Bangkok

Arriving in Bangkok is organised, air-conditioned bliss after the anarchy of Kathmandu…even if you’ve grown fonder to the craziness as I had. Everything in Bangkok is signposted, efficient (take a ticket number for an airport taxi and go to the booth with the same number, voila!) and there are plenty of people around to ask for help. Still, after an intrepid first fortnight of travels, I felt a slight sinking feeling as we stepped back into an intensely structured universe.

Thankfully, that sanitised order ended at the airport door – the area around our hotel in China Town was more like a bustling street bazaar full of exotic food for sale like Durian, sticky mango rice and Jack Fruit. Delicious!

With its rich-poor divide, its drive for convenience and modern comforts (particularly good coffee) and its seedier side nestled down dark alleys, Bangkok is like many cities I’ve visited before. But it has its own vibe too. It has alligator-like lizards swimming in its canals, Tuk Tuks dressed up with flashing lights zipping down busy alleys, anything you can imagine available to buy on its streets and an architecture style that is completely new for me. 


The lizards of the canal – Water Monitor lizards.

Day 1 sees us decide to walk the 30 minute journey from our hotel to the Grand Palace as a novelty after it being near impossible to walk in Kathmandu due to pollution. The humidity gets in on me and it’s clear why most people ride mopeds rather than walk here. I worry that this heat may bring about some issues with my MG as I feel exhausted almost right away. But I learn on that first day that an air con break with a delicious fruit smoothie and a salty sandwich is what will revitalise me here, not my normal caffeine fix. 

Over the next 4 days we try to take in as much of the city as we can including temples, art exhibitions, a boat trip, shopping, night life and a ladyboy cabaret. We also dedicate a day to our hotel’s rooftop pool and bar; watching the boats on the Chao Praya river and trying to conquer the inflatable flamingo. Thus in Bangkok we try to cement the balance of ‘doing’ and ‘being’ that we want to keep throughout the trip. This trip is about rest and recovery as much as it’s about adventure.

I’m not sure what I expected, but Bangkok is definitely better. From a privileged tourist perspective, the value for money is unreal compared to home, it’s easy to get around and no matter where you are at what time of day or night, there’s a Tuk Tuk or taxi driver waiting to haggle with you – and 9/10 times for me they were polite. While there are quite a lot of Seven 11s, Starbucks and McDonalds, there are a lot less chains here which allows different areas to have their own feel.

I have no doubt that Bangkok has its own issues (many of which lurk down those dark alleys), but as someone passing through its relaxed atmosphere, variety of attractions and affordability mean I’m certain I’ll be back here.

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Trekking in the Himalayas 

After a couple of days rest in beautiful Pokhara, I can hardly believe what the last week has entailed and how well my body has coped. 

When we decided to go to Nepal, we initially signed up for the Annapurna Circuit trek. This is an 18 day trek with 11 days of walking. However, neither of us have been above 3000m (the level that altitude starts to impact most people) before and the circuit trek reaches over 5000m. Our initial excitement was replaced by last minute panic, as I had no idea how much impact the lack of oxygen would have on my MG and the only option from some of the places along the way was to be helicoptered out. So we changed to a 6 day trek below 3000m – with equally stunning views and daily yoga sessions. 

Elaine and I joined a group of 4 lovely women to trek through squelching jungles and up the 2500m Panachassee mountain (Nepalis consider this a hill). Our daily schedule was a morning yoga class, a hike, an evening stretching session when we reached our destination and an hour of relaxation – mostly with the soothing singing bowl.


The Buddhist temple at the Panachassee summit.

How it went

Between the strength-based yoga sessions and the daily step count, I was nervous about how my body would handle its first challenge in an alien ecosystem. The walking wasn’t too strenuous – we spent between 3 and 7 hours walking each day. However we were battling a relentless sun, post-Monsoon season boggy ground, leeches, steep upward and downward ‘paths’, jungle insects, lots of creepy crawlies in our rooms at night, and, on one day, the heaviest rain I’ve ever had the pleasure of walking in (says something considering I’m used to walking in Scotland). 

The group also collectively battled a lack of sleep – from 2 nights before the trek I managed only broken sleep and this continued right through to day 3 of the trek. Because we were tired each night, we all wondered whether there was less oxygen above 2000m and whether this was impacting our zzzz time?! 


Our rustic accommodation in Bhadure.

Coping with sleeplessness

After another restless first night of the trek, I decided to double my steroid dose and take a pyridostigmine just in case. I only did that for one day as I felt strong and healthy during the other days.

When it came after 4 horrible nights, 6 hours of solid sleep left me jumping out of bed to embrace the day. I’ve never felt better than during the yoga session that morning in Bhanyajang – watching the Annapurna range appear and disappear behind the clouds and feeling like I could hold the poses for hours.

While it was psychologically challenging, the lack of sleep didn’t challenge my body as much as I expected. In fact, I’ve rarely felt better than during those five days of circadian rhythm and healthy eating. 

