Change – Press on, & Move Forward – Hello 2026

Life, it seems, is a series of natural and spontaneous changes. No matter how organised we are, or how well we plan, we can, & should, always expect the unexpected. As we walk through life, we come to realise that change is inevitable. Living with change and uncertainty is difficult. But most of the time, and arguably always, if we worked as hard at accepting change as we do to prevent it, our efforts would likely bear a better outcome. Here we go again, with another journey around the sun and a new year full of hope, surprises, & with some luck, change for good health. I wanted to share a synopsis of how the year ended for Ace & my enjoyable life. What’s on the horizon going into 2026?

My last post in October was about a medical trip to Sisaket & some Isaan road-tripping. Other than a few Facebook posts, I have been fairly quiet on the social media scene, due to health issues I am struggling with. A dermatosis problem that was escalating and taking a toll on my aging body had me on the back foot and suffering. This was on top of existing urological issues from side effects manifested from the various prior prostate cancer treatments.

So what is this change all about? Not to sound alarmist, but having unknown medical problems that were causing significant issues, & that nobody can diagnose correctly, was affecting me in many personal ways. Luckily, the start of 2026 resulted in a great dermatologist diagnosing a skin disease as the problem, and my urologist confiding that my “older age problem” is a change that I need to learn to accept, live with, and manage. But before delving into my health changes, let’s review what life was like in November, December, and January in our sleepy rural oasis in the country town of That Phanom.

RIP Panda – On a sad note, our friendly stray that stayed with us since the house was built passed away early in December. It seems that he had gotten into many dog fights over females in heat around the area, had many wounds, and probably developed sepsis. We were trying to treat him, but were not successful.

Around Our Neck of the Woods

Outings & Exploring

It is said that retirement is not a destination, it’s a journey – so taking daytime road trips to cities around us is always enjoyable. Like Sakhon Nakhon for a day of simple pleasures. About an hour drive to do some shopping at the mall, and indulge in delicious foods & treats. Another day was discovering a new food and coffee spot, just opened, on the road to Renu Nakhon, & only about 15 minutes from our house. On another day, we headed to Nakhon Phanom for lunch by the river and checked out the new tourist attraction being built – the Mekong Eye, a large riverside Ferris wheel. Another favorite is Mukdahan, where we have found a nice Vietnamese restaurant for lunch, the TOPS supermarket, and the Robinsons Mall for various supplies.

Izzy was delighted that we found her a new dog groomer in town. A large bloke, primping this little lady. Operating from his home, we drop her off, and he does a home delivery when she is all done. It was her first motorcycle ride and we were pleased with the results.

The Loy Krathong Festival took place on 5 November, so we went to town in the evening for the activities in the local park and enjoyed dinner. It was a night of light, love, and renewal. There was the traditional floating of Krathongs; each district village had a float display, fireworks, and dance performances. Saw my first “sepak takraw,” also known as kick volleyball or foot volleyball. A popular SE Asia sport where players use their head or feet, but not hands, to volley the ball over the net. Lots of acrobatics & gymnastic skills involved.

Often on weekend evenings, we wander into town to take in our small, walking-street, & generally to buy food for dinner from a wide variety of vendors. Actually, a good selection of foods – including a few western offerings. In early January, we took a drive down the Mekong River Rd toward Mukdahan for lunch and a history lesson at the site of the Martyrs of Songkhon. This is where seven Christian Thais, in December 1940, were executed in Songkhon village, Wan Yai District, in Mukdahan Province. It is reported that the local Police were responsible for the killings that occurred during the Franco-Thai War. Apparently, the police falsely believed they were spying for the French, as well as not liking Christians. There is an interesting museum at the church that reports on this event.

We were recently invited to the housewarming ceremony of the young contractor who built our country cottage. He recently finished his new home in Nakhon Phanom, and according to him, he used some of the design and finish ideas that were installed in our house. It is a very nice house for him and his partner, just on the outskirts of town. A modern-looking, light, and airy-feeling home. We had donated a space wooden ceiling light fixture for his home & also provided him with a framed photo-painting of a Nakhon Phanom Mekong River scene, as a gift. It was also an opportunity to do some major grocery shopping at Makro. No longer a chore, with time on your hands, but an adventure to see what delights can be found for the dinner table. Having worked up an appetite, we headed for lunch by the Mekong on a wonderfully sunny winter’s day.

Home & Yard Work in the Winter

Due to the health challenges & medical restrictions, we stayed home a lot of the time. In November and December, the wonderful winter weather arrived, providing pleasant, cool evenings and brilliant, sunny days. The sky was blue and dry, with wonderful temperatures in the high 20’s. Great for yard work.

