A hole in my back

The possibility of getting skin cancer has been on my mind for some time. I have lots – lots – of mole, several quite big. They’re mostly on my back and seem to a have grown and multiplied imperceptibly over the years. Having moles and freckles is associated with a higher risk of getting skin cancer (although I’ve also read that having many moles is also connected to ageing more slowly – those of you who know me well won’t be surprised at that). It’s really about time I saw a dermatologist.

Which is what I did a couple of weeks ago.

On the Monday, I went to a hospital in Cheonan that was recommended by my boss, Soonchunhyang University Hospital. I went into one building and inquired after the 피부과, or skin clinic, and was directed to a neighbouring building. In the lobby there I spoke to a member of staff who spoke English and she explained that I should get a referral from another 피부과 first. I was given some directions and headed off there in a taxi.

This skin clinic – 퀸 피부과, ‘Queen’ – was also a cosmetic surgery place. It was a bit rhinestoney – kind of down-market princess chic. My presence there seemed to be equally confusing to the staff and the female clients. But I took my T-shirt off for the doctor and he figured out want I wanted. Eventually, I was sent on my way with a piece of paper.

I headed to a nearby Starbucks to do some work on one of my games.

The following day, I went back to the hospital and saw a dermatologist there. He gave my torso a fairly cursory examination and said that they would take a biopsy from the darkest mole – or naevus – on my back.

A younger man did the procedure. I lay on my front and he anaesthetised the area, used some device to punch a small hole in my back, then sewed it up with a couple of stitches. The sample was a little cone of skin a bit less than a centimetre tall and about half a centimetre across the base (the skin surface), pinkish-greyish-brownish in colour. I was told to keep it dry and was prescribed some medication and told to get iodine and waterproof plasters. I was to come back the following week to get the biopsy result and have the stitches out.

The mole is a little to the left of my spine, but pretty much in the middle of my back. Not easy to reach oneself. However, with a little daily practice, I got fairly proficient at wiping the stitches with damp tissue, dabbing it with iodine and putting on a fresh plaster (the waterproof plasters were excellent – they have a slightly rigid plastic covering that keeps them straight when you’re putting them on, they really are waterproof, they don’t peel and they don’t leave much of a sticky residue behind). I took the medicine – antibiotics, I think – most of the time, but had a few left at the end of the seven days. The wound didn’t bother me at all.

I went back the following Tuesday and the dermatologist told me the result was negative – there was no sign of cancer – in that mole, at any rate. I wonder whether some of my other moles ought to be tested, as well, just to make sure. I’m going to try to keep an eye on them – on the irregular ones, anyway. Having the stitches removed was quick and painless.

I walked home feeling pretty good that I’d finally done the right thing, but conscious that it may not be the end of the story.

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Looking inside

A couple of weeks ago, I had an appointment on Monday morning at the hospital not far from my home – the one I’ve gone to for all my health needs so far – for my latest colonoscopy. I think my last one was probably in 2010, so I’m a little overdue for one. And, as I’ve had bad flare-ups every other year since about 2005, I’m pretty much due for another.

I told the doctor that I had to work in the afternoon, so he promised a ten o’clock appointment. It turned out to be eleven o’clock. Perhaps because of this, I wasn’t given a general anaesthetic like every other time I’ve had a colonoscopy in Korea. Wasn’t even given the option, actually.

Another difference to my previous experience was the laxative I was prescribed. The earlier ones were small bottles of vile fluid that I had to drink and follow up with two litres of water. This one was a powder that you dissolve in water and then drink. It had the same horrible, sweet-bleach taste, but was at least a lot milder. I couldn’t manage the whole dose in the evening, but in the morning I figured out that if you just down each 500 ml dose in one go, it wasn’t too bad. I drank an extra litre of water both morning and evening to make up for my under-dose.

The examination, then, wasn’t a huge amount of fun. I could watch the progess of the endoscope on the monitor, see the brown fluid in my gut get gurgled up by the tube, observe the flushes the doctor administered. With my lack of sleep and low blood sugar, I didn’t try too hard to follow it and instead just tried to relax. It was uncomfortable, but not unbearable (unlike the barium enema and bowel X-ray I had once on the NHS), and it was pretty weird to feel the endoscope poking my abdomen from the inside. The nurses moved me about a few times and squeezed my belly, perhaps to improve suction. The doctor took five biopsy samples, but I at least didn’t feel that.

