Saturday, October 25, 2014

Of Bikes and Tuk-Tuks: Thailand, Part 1

We ventured off to Thailand for my husband's birthday in July. The dates we picked coincidentally lined up with another co-worker's trip from the Philippines. Both flights arrived late Friday night allowing us to meet up at the airport and and split a cab to the hotel.

The hotel room greeted us with Elephant towels!
My face is ridiculously red from the exhaustion that comes from traveling.
After my adventure in Korea, I purposefully scheduled Saturday morning as a time for me to rest and recover. I knew Thailand would be a trip full of adventures and I wanted to make sure to have an ample amount of spoons stored up. However, my husband did not have the same physical limitations as me. He and my co-worker ventured off Saturday morning for a walking food tour of Thailand as I spent those morning hours resting in the hotel room.

Omelet at breakfast. Eggs are gluten free!
My co-worker and husband were going to do a bike tour of Bangkok that afternoon. I decided I felt well enough to join them. I was a bit nervous about biking around Bangkok in July given the ridiculous humidity and heat. I figured if I remained very pro-active about hydration and cortisol everything would be fine. I took several salt tabs, extra HC, and wore my camelback to guarantee that I always had access to water.

My husband and I outside a Chinese temple.
I am rocking that Camelback.
Although I greatly enjoyed the bike tour, it was physically demanding. I must admit that a couple of times, my adrenal insufficiency scared me. A few hours into the tour, I realized I was growing confused and dizzy. There was so much happening around me that it was difficult to take in everything. My brain started to fog over as I grew increasingly confused. I then realized the wisdom in providing everyone on the tour a lime green hat that said "Follow Me." At the beginning of the tour, I judged the hats to be unbelievably stupid. While riding around crowded streets battling brain fog, I loved the obnoxious identifier of our group.

Green hat? Part of our tour.
Very easy to spot.
A few times, we paused for a break. During these times, I actually had to sit down because I was too weak or dizzy to stand. I also realized that I critically miscalculated the amount of snacks I needed. I had run out of food and we still had another two hours left on the tour. Luckily, fruit was readily available. Our tour guide helped me purchase a bag of apples after I informed him of the urgency of my need for food.

I was too tired to keep standing, so I sat down.
I then found a puppy.
We ended up seeing a few churches, Chinatown, a flower market, old town Bangkok, and then crossing a river to see some temple. By the time we reached the temple, I had absolutely no energy to climb the stairs. My husband suggested for us to wait at the bottom of the temple instead of exploring it. While the rest of group headed up the stairs, he and I found a shaded spot with a large group of cats.

I missed my Olive Thief. I took every opportunity possible to play with the animals.
Although I was feeling a bit better after sitting in the shade for thirty minutes, my husband knew that I did not have the strength to finish off the tour. There was still over an hour of biking left and it was now the hottest part of the day. My husband pulled our guide aside and requested for us to leave early.

Preparing to ride in the tuk-tuk.
Our guide decided that the best course of action would be to send my husband and I back to the club house by way of tuk-tuk. We actually had to wait a while until we found a tuk-tuk that agreed to transport us with the bikes. I did feel awkward as the entire tour had to wait while the guide took care of my special needs. I hate drawing attention to myself in group settings and I absolutely hate admitting that I cannot complete every activity. Primary Adrenal Insufficiency does at times come with physical limitations. However, I had to remind myself that I was making this out to be a bigger deal than it actually was. The rest of the tour did not mind waiting while our transportation was being arranged.

The driver thought he attached the bikes well.
Five minutes into the ride proved otherwise.
We had to stop again as he reattached them.
By the time we reached the club house, I did not want to move at all. Our goal was to return to the hotel as soon as possible, but my body was moving no where fast. I continued to down water and we had Pad Thai delivered so that I could eat dinner without having to go anywhere. I sat in silence for about an hour as my body cooled off from the physical activity in the heat and humidity.

"You aren't going to smile for the picture?"
"No. Takes too much energy."
Once I was feeling well enough, my husband and I cabbed back to our hotel. We were both very exhausted. That night, I had to watch my self talk. I could have chosen to dwell on how pathetic it felt to state, "I cannot complete this tour. Please take me back." But that's not beneficial to me or those around me. I purposefully chose to focus my energy and strength on acknowledging how my limitations actually allowed us to have some extra adventures that we would have otherwise not experienced.