Back to basics

The accommodation was rustic, with Nepali rather than western toilets (essentially a tiled hole in the ground), cold water, no electricity for part of the trek due to thunder storms and, shock horror, no internet. However I adapted quickly and was a little upset when the electricity returned. Saying that, I was so grateful for a bucket of hot water during my last night in Bhanyajang that a few moans escaped as I tipped the water over my head and felt my tired muscles relax.



Our toilet in Bhanyajang.

All good things must come to an end

We watched the landscape change from a quaint mountain village with locals lounging and Tibetan women selling bright jewellery to woodland paths; from dusty tracks to open hillsides; from endless stone steps to dense jungle full of mutlicoloured butterflies; from fields of buffalo grazing to hilltop temples in the mist; from ridges with endless mountains in the distance and eagles swooping to rice and millet fields lit up by the warm afternoon sun. Finally we found ourselves back in a different village in the throws of Dashain celebrations – giant swings are made out of bamboo and bright coloured decorations on the streets.

By our 6th early morning of yoga back in Pokhara, my body was tired and I felt fatigued as we travelled to our new hotel. But taking a nap right away followed by a couple of rest days helped my recharge and I found myself back on my brand new yoga mat two days later.

Having loved Panachassee trek, I’m determined to try a longer, more challenging trek in the incredible Himalayas (with some kind of sleep remedy in my first aid kit). We’re likely to be above altitude in South America for a short time so it’ll be a good test to see how my body responds. Hopefully I’ll be able to tackle the Annapurna Circuit or something similar in the future as the thought of spending triple the amount of time out in that beautiful countryside fills me with pure joy. 


Walking through rice fields on our last day of trekking.

Travel vaccines and myasthenia

There were a lot of expenses for our extended honeymoon before we left home and now that we’re ‘here’, I’m not sure how many of them were necessary. The most important and least pleasurable pre-travel expense was the money for injections.

I spent around £500 on injections over a period of 5 weeks and felt like a pin cushion. While I don’t grudge money spent in order to keep myself healthy, it was difficult to hear that because of suppressing my immune system it’s not guaranteed that any of the 11 injections will work. Goodbye £500.

Still, like a reasonable non-stingy (cough cough Scottish) adult, I figured it’s better to have them than to leave myself open to a range of exotic diseases – most of which the pharmacist explained in far too much detail. He was who you should talk to if you never want to adventure beyond your bedroom. 

Side effects 

I was mostly fine after the injections excluding some heavy arms and the first three injection day where I felt nauseous and lightheaded. On other days I was able to go for a light run or swim on the same day as the vaccines. 

No can do

A vaccine that is recommended for the areas we’re travelling to and that I couldn’t get was yellow fever. As it’s a live vaccine, I wasn’t allowed to have it due to my thymectomy and immunosuppression – there’s a risk I’ll get the disease from the vaccine.

The mosquito-carried disease doesn’t have a presence in Nepal or south east Asia so I’m safe for now, but it has a grip on certain parts of South America including the Amazon rainforest. While I don’t need it for this stretch of the trip, I need to carefully pick where I travel to in SA. This unfortunately means minimising my time in Brazil. 

Instead of the vaccine, I got a yellow exemption card (pictured) which will hopefully allow me into the infected countries if not the infected regions. 

So while it was a ‘pain’ to spend so much on vaccines which aren’t guaranteed to work, as I travel to my next destination it brings me peace of mind to know I’ve done all I can.

Kathmandu, Nepal – destination one

Our first stop of the South Asian adventure is Kathmandu and there couldn’t be a better place to take me out of my comfort zone.

From trying to get a visa in the airport on arrival (3 separate parts of the process and each took an age) it became clear that we were on Nepal time, which took a bit of getting used to. 

Even as I write this we’ve been in a taxi for days (an hour and a half) endlessly stuck in traffic travelling from the Boudhanath Stupa back to our hotel. Still it’s given me the chance to people watch, write today’s diary entry, delete and edit my photos, write two blogs (well once this one is done) and do a good bit more people watching. As you can see, I’ve not quite switched into holiday mode yet. 

How do I explain Kathmandu? I would say both hostile (the head ache inducing pollution, the constant beeping, the piles of rubbish everywhere) and welcoming (the people and their hospitality, the variety of colours that just don’t exist at home, the amazing food). Add to that the incredible beauty of the many temples where people worship, the quiet spaces that people try to create in amongst the chaos and the unpredictability of it all, you have a slight glimmer of what being in Kathmandu is like.

On the way to the Buddhist stupa I mentioned above, here are just a few of things spotted in and around the roads:

Monkeys swinging from dilapidated temples, monks on mopeds, cows walking in gangs down the road, families of 3 and a kids bike on one tiny motorbike, a man counting money while he drives, goats and stray dogs making friends, trucks decorated with colourful patterns and necklaces, chickens chasing each other, a man taking a pee in a pile of rubbish beside our taxi…etc etc.