The doctor told me afterwards that my colon was mostly healthy, but that I had – have – a ten-centimetre patch of inflammation in my upper large intestine that bled on touch. I’d already told him that my regular doctor was a specialist at Daehang Hospital in Seoul, so I got a CD with images from my exam and started thinking when I would go up for a consultation.

Later, at work, my boss gave me some fish jjigae to take home for dinner. I duly did, warming it up in the microwave for a couple of minutes. Later in the evening – while I was trying to go sleep, in fact – I started feeling a bit feverish and nauseous. I vomited up aforesaid dinner and worried about whether I’d merely contracted food poisoning or whether I’d suffered some horrific damage to my bowel and was now developing septicaemia.

The following day, I felt better, but was weak, so I took the day off work and went to Seoul to see my doctor there. He looked at the pictures from my examination and declared that I was fine. He didn’t prescribe any steroids for my inflamed bowel, nor anything for my bout of food poisoning. During the day, I was only able to eat half a small bowl of cereal and a few French fries for lunch. My guts weren’t too happy.

I recovered from all this over the next few days, but had occasional twinges in my colon in exactly the place the Cheonan doctor had told me I had the inflammation. These moments of discomfort have dwindled in frequency to more or less nothing, now, but I couldn’t help thinking the colonoscopy was more harm than help. I went back to the hospital last week for my biopsy results and they revealed no nasty surprises.

So, to keep my colitis under control, I think I just need to make sure I don’t fail to take my daily dose of mesalazine – all 3,400 milligrammes of it. At least the whole thing turned out to be a lot cheaper than I was expecting; really cheap, in fact: less than £20.

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Cheonan on and on

On Thursday I went for a walk up to Cheonan Station and found a foreign foods shop that I’d read about on the internet. Not as big as the ones in Itaewon, but it had various Thai sauces, Indian curry powders and Western deodorants that I might take advantage of in the future. With not much money in my wallet, I didn’t buy anything. I headed over to the railway station and got a couple of maps from the little tourist information office. Then I walked towards home, found a Daiso shop and got myself a cheap set of kitchen knives.

A little later, I was picked up from my flat by one of the hagwon’s older students – a favourite of the director. He took me to a pretty big hospital, Cheonan Chungmu Hospital (in front of which stands a statue of Yu Gwan-sun, a protester against Japanese occupation in the early twentieth century), where I had my medical test. He took me around to the various departments and translated for me. I had a pretty bad headache, having gone to bed straight after work without drinking anything; I didn’t want to take any pills just in case it compromised my drugs test (despite the fact that my doctor had said it was impossible). I discovered that I had a couple of small cavities and that my vision was now 15/15. Presumably, these defects, in addition to my colour-blindness, won’t prevent me staying in my job.

The student paid for the test with the director’s credit card. It was ₩104,000, which is about ₩20,000 more expensive than the price for one of the previous tests I had. The director is going to deduct this from my pay, which I’m a bit disappointed about, but it’s not such a big deal that I’m going to be bothered about it. She said (I think – she put in a bit of strange way) that should would give me the money if I signed a second contract – although that’s a pretty long way down the line.

The result comes back next Thursday. The day after, we’ll go to Immigration to get me my Alien Registration Card.

I thought I might go to a café on Friday morning and do some writing, but I discovered I’d left my backpack at work overnight. With nothing practical to carry my computer in, I decided to go for a walk. I headed in the opposite direction from the city centre towards the nearby smaller city of Asan.

I passed over a distinctive circular bridge – there’s a ring-shaped walkway suspended over a big junction with ramps and lifts on each corner. I’ve seen similar footbridge in Japan, but never in Korea before. I had brought my camera with me this time, so I took a few photos.

A bit further on, I found a new department store, the Galleria – where the mother of the boy who took me to the hospital works; as he has no more school work to do, he helps her there. It was 9 – 9:30, so too early for the shops inside to be open – so I didn’t go in. Instead, I carried on a bit further and had a look inside the KTX (bullet train) station, Cheonan-Asan. The track is elevated for quite a long stretch, built on top of some monumental, multi-level arches. Inside, it’s full of huge, tubular metal supports. Impressive, if you like that kind of thing – and I rather do.

