The National Institute of Health defines a hypochondriac as someone who "believes that physical symptoms are signs of a serious illness." Wikipedia adds that hypochondriacs "become unduly alarmed about any physical symptoms they detect, no matter how minor the symptom may be." To help you visualize the difference between hypochondriacs and non-hypochondriacs, I've created the following helpful graph:
Now, I'm a tough cookie. Though I am, as we discussed a couple of posts ago, somewhat prone to injury and accident (especially on bicycles), I'm pretty good at bouncing back from anything that happens to me. I don't freak out. Well, at least not initially. I am, I suppose, more of what you might call a "stoic hypochondriac." Let me refer you to another helpful graph.
So when, towards the end of our stay in Kanchanaburi, I discovered that I had an infected ingrown toenail on my right foot, I toughed it out for a couple of days.
"Toe update!" I'd announce to Leah every morning. "I just dug some more crap out of it and now I think it's definitely going to start healing."
"I think you should stop digging crap out of it and go to the doctor," Leah would reply.
"No, no, it's getting better. I'll be fine."
And then I'd spend the rest of the day driving Leah crazy by periodically reminding her of the stabbing pain in my perfectly fine toe.
This went on until the evening that we got to Chiang Mai on Wednesday and I looked up toenail infections online.
"Can you die from a toe infection?" Yahoo Answers asked.
"Yes, if you have a gangrene infection, and if it spreads, it can kill you," the Best Answer Chosen by Voters answered, citing a "Distant relative [who] died of gangrene infection."
"Leah, I need to go to the hospital tomorrow."
As it happens, Chiang Mai is home to The Podology Center--the only clinic in the nearest five countries that specializes in the treatment of skin and nails on the feet. The German founder, Dirk, regularly treats the toenails of, variously, the royal family, the daughter of the man who controls all of the gold in Thailand, and local elephants. Or so we were told by Janet, the sextagenarian expat from Kansas City, MO who's spent the past six years working as an assistant at the Podology Center and who, because Dirk was out of town for the week, picked me and Leah up from in front of Tha Pae Gate at 10:30 last Thursday morning. Janet, we quickly learned, was a little nutso.
As we sped along the highway leading from Old Chiang Mai towards The Podology Center, expounded at length to me and Leah about podology, expat life in Thailand, and the character flaws of her husband. We learned a lot.
"Podology is a science only practiced outside the U.S., mostly in Germany, and is not the same as podiatry. Podologists study the causes of foot problems, but podiatrists just treat the symptoms. It's the difference between pulling off the head of a weed and digging it up from the root. Speaking of which, if you go to a podiatrist with an ingrown toenail, they'll want to pull the entire nail off. If you go to a hospital in Chiang Mai, they'll just chop off the toe. And you don't want that!"
"No," I agreed, "we certainly don't want that."
"Podologists are much better for long-term foot health. My husband and I receive regular treatment. But my husband is such a baby about it. Us women are much tougher. A couple of years back, we went with my girlfriend and her husband on Flight of the Gibbon, that ziplining tour--have you done it?"
This last with a pointed glance into the rearview mirror.
"Um, no, not yet," I offered. "After all, we only got into Chiang Mai last night."
"Well, you simply must. It's enormous fun. At least for me and my girlfriend. Oh, we were laughing...and our husbands were shaking on the platforms!"
I joined in, a half-beat late, to Janet's conspiratory chuckle. Ah, men. What babies!
"Yep, my husband, you know, he even gets nervous when I'm driving! He thinks I go way too fast, and he hates the roads here. In fact, when we first got to Thailand, he refused to drive at all! So then one day, we were out to dinner with my girlfriend, and we suddenly just got up and left him at the restaurant with the car to drive home. Oh, we went shopping, and had such a time! Yes, we were laughing..."
Another chuckle.
"Have you been to that restaurant? La Fourchette?"
Another pointed glance.
"Uh, no. After all, we only got into Chiang Mai last night."
"Oh, you have to! It's wonderful! We have our annual dinner there every year. People offer us extra to get in, but we fill up the reservations so fast! I always make them napkin rings for their Christmas gift."*
By this time, we had arrived at The Podology Center. Janet led us past the German shepherds, iguana, and turtle in the front yard into the clinic, where she sat me down with my feet soaking in a warm iodine bath while she bustled around collecting supplies from where they had all apparently been misplaced by Dirk and his Thai assistants.
"I'm going to shoot them," Janet muttered audibly. I was concerned for Dirk and the Thai assistants.
After ten minutes, treatment commenced.
Pre-operation consultation.
"We'll start with the left foot," Janet declared. "Wouldn't want you to be uneven, right?"
I felt this was akin to a dentist suggesting that it was necessary to extract your left molar because the right had a toothache. This did not seem right.
"Right!" I replied with enthusiasm, not wanting to join Dirk and the assistants on Janet's hit list.
Janet pulled my foot out of the water and immediately began tsking.
"Your skin is very dry and hard, and you're retaining a lot of water down in here. You've got a corn starting on this toe, and oh, I don't like the looks of this callus on your big toe. I've never seen that before. I'd better take a picture and send it to Dirk."
She whipped out her Samsung, did so, and continued.
"But don't feel bad. I've seen feet that are much worse. Yep, I think I'd better see what I can do here. I'm going to need my power tools. I love my power tools!"
Janet removed a small electric sander from a nearby rack and went to work on my dry, hard, water-retaining left foot. I stayed very still--a wise move for all those who happen to find any part of their anatomy in close proximity to whizzing German power tools wielded by a small, feisty grandmother--and tried not to think about what would happen when Janet began working on the foot that I had actually come to have treated.
What did happen was this. Janet zipped a zip tie around the knuckle of my big toe. Leah was enlisted to hold my foot down in case I kicked while anesthetic was being injected into it. Janet loaded up a standard syringe with lidocaine. Hannah was thankful that there was going to be lidocaine, and that it was not going to be administered with any sort of German power tool.
Post-lidocaine, pre-nailectomy.
And then...everything went great. Janet cut away the offending part of my toenail (while I watched with morbid fascination--it's really quite surreal to watch someone cut into part of your body without feeling it at all), cleaned up the wound, wrapped my toe up with enough tape and gauze to stock Princeton fencing's medical bag, and gave me some antibiotics to stave off any recurring infection. Three thousand baht, four days, and one follow-up appointment later, my toe really does feel fine, and I'm a new believer in the power of podology.
And that is how I received minor surgery in Thailand for less than a hundred bucks.
*Leah and I did, in fact, eat at La Fourchette the following night, where we each had an amazing three-course French meal, with wine, for less than $40 total.