We sought the assistance of local workers to help put down 30-step pavers for pathways on the front & side lawns to align with other existing pathways. It was a whole day’s task, and the sod taken out was repurposed by laying down on the slopes of the yard to stop erosion.

Took the DJI drone out for a few spins to regain some operating skills. I hadn’t used it since we finished the house and yard build. After some ups & downs, it all worked out. We added a few new Colorbond planter boxes in the garden for roses and vegetable planting. Will see how the green thumbs go – I mean Ace will?

I laid down some paving bricks as a border of our fire pit and pet cemetery. It was a bit of a slow effort, as I only went out as the sun was setting to avoid the strong winter UV. Really enjoying the winter season, with cool nights, refreshing mornings, and milder daytime temperatures. The front and back balconies are getting a workout for morning breakfast and afternoon refreshments.

Christmas & New Years

In the lead-up to Christmas, a special Buddhist chanting ceremony took placeat our famous Wat Phra That Phanom. The town was jammed with believers. Separately, Ace and I also participated in a Buddhist merit-making ritual at our local temple to honor Ace’s family ancestors. This involved monks chanting, making offerings, and performing other ceremonies. We were also volunteered by Ace’s mother to collect a large food feast for the monks from a local restaurant.

We also headed to the Nakhon Phanom Winter Festival one evening for a riverside dinner, followed by a stroll to view the town’s impressive lighting displays, including a Christmas light parade. With the Catholic Church’s influence, it results in numerous colorful Christmas lighting displays. It was very pleasing to the eye and a bit nostalgic thinking back to years in Canada and Christmas lighting displays.

The holiday period was a quiet affair, given my medical situation. On New Year’s Eve, we enjoyed a lovely homemade dinner before watching the Sydney Fireworks on TV. Welcome 2026.

In That Phanom this month, there is the annual Wat Phra That Phanom Festival, from 26 January to 3 February. It involves parades, rituals, processions, a large fair, with kids’ rides, games & a large market area where all manner of items are sold. It reminds me somewhat of the fall fairs that we had in Canada (with the religious aspect), with rides, games, and events. The event attracts large crowds to our small town. We will take a walk one evening to enjoy the atmosphere. Much is being set up this week & at night it is very colourful in the town center.

Fun Anniversary Dates

23 December 2025 was the 1st year anniversary since moving into our new retirement home – @ R/Ace Country Cottage. 12 months ago, a team of young lads from the building workers moved all our belongings from our temporary accommodation to our new home.

Then, on 17 January, it was the 2-year anniversary (2024) of my farewell lunch, hosted by the Australian Ambassador to Thailand in recognition of my retirement from my role as the Australian Honorary Consul in Chiang Mai. How time moves on.

Visa Extension Time – My current retirement visa extension ends on 19 February 26, and as an annual renewal, it was time for paperwork and a new application. This year, I am applying to amend my extension of stay, from Non-O Retirement to Non-O Marriage (to my Thai spouse). This is now possible with the Thai law allowing for same sex marriage, which we registered last year. I am doing it because it reflects the reality of our life and my residence in Thailand. A positive benefit is that it requires less funding in a Thai bank (by half) than is required for a single retirement visa. The slight downside is that there is a bit more paperwork and approval time involved. But nothing major when one has retirement time on their hands.

We dropped into our friendly Immigration Office to confirm the application requirements and then set about getting it together. The list involved – my application form and Ace’s form, photocopies of my passport pages, copy of Ace’s ID and House book, updated & certified marriage certificate from the District Office, 6 photos of Ace & me around our house, Bank statement, certification letter, and a copy of my updated bank account passbook pages (all on the same day). Two sets were required, and all original documents to be submitted with the copies.

As I was amending my reason for the extension of stay, it took longer to process the application. On 21 January, we had a 3-hour afternoon at the Immigration Office. A further one-off interview and a written statement prepared by Immigration for us to sign. A temporary extension stamp was placed in my passport. It takes about a month for the application to be processed at Khon Kaen Region HQ, and I must return to Immigration on 20 February to have my new visa extension stamp placed in my passport.

Medical Situation

Since my urology intervention surgery in Bangkok in August 2025, life has been an ongoing challenge both in terms of bladder management and, more recently, with the onset of disturbing skin blisters breaking out on the face, scalp, front, and back of my torso.

Visits to three different dermatologists over the past two months failed to diagnose the problem or prescribe a course of treatment. In December, I had had enough (!) and was really concerned that there was more to what was going on. I felt unwell, not able to sleep properly, and felt things were serious.

Khon Khan – December Consult

This led us to an appointment with a dermatologist at the Khon Kaen University Hospital before Christmas for a diagnosis and medical help. It is a 4-hour drive there for an evening appointment, and we stay overnight. We did try to enjoy the trip with some shopping & food delights.