The area around the station and the Galleria is pretty dead. There’s a Lotte Mart nearby, with associated shops, something called E-Mart Traders, some big apartment buildings and an area of new, small buildings that’s very reminiscent of the ghost town-like new development close to where I worked in Bundang. The area seems very symptomatic of the Korean enthusiasm for development. They seem to believe strongly in the idea that, if you build it, they will come.

I had some kimbap at the station and headed back home. Then headed out again immediately for another walk – in the other direction, this time. My aim was to scout out more ways of walking into the centre and to locate the Korea Exchange Bank, at which I will open an account once I’m able (KEB apparently has good a good set-up for transfering money to foreign accounts). I found, along with a big market along a street characteristically covered with a big, arched roof. I kept walking, passed an Indian restaurant that I’ll have to eat at some time and found myself at Cheonan Station.

I went home, got some indifferent and over-priced pizza for lunch, went to work, finished said pizza for dinner, completed work and returned home again. The weekend followed.

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Ah, go to Korea

I now have an e-ticket for a Turkish Airlines flight to Korea via Istanbul, leaving on Sunday afternoon and arriving on Monday evening. I have no passport still – I’m hoping it’ll arrive on Saturday, but if it doesn’t, my recruiter will be able to reschedule my journey. Once at the airport, I’m to be met by a ‘pick-up man’, whose duty is to buy me a ticket for the bus (although I’ll have to pay for it) and see that I get on – and presumably let the recruiter know so that they can let the director know what time to pick me up from the bus station.

I’ve doing some partial packing to see how much stuff I can fit into my backpack and suitcase. My baggage allowance is 30kg, with 8kg carry-on. I may be making full use of this allowance – and leaving some stuff behind that I had hoped to take. When I launder my last clothes on Saturday, I’ll have a better idea.

The other day, I went to the doctor to ask about whether my medication, mesalazine, would trigger a false positive on the drugs test I’ll have to take as part of my official health exam, which will prove that I’m literally fit to teach in Korea. He said that it wouldn’t and neither would paracetamol (unless I took huge amounts of it) and similar pills; steroids and sleeping pills would – but I’m not going to be using either of those.

I also showed him a couple of photos of my back that I’d taken – at his recommendation – over the past couple of months. I have lots of moles and they’ve grown and multiplied over my life – it’s hard to say, as it’s such a slow process and, being mostly on my back, they’re hard to keep an eye on. I handed over my memory stick, on to which I’d copied the two photos. He connected it to his computer and had a look at the two pictures. The third picture turned out to be a saved soft porn picture I’d saved in a different folder – I never use the automatic slideshow option, so I wasn’t expecting that. Kind of embarrassing, but the doctor took it in his stride.

On the subject of my moles, he said he would have referred me to a specialist to check out two irregularly shaped moles espcially – if I wasn’t leaving the country. He recommended I see a skin specialist before too long.

After that, I headed off to Manchester on the train. I had been thinking about getting a couple of non-fiction books, but ended up just getting Robert Rankin’s new novel – The Educated Ape and Other Wonders of the Worlds. I’m not sure whether I should make this my in-flight reading or plump for something else, as I only recently read the book’s immediate predecessor, The Mechanical Messiah and Other Marvels of the Modern Age.

I also went to see Argo, which I thought was great – a tense, funny and apparently realistic depiction of the rescue of six embassy workers from revolutionary Iran. The stand-out feature of the film, though, was the period detail – the hairstyles and facial hair, the grainy footage, the vintage Warner Brothers logo at the start. This sense of authenticity was bolstered by snippets of historical footage intercut with the movie; it was especially powerful in the early scene when the US embassy is stormed by Iranian protesters. Alan Arkin, John Goodman and Bryan Cranston were all great, along with the lesser know actors playing the six staff; Ben Affleck’s performance was understated to the point of being semi-somnolent. The climax of the film was drawn out too much for dramatic effect. Overall, a very fine movie.

The title of this post comes from a line in the film that becomes a catchphrase for some of the characters. Alan Arkin’s character, a producer, is being badgered by a journalist who wants to know the meaning of the title of the fake film within the film – Argo. Eventually, he snaps and says, ‘Argo fuck yourself.’

