Bevan, Bon Rouleur
5 December 2005 | Southeast Asia, Part Two
An unfortunately related inconsistency with the western world is the potency of food. With my metabolism in a cycling-induced frenzy it takes a couple of meals to start feeling full, especially with Asian portions being smaller than those back home. My first day in Singapore I was excited; I could eat for a fraction of what I could in Sydney. This was novel; my budget no longer restricted my food intake and I didn't have to cook. And oh, the variety! The flavors and textures were just so different. I could eat indefinitely and indiscriminately, which, regrettably, I did. I was especially craving curry that first day. I haven't touched the stuff since!
So what have I been doing in Asia aside from sweating, eating and making use of the squat toilets? A lot of scratching. I haven't been putting in nearly as many miles as I would have liked, because of it. At first, I was very determined to muscle through any initial discomforts (which were many). Later, however, some problems got exacerbated, and forced me to quit biking.
My first day on the bike in Asia was incredible, though. I got lost (there's a dearth of signage), but it was very exciting to be biking amongst banana, palm, and rubber. I felt cool, like I was an explorer seeing this stuff for the first time. Never mind that these were plantations, the rainforest having been cleared many years ago; the terraced hillsides were still jungle to this city boy.
My first tropical shower was also fun. Unlike normal rain (precipitation at home conforms to international standards of normalcy of course), these tropical downpours don't usually last for more than an hour, but are extremely fierce. What's more, the rain's arrival is extremely sudden, and the drops are really really big and make lots of noise. My only warning was fifteen seconds before the shower, when I noticed large droplets exploding on the ground in front of me.
Unlike all of the locals, I was tough enough to brave this first torrent without seeking shelter. 'They must think I'm a real bad-ass,' I thought, as I noted the stares of parked motorbikers beneath an overpass. Thus I continued, soaked to the bone, picking up tremendous amounts of grit from the road while working my way upstream (really) with visibility near zero. When the rain finally stopped, the wetness didn't. With the extreme humidity I never dried, despite a very hot sun, and arrived soaking and smelly to that day's 'X'. Lesson learned. I have to give credit to my Ortlieb panniers, though, as despite dozens of complete drenchings, my belongings have not once gotten wet. Goretex clothing would be near useless in these conditions as you would become equally drenched with sweat; it's always over ninety here, and the humidity pushes the perceived temperature over a hundred.
The wetness caused problems beyond chafing and my feeling gross: it made my eczema explode. The combination of extreme humidity, heat, sweat, and physical strain made my skin condition severe. I also found that my water-logged skin was significantly weaker than dry skin, and if I wasn't careful, I could damage it very easily by scratching. Sometimes I'd be scratching my arm and look down, and I would've just scratched out a chunk of skin.
The badly-affected areas are behind both knees, the near entirety of both arms, above each armpit, entire neck, back of wrists, areas of my back, where lovehandles would be if I quit biking, and ankles/upper part of feet. The worst-affected area is behind my knees; scratch wounds are opened or irritated with each pedal stroke (and even while walking; climbing or descending stairs is quite painful and awkward). It takes complete focus not to scratch, and it gets progressively itchier, to the point where scratching provides a feeling of pleasure and relief beyond any (yes, any) climactic release known to man. That's no exaggeration, either; it's really something. I'd recommend you try it, but the condition (atopic eczema) is inherited, so unfortunately you can only get it by being my child.
The condition is maddening. I try to leave as early as possible to avoid the heat, but it rarely makes a difference. Within fifteen minutes I'll invariably start scratching my arms and the area behind my knees, and it will continue all day. Sometimes I'll have scratching fits, very intense periods of itchiness where I may have to stop cycling to scratch. When I get these, every affected part of my body is so itchy that I feel I can't dig deep enough with my nails. With every affected area at its maximum itchiness I'm scratching everywhere at once, quickly moving from one area to another. I look like a mad man, but my appearance is the last thing on my mind when these occur (rarely is it last on my list of priorities). These episodes last for around an hour. They end when the dull, sore pain caused by scratching is worse than not gratifying the urge.
Eczema is a daily battle. Not a day has gone by on the bike in Asia where the condition hasn't painfully manifested itself. Every single day has been hard. Showers are hell, too: whenever water hits my broken or severely irritated skin it hurts, a lot. What's more, I usually have to gently scrub the back of my knees clean so that the area can heal- a bunch of little rocks and dirt get stuck in clotted blood or interstitial fluid that leaks from the damaged skin. In fact, the area gets incredibly dirty on a daily basis, due to the amount of stuff thrown up by my wheels and passing vehicles. Sometimes it's unbelievable; after one long day I looked back to see a bunch of tiny bugs back there amid the dirt and grime. Ahhh!