The doctor was pleasant, spoke good English, and after an examination and discussion, he determined that another skin biopsy was required. A series of lab tests was ordered, but he informed me that the results would likely be one of two suspected diseases. One disease was very concerning, and he hoped it was not that. Given the Thai year-end holiday period, the next appointment for the results was not until 9 January. That was a worry for me, but I was prescribed various lotions to apply in the meantime to assist in controlling symptoms somewhat.

Khon Khan – January Diagnosis

At our appointment, it was revealed that lab work & further confirmation testing resulted in a diagnosis of: Superficial pemphigus, or pemphigus foliaceus (PF), which apparently is a rare autoimmune skin disease in which the body attacks its own skin cells, causing fragile, itchy, crusty blisters and erosions, typically on the scalp, face, and chest. It usually has a better prognosis than deeper forms, often managed with steroids or other immunosuppressants. 

I am told there is no cure for autoimmune disease, but a management regimen can help control the symptoms and potentially suppress the problem for a more enjoyable life. Only time will tell. For more specific information on the disease, refer to the Annex at the bottom of this post.

I believe that significant UV exposure during our house build, along with considerable antibiotic use more recently (while dealing with urology matters), might have been the trigger for me. For now, I am on 30 mg a day of prednisone & vitamin tablets. I also need to apply steroid cream to blisters daily and use a moisturizer on my troubled areas.

Going forward, the doctor has indicated that I may need to have an annual infusion of rituximab, (a targeted therapy monoclonal antibody), requiring a one-day admission to the hospital. This drug avoids the long-term use of steroids and risky side effects. I will need regular blood tests & Dr visits to manage the risks associated with the use of steroids longer term, as well as other side effects from potential infections that the body can’t fight due to steroid use.

I was informed that prednisone can cause an increase in appetite and weight gain, along with fluid retention. So far, I have managed to lose 6 kg, and for fluid retention, that is currently no issue. I have also been advised to stay out of the sun when possible or cover up extensively if going out. I am apparently susceptible to getting infections easily with the medication I have, so I have been asked to stay away from crowds and to wear a mask in situations I can’t avoid with lots of people.

I seem to be improving slightly after a few weeks on the medication, but there is a long way to go. I take joy in small improvements, trying to be relaxed and accepting that life is full of changes & challenges to be met and tackled. Other than that, it’s all good. Wish me luck.

Nakhon Phanom – January Follow-Up

I am also continuing to consult with my Urologist at Nakhon Phanom Hospital to do lab work and discuss the ongoing management of my situation. Since the cystoscope procedure in Bangkok, I have not required further catheterisation. In 2025, I required a catheter 13 times, & I was over that. The visit in January showed good lab results, but I have to wait and see if the unpleasant habits of incontinence management are ongoing or if the dreaded inability to pee, due to strictures, comes back. Every day is a mind game with the bladder. Will it all work, or will I need a catheter again? Stress – Enough on the medical stuff.

Major Transport Projects – Near US

Some time ago, the Thailand Transport Ministry had developed plans for two major infrastructure improvements involving road and rail in the NE area of Thailand. It seems now that we have established ourselves in our new home on this lovely rural property & set it up nicely to our liking, the projects that have been stalled are coming to life. The rail project being built will pass within 400 meters of our house frontage, but it can’t be seen due to forest cover.

However, the That Phanom 4 lane highway bypass will be directly to the rear of our property. In fact, the Government will appropriate about 1/2 a Rai of land from Ace, with payment. The back of his mother’s country house will be on the highway right-of-way. It is expected these projects will require the next 2 or 3 years to complete. It will change the nature of our country property, but the highway itself will be some distance from our house. Time will tell regarding the impact on the tranquil peace and quiet we now enjoy.

Train Line

The Ban Phai – Nakhon Phanom Railway is a 355-km railway in Northeast Thailand that is under construction. The line would begin at Ban Phai on the current Northeast Line and travel via many cities to arrive at Nakhon Phanom. The purpose of the line is to connect provinces of the Mekong region to Laem Chabang Port in Chon Buri.

The Ban Phai-Nakhon Phanom project has been split into two contracts: Ban Phai – Nong Pok, and Nong Pok – Saphan Mitraphab (Nakhon Phanom Province). The dual-track railway route, which will accommodate high-speed rail, will include 32 stations and three freight stations.

Near us, the new rail corridor has been laid out, and recently, they have started to drive pilings to make a bridge over the track for the country road we & other use for access. It will be interesting to see it all develop over the coming years. There will be a train station in That Phanom, not far from our place.