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Nailing one’s colours to the mast

As we’ve been travelling, so my injured thumb and toe nails have been growing. This how they looked a few weeks ago in Dubrovnik:

The whitish part of my thumbnail is what I had originally thought to be exposed bone. It was under my previous nail and under the scab that developed when I injured it. However, it hardened and I suddenly realised one day that it was growing out, over the rough nail bed. That nail bed is now completely covered, but the nail has grown a little oddly – it bulges out quite a lot. Hopefully, in a few more months, successive nail growth will be more normal.

When I started our trip, I put plasters of ‘artificial skin’ or waterproof bandages on my toenail all the time – often leaving one bandage for a couple of days or so. Eventually, though, I decided that the toenail bed would be tough enough to stand a day’s walking inside a boot without protection. It’s been completely fine since then – better, in fact, as, when it was covered, the skin around my toenail got very soft and sticky from adhesive.

Here are the latest photos, taken in our hotel room in Amsterdam:

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All toes and thumbs

Buses to work have been mostly OK recently – I’ve either become accustomed to the noise and the jouncing or my luck in catching quieter, gentler buses has improved. However, one ride earlier in the week was particularly bouncy. When it neared the stop I wanted to get off at, the driver hesitated for a long moment at a zebra crossing, apparently asking me and another passenger if where we wanted to get off – as if the fact that we’d rung the bell and stood up wasn’t enough.

As soon as I got off the bus, I tripped on the uneven pavement, fell on my hands and rolled on to my back. In frustration, I kicked the bus shelter – pretty hard. Too hard, really, as my right big toe hurt pretty badly. I limped off, down the steps to the river, but I had to stop and rest a moment. I took of my shoe and sock and held some snow to my toe. It was already quite purple in the nail and the skin around it. When I eventually continued, I realised I didn’t have my travel mug and had to go back to the bus stop to where it was lying on the ground.

At the end of the day, much of my right foot was swollen. The toe itself, several days later, is still swollen and still hurts. The sensations reminds me of my wart treatment from a few years ago. I haven’t seen a doctor about it. There’s no structural damage – it flexes readily and painlessly. But the nail is pink and it’s surrounded by some bruising. I’m a little worried that the horror of my thumb might be repeated, but the bruising is not that intense – the nail is lilac with bruising, not black with pooled blood. I’ll be happy when the swelling goes down and it stops hurting.

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Under the thumb

This is what my left thumb now looks like. It’s better, in other words. I peeled away another strip of nail that wasn’t connected the matrix underneath. The bit of pulpy flesh has dried up and shrunk down to that little red scab. Most encouraging of all, skin is slowly growing up the bone and it’s being followed by new nail – it’s the pearly arc slightly left of centre. The yellow discolouration is from the plasters I’ve been sticking over it most days.

It’s going to take a good few months before it grows back completely; Wikipedia says fingernails grow at a rate of 3mm a month.

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I thumb my nose at rules of thumb

This post contains images of a graphic nature.

About a month ago, I slammed my thumb in the heavy metal door to our apartment. I was closing the door with my right hand, pulling it towards me, and I didn’t realise that, as I was leaning with my left hand on the door post, that my thumb was in the way. It made a bit of a liquid crunch.

Very quickly, I got a big black bruise under my nail, filling about half of it. Obviously, the initial injury hurt like the proverbial motherfucker (assuming that ‘hurt like a motherfucker’ is a proverb). This faded away and I was left with a half black thumbnail that didn’t seem to be causing me any problems, so I left it.

I read later that you should get the blood drained by a doctor if the bruise covers more than a quarter of the nail. The technique is to bore a small hole in the surface of the nail – a heated paper clip is apparently a good tool for this.

But I didn’t do any of that. Instead, I waited to see if it would grow out.

Well, it did, to a certain extent, but the problem I discovered on Wednesday was that the nail wasn’t being replaced with new nail – a gap was growing at the base of my nail between it and the skin. The nail itself was bulging a little from the blood underneath.

On Wednesday, then, I started picking at some flakes of what might have been skin in that gap and dislodged a few granules of dried blood. I resolved to try to scrape out what I could, so, armed with a pair of scissor that I gave a good clean and in the privacy of one of a bathroom on one of the upper floors at work, I started digging out the dried blood. One thing led to another and I ended up peeling away the thumbnail from the bottom, revealing a dense scab underneath.

