Bangkok, Khon Kaen & It’s Official – Aug/ Sept 25

Retirement life has had its good & challenging times. The last 3 months have been horrendous in terms of quality of life, lifestyle enjoyment and medical challenges. With my urology problems & associated interventions has come considerable discomfort and painful moments, that impact being able to undertake normal daily activities. While I don’t often complain, these few months have been ones that I wish to forget. Thank goodness Ace is healthy.

Siriraj Hospital – My previous blog post shared that we were scheduled to return to Bangkok for my admission & urological surgical procedure at Siriraj Hospital. As planned, we flew to Bangkok on Wednesday 30 July, stayed local at a budget hotel near the hospital, with admission on Thursday, 31 July.

The cystoscopy and dilation procedure occurred late in the day on the 1 August. I was under general anesthetic for the procedure, given the uncomfortable nature of inserting the instrument and the techniques required. It turned out that while there was no stricture of the urethra requiring cutting (DVIU), there was some narrowing discovered that was treated with dilation (widening of the urethra). Tests indicated I had a significant UTI (thanks to be catheterized frequently) so was in hospital for 2 nights and discharged Sunday 3rd, 2025, and allowed to return home. I was accompanied by yet another catheter for 2 weeks along with a course of antibiotics. Interestingly, an infection can also cause the symptoms I have been experiencing?

Hospital Follow Up – We flew back to Bangkok on 17 August, & stayed at a nice Chao Phraya riverside hotel not to far from the hospital. It allowed us to enjoy a nice riverside restaurant meal and enjoyable breakfast before heading to the hospital for the appointment.

I had an appointment on the 18 August, with the urologist (who operated on my original prostate cancer) to undertake a voiding test before removal of the catheter. It was a very long day of waiting at Siriraj Urology Clinic (10 am – 3 pm) – as my 11 am appointment turned out to be 2 pm before seeing the doctor.

It was a bit of a disappointing visit. There were challenges with the voiding test & the doctor was very cold, dismissive of questions & basically advised – “you can pee, so leave and return in 3 months for follow up”. I had asked about urodynamic testing, as requested by my urologist in Nakhon Phanom, but that was dismissed as not required, at least at this time. I left feeling very let down by the Doctor & annoyed with his lack of discussion and explanation of the problem & way forward.

While my urinary tract did work somewhat for 5 days, it was an unfortunately short lived, as I needed to attend the That Phanom Hospital (near our house) again for yet another catheter on 24 August 2025. This time the catheter was only in place for 7 days, as it seemed blocked on 30 August & not draining correctly. We went again to our local hospital to have the catheter removed. Very minimal wait times at the small emergency department (thank goodness) and the cost are very reasonable. 240 THB to insert the catheter and 100 THB to have it removed or $16 AUD.

This lack of engagement with the urologist at Siriraj and the continued problem of urinary retention prompted us to contact Khon Kaen (Srinagarind) University Hospital to seek a urology appointment with a different urologist to hopefully obtain urodynamic testing – with the referral I had from the Nakhon Phanom urologist. But before that next medical adventure, there was another official, pleasant activity for Ace & I to undertake!

Its Official – What’s Official?

Ace & I have been living a common law relationship now for 26+ years in Australia & Thailand. Thanks to the Thai Government, enacting the Marriage Equality Act effective on January 23, 2025, it was easy for us to officially confirm our relationship by getting married.

Being a mixed, (Thai & Foreigner) couple does require some additional paperwork to be provided. When we were in Bangkok in July this year we took the time to attend the Australian Embassy to obtain a ‘certificate of no impediment to marriage’ for myself. (3500 THB) This was then taken to an agency for translation and to get the documents certified by the Thai Department of Foreign Affairs (4500 THB). This took around 3 weeks to complete and was sent to us by mail.

Ace looked up an auspicious date, being the 2 September 2025, to register our marriage at the local District Office, not far from our house. We needed to complete a 4 page application form, have 2 witnesses (Ace’s mother & friend) & the Embassy/Thai Foreign Affairs documents. It took about 3 hours from start to finish at the district office.