Hwy Bypass

The That Phanom Bypass Project, designated as  Highway No. 297 (Muang That Phanom Bypass), is a major road infrastructure project in Nakhon Phanom Province. As of early 2026, the project is a central part of regional traffic management and connectivity efforts in the Northeast.  The purpose is to alleviate traffic congestion within the urban areas of That Phanom District and improve the transport corridor toward the Mekong River border region. It is designed as a four-lane divided highway and is 8 km long. There will be an interchange with the bypass and our regional road, about 1 km from our place, so there will be easy access to the new highway.

These pictures give a sense of the work involved. Unfortunately, during the build phase, I believe our peaceful existence will be compromised for a few years. What a shame, but perhaps a good opportunity once it is all complete? Life is all about change and adapting to it – apparently.

Ace’s Possible Ad-Venture – A thought Bubble

With all this transport infrastructure work, Ace has been thinking about a potential small business opportunity. He has been discussing the development of “Ace’s Cozy Cottages & Cafe” on the rear or side of the existing property. Our rearranged boundary will have highway frontage & access. For now, it is a dream, playing around with concepts.

The first step is waiting for the Thai Land Dept. to visit with Ace to appropriate the required land and to mark the new property boundary so Ace can be certain of the area he has for use. He visited the Land Dept recently and was told they have just received approval to take the land and pay the owners, hopefully in the coming months.

Stay tuned for development, & if anything comes of this bold idea. Ace is looking for something as a sideline & his future. That Phanom is visited by many thousands over the year due to the significant temple in the city. Many annual events draw crowds, and places to stay are often limited and very old. Catering to a younger crowd, foreigners & those looking for a more modern space just might be an opportunity. Time will tell if this comes to anything beyond the thought bubble!

Winding This Up

You may have seen a recent post about a new page on my website, entitled – The Art of Pivot: Reflections on 12 Years of Tranquil Retirement in Thailand. It is a simple observation piece about my thoughts on fitting into Thailand and the need to change our perspective to appreciate Thailand. See what happens when you have too much time on your hands!

So 2026 is looking like it will start with a medical focus for me & enjoying my retirement. Ace is focused on the landscape and gardens, with my support. I am hopeful and look to pressing on and moving forward. As quoted by Robert Frost,

“In three words I can sum up everything I’ve learned about life; it goes on.”

Further Disease Information – Pemphigus Foliaceus (PF)

Key Characteristics of this disease:

• Autoimmune: The immune system mistakenly creates antibodies that target proteins holding skin cells together, causing them to separate.
• Superficial Blisters: Blisters form high in the epidermis, leading to superficial, easily broken blisters, scales, and crusts rather than deep, painful sores.
• Common Sites: Starts in areas rich in sebaceous glands like the scalp, face (especially nose, ears), and upper back/chest.
• No Mucosal Involvement: A key differentiator from other pemphigus types; mouth sores are usually absent.

Causes and Triggers

Superficial pemphigus occurs when the immune system mistakenly attacks a protein that holds skin cells together in the upper epidermis.  Medications: Certain drugs can induce drug-induced pemphigus. Common triggers include thiol-containing drugs, like penicillamine, as well as some antibiotics and anticonvulsants. Environment: UV exposure (sunlight) can worsen or provoke lesions. 

Diagnosis and Treatment

A definitive diagnosis required a skin biopsy andimmunofluorescence to detect antibody deposits in the skin. Treatment options include: (1) Corticosteroids: Topical creams & oral prednisolone for more extensive disease. (2) Immunosuppressants: Drugs like azathioprine or rituximab may be used to reduce steroid dependency.

Taking systemic steroids (such as prednisone) is the conventional, first-line treatment for pemphigus foliaceus (PF) because they rapidly reduce inflammation and control the autoimmune attack on the skin. However, because PF often requires high doses and long-term treatment, the side effects can be severe, debilitating, and sometimes life-threatening, such as:  (1) High Risk of Infections and Sepsis, (2) Metabolic and Cardiovascular Complications, (3) Musculoskeletal Degradation, (4) Psychological and Cognitive Effects, (5) Other Long-Term Effects

Managing the Risks

To minimize these side effects, physicians often: Taper Dosage: Start with a high dose to control the disease, then slowly reduce it to the lowest effective dose. Use Steroid-Sparing Agents: Introduce immunosuppressants like rituximab, early in treatment to reduce the reliance on long-term steroids. Provide Supplements: Prescribe calcium and vitamin D to protect bone health. 

Because of these risks, the current consensus & recommended by my Doctor is to use steroid-sparing agents like rituximab as a first-line therapy to avoid long-term steroid toxicity. But that can be costly at around 20,000 THB an infusion. Time will tell if it is needed.