Sick on the Road

Face of pain

Face of pain

Sick ON the road, not sick OF the road.
You may want to skip this post unless you’re a really close friend or family, since it’s basically a bunch of whining combined with a cheap ploy for sympathy.

So after being sick most of last week with a bad cold that I feared was H1N1 (but I suppose wasn’t since I got better), I went for a run on Wednesday to get some much-needed exercise. The next day I was in such pain that I could barely walk! Guess I overdid it, dummy. Friday (yesterday) my legs were still aching, but I decided to visit the Incan ruins of Ingapirca (more on that in another post), since I’ve got to get a move on and finish seeing Ecuador.

On the bus ride back from the ruins my eyes started tearing and getting irritated. No problem, I thought, it’s probably just something in the contact lenses – I’ll take them out when I get back to the hotel and all will be fine. It wasn’t fine. I was supposed to go out with a (male!) Couchsurfer last night but had to cancel since my eyes were a mess – swollen, painful, itchy. Tried washing them out with tap water, saline solution, and eye drops. For several hours. Tried taking a long hot shower thinking the humidity might help. I couldn’t understand it, it really felt like some grit was stuck in there, and if I could only rinse it out all would be fine. I kept thinking it would clear up, but finally around nine o’clock I went to an all-night pharmacy to see what they could give me. They said Visine would do the trick, which of course it didn’t. I considered going to the hospital, but thought maybe a good night’s sleep is all I needed. Plus I was scared to go alone to a foreign hospital in the middle of the night.

I slept pretty well.. it doesn’t hurt when my eyes are closed. But I woke up this morning to the same condition – swollen, tearing, painful eyes. Fortunately the hotel knew of an eye doctor in town who was open on Saturdays thank goodness, and he was able to fit me in pretty quickly. It felt good to get a proper examination, and fortunately he knew a bit of English, so we were able to communicate after repeating things back and forth to each other in both languages to confirm that each other understood.

The doctor told me I have an eye infection (he didn’t tell me exactly what, and I didn’t think to ask the name), and he prescribed three medications, all antibiotics: 1) eye drops to take every three hours for the next 10 days; 2) drops to clean my contacts with twice a day for the next five days (but to not wear them for two weeks), since they’re probably infected; and 3) ointment to put in my eye before bed each night. He said it might take a week or longer to clear up. I’m going back for a check-up in three days. The meds cost $67, three times more than the exam ($20). The contacts I was wearing are brand new, in fact they’re my last pair of the pack of disposables I brought. And I’ve been a good boy, I only wear the contacts when I want to wear sunglasses, i.e. about 30% of the time. He said the infection could have come from anywhere my fingers touched, then touched my eye. Who knows. He said it’s normal for such an infection to come on so suddenly.

In the meantime, I’m in pain! It hurts every time I blink, it feels like sand is in my eye. As a result my eyes are constantly tearing, causing my nose to constantly run. I look like a stoner mess. I want to be out with people, eating in restaurants, but I keep thinking they’re staring, like I’m a leper or something. Not that I would wish for any other kind of illness, but you know most of the time when you’re sick you can just sit and use the computer all day or watch TV or whatever. But I can barely see! I’d like to hang out in the park, but bright light hurts. This would be a good time to dig into my new book, but I’m not sure how long I’ll be able to focus. In the 30 minutes it’s taken me to write this post my eyes are already burning. I suppose I could lie down and just listen to podcasts (or language tapes) all day, but gawd, that’s going to get boring.
Although I thought I would be in Peru by now, I’m going to have to hang around southern Ecuador for the next week until this clears up. Thank goodness I’m in a large city with medical facilities.

This is one of those times when it’s difficult being alone on the road. No one to confer with or help me, it can feel pretty lonely and scary when sick and not sure if I can trust my own judgement. On the other hand, as Nietzsche is so often quoted as saying, getting through experiences like this will only serve to make me stronger.

Written by in: Health | Tags:

Road to recovery

Note to self: don’t Twitter when upset. I realized later that my tweet about the hospital might have scared you. And it wasn’t entirely accurate, I actually did get some good out of it. So here is a more thorough update on my health as I struggle to end this month-long bout of travelers diarrhea:

A friendly local who works in my favorite cafe offered to take me to a doctor and help translate. Excellent. The clinic turned out to be a hospital – quite modern and sterile, rivaling anything in the U.S. I’m impressed – Santa Marta is not that big a city.

Mom rightly insisted on signing me up for health insurance before I left on this trip. I actually have two – one for life-or-death emergencies should I need to be airlifted out of somewhere (although it says in big print on the card “Services not arranged or pre-approved will not be reimbursed!” which kind of goes against their name of Traveler’s Emergency Network.) Then I have regular health insurance through Kaiser Permanente, an HMO. But that’s more for long-term care, should I get cancer or something. So neither of them help me in this situation. I guess there is a chance Kaiser might reimburse me, but somehow I doubt it. They’d probably say, “what are you doing leaving the U.S., anyway?!”