It was a local requirement for same-sex couples to met with the District Governor to introduce ourselves & for him to sign off on the marriage registration – basically a courtesy meet & greet. We were provided with 2 marriage certificates (one each) & a registration document (for Thai Immigration visa purposes).

Having been together for the many years & having enjoyed our long relationship already, taking so many trips together and having indulged in wonderful restaurants around the world, we decided it was not necessary to have any elaborate ceremony or festivity to mark our marriage registration. Just the official registration accompanied by a large lunch, with Ace’s mother & friend, at a nearby restaurant that serves delicious food, was adequate celebration.

In the afternoon with the marriage registration activity completed we went to a local cafe for afternoon treats. It turned out that the owner is related to Ace’s mother so a long chat was on the cards. It was a fun day & we are delighted to be officially a married couple after many years together as common-law.

New Train Line Near Home – Khon Kaen to Nakhon Phanom

A new dual track train line is being built from Khon Kaen to Nakhon Phanom with track right of way coming by our town of That Phanom and passing nearby our home property – about 300 meters away. It will be a 355 km railway, for passengers and freight, to connect provinces in the Mekong region to Laem Port in Chon Buri. It will also form a section of the east-west economic corridor railway where it will cross the Mekong River at Mukdahan to the the Savannakhet – Lao Bao railway.

The dual-track railway route will include 32 stations and 3 freight terminals. There will be a station for That Phanom. Land clearing has begun on the proposed right of way including the portion that runs near our property. It is due for completion in 2028? It will be interesting to watch the rail line near us being built & the new services operating. It won’t be a busy line so should not create too much noise for us.

Khon Kaen Trip

It is about a 3.5/4 hour drive to Khon Kaen from our home on a good wide 4 lane highway with surprisingly sparse traffic. We headed there on Friday 5 September, leaving around 10 am, taking our time on the road trip. We made a stop in Mukdahan on the way to get a test at a medical lab (that later proved very useful). A few stops for a rest break, food and drinks as we journeyed to our weekend destination.

Khon Kaen is the commercial and political center of Northeastern Thailand and is well known for the high-quality silk that is produced in the province. Located in the heart of Isan, Thailand’s northeast region, Khon Kaen has been one of the fastest-growing areas in Thailand. It has all the major retailer and shopping malls along with a wide selection of food offerings. It is much like Chiang Mai in that regard. Khon Kaen also contains the largest university in the northeast, Khon Kaen University, a major center of education, technology & a hospital. We secured a small, boutique hotel not too far from the hospital for a few nights, with breakfast – very comfortable & friendly.

After checking into the hotel & resting a bit from driving fatigue, we headed out to Index Furniture Mall for some shopping before making our way to the large Ton Tann Night Market. There we browsed the open air vendor shops for a few items and then sat down for dinner in the large outdoor food court with hundreds of food vendors to choose from. After a great feed & ice cream we enjoyed a great night sleep.

Khon Kaen (Srinagarind) University Hospital – Ace managed (ahead of time) to register me, getting a Khon Kaen University Hospital patient number, and speaking with the urology department managed to book a Saturday clinic appointment on the morning of, 6 September with a urologist. I had my referral in hand, my long history, to discuss with the doctor & hoping for a urodynamic bladder test booking.

We had to work out the local hospital check-in, & processing procedures from around 9 am, ahead of a 10 am appointment (along with many others). Luckily we only waited for 45 minutes before seeing the urologist. He had read my history & medical paperwork before the consultation so was well prepared for discussions. He agreed, that with my history the Urodynamic Test was necessary to see what was going on. He was shocked that the Siriraj Hospital in Bangkok, when I was previously there for treatment, had not agreed to this testing regime. That was an interesting discussion.

