I must admit the way I view dogs now is quite differently than I viewed them before. Once a dog (or two in my case) decides to make a meal of you things change. I can't imagine how a child handles this. I used to think about petting dogs, and now I think about avoiding them.
I was at a local mall last night and these pics are quite common:
These dogs appear to be related and are sleeping in front of the mall. They belong to know one and people walk around them. This would not happen in Canada as someone would call and the pound would be around to pick them up.
A friend told me that when he was in Guatemala, the local cops would drive around in a pickup, shooting the strays and just leave them where they were shot and the locals disposed of them.
Thavorn mentioned to me that it is not unusual be be charged 40,000 baht for kicking a dog in public. I can only assume this is because of their Buddhist religion and the dog is simply some unfortunate soul lower down on the wheel of life. I assume this is also why the local street vendors feed the rats on the street.
I finished my antibiotics yesterday and my puncture woulds seem to be healing okay, without infection. I receive my 3rd rabies shot this Saturday and hope to play some pool afterwards and indulge in a few pints at the same time.
On a lighter note, we are approaching 3 months in Thailand, our halfway point and I may start my countdown to Canada. We will visit the village for Christmas and New Years. Speaking o Christmas, our building put up some Christmas decorations.
Everyone I talked to said I should go see a doctor. I was bitten by a soi dog at 6 pm the day before and woke up the next morning and decided to go visit Dr. Donna, my doctor of choice in Bangkok. It appears those who convinced me to go were wise indeed. Some stats:
The highest incidence of rabies continues to be in Africa and Asia, particularly India. Most deaths from rabies occur in India and Southeast Asia, Africa and Latin America. Thailand has an estimated 10 million stray dogs, with 1 in 10 dogs in Bangkok estimated to be infected with rabies.
What follows is the best article I found on the net. What should I do if I am bitten by a dog?
Bitten or scratched by a dog, cat or monkey is a common problem seen in our travel clinic. Most important concern in this scenario is a rabies risk. Since it is a serious and untreatable disease. Once someone develop symptoms of rabies, it will always fatal. So we have to do everything we can to prevent rabies virus when they have been bitten/scratched by a mammal. Here are some useful information and advice
1. Once you exposure to any mammal (dog, cat, monkey, etc), the first step is to clean your wound immediately with antiseptic or just soap and water. This is an important step that could minimize the risk of getting rabies. Do not forget to do this.
2. You can get rabies only when you ‘expose’ to an infected mammal. The keyword ‘expose’ is important and should not be confused. The World Health Organization (WHO) has classified the possible rabies exposure in three categories as followed;
3. You’ll see, in most cases, if you’re bitten you are likely to have a category III exposure which require rabies vaccine and immunoglobulin. Rabies immunoglobulin, in simple word, is just a rabies antibody that could neutralize the virus at the wound. So the concept is, if someone has trans dermal bite (bite that break to the deep layer of the skin); it is possible that rabies virus could find its way to the nervous system. So we immediately need something to neutralize it. We cannot just give a rabies vaccine and wait for the protection since it could take more than a week before a series of vaccine will become effective. And unfortunately, the incubation period of rabies could be as short as 7 days. No one would take that risk.
4. If you has been scratched by an animal, the wound is not deep and there is no bleeding. We could categorize as category II exposure. In this case, you just need a series of rabies vaccine i.e. 5 shots on Day 0,3,7,14,28.
5. However it is not always easy to categorize the exposure in the real life. Someone might get bit; the wound is small but there is some minimal bleeding or bruise. Should we categorize into category II or III. Sometimes it is difficult to say. However, giving that rabies is 100% fatal, so in the grey zone case, most doctors prefer to give ‘over’ treatment to ‘under’ treatment. We also agree, we prefer to err on the side of caution.
6. There is a common scenario that traveler has category III exposure, but rabies immunoglobulin is not available on the first visit. On that case, you still need to get the vaccine and should find the place where you can get the immunoglobulin without delay.
7. If you have already completed rabies pre-exposure series i.e. 3 shots, it is not necessary to receive immunoglobulin. You just need two shots of rabies vaccine on day 0 and day 3 once you exposure to animal.
8. If you’re not sure, whether you should go to see a doctor or not; or whether the scratch is severe or not. DO NOT try to consider it by yourself. You need a qualified medical doctor to assess for you. Visiting a doctor is an urgent issue after possible exposure to rabies virus.
9. In the standard recommendation, we do not use the ‘behavior’ or the ‘looking’ of the dog/cat to consider the necessary of the rabies post-exposure treatment. Since even healthy-looking dog/cat could transmits rabies. So we will consider all exposure to animal is a rabies risk. We could be sure that there is no rabies risk when that dog/cat survive more than 10 days after exposure. However, the rabies post-exposure treatment must begin immediately on the day of exposure.
