3 slices of cake and a new piece of jewelry

I SURVIVED!!! :-D

Alrighty, the actual doctor’s appointment wasn’t that bad. I’ll go through the list of pokes and pills that I received, but it really truly honestly wasn’t that bad. What does sound bad though is all the really bad shit that can happen to you in Tanzania!!! My god. First thing first though. I need to gloat in my successful appointment survival for at least a bit before I return to freak-out mode.

Again, lets just take it from the top…

1. Routine vaccinations:

a. MMR – check

b. DPT – check

c. Polio – need a booster – This is true, I did. But my nurse was amazing and it was a total piece of cake.

d. Seasonal flu – I NEED THIS?!?! (So Dr. Trot is NOT  a fan of the seasonal flu vaccine. FULL DISCLOSURE. This is just my own (potentially ignorant) personal opinion. But, I am young, healthy, not in the health care field, not in contact with at-risk populations, and I thus do not feel the need to inject myself year after year with the (attenuated) flu virus strains that a handful of quacks have generously decided we are most likely to be exposed to this year.) An opinion of one. – Correction. An opinion of two! So in going through the list of items that may or may not kill me in Tanzania, we got to the flu somewhere near the top. Dr. C asked if I had already gotten the flu vaccine…”no.” He then asked if I wanted it…”no.” And that was it!! Dr. C nodded and moved right along to the next item on his list!! WHAT!!??!! I could hardly believe it! With all that ranting and raving about how everyone needs to get the seasonal flu vaccine, I couldn’t just let this conversation die here! I totally interrupted whatever Dr. C had moved onto (I hadn’t actually heard a word of it in my totally dumbfounded state) with “That’s it? That’s all you’re going to give me? I thought everyone was supposed to get the flu vaccine! Why are you letting me off so easily?” Dr. C (who was really quiet awesome — a rarity at the particular clinic that is most convenient for me unfortunately) leaned back, smiled and explained…

It’s really up to you. The virus is attenuated, not killed. So you are putting yourself at risk to come down with the flu from the vaccination. Once vaccinated, you are protected to ~60% from the seasonal flu viruses and H1N1. I’m old and every day I come to work in a building that specifically selects for sick people. So yes, I personally do get the vaccine.  You are healthy, you seem to have done your homework, and you don’t want it. I thought I’d move on to the next thing on the list that we will try to keep from killing you. 

At this point I’m literally laughing out loud but I manage to ask, “But 60%? That isn’t very good!” 

With that, I received a facial expression that may as well have been accompanied with a “THANK YOU CAPTAIN OBVIOUS!!” tattoo and…

Of course it’s terrible! 60% is really really crappy! But the CDC building in Atlanta is not filled with crystal balls. They don’t know what flu strains we’re going to see. Even if they did, they’d mutate so fast it wouldn’t matter in the end anyway. But do you know what does matter? Hepatitis A. May I? 

And with that I shut up.

2.  Hep A vaccination – need (I think) – Yup. I need two actually. I got one (same amazing nurse, second piece of cake) and will get the second between 6 and 12 months from when I return (and find the aforementioned nurse).

3. Typhoid vaccination – need – Yup. So there are two options. A shot vaccination that is good for 2 years or an oral vaccination…4 doses that must be kept in the fridge, must be taken every other day, at the same time, on an empty stomach and with a full glass of water. They give you a snazzy orange bracelet to help you remember and 2 stickers – one for your fridge and one for your bathroom mirror. If the directions aren’t followed to a T with all 4 doses it’s apparently not effective and you must go in for the shot. My bracelet is on and my stickers are stuck.

Bracelet

Bracelet

Fridge

Fridge

Bathroom

Bathroom

4. Yellow fever vaccination – need – Yup. Cake slice #3.

5. Rabies vaccination – need? Nope. This experience is apparently not much better than receiving the anti-toxin. Sooooo…if I get bitten or scratched by a mammal that seems “high risk” I “just” need to find a doctor within 24 hours. Great.

6. Anti-malaria drugs – need atovaquone-proguanile? And I need to take from 2 days prior to departure through 4 weeks after I return?! – Yup. Although I only need to take them 2 days pre-travel and 7 days post-travel. Not so bad.

7. Dengue fever – Dr. C: “Don’t wear dark blue.” Of course I proceeded to burst laughing out loud. Apparently this is no joke though. The mosquitoes that carry dengue fever are attracted to dark blue! Ok. No dark blue, I guess I can do that.

8. Cholera – Cross your fingers. Great.

9. Tetanus – Already got it.

10. Meningitis – Keep fingers crossed.

Now there is also 11) dysentery, 12) sleeping sickness and 13) some nasty parasite that lives in all fresh water. For these it’s a matter of 11) being VERY careful about what I eat and drink, 12) protecting myself from the mosquitoes and 13) keeping my ass out of all bodies of freshwater.

I also got altitude sickness pills to be taken 2 days before I arrive through the day of the marathon (for a total of 8 days) and one dose of serious anti-diarrhea medication only to be taken in cases where I am “uncontrollably pooping blood and think that I’m about to die.” Thank you.

And that’s it!! 

OMG! That is it?!?! That is what I’ve bought the most expensive plane ticket of my life for? That is what I’m taking 2 weeks off of work for?!?! Aliesha! How did you ever live in this place? And literally live to tell about it?!

No, I can’t let myself focus on these things. I am lucky to be able to go somewhere new and exciting like this. I am lucky to have vaccines to protect me from many things. And now I must just manage keep my head sufficiently outside of my ass to protect myself from everything else while I’m there. What will really probably cause me the most pain and agony is the little 26.2 mile run up a mountain in 85F and 80% humidity that I haven’t been training for.

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3 Comments

Filed under Tanzania

3 responses to “3 slices of cake and a new piece of jewelry

  1. Firstly, have a safe trip! You will have GREAT fun! Your itinerary sounds like something I would love to do… Kili is on my travel list for 2014, so I look forward to your posts/photos/insights! Secondly – I would def get Hep A, Hep B and Tetanus – those, as well as yellow fever, MMR and typhoid, are the shots I obtained before leaving for South America.

    Not sure about rabies – are you going to be in contact with animals? If you get bitten/scratched you will still have to be seen by a doc to get a shot regardless of whether you’ve already had your rabies vaccine, so maybe skip that one, depending on what your travel doctor suggests?

    Each region is different – if you are NOT going into dengue/malaria country there is no need to take those drugs.

    PS I’m also against the flu vaccination – the cold viruses in Africa are going to be different from the strains you will get the jab for here, so really what is the point?

    Safe travels!

    • Thanks for the comment! Yeah, the doctor made sure I was all loaded up with what I’d need to stay alive during and after my trip! I got a very similar line up to what you had, although I was already set with my HepB, MMR and tetanus. I did get HepA, a polio booster and yellow fever shots AND I’ll be on typhoid (vaccine), malaria and altitude sickness pills. Apparently the rabies vaccine isn’t much better than the anti-toxin so since I *should* be able to access medical care within 24 of anything happening (a “high risk” dog bite, scratch, etc…) doc recommended against that vaccine. Doc also said that there was no vaccine for dengue but malaria was everywhere so I’m going to be on those pills like a hawk!

      I’m definitely looking forward to sharing my travel experiences!

      Thanks again for the insightful comment!
      Dr. T

  2. Pingback: Dr. Trot must copy and then edit posts, just editing them deletes them…duh!! | DrTrot

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