So, apparently the Western World of Medicine holds certain ideas about Africa, one of which is that anyone who goes there without a pedigree of immunizations will surely die in a horrible and painfully spazzing way (and might anyway). I'm told this is accurate. At the risk of making an off-color joke that will get me into an *awful* lot of trouble later about certain popularly-held conceptions of Africa, I'll launch right into an inventory of the various things I've been subjected to lately in the goal of preserving my quite excellent (if hiccupping) health during my travels.
First there are the shots; the yellow fever goes without saying, nasty but neccessary; I've already got the HPV and Hepatitis B, and suffered through tetanus-pertussis, measles, mumps, and rubella. Discovered through failed titers that I additionally needed polio, so got that too. So far so good right?
Until the Hep-A - it's a six-month series, but I was only in the States for four (Sept-Dec). The card-carrying lab-coat-sporting doctor optimistically told me that if I went to get it *right* before I left, I'd earn myself a shadow of immunity that would last through the first six months of the trip. Then I'd just sort of .. float my way through those last two months. This sounded like a pretty good plan to me (as opposed to zero shot, zero immunity) so I went for it with my usual zeal, waiting riiiiiight up until Dec 20th to get that shot.
At which point I discovered that while what he said is related to the truth, it's not quite all the way there. That truth being that the first Hep-A shot gives you immunity for up to one year; you just can't get the second shot until six months later at the earliest. So I could have gotten the shot any time over the last three months, and would have been fine through to at least September of 2009. The beautiful irony of his advice is that the one time I actually couldn't get the shot and have immunity is, you guessed it, right before the trip - because the immunity takes several weeks to kick in. So, I'll be washing my vegetables carefully in the Sudan.
Then, there are the pills: after a particularly intense session at the Allegheny County Health Clinic in which my upper left arm was visited by pertussis, yellow fever, and MMR, I was enchanted to learn that typhoid is immunized orally. Fantastic! I thought to myself as I pocketed the $45 pills. I got busy, it rained, the dog ate my homework, etc., and not until I pulled them out of their safeguarded location in my med cabinet six weeks later did I notice the "PLEASE REFRIGERATE" label pasted on the front. Highlighted. In blue.
Feeling a bit sheepish, I drove my way back to the Health Clinic yet again - they knew me pretty well by this point - and explained what happened. For reasons I'm not examining too closely, they somehow accepted responsibility for my refrigeratory incompetence and gave me a brand-new set. Needless to say, I was more careful with this one, knowing it would surely be my last, and over the eight-day regimen I followed the temperature requirements to a tee. Even, when necessary, stuffing a single pill, ziplocked, into a bag of ice, ziplocked, in the back of my car so I could take it while out/about, at 50F, exactly the same time each time, and one hour before I ate.
Take THAT, typhoid!!
Boy, if I get typhoid in Ghana, I'm gonna be so pissed.
So then all that remained pill-wise was to protect myself from malaria. While vaccination isn't exactly an option, anti-malarial pills are, and a wide and exciting variety exist. Including, in fact, one with side effects rivaling heroin itself, the usual hum-drum suspects of headache, nausea, dizziness, fever and vivid dreaming paired with the excitement of confusion, nightmares, ear-ringing, unexplained anxiety, severe depression, paranoia, aggression, seizures, suicidal urges, hallucinations, and the general psychosis that only hard drug-users normally get to have. (the lucky sods.)
But don't you know it's my lucky day... because guess which anti-malarial drug is also the easiest to obtain and easiest to take along this type of trip?? At the recommendation of a former peace corps volunteer, I bought one (1) pill and decided to try it out on myself while in the (in theory) "controlled" environment of my parents' house to see how much joy I might really bring to this trip.
I was quite excited about this one-week trial (see picture) and made a point of telling two close people and no one else, hoping to hear both specifically-attentive and unbiased reviews of my personality on psychosis-inducing drugs. I secretly rather looked forward to a tense moment of melodrama at the end of five days in which I would potentially find myself perched on a ledge, holding a scimitar, screaming to astonished friends my terrible secret: I was tripping on mefloquinine.
Unfortunately... I am apparently one of the dull three people in four who isn't really affected by the drug. Nothing happened. My confessions of anti-malarial-pill-poppings to friends didn't really elicit more than an "oh, really?" The only change seemed to be that I am somehow LESS crazy while on it. After someone pointed this out, I noticed that the anti-malaria week did in fact seem mildly shrouded with a veneer of general euphoria.* Homicidal pitfall avoided; I eagerly picked up $246 worth of the stuff. (Get excited: shopping around saved $300.)
*Side note: said euphoria abruptly terminated in a pit of cranky hopelessness two days after the cycle ended. that, too, passed, but briefly made me wonder if I was going to have issues coming "off" the mefloquinine.. but only briefly, because apprehension about coming off was forgotten in excitement to go back on.
So, it would seem I am medically quite ready to go. In case of a happy-pill failure, I also have DEET and a mosquito net; to tide me until my hep-a immunization I have Purell and a water pump. Side comments about Imodium AD not welcome. And I'll try not to feel too silly about all of this if I'm ultimately taken down by a pride of lionnesses. After all, we're all mortal, aren't we ?
See, the pride of lionesses is what I'd be most afraid of. That makes sense, of course, since my most terrifying experience in Africa was getting charged by a white rhino.
ReplyDeleteGood luck.
~ Gina
I went to Gambia in ’99 on a mission trip, and I did the same thing with the typhoid meds; forgot to refrigerate them and all. I forgot to get my third hep B booster when I came back and ended up getting it in 2004 before I went back to Gambia. Baylor thought I might have goofed up my immunization schedule so they made me get a hep b titer, and there went another $100 to the machine of medicine.
ReplyDeleteHeh, thanks for taking the recommendation on the mefloquinine, I assume that was me and turn my mind from the possibility open that you talked with other peace corps volunteers from Africa. Thanks for listening and being responsive. Sorry you didn’t get to dream you were a dog playing piano on the Tonight Show; believe me, the generalized euphoria is a lot better than the anger and hopelessness I felt while I was on it.
btw, my e-mail's pruet@bcm.edu in case you ever feel like responding to my posts.
And Gina, holy crap dude. I camped out one night and the hyenas were prowling, and the monitor lizards had a strange habit of hanging out in my back yard, but that doesn't hold a candle to being chased by a rhino.
haha yes chris - that was totally a shout-out. i did talk to other pc people occasionally while i was in the states last fall, but you were the only one to have that idea - and it was a good one. i am on the mefloquinine now (spelling?) but i don't think it's affected me TOO badly.. though perhaps you should ask david about that.
ReplyDeleteditto, chris, about teh rhino thing... shoot, gina, was that with snix in south africa??? why did i not hear about this story??