Sunday, January 9, 2011

Meeting with the Nurse

I went to a nurse the other day that specializes in traveling health. This is basically all the health information you need to know when traveling from the US to India (save your $65 I spent to meet with this great nurse that had an overwhelming amount of information):

A Hepatitis A and B vaccination is recommended for all travelers to India:

What is it?
Hepatitis A is a disease that affects the liver.  
What are the symptoms?
Flu type symptoms, diarrhea, jaundice
How is it spread?
Carried in the stool of a person with HAV.  close contact, food or water that is contaminated with HAV.

What is it?
Hepatitis B is a disease that affects the liver.
What are the symptoms?
Acute: loss of appetite, tiredness, diarrhea, vomiting, jaundice, and pain
Chronic: liver damage, cancer, and death.
How is it spread?
Blood or bodily fluid of someone with HBV.  You can get this even by touching an object that has the blood or fluid on it. ex: toothbrush, razor, or a needle.  

My experience:  I did not get the complete series of my Hepatitis shots when I was younger so I had to get these.  You can get a series of two Twinrix shots which is the Hepatitis A and B shot in one. They have to be given a week apart.  I did not have time for the series because I leave Friday! I did not plan ahead very well with these shots.  The nurse said I could not get just one Twinrix because it is not enough Hep A coverage but it is enough Hep B.  The health department gives out Twinrix for free so I got one shot from them which gave me my Hep B coverage.  I had to dish out the $85 for the Hepatitis A shot at the doctors office.  So now I have extra Hep A in me.  Hmmm...I wonder what that does to the body?  The nurse said it does not matter and we over vaccinate in this country all the time.

A Typhoid vaccination is recommended for all travelers:

What is it?
Typhoid is a disease caused by the bacteria Salmonella Typhi.  
What are the symptoms?
High fever, headache, loss of appetite, and sometimes a rash.  30% of people die if it is not treated.  
How is it spread?
The stool of a person with Typhoid or contaminated food or water.

My experience:  The nurse told me I can get this vaccine in a shot form which will cover me for 2 years or I can take the pill and it will cover me for 5 years.  So why not just take the pill?  Taking the pill can be annoying.  Also, I am a little worried I will not take it correctly.  She said it is very important I take it exactly right because I am keeping this bacteria alive and taking small doses of it.  I decided to go with the pill!  I have to take 4 pills.  1 every other day.  It must be taken on an empty stomach with warm water.  The pills must be kept in the refrigerator.  They should be taken at least a week before traveling.  Well my last one I take is on Tuesday I leave Friday.  Hopefully I do not get Typhoid because that does not sound fun.

She also recommended these vaccinations:
Tetanus, Diptheria (Td) or Tetanus, Diptheria, Pertussis (Tdap)
Measles, Mumps, and Rubella (MMR)

These are not on the recommended list I found at MD Travel Health.  I have been vaccinated recently for all of them anyway for my preparations for the Peace Corps.  

Schistosomiasis- This is a parasite or a worm that can enter your skin through fresh water.  She said not to even touch fresh water.  It causes bleeding ulcers and other terrible things. I can not really prevent this so I am not really going to follow this one.  I am going to touch water.  I will let you know how it turns out.

Leishmaniasis- This parasite is spread by sand flies.  This is the flesh eating parasite.  It causes open seeping ulcers.  Gross.  She just said be cautious around the sand.  I am not going to be looking out for sand flies and I am going to be on the beach.  Hopefully I just don’t get this one either.

Arboviral Infections- She said I am at risk for Chikungunya which is a virus spread by night time biting mosquitoes.  I am going to use insect repellent.  She told me to buy 3M Ultrathon insect repellent lotion.  This Repellent is 34.34% DEET and it is dispersed in a controlled release polymer. The controlled release will help prevent it from absorbing or evaporating.  Just one application lasts 12 hours. I am suppose to put suntan lotion on in the morning and then put this on top.

Dengue Fever-  This is called the bone breaking disease because it is so painful. This is a disease spread by day time biting mosquitoes.  I am just going to wear my bug repelling lotion.

Yellow fever- Only worry about it if traveling from certain places in Africa and South America.  

Zithromax- This is just in case I forget to keep my mouth shut in the shower. If I do not boil, peel or cook my food, or if I have a salad (especially lettuce) or any sort of fruit mixture.  This is a 500mg dose that I will take if having diarrhea and stomach pains.  I will also take Imodium at the same time.  I have 6 of these pills. I only have to take one zithromax if I have these symptoms.

Doxycycline- Malaria Prevention:  I have to take 1 a day.  I start it 4 days before my trip begins and stop taking it 4 weeks after my trip ends.  These pills are only 12 cents a pill.  It causes skin sensitivity to the sun so I have to apply sunblock a lot.  My olive Mediterranean skin will never get color like this!  I am very pasty because of this bitter dark Midwest winter. I could take Mefloquine instead but I guess it can make you anxious or crazy. I really don’t want to deal with my own craziness on this trip.  The other choice was Malarone but its $12 a pill.

Diflucan- This is in case the doxycycline causes me to get a yeast infection.  I pop one of these and it will take care of it.  Really?  I don’t even know if I want to take the malaria prevention pill.

The nurse gave me so much information it really was overwhelming so here are some websites she recommended:

Centers for Disease Control and Prevention  
 World Health Organization

Travel Insurance:
The nurse really wanted me to get travel insurance that will cover medical evacuation.  This is an organization that has information about it:  International SOS

I have insurance that I bought with my plane ticket.  It covers maybe $50,000 for evacuation costs.  It is not nearly enough.   It is good to have things lined up for precautionary measures. It is also okay to live freely and relax. I am going with the second choice. Do not worry about everything all the time.

Mostly free or just good organizations to know about in case something does happen:
International Society of Travel Medicine
The Blood Care Foundation
Traveler ER

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