Night provides some relief. While being off the bike makes my eczema much more manageable, especially if I'm in a room without air conditioning (most of the time) I tend to scratch at night as well. I don't usually go into scratching fits and thankfully it doesn't generally affect my sleep. My skin becomes very dry at night, especially in air-con rooms, which further exacerbates the problem. Hot showers are out of the question, not that I have that option in most places. I have gained the strange habit of frequently smelling my fingernails as a way to detect bleeding at nighttime.
I have several expensive prescription steroids, but the only way those provide real relief is if I rub them in so vigorously as to abrade my itchy skin with my leg hair. Since my eczema is over such a large area, if I were to use the cream as directed I'd be out in a day or two. Maybe even less with the rain, sweat, and heat. I'm saving the more effective medicine in case it moves to more sensitive areas, which is a serious concern given the amount it has spread during the last few months. Temporary relief comes if I trade pain for the itch; I accidentally rubbed Purell into a scratch-zone once, and after the white-hot pain came a few minute of calm. There is no cure for eczema, one must simply avoid triggers and apply steroid creams if necessary. The triggers read like the trip log. Among them are heat, humidity, sweat, physical and mental stress, and moisture. Great.
The best part is the attention it garners. "There's some sort of rash on your..." "DO YOU REALLY THINK I HAVEN'T NOTICED?" It can be embarrassing. Usually people are courteous enough not to point out the rash, but occasionally they do, and sometimes even ask to feel it. The first thing people usually notice is the back of my knees, since they are discolored compared to my tanned legs, and are sometimes covered in scabs of varying sizes. Luckily there is a lot of blood flow to that area; scabs come and go regularly, and the area heals quickly. The tops and sides of my feet, however, take much longer to heal, but aren't itchy nearly as often.
My social interactions are affected; I'm more irritable when my eczema is bad. This can mean that I get visibly upset at minor things, which, in South East Asia, is very frowned upon. In China there is a concept of face, or honor, and outward displays of anger serve to degrade a person's standing. The same seems to be true of South East Asia, so it is a big deal to get mad. I tend to be a lot edgier as well, and during an intense scratching fit I tend to lose it much more easily.
Eczema has made my trip hell and recently I have been unable to continue my trip. I have stopped biking for nearly a month now, interrupted mid-way with a 3.5-day effort. I've been very close to returning home, or finding other ways of completing my HIV/AIDS awareness goal, including continuing on a motorbike and volunteering at an HIV center in South East Asia.
I grew very depressed when I decided not to bike because I knew it was still possible. It was bad, but not that bad. After all, I'd come 100km that day, as uncomfortable as it had been, and could do so again the next. By not cycling I was letting everyone down: friends and family, the HIV/AIDS cause, sponsors, and myself.
I cried. In my vanity I knew I couldn't end the trip because of a rash. I kept thinking about all the shit I'd get. People would act understanding, all the while wearing slight grins on their faces as I explained why I couldn't continue. The more indiscreet ones would simply ask, "what was the real problem?" I was tempted to exaggerate my symptoms to inspire sympathy. In my worst moments, I even contemplated injuring myself. I thought of ways I could break my leg or arm without causing any long-term damage, in order to return home with a reason. I wanted a clean and minor break but didn't see how I could assure myself one: I was afraid I'd get a compound fracture. The quality of healthcare in this region was another concern. I was very seriously considering this option, and after awhile it scared me.
There are misconceptions about eczema, some of which I had. Many people seem to assume (as I did) that since it's just itchiness, it can't be that bad. I've since learned that the discomfort from my eczema is reason not to bike and that I shouldn't have continued as far as I did with it. On top of its causing maddening itchiness, it puts one at great risk for infection. Even in cases that do not require hospitalization, eczema can drive one insane. Please consider that for a moment; the idea that an itch could drive you to the point of insanity. That sounds cliche, but I'm not exaggerating. The incessant itchiness all but prevents any other activity in its worst moments, and the most extreme itchiness can last for over an hour. After that, your skin's top layer has been so brutalized that anything irritates it, provoking further scratching. I've nearly broken down during scratching fits, as in, I've started crying, regardless of onlookers (and, as always in Asia, there were many). And I'm a pretty tough guy. That's when I decided to give it a rest.
A week of indecision followed. As I mentioned I sought alternatives to cycling, including continuing on a motorcycle (thereby eliminating sweat and physical stress), and volunteering for a few weeks. I eventually decided to travel north by bus in order to resume cycling in a cooler environment. In Australia my eczema was very manageable, and went away almost completely after awhile. I'm confident that winter in Asia will provide a good environment for me to resume cycling.
(Continue to Part Three)
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