10. Once you get bitten/scratched, you should seek for medical care as soon as possible. No one knows the safe time-frame that you can delay, i.e. we have always been asked whether it is ok to delay the treatment for 12 hours/24 hours/48 hours, etc. Unfortunately, no one know the answer. Generally speaking you should do it as soon as possible.
After a quick visit with Dr. Donna she suggested her Thai medical partner would best be able to server me as he had lots of experience in dog bites in Thailand.
The Thai doctor asked me quite a few questions which boiled down to the fact the bite was unprovoked and I did not have access to the dog or the dogs owner (if any) to discuss whether or not it had a current rabies vaccination (not likely).
The doctor deemed me an intermediate risk although the above article would classify me as category
The good doctor stated my chances of getting rabies from the bite was 50% so I had to make a choice of going the full monte or just the vaccination. I found the choice quite easy and went with the full monte. However the good doctor never explained what the full monte implied. He did tell me the nurses would handle me. I later figured out he probably did not want to inject me with the 44 needles. OUCH, OUCH, OUCH.
20 injections went around and into each of the two puncture wound for a total or 40 needles. Now, the human body does not have pain nerves everywhere but I figure at least 15 of the injections hit a nerve. This took about 20 minutes. This was the injection of the immunoglobulin.
I then had 2 shots in the shoulder and 2 shots in the ass. Over the next 28 days or so, I get 4 more shots to finish the treatment. Apparently it will be difficult to get rabies in the future as I will only need a booster shot to protect me if I am bitten again.
All this brought back memories of my first bite in Thailand about 6 years ago:
At that time I knew the dog owner and its vaccination history and I avoid rabies treatment.
I am including all this info as a warning to visitors in Thailand to be a little weary of soi dogs.
One of the differences between civilized countries and countries that pretend to be civilized is how their dogs are controlled. In Thailand, soi dogs (street dogs) are everywhere and of course are not licensed and usually just wander around on the loose.
I was bit for the second time tonight, walking back from the mall. This particular dog was chained to the front door of a house (term loosely applied as a house). I thought that was unusual as I walked by and was taken by surprise as the dog lunged out at me and bit me. The chain, was simply too long permitting the dog to enter halfway into the street.
Needless to say I was incensed and would have called the police in Canada and reported the dog and then would have gone off to the hospital for treatment.
However, this is Thailand and farangs basically have no rights when a situation involves Thai people. However, if I would have had a bat, there would have been one dead dog. On second thought, I should have picked up a rock and heaved it through the window of the house.
Instead I limped off home and looked up what to do on the internet. Going to the hospital was not something I wanted to do as Thailand just passed a new law authorizing hospitals to charge twice the usual fee when treating a farang. Thai hospitals just love farangs showing up as a cash cow. My insurance back home would cover it but trying to explain to a Thai hospital what you want is also a challenge even if Thavorn was present. Thai people are intimated by doctors and just take what they say as gospel truth.
I have experience this with my basketball players as hospitals always cast an ankle sprain as it generates more cash. Then they tell the player to stay off it for a month when the cast comes off in 2 weeks. BTW, this is not the way to treat an ankle sprain.
The internet agreed that the proper treatment was to wash the bite with soap and water, apply a topical antibiotic cream and the take an oral antibiotic, with the recommended tablet you will see below. The only thing I miss out on is a shot of antibiotic in the hospital to get me started but Thavorn was able to buy the correct tablet at the local pharmacy without a doctor's prescription, which is of course against the law, but then again, this is Thailand.
Rabies? The chances are quite low that a chained up dog would have rabies so I will roll the dice.
Thavorn needed a lot more dirt than she thought. Now that the dirt is in we won't do much over the next 2 years and then start building in earnest. Total cost will be under $50,000 CDN.
I have been remiss in posting as of late as not much is occurring in my life. Thavorn and Jaidan arrived back from Phuket and immediately left the next morning to go to the village as Thavorn needed to be there for the surveying of her property that we purchased in September. The other item that needs to be done is the raising of her land to the level of the road for easy access.
At the Phuket airport
Travelling to the village
Surveying is finished
Awaiting dirt, hopefully today
My U15 basketball team season ended today. We finished the year end tournament winning 3 and losing one, to finished second. The winning team shot 8 of 10 from the 3 pt line despite us having a hand in their face. We lost by 2, despite winning by 1 with 30 seconds to go. The next game they shot 5 of 19 which included 2 banks so they had horseshoes up their ass when they played us. C'est la vie, a good season nevertheless. On to varsity boys now.
Hopefully Thavorn and Jaidan will arrive back tomorrow and I will have some company. It is rather boring living alone. My buddy John is going to join me for a beer, perhaps tomorrow.