I made friends with more animals and got to ride in a tuk-tuk.

AND this was only day one in Thailand! Our private tour guide was set to pick us up from our hotel at 4:30am the very next day for an extremely early start on our next day of adventures.

Read Part Two.
Read Part Three.

Saturday, October 4, 2014


At my engineering job, I have the potential to play with "high voltage." This requires extra safety certification to teach me important lessons such as if a coworker is being electrocuted, DO NOT TOUCH HIM! However, feel free to whack him with a wooden stick to dislodge him from the exposed wires.

FAD402 (a.k.a. Blood Born Pathogens, First-Aid Training, and CPR) is a four hour long, instructor-led, required saftey course that no one particularly looks forward too. The lucky employees are able to snag the 13:00 - 17:00 time slot, but those often fill up over two months in advance. The unlucky ones must sign up for the 20:00 - 00:00 class. This year, I fell in the middle. My class ran from 08:00 - 12:00.

I was absolutely dreading it.

I remembered taking the course a year ago. I was still working through the PTSD that accompanied The Nightmare. I struggled greatly when we had to "practice" what to do in an emergency situation. Person X must call for help! Person Y must ask "Are you ok?!" Person Z must begin CPR treatment immediately.

That simple role playing game triggers horrible flashbacks for me. Nurse X is yelling my name trying to keep me conscious. Nurse Y is attempting to collect my vitals. Nurse Z is running out of the room to call for help. This is all happening while I'm crashing closer and closer towards absolute darkness. I do not like practicing what to do in a medical emergency. I have lived through one too many myself.

A year ago, I realized that although what she taught applied to the general population, it would kill me. She repeated several times to never ever administer medicine found on a patient. I informed her last year that the protocol she taught as life-saving would end my life. I showed her my solu-cortef shot. I sank back in despondence as she responded, "See, I wouldn't give that to you. I'm not trained up on it. I could mess it up. No, I would refuse to give you that shot."

Dear readers, hear me when I say this: You cannot mess up the delivery of that shot. Even if the dose isn't exactly 100 mg. Even if you don't inject it in the exact correct muscle location. Even if the solution isn't 100% mixed up. It is better than the alternative. I will not be mad at you. I will be extremely grateful that you stopped the crash towards a crisis. That crash is beyond terrifying.

If you see me start to crash, inject me with 100 mg of solu-cortef immediately. I am clearly labeled. I tell you where my emergency injection is. I have printed instructions for how to administer it. I understand that you are scared. But you must understand my life is hanging on the line. Every time I crash, there is irreversible damage done to my body. Each minute delayed in delivering my medicine increases the potential for more irreversible damage.

If you try to just perform CPR on me without that emergency steroid shot, I will die.

CPR is used to address cardiac arrest. I don't want to reach that part of the flow chart.
Find the original chart by Prof Hindmarsh of the Great Ormond Street Hospital here.
I went into FAD402 this year better prepared. I saw how my conversations with her last year influenced her teaching for this year. Off of my feedback, she mentioned to look for medical alert bracelets. She never once stated to not administer patient medication. My conversations with her made a difference.

During one of the breaks, I went up and placed my solu-cortef shot right next to the epi-pens she had on display. She immediately stated, "I thought I recognized you!"

Epinephrine and Cortisol are both produced by the adrenal gland.
I produce epinephrine. I do not produce Cortisol.
She asked me if I had any more adventures like my Nightmare and I said a few. But luckily, my husband was close by to administer my shot. She loved my re-written medical alert bracelet with "Give Drugs or Watch Die." She remembered how last year she informed me that she would refuse to give me my medicine if I began to crash because she wasn't trained. This new wording would definitely encourage her to act.

A few others in the class were listening to our conversation. They wanted to know more about my disease and my story. I gladly handed out my business card with links to this blog with a goal to raise more awareness.

I will take horrible and dreadful situations and focus on the positives in them. I will use my experiences to help others. I will speak openly and honestly about my struggles while remaining positive. I want to show the world that although my broken adrenal glands make my life more complicated, they do not stop me from living life. I want to remind people that we can be Clearly Alive.

PS: I recently found a new video explaining our emergency injection. It's very well done. Just remember that by the time I require this injection I am incapable of administering it myself. Next time you see me, ask me about my emergency kit. I will gladly show you. May we continue to raise awareness to make our lives safer.