First off: a warning. I'm gonna get medical on your ass. Or my ass, rather. This post details my second experience in a Thai hospital, and the result is overwhelmingly positive. But the back story and the details are a little -- well, not so much gory as unpleasant.

This morning I dropped into Bangkok Hospital Phuket to see about what I thought must be a hemorrhoid on my ass, an external growth that had been getting larger during the past year or so. I first noticed it while I was on the ship after a bout of constipation. My diet is heavy on fiber and roughage, and I almost never get plugged up. But from joining the ship and processing food from the crew mess and passenger buffet, my innards got totally stopped up. After a couple of days, I saw the ship's doctor, who gave me a fiber drink that managed to get things moving again.

A few weeks later, when I first discovered the tiny growth on the outside of my O-ring, I thought I had blown it out. Which was unexpected. About 15 years earlier I had gone through a painful bout of prolapsed internal hemorrhoids. I'll spare you a rundown of the several types of hemorrhoids since Wikipedia has a clear explanation (with a nifty graphic). Suffice it to say that prolapsed internal hemorrhoids are very uncomfortable, and there's almost no relief from the dull, throbbing pain, whether seated, lying prone or floating in a bath of warm water.

Back then, I went to a proctologist for treatment, and the first thing he told me was never, never, never strain when having a bowel movement. His next advice was never use toilet paper and instead use a medicated wipe like Tucks. I took both pieces of advice to heart, though I modified the bit about Tucks. I figured out that Tucks is mostly made of witch hazel, so I got into the habit of dousing toilet paper with witch hazel before wiping.

By the way, the treatment for prolapsed hemorrhoids is brutal. I had to go in for three sessions, and for each one the doctor opened up my ass. He then attached electrodes to the hemorrhoids and sent in a cauterizing current. For the first session, I didn't bother taking the Valium he gave me to relax beforehand. For the next two sessions, I definitely took them. That was the most distressing and humiliating medical procedure I've ever experienced, worse even than an endoscopy I endured about a bladder problem. I hope I never have occasion to recount my endoscopy story here.

Anyway, during the 15 years since that hemorrhoid flare-up, I have been very careful about anal hygiene. No problem since then, and the first evidence of anything amiss was the growth I noticed one day while showering on the ship. Thankfully, no pain, and no blood. So I let it go for a while.

What prompted me to have it looked at today is knowing I must go through a medical exam to get certified for working on the ship again. I join the ship on Nov. 17, and I've scheduled a medical exam in Bangkok on Nov. 3. (I want to get the exam done here since visits to the doctor in Thailand cost a fraction of what they cost in the US.)

After taking a quick look, the doctor at Bangkok Hospital Phuket (the local branch of the Bangkok Hospital chain) declared that I didn't have a hemorrhoid. He even lubed up my ass and probed inside, giving me a clean bill of hemorrhoid health. The growth outside my ass was merely a "skin tag" that could be whisked away with a quick snip-snip. Which he proceeded to do after moving me to a minor surgery room and administering a prick or two of local anesthetic. I did get the electrodes again, but only a few jolts externally to cauterize the wound and stop the bleeding.

Here's the best part: I was in and out of there in about 45 minutes. The whole shebang cost me 2,577 baht, which works out to around US$80, including a packet of antibiotics to ward off infection. Bangkok Hospital Phuket is one of the finest medical facilities I've ever used, and the staff seem always to be unfailingly pleasant and efficient.

The slight pain in my ass left over from the surgery, and a bit of discomfort from a gauze bandage in my crack, is a small price to pay. No Valium required.