I took away an oval of nail extending about halfway up the thumbnail. In addition to the compacted scab there was a fair amount of old liquid blood, which I squeezed out and washed away, which was followed by some fresh stuff. Under the scab there was a flat white surface, which I initially interpreted as nail that had grown under the scab, but which I’m now sure is bone. Apparently, the trauma to my thumb had killed the flesh underneath.

Now that I’ve cleaned all the blood away, there is a pulpy bit of flesh poking out from under half of the remaining nail; next to it is a flat pink bit of flesh. There are a couple of pockets leading away to the sides under the skin and under the nail. Most of the remaining nail is attached to the meat underneath, but the flat bit of flesh I mentioned has a shallow space over it, from where I’ve squeezed out a bit of pus – although that seems to have cleared up in the past twenty-four hours. And there’s the bone – which isn’t as hard as you might think and gives a dull, unpleasant feeling when you touch it that is just short of being pain.

I’m keeping the whole area as clean as I can, washing it regularly, avoiding using the thumb, putting antiseptic cream, a fresh plaster and some protective tape on it two or three times a day. Since I removed the nail and scab on Wednesday, some skin has already started growing over the bone from the left hand side. And, surprisingly, the whole thing hasn’t caused me any pain; it’s sensitive, running hot water over it isn’t nice, but cleaning it and poking at the dried blood hasn’t hurt at all.

Because of all this, I’m not planning on seeing a doctor about it in the immediate future. If it gets more infected or painful then that might change, but I think I’m doing as much as can be reasonably done. Also, I don’t have insurance, so it’d be expensive and the doctor would probably want an X-ray.

I don’t regret removing the nail, either, as I’m sure all that scab was preventing the skin healing and the nail regrowing. We’ll see how it develops over the next few weeks.

And now, some pictures.

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Pus(h)ing it out

It’s been a while now since my operation (which Wikipedia assures me is actually called an appendicectomy). For a few days, it seemed like the amount of discharge I was squeezing out of the main surgical wound wasn’t decreasing. One day, I happened to squeeze a little harder than usual and forced out a maggot of solid, pale green-yellow pus; and then I squeezed out another, larger lump, almost the size of a bean (although not as wide) – and later on, a third. After the last one, the liquid pus, mixed with a little blood, flowed more freely.

Even I was somewhat disgusted. Habiba’s exclamations at the last specimen were quite entertaining.

Since then, the amount of discharge has slowly tailed off, to the point where it now only generally comes out when I squeeze it – yesterday’s daytime gauze and pad were untainted when I removed them.

I could probably leave the incision alone and it might heal, better, but I’d be worried about a build up of pus inside me. Then again, the body must have ways of dealing with that kind of thing.

As I write this, I’m in a 24-hour McDonalds near City Hall in Seoul. It’s the middle of the night. I have a 5:30 train to catch down to Busan on the south coast (a bullet train, no less), from where I’ll take a ferry to Tsushima, a Japanese island in the Korea Strait. I have to: my tourist visa is due to expire on Sunday. Habiba and I had been planning to go to Japan last week, but events conspired against us. Now, I’ll return on Sunday with another tourist visa good for three months.

Hopefully, I won’t need another. I’ve started making inquiries into getting a job for September. This will actually require another visa run, as the E-2 teaching visa can only be obtained in a foreign country. I’ll probably be heading down to Japan again.

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A real pain in the gut, part three

On Friday, I went back to the hospital to have my main surgical incision squeezed and checked. The doctor decided to take the stitches out. It was somewhat painful – more so than the smaller scars that had been de-stitched the day before. She told me that I should do the squeezing and changing the dressing from now on, and that I didn’t need to come back unless I had a problem or the discharge didn’t dwindle away over the next few days.

I bought myself some dressings and since then I’ve been squeezing pus out of the wound on a regular basis – rather more gently than the doctor did. The incision is about an inch long, just under my belly button, and it’s healed on the right-hand side (my right); when I press it, pus comes out of a cross-shaped incision on the left – a fair amount of it.

I’ve been changing the dressing twice a day – the pus tends to soak through the pad within a few hours. It makes me wonder how long it’s going to take to fully heal – if I keep squeezing pus through the opening, it’s not going to seal up. It doesn’t hurt, though, and seems to be slowly getting better.

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