Initially he said that I would need to take antibiotics ahead of the tests & that it would need to be scheduled in a few weeks time. I showed him the results from the lab test done on the Friday in Mukdahan while heading to Khon Kaen (I mentioned this earlier, that it was helpful) & he was pleased with the clean result so advised that he would schedule the testing for later in the afternoon on Saturday. He sent us off for lunch & advised to return at 1 pm for admission & pre-op processing.

I won’t go into the detail of the testing preparation, but when the doctor arrived I was moved into the test theater and seated in the ‘special chair’ that is used for this test. Your dignity is quickly compromised with all on display. If you are interested in what is involved in this testing procedure I will leave it to you to “search the internet” for “urodynamic testing” to see the details. With the probes & tubes inserted the testing was undertaken – it lasted about 1 hour & the doctor offered the results immediately and provided a print out to take to my local urologist. I was done, truly over it & left the hospital around 3.

Long story short – I have very, very week bladder muscles & bladder sphincter that does not function as it needs to. It is likely the result of the prostate cancer radiation treatment a number of years ago. Neurogenic bladder or late radiation bladder cystitis or a combination of both are likely reasons for my problems. The muscles and nerves are damaged and not working correctly together. My bladder will only hold a fraction of what it should & my symptoms (incontinence, retention and nocturia) are all the result of the diagnosed problems.

The doctor indicated that it was a situation that I would need to learn to manage and live with as there are minimal options for an intervention. The management of this medical drama is limited to medications to assist the bladder function, managing liquid intake, pelvic floor exercises and using control products like pads. He also indicated that I may need to use a catheter from time to time, if I have retention issues.

For now the bladder is funtioning, albeit to a reduced degree & life has returned to some normality. Hopefully it does not get worse as contemplating the quality of life impacts & medical requirements does one’s head in.

A big shout out and thank you to my wonderful partner Ace who has been such great help and assistance in navigating the Thai Hospital systems & administrative requirements. Most Doctors speak good to reasonable English so that helps.

Enjoying KK – We opted for an afternoon visit to a local lake in the city for some photo opportunities and refreshments at a local cafe. We also went to a couple of specialty shops (Thaiwatsadu & Baan & Beyond) to pick up a few household items we were looking for. The evening plan was dinning on Chinese food at a restaurant in Avani Hotel & Convention center in the city. It had been a long time since enjoying Chinese food specialties.

With the medical prognosis taken care of (for now) & an otherwise enjoyable few day trip we decided to head home. After some breakfast on Sunday, 7 September we toured a couple of local plant markets in Khon Kaen (Ace was looking for something in particular) but did not find what he wanted.

Journey Home & Garden Additions

Along the journey home we stumbled across a landscape ornament shop that sold all manner of large garden products. I had been looking for a couple of elephant statues for the garden and we found exactly what we wanted. The shop is about 2.5 hours from our house, but they were happy to deliver the two elephants for us on Monday. As promised by the shop, on Monday two guys in their truck arrived around 11:30 am to deliver the two heavy, cement elephants.

We also placed a garden bench to the rear of the house by a nice transplanted tree. An afternoon shady retreat, & kind of a “check-in spot” for RAce Country Cottage. Once some additional plants & foliage are added these will help to enhance the garden we are developing – always a work in progress.

A new landscape project almost finished, after some weeks of work. A featured wood fence, on the yard corner, erected with an old wagon wheel highlight. We made an “Omega” symbol (the end, finality – ?), with azora bushes, & planted other accent plants, like mini bougenville, in the dark pots. Only a few more to go.

I will leave you with some twilight images of the garden that I enjoy looking over from my “old man” balcony chair.

As it is the rainy season, it has lived up to the name around our part of Thailand. We have had multiple tropical storms and heaps of rain. Everything is well watered regularly – naturally. A bit of wet over the past two months has been good for garden growth & unfortunately grass growth – that needs cutting.

That all for now on life’s happening & adventures of Ron & Ace, at RAce Country Cottage.

Cheers until next time.