sick as the malaria, but our pharmacist assured us that this particular drug, taken with food had a very low reaction rate.  I haven’t had a chance to try it yet, as we have stayed out of most of the malaria areas.

Dengue Fever

We had heard that the medical care in Chiang Mai was excellent.  I’ve met people who had surgeries here.  One of the local hospitals promotes check up screenings for a reasonable price.  My friends in Cambodia come here for skin checks for cancer and an ultrasound follow-up that couldn’t be done in Canada in the 4 months she was home last year.

Earlier this month I had a chance to check it out firsthand.  While my sister was visiting, I felt like I had the flu.  I had a fever that came and went.  My joints ached, my eyes hurt and I had a constant headache.  I didn’t have any vomiting, but some bowel issues that I just put down to Thai food but I was also really tired.  After a tick bite in December, I worried that it might be a reaction to that, although enough time had passed to make that fairly unlikely.

A doctor owns our building and does “house calls”.  I explained my symptoms to him and he said that there was a flu going around and that his doctor daughter had seen many cases recently.  I took him at his word and finished showing Nancy Chiang Mai, although with more naps and some skipped meals where she and Peter went out without me.

The day after she left, I awoke to a rash all over my body.  It sort looked like a measles rash, although it wasn’t on my face.  The palms of my hands and soles of my feet were very red and itchy.  After entering my symptoms into google, It was time to get this checked out.

Hospital Day 1

We took Uber to the hospital recommended by Dr. Smith.  It was about 15 minutes away.  After giving them my name, address and passport number, I was asked to wait.  Within about 5 minutes, they had taken my temperature and blood pressure and recorded my symptoms.  After another 15 minutes or so, I was in to see the doctor.

He didn’t think it was related to the tick. He felt it was probably Dengue Fever, which is a virus you get from mosquitos.  It affects your bone marrow production of platelets and white cells, as well as causes plasma to leak out of your blood vessels.  Serious cases can turn into hemorrhagic Dengue Fever which can cause internal bleeding.  Those need to be treated with blood transfusions.  It was fortunate that we decided to get it checked out at the hospital, even though I had only a mild case.

He was surprised though, as there had only been a couple of other cases in the hospital all month.  It is much more common in the rainy season.  We had only been back from Laos for a couple of weeks, so maybe the bite happened there.  He said the rash is a sign that you are starting to get better and was the body’s reaction to the virus.  He sent me for blood work.

The blood results were back in about 45 minutes.  I waited a little longer for the doctor who said that the Dengue test takes longer, but that my white blood and platelet counts were below normal and that indicated Dengue.  He sent me home with Tylenol for the headache and fever, antihistamine and Calamine for the itch.  He also arranged for an “appointment” page to come back the next day for another blood test.

We waited about 10 minutes to have the appointment printed, the medications filled and went to pay the bill.  Within 90 minutes, 2 doctor talks, blood work and medication, the bill was 672 baht, or $25 Canadian.

I wasn’t very hungry but was craving some comfort food.  We had a couple of boxes of Kraft Dinner in our kitchen that we had been saving for just such an occasion. It did make me feel less far away from home.

Hospital Day 2

After sleeping most of the next day I returned the hospital, but this time I turned in my “appointment” and was sent directly to the lab where the blood was taken and processed.  I met with the doctor after about hour from arrival.  She showed me that the white blood and platelet count had gone down some more.  The previous test also confirmed it was Dengue fever.  The doctor suggested that I should stay at the hospital to have an IV to ensure I wasn’t dehydrated.  Since I wasn’t vomiting, I said I wanted to stay at home, but would come back if I had any signs of bleeding.  She sent me home with electrolyte powder to mix with water and another “appointment” sheet for the next day.

Again, it took about 90 minutes and with the extra Dengue test, the cost was 942 baht or $35.91!

Hospital Day 3

I woke up the next day feeling like I had a little more energy.  My headache was less severe and I felt like some food.  I did more reading and watched a movie.  We went back to the hospital in the afternoon and they took me right in for my blood work. They also wanted to check liver function and do a urine test.  When I saw the doctor, he showed me that the platelets and white count were on their way back up and that I didn’t need to come back.  He recommended continuing with the electrolyte drinks for a couple of days and continue to rest but all was well.

The wait time was about the same but I had more lab tests done.  The final bill was 1337 baht or $50.96.  In total I paid about $112 to the Rajavej Chiang Mai Hospital.

Recovery

It took a few days to get my energy back.  As my appetite returned, I felt better.  The rash lasted about a week, but it was only itchy the first couple of days.  By the time we returned from Cambodia about 3 weeks after the first fever, I was ready to get back to the gym and find my lost fitness level.  I am also much more vigilant in using the DEET every day.  My Thailand hospital experience was very positive, but I’m in no rush to experience it again anytime soon.