Getting Sick Abroad

Ok, let’s face it.  The subject I’m about to espouse on isn’t a pleasant one.  But most of us have been there.  And everyone’s been ill at one point in his or her life.  So I’m gonna do my best not to dwell on the gory details, but be warned.  Those who get queasy easy (I love alliteration) may want to pass on this one.

First of all, before you go anywhere, you should make an appointment with a travel doc to be sure YOU are in good health before you take off.  Don’t want anything untoward surprising you on the road.  The next reason is because if you’re going anywhere that isn’t Cleveland (and maybe even if you are), there’s a chance you’re gonna need some sort of vaccine over and above the standard school immunization panel.  Good idea to do this as soon as you start planning, some vaccines are done in parts that need to be spaced weeks apart or have a long incubation time.  I’ve had Yellow Fever, Typhoid, Hep A and Japanese Encephalitis all in the past few months.  And carry that yellow card they give you with you, some countries won’t let you in without proof of vaccines.

The next step to prevent getting sick abroad is to hit the CDC or State Department website for info on common illnesses wherever you are going and how to prevent or treat them.  Malaria is a good example.  Best not to show up in a malaria zone unprepared.  I’ve been on Malarone for the past 20 days and haven’t had a single side effect, so I recommend that one.  I did hear a good joke in Cambodia, though.  It went something to the effect of; “I can’t remember if I took my malaria pill this morning.  Man, if I were a girl I’d be pregnant a lot.”

The old adage goes, an ounce of prevention is worth a pound of cure.  Always true.  The Boy Scouts say “Be Prepared” for a reason.  Although over-preparation can smack of neuroses, Cary.  Just sayin’.  There are 3 over-the-counter meds and one prescription medicine that you should always carry with you.  Pain reliever, you never know when you’ll get a headache and it sucks being stuck without.  Pepto Bismol tablets, they really help ease the transition across time zones and are a blessing after overnight flights, I’m usually chewing some before we even get off the plane.  But that’s just a personal thing I guess.  And the next two combat a rather unpleasant side effect of eating strange foods in strange lands.

Traveler’s diarrhea, the Trots, the Brown Rain; whatever you want to call it, its not fun.  But it is nearly inevitable, especially if (like me) you’re a big fan of street food.  Somewhere along the line you’ll gorge on something that disagrees with you.  It could have been that bowl of crickets or something as simple as bahn mi off a cart on the corner.  The tiny little organisms in your stomach that help you digest things, as an American, are very different from those of someone from Vietnam or Cambodia.  Your bugs may not be used to noodles or rice for breakfast, lunch and dinner.  And to punish you for the onslaught of new and different food, they will voice their protest in the form of frequent and noisy trips to the lavatory.  So the third bit of preventative medicine to always carry with you is some Imodium, or the generic equivalent.  Hopefully that’ll put a cork in the flood without totally corking you up completely.

And if the Imodium doesn’t work completely, it’s best to get a prescription for some Cipro or another type of medium duty broad-spectrum antibiotic.  Spend a few days taking those as prescribed, and you’ll be able to sit through dinner without bouncing up and down out of your chair every 10 minutes.  It’s also best to note that if the Trots do come calling, you should be drinking a lot more water than you would normally.  I ran into that problem as I left Vietnam for Cambodia.

On my last night in Vietnam I went to an expat bar for dinner and ordered a burger.  Seemed innocuous enough.  And it was a pretty good burger, great flavor and nice and juicy.  Wasn’t until I finished the damn thing that I noticed all that juice was pretty damn red.  Even I’m not stupid enough to order a burger anything less than well done in a country where refrigeration and food safety have a long way to go to catch up to say, India.  So I had an inkling of what was headed my direction.  I went home and started my regimen of Cipro, hoping to head it off at the pass.

Woke up a bit queasy the next morning, but I chalked that up to Tigers and not the burger.  Packed up and headed for the airport for my two-leg journey to Cambodia and Siem Reap.  The entire day was spent with that background nauseousness of creeping illness.  But I powered through and made it to the hostel I had booked.  Thank god I had thought ahead and booked a private room with A/C, climate control was clutch.  By the time I got there, things had gotten worse.  I was running a fever, which SUCKS when the ambient temperature is 90° F.  Couple that with the fact that I’d been in transit all day in similar heat and high humidity, was still suffering the beck and call of the brown rain, was sweating like a contestant on The Biggest Loser, and not drinking enough water and it’s easy to see I managed to get massively dehydrated.

I appealed to the hostel’s owner, a British expat named Mark and a really awesome guy, for some help.  He took the opportunity to tell me to quit freaking out about any weird tropical illness solely because I was standing there talking to him in a calm voice and not curled up in bed hallucinating.  Small relief, but I was grateful for it.  He told me to walk down the street and pick up a few packets of powdered vitamin C and salt packets and a bottle of water.  He advised I drink two of the packets over the next 12 hours and get some rest.  If I wasn’t feeling better in 24 hours, then he’d “take the opportunity to start to be mildly concerned” for me.  Normally I’d laugh at that dry British humor, but that’s a tall order when you’re simultaneously sweating profusely from the fever, heat and humidity and freezing because of the shitty undercooked burger.

I had no idea what these rehydration packets looked like, but thankfully another guy at the hostel, Stuart, offered to walk down the street “to the Chemist” and help me find what I needed.  During our epic journey of 300 meters, he recounted a story to me of how he managed to fall in a river in Laos and swallow more than a bit of it.  He said he wound up with searing stomach pain and vomiting for a few days before he “decided something was wrong.”  Being in rural Laos (its pretty much all rural from my understanding), someone took him to the closest thing to a doctor they could find, “he was pretty much some guy in a thatch hut with some bags of unlabeled pills.”  Stuart said the guy pointed to one pile of pills and motioned to take one three times a day, and then pointed at a different pile and indicated to take three pills twice a day.  2 days later, the witch doctor (I use the term lightly) had managed to cure whatever gut rot had afflicted him. 

Buoyed by this optimistic, if unappetizing, account of his bout with accidentally ingesting what was presumably the product of someone else’s similar affliction, I mixed up what amounted to a packet of Emergen-C and downed a liter of (purified) water.  I spent much of my time in the shower that night running the what-if scenarios through my head, all the way up to and including medical evacuation by the American embassy in Cambodia via military transport.  (Just goes to show you that letting your mind wander when wracked with fever can take it weird places.)  A lot of my night was spent drifting in and out of not-at-all restful half-sleep and alternating between sweating and chills.

Then somewhere around 4am I was summoned by an urgent and unmistakable call to worship the porcelain throne.  And as with almost every other similar occasion I’ve had to engage in such devotion, I was immediately cured of my fever and chills.  Hallelujah, praise be to the porcelain god.  Amazing how that one act can virtually wash away all illness, but I was transformed.

I managed a few hours of more restful sleep and then spent the day hanging around the hostel, not doing much other than drinking a boat load of bottled water.  All told, over my stay in Cambodia, I managed to drink seven and a half liters of water.  And most of it stayed in me or was sweated out due to the heat and humidity. 

I guess the tropics really are, well, tropical.

Stay healthy my friends.