Topic author: Philippe-Belgium
Subject: Fever : a Tale of Malaria.
Posted on: 09 May 2004 19:16:18
Some time ago I posted a story about our trip through Mondulkiri, Ratanakiri, etc..., under the title "Pain and Delight in Cambodia". The end of the trip was, as you might remember, celebrated with malaria and other diseases. They say that malaria is nasty and/or difficult to cure and I am a living witness of this. Here's what happened two months after I thought being cured :
Two weeks ago, on a friday I suddenly had a new access of fever, for no real reason. Slightly anxious, I didn't lose time and went to a small private lab for a bloodtest the next day. Got the result the same afternoon : malaria vivax. The same strain my friend Lee had. To double-check I consulted another lab that same day. Result came later in the evening : malaria falciparum. The one I had before. Typical for the bad infrastructure and low education of doctors and nurses in Phnom Penh, the margin of error is high. But what if falciparum had come back, together with vivax? Vivax maybe having a longer incubation period.
Next day, sunday, while having fever again I went to one more lab which did two different bloodtests. Received the result on monday : "Sir, we didn't find anything in your blood, you don't have malaria". Very confusing and frightening how everything can go wrong when you have a medical problem in this town. I knew it was malaria because the fever had recurred exactly 48 hours after the first crisis. So we were monday already and the National Center of Malaria was open. They use the same tests as the very expensive Pasteur Institute and also have reasonably reliable staff. And there I could see by myself that I was infected with malaria vivax. That means that I had two strains in me without knowing it. The first cure had probably killed the falciparum but was ineffective for vivax.
Now I had to take chloroquine, but to make sure that all the parasites would be eliminated from the liver it is indispensable to continue with primaquine for the next 21 days. Primaquine is dangerous for Asians as they lack a certain enzym in their liver and is therefore unavailable in Phnom Penh or the rest of Cambodia. I was about to order it through my parents in Belgium when I received a message from friends who found some in Chiang Rai. Am now waiting for the little package to arrive and I hope with all my heart that I'll finally get rid of all those nasty parasites. A problem never comes alone... I feel much more vulnerable than ever before.
Also seems that everything has to come at the same time while I hardly had any problem for years. My friend Lee is in much worse condition than me, having had malaria vivax and dengue at the same time. He was not improving and is now diagnosed with hepatitis E. Just incredible.
Meanwhile I order each and every one of you to destroy any mosquito you can lay your hands on, particularly the females. It's indeed the female Anopheles that transmits the disease to humans. Another proof that women are nothing but trouble. Alright, I'm just joking....
Reply author: JimCA2
Replied on: 10 May 2004 18:40:48
This is no joke...this is why I choose to sleep in a nice guesthouse along the way instead of in the bush....not to mention a nice massage perhaps to work out the kinks after a long day of riding!
Reply author: SilverhawkUSA
Replied on: 11 May 2004 16:16:41
A little additional on the medicine:
I received a text message from Philippe asking if I could locate the malarial medicine Primaquine in Chiang Mai. As I was in Chiang Rai at the time I walked in the nearest pharmacy I saw and asked about the medicine. With no problem he removed a large jar of the medicine from behind the counter. As I had no further info or requests from Philippe I just thanked the pharmacist and did not buy any. If they have it in Chiang Rai I am sure they will have it in Chiang Mai.
After returning to Chiang Mai we searched everywhere for the meds. At least ten pharmacies as far as San Khampheng were checked and we received excuses of “it is an old medicine” to “they don’t have that medicine in Thailand”...I phoned Philippe and he gave me the information on the medicine and just what he needed. It was obvious a quick trip back to Chiang Rai was in order. The next day the meds were in the mail to Philippe.
I have no idea why the meds were available in CR but in case you may be in the same situation, that’s the story.
BTW; How do you get those little legs apart to see if they're female or not? Worse than a woman, and you can't buy them drinks!
Ever notice that "What the Heck!" is usually the right answer?