Back to the hospital – I had an initial consultation with a doctor in which I explained the mild symptoms and how I’d been treating it with different antibiotics, but none of them seemed to be working. He gently reminded me that one of the side-effects of all of these antibiotics is… diarrhea! Good grief. So I’m a dog chasing it’s tail.
He then gave me a physical, pronounced me fit and fiddle, and sent me off for blood work and a stool sample (I was particularly excited about this part). And then we waited… for the lab.. and waited for some more for some internist.. and waited for the shifts to change.. and waited some more. I read the entire newspaper cover to cover, even at my 5 seconds per 1 word reading level!

Finally another doctor comes along and shows me that the lab found zero parasites, eggs, ova, protozoa, worms, bacteria, or other baddies in my stool. Huh, this really surprised me. The blood and glucose work also came back normal. So.. what did this leave? This is where we leave reality as we know it. First, the doctor suggests that I stay there in the hospital for two to three days.. as in, overnight, just to make sure everything is all right. When a doctor tells you this, you think, shit, really? Something really must be bad. But then I caught hold of the reality he had lost and told him what a cockamammie idea that was. Next? His next try would have been laughable if it weren’t so tragic. He dramatically drew the curtain which cut off sight, but certainly not sound from the rest of the busy ward (which of course were all paying attention to the gringo desperately trying to understand the doctor and my restaurant buddy who it turns out is not that great a translator), leans in close, and explains that I may have AIDS. You know, he says, not everyone with diarrhea has AIDS, but everyone with AIDS has diarrhea. Yes, and about 47 other symptoms, none of which I have. I’m really freaked and irate at this point, so I begin forcefully explaining why he’s full of shit: a) I was tested six months ago, before leaving for this trip. Negative. b) In the ensuing time (and the 6-month window previous) I have not engaged in any risky activity. c) Even if I had, and it’s unlikely that enough time has passed for symptoms to begin showing, I would surely be exhibiting more common symptoms such as fever, rash, loss of appetite, swollen lymph nodes, aches, none of which I have. So he proceeds to give me another physical, perhaps to confirm my assertions.

I mean, I know this doc must have been taught Occam’s Razor in med school, so why he didn’t use it is beyond me. Unless of course he was using it and that’s the likeliest explanation around here, which would be pretty scary. Anyway, he gave me a prescription for probiotics (not cheap!), rehydration formula, and something in case I have abdominal pain. Also a list of foods to eat and avoid, some of which surprised me. Coffee is fine, he said (against everything I’ve read, since it’s such a diuretic). Papaya and bananas are not good, contrary to received wisdom which states they’re great for healing from TD. Mango, guava, and peach are good, while all dairy is out. No sodas, gatorade, or beer. That’s going to be the tough one.

The hospital gave me an initial estimate that it would cost $70, which turned out to be a lie – it was $120. Damn. I wish they had asked me first before doing some of the stuff. One thing I really appreciated, though, was the stack of paperwork they gave me upon exiting – all the lab results, doctors notes, etc. It’s always frustrated me that the U.S. medical system hides all the patient records from the patients themselves – as if we’re too stupid to comprehend our own medical charts. This was a pleasantly straightforward transaction – I paid to consult with some specialists and have lab work done, and they gave me all the results, nicely formated and presented. Although parts of the process frustrated me, ultimately I think I actually received better care than I would have in an average city in the U.S.

The other great thing to come out of that day was the guy from the restaurant who sat with me all day (from 3:30 – 9pm), putting off his wife and job. Surely, I thought, he’s going to ask for a tip or something at the end of all this. Nope, he just wanted to help out a traveler in need. Well, I am certainly going to buy him a very nice present. This seems to be a common trait in Colombia – friendly, gregarious, generous people that aren’t trying to scam you. It’s hard to get used to after all those months in Central America.

The good ending to this story is that in the two days I’ve been off the antibiotics, my shit has almost returned to normal. Wouldn’t it be ironic if I was perpetuating the diarrhea with medication that I thought was treating it.

This is one of the most personal posts I’ve written, so please do tell me if it’s TMI territory. I certainly don’t want to scare off any of my dear readers.

Written by in: Colombia,Health | Tags: ,

Chillin’ in Santa Marta

So here I am a week later, a couple of hours up the coast from Barranquilla, in the small city of Santa Marta. Santa Marta is one of the oldest cities in the Americas, and is where the famous liberator Simón Bolivar finally met his fate. Gabriel García Márquez is from a small town nearby, fictionalized as Macondo in his novels.  It’s nice here – much cheaper than Cartagena and Barranquilla (many decent hotels for $5-$10/night!), there is a decent beach, good internet, friendly people. I’m not such a beach person, otherwise I would get all excited about taking boats to neighboring coves where there are meant to be spectacular beaches. But I’ve had my fill of that for a while.

