Sunday, January 30, 2011

Rumbly In The Tumbly: Some Advice

Streetside dish washing: fine for the locals - a crap shoot for tourists

Forgive me for repeating an image here, but it makes a point: things are done differently in Thailand than you'd do at home. Some of you will remember the picture above from the 08/17/10 story "Staying Healthy In Thailand" where we covered things we can and cannot control while traveling through Thailand and similar places, and it's an excellent example of why it's important to do all we can to keep our immune systems "up" as best we can while on holiday, and oftentimes that's just more than anyone can do unless you're carted about wrapped in cellophane, eating only from sealed packages of prepared foods with utensils you've personally boiled on a hot plate in your room. It's just not practical, and you have be be realistic about the possibilities of falling ill while away from home. I did again myself this time, and I've been there for well over a dozen extended visits.

You can try to be careful on planes and public transport, you can take steps to clean things where you stay, but you have to be realistic and roll with the possibility that you may find yourself under the weather. Hell, with a cold taking a week to incubate you may well bring one along with you from home. But again, I digress.

I arrived at Suvarnabhumi International feeling like a million baht, even after 17 hours of travel; fresh, excited to be just beginning a three week-plus adventure and couldn't have been more enthusiastic while riding to Pattaya, looking at the familiar sights along the way.

I awoke the next morning with a rumbling in my intestinal area that was to become far more of an inconvenience than I'll go into here (some may want to refer back to the story on squat toilets here - something that's never been a strong suit for me). As most sources would advise I let Nature take its course for a couple of days before walking into a pharmacy and making the same request a million other farang have undoubtedly make before me - asking for some sort of chemical cork to control things. However, being more stubborn than most I stuck to my schedule and just dealt with the increasing problem, figuring I could always walk into Bangkok Nursing Hospital when I'd be back in Big Mango a few days later.

I had one day in Bangkok before flying to Cambodia for a week and no time to fool around, so immediately after dropping my bags in my room I took a taxi (37 baht, and well worth it to avoid the stairs and wait to take the BTS) to the BNH, where I broke my previous record by being in, seen, treated and prescribed within 35 minutes at a cost of less than $40US.

The doctor there informed me (in better English than I speak myself) that she's seen thousands like me, fallen victim to nothing more than a microscopic bacteria that the Thai have ingested since infancy but that many visitors' systems just don't know what to do with. After doing some poking and prodding around on my abdomen below the belt and taking a listen with her stethoscope she assured me that I'd be fine within four or five days, put me on a regimen of antibiotics and electrolyte powders I was to dissolve in the multiple bottles of water I was instructed to drink while hydrating myself and sent on my way. The next day I flew to Cambodia, as planned.

Something else I can share with you is this: if you DO find yourself with traveler's diarrhea, it's wiser to let your body purge itself to begin with without trying to stem the flow with Immodium or Lomotil - but only to a point. If you're still incapacitated after the second day, seek medical help. Most of you won't be out in the boonies, and the health care for basic things like this is reliable and readily available in Bangkok, Pattaya, Phuket and most cities of any size at all.

My stubbornness in waiting an entire week while self-medicating only gave the bacteria more of a firm foothold and turned what probably would have been a three day course of treatment into a week's worth... and that was foolish on my part. Hopefully you'll learn from my mistake.


Anonymous said...

What antibiotic did the doctor put you on? My health clinic in the US gave me antibiotics before I left for Thailand.

khunbaobao said...

I was prescribed Cifloxin, which is primarily for bacterial infections (including E Coli - easy enough to pick up from improperly handled produce). I had to stay away from dairy, beef and caffeine for the duration of the treatment - which was short, thankfully. Everyone's different, but I had no side effects.

krobbie said...

BNH is my hospital of choice and I also had a to quickly pop in to see why I started to feel nauseous each afternoon about 4pm.

It turns out that there is no answer for that, in my case. I had blood and urine tests but to no avail. After further discussion with the doctor when my results were back in, it was decided I should take anti-nausea drugs for a couple of days and see.

I could have done this straight off but I wanted to be sure there was no other reason for it. This cost 7500 baht which I will claim back from travel insurance.Worth the effort and it took less than 1 hour out of my day.

Security is having your history recorded in your BNH file and a barcode on your BNH card. Ahhh.


Was Once said...

I have found that the more trips the less problems with bacteria, and I even was in the countryside, off the beaten path. But like any Thai would do, a day after a bacteria exposure and severe symptoms, get on anti-biotics and they have several to recommend there. It is almost a waste of time to bring it with you, unless flying straight into a remote area.

khunbaobao said...

I agree - a physician worth their salt there have a better idea of what to try than a doctor here who may well have never faced a similar bacterial problem. Besides, there are (in my opinion) too many doctors in the West who tend to drag out the Big Guns unnecessarily, and that doesn't help the problem worldwide. I tend to err on the side of caution, myself - not everything needs Cipro to cure it.