If ridding myself of western ideas of what society should be is something I want from this travelling malarkey, there can be no better place to start that journey than Kathmandu. Still it’s ok to admit that I’m looking forward to the peace and quiet of the mountain paths and tea houses right? Onwards to Pokhara for a 6 day trek.

Preparation: Enough medication for travels

When I first had the diagnosis of Myasthenia Gravis four years ago this month, one of my first thoughts was I’m not going to be able to do any extended travelling.

Before I left home for university, one of my bedroom walls was covered with magazine cuttings of places I wanted to visit. The more exotic the place, the more likely it was to feature in my shrine. And while I’ve managed to visit many wonderful places over the years, there was one kind of trip I pined for then and haven’t managed to do yet. The gap year – a year away from the stresses of everyday life to re-evaluate what I want from life.

After the MG diagnosis in 2013 and starting medication to treat it, I realised that taking off to the explore for a year was very unlikely. This was mainly because the longest prescription I could get at the time was a month. Even a 10 day holiday proved problematic and needed careful planning. My travel dreams were in tatters, but my focus shifted to getting well.

As I reduced my meds and my condition stabilised, I was told I would be able to increase my prescription length to 3 months for all but aziathioprine – the drug that suppressed my immune system. While 3 months wasn’t a year, it was a lengthy chunk of time that gave a lifeline to my travel dreams. If only I could get off the aziathioprine.

And that’s what I did – slowly, slowly, with several set backs and with the support of a very encouraging consultant. Once that finally happened at the end of 2016, Elaine and I were already planning our wedding. Honeymoon destinations had come up with the discussion of some travelling at last but it was going to cost enough to get married.

Then one day we just decided, let’s do it. Elaine had wanted to travel too, and with her own health issues calming down in harmony with my own, the timing seemed perfect. As did the shorter period of travel – 3 months – so that I could come home to get another prescription and we could celebrate Christmas at home (not to mention my mum’s 70th birthday).

So here we are – 3 days into an (almost) 3 month trip to Nepal and south east Asia. We’ve already seen so much and I’m so very glad I didn’t hold off for the indefinite one year break. I have enough meds to last the time and a few extra just in case. I also brought a bottle of pyridostigmine with me in case my symptoms flare in the exotic climate. I can only hope nothing happens to them during the trip.

Extended honeymoon

It has been a while since I’ve posted here and in truth that’s because I’ve been busy. I’ve been working away from home Monday to Friday and in my free moments I’ve been preparing for my wedding (most definitely the best day of my life) which happened in August.

More recently I’ve been preparing for my upcoming extended honeymoon.

That’s right – Elaine and I have decided to do something extra ordinary for our post- wedding break and so we’ve given ourselves up to 8 months off work to travel.

After many years of one of us working away from home, we’ve decided to start our marriage with some lengthy quality time together and to go to parts of the world we’ve dreamed of seeing:

  • Nepal
  • South east Asia
  • South America

Far flung foreign climes with completely different eco systems and germs  – that’s pretty terrifying for a person with MG. Particularly someone who was immunosuppressed for years. 

But now feels like a good time because: 

  • I’ve been in good health over the last number of months and years
  • I’ve trained hard to get strong enough for the adventure
  • I’m on very low medication meaning that I am able to survive without trips back for meds
  • If not now, then when?

I plan to write this blog regularly when I’m away to show the highs and the lows of life on the road with MG. I’ve not met anyone with MG who has travelled for long periods and so I want to share my experiences about it (if you have, please share yours with me). But I’ll also be sharing general experiences of being on the road.

I’ll get into all the different aspects of preparation and the actual going over the next few blogs, but for now I have a 2 page to do list that will not sort itself! Pictured in preparation mode – testing my equipment in the Pentlands.

Extreme cold

This weekend I climbed Ben Nevis with one of my good friends. For most of the way, the sun was out and the air was warm enough for it not to be called ‘freezing’ (a rare day in Scotland). However about 2kms from the top, there was snow on the ground and due to exposure and wind chill the temperature dropped straight away. By the time we were on top, the wind chill was up to -11 degrees.

What does this have to do with Myasthenia Gravis? Well, when the temperature dropped my speech went funny. As in I couldn’t speak properly at all – my tongue and my lips felt too thick and the sounds I was making were slurred. My mouth seemed full of saliva. It was frustrating as I tried to communicate with my friend about our last stage of the journey.

Yet when we came back down, the symptoms disappeared as quickly as they had come on.

It wasn’t the first time this has happened. When my body temperature has dropped on other winter walks, it’s been the same thing. But this was the worst experience (possibly because it was the coldest) and helped me to recognise the pattern.

All the time I’ve been worried about my MG responding to heat – in the bath, in saunas, in hot countries – and I’ve never had any problems. But it seems that I’m not so lucky in extreme cold. 

I didn’t have any other weakness, but then again I didn’t hang around to find out what would happen to my body over a longer period.

Does anyone else have similar symptoms in extreme cold?