Instead I’ve just been taking it easy, trying to kick this stomach bug that’s kept with me for a month now. I haven’t been worried about it because I’m not showing any of the symptoms of serious Traveler’s Diarrhea or worse bugs like Cholera. I simply haven’t had a solid shit in a month! But after finally doing a bunch of research I am now on my fourth antibiotic and taking mom’s advice to eat bland, simple foods. The madre of my hotel offered to heal me, to which I said, “oh, you’re a doctor?” No, she replied, pointing at the statue of Jesus on the desk, she would heal me in other ways. Thanks, I’ll think about it. If this latest drug doesn’t finally work then I probably have a parasitic infection, which antibiotics won’t kill. But maybe Jesus could.

I went for two runs so far this week, which felt really good. One of them led me up into the foothills which afforded fantastic views of the city below, the busy port, and the Sierra Nevada mountains beyond. These mountains rise abruptly from the Caribbean to 5,800m snow peaks in only 45km, an incredibly steep gradient comparable to the south face of the Himalaya, and unequalled along the world’s coasts. It’s also a region of drugs-growing and processing, guerillas and paramilitaries, which unfortunately puts it off-limits for tourism which is too bad, since it’s meant to be spectacular.

Santa Marta’s beach faces directly west (odd, since we’re on the Carribean – i.e., the coast generally faces east), so each night the sun sets right in front of your eyes over the ocean. Although there are no places to hire bikes in town, I did manage to finagle one through the hostel for a day. Had a wonderful ride up and over the foothills to the neighboring towns of Taganga, a sleepy tranquil beach town, and El Rodadero, an upscale enclave of high-rise condos and fancy beach chairs. It felt wonderful to be on a bicycle again after so many months.

continue reading the rest of this post (and view the photos)…

Written by in: Colombia | Tags: , ,

Traveling Blues

Ended up staying in Roatán a few days longer than I thought I meant to, due to meeting people and partying.
Got invited to an impromptu local party (taxi had to drive along the beach to get there!)
Later in the night, us gringos wanted to go back to his hotel to wind down. We invited whomever to come, and lo and behold, two working girls (ok, one tragic queen, one equally tragic actual girl) got in the cab with us. We spent the rest of the night coming to the realization that they were hustlers, and were going to be sorely disappointed in their lack of catch that particular night… neither the other gringo nor I were biting. Morning finally came and we sent them packing. Of course, they needed cab fare home. Much more than was reasonable, but to avoid a loud fight that would wake up the other guests and owners, we just gave them some cash to be rid of them. Another lesson learned.

Caught the early ferry back to the mainland, cab to a bus to San Pedro Sula, then a chicken bus towards Lake Yojoa. I was headed to a hostel / microbrewery some fellow travelers had told me about. An Oregonian (thus the brewery) had married a local woman, and started this thing near the pretty lake. Before I tell you about this place, though, prepare to be grossed out. That´s right, I got my first food poisoning for this trip. Ironically, I had just finished bragging to someone about how strong my stomach was and had been fine with all the crazy things I’d eaten down here. But that day, I was hot and stressed from all the traveling that day, so on the bus, I bought one of the snacks on offer – a homemade cream ice fruit thing. All the locals were eating it, so couldn’t I… ?

It felt cool and refreshing, but about an hour after eating it, I began to feel cold. Then I got really cold, and flushed. Teeth chattering. Achey and numb all over. Intense headache. Fortunately no impulse to shit at this point, I don’t know what I would have done – I guess gotten off the bus and shit by the side of the road! I think the Bonamine I had taken that morning for the ferry ride helped with not feeling nautious on the bus. That stuff is amazing (thanks for adding it to my pack, Mom!). Anyway, we eventually made it to the hostel (this place is tricky to find.. “ask the driver to stop after you see the soccer field after the bridge over the creek..” ).
Just as an aside, customer service is not Honduras’ strong suit. The woman hemmed and hawed about giving me a room, even though it turns out they had one free. I think she just couldn’t be bothered. And that’s not the first time I’ve had to cajole a proprieter into giving me what they’re supposedly in the business of selling, whether it’s a meal at a restaurant or a room for the night. And forget about smiles, or thanks for coming. Oh, no. You’re lucky to even get served.

Finally making it to my room (with my own bathroom, yes!), I put every stitch of clothing I own on and crawl under the covers, still freezing. Two hours later, I wake up drenching in sweat. Now I’ve got a serious fever; I strip off everything, and throw the windows open. I make sure to drink plenty of water, take what few probiotics I have left, along with plenty of vitamins and pain killer. Go back to bed. This alternates for the next 12 hours. Eventually by morning I’m feeling better, although seriously weak, and still pissing out my butt. [Shall I go into more detail?]

The only other time I’ve had food poisoning in my life was in Edinburgh a few years ago when we were premiering a new piece that I was lighting. I had tuna tartare for lunch, and upon commencing work in the afternoon, began the exact same symptoms. It’s rather hard to direct a crew of 10 technicians (let alone have the mindspace for creative design) when one is running to the toilet every 5 minutes! The best part was when one of the crew mentioned that he had had the tuna tartare at that same cafe the day before and the exact same thing had happened to him. UMM, SO WHY DIDN’T YOU TELL THE RESTAURANT THAT THE TUNA WAS BAD SO THEY WOULD STOP SERVING IT, DUMB-ASS?!

Written by in: Health,Honduras | Tags: , ,

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