Reply author: Philippe-Belgium
Replied on: 14 May 2004 18:46:12
Note to Jim : sleeping in a nice guesthouse every night while being in the bush of Cambodia is something quite impossible and also somehow comparable to eating in the Mc Donald's every day while travelling through Thailand. Now I hope that the Kellogs family won't sue my ass for defamation...
Note to Dave : thanks again for getting me the medicine. I owe you big time (but as I told you already, please never mention that in the future...). I was very impressed by the fact that you didn't hesitate to drive all the way to Chiang Rai to get my primaquine. Last time I felt so impressed was at the moment of my birth. As soon as I saw the light and the outside world I was so stunned that I couldn't speak for two hours.
Reply author: Chicagonaut
Replied on: 14 May 2004 23:01:51
No, there aren't any Ramada Inns out in the bush of Cambodia. However, you might admit now that it's advisable to schedule(as much as possible) your rides in such a manner as to avoid being stuck in the bush at night. I think that's what Jim was getting at...
Call me crazy, but I'm going to avoid sleeping in a hammock in the jungle at all costs -- expecially after hearing of your ordeal.
Reply author: SilverhawkUSA
Replied on: 17 May 2004 12:05:41
Just mentioned the medicine in case someone else needs to track some down(don't believe everything a pharmacy may tell you). I surely will not mention anything in the future, what can I say, I am just an impressive kind of guy! BTW if you were so impressed at "seeing the light" at your birth, why do you spend so much time now trying to get back in again?
Hope the "bridge" expedition goes well for you. Careful where you sleep...
Ever notice that "What the Heck!" is usually the right answer?
Reply author: Davidfl
Replied on: 17 May 2004 15:15:40
Dearest Sweetest Philippe
Dave might not mention it again, but Im not so sure for myself.
Its raining heavy in LPB & we are seriously wet at last.
Now which malaria free way to get out of here?
Keep the power on
Reply author: Lee_Canada
Replied on: 13 Sep 2004 14:18:05
This WAS a fantastic ride. It wasn't the longest, and was no more memorable than other great trips. But it was distinguished by the remoteness, living outside as long as we did, and mostly, the like minded international crew that assembled for it. And it wasn't even over when we got back to home base... it was time to pay the check as it were.
Yes, I was the guy that contracted the host of nasty diseases on this one trip. I'm pleased to say I've been fully recovered for some time now but it took 3 months, 20 kg, and half my blood to get over everything. It's difficult to say what was worst, the malaria or the dengue... since I had them both at the same time. But Hep E took the cake. For the "least dangerous strain of hepatitis and the only one that doesn't leave any lasting effects" it was quite an ordeal. Even Dr. Gavin Scott was mystified until the 3rd set of lab results came in.
Thoughts of returning to Canada to get treated frequently entered my delusional mind, but were summarily dismissed when i reasoned that there was no way anyone would let me on a plane with my laptop leaking water, until I wrote a program that would stop the leak (I'm a software engineer).
Another inconvenient side effect is anemia, mostly from the dengue, which inhibits the production of platelets to the point where you lose blood internally. Your blood literally leaks through the walls of your blood vessels. I must say I was getting rather sick and tired (pun intended) of collapsing in the hallway walking to the kitchen and generally looking like I just rose from the grave. Not to mention collapsing in the Walkabout one friday night during the Joker draw. ;-) Thanks again to David B and friends for hauling my cold, sweaty keester back to my pad where I could at least keel over without an audience. Despite the attention it doesn't do much for one's social life. And I'm sure I can speak for my roomie California Jim who must have been relieved everytime he poked his head into my room and wasn't hit by a stench that could only come from a decomposing human body.
It definitely was a noteworthy trip though, with two of us getting deathly ill, one with a freshly pinned together shoulder, and last and least, an equipment breakdown.
As I'm currently back in Canada topping up the coffers for the next go, it all seems much like a dream now. Which I suppose it should considering my, ahem, so called state of mind at the time. Would I do it again? In a heartbeat... just with a twelve pack of bugspray.
for pics of this and other trips, visit www.baerware.com
GT-Rider Board : http://board.gt-rider.com/
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