Sick, Abroad

I am writing this post from the comfort, or, er, sometimes discomfort, of my Medevac (Medical Evacuation) to Washington, DC. This post however is NOT about my Medevac.

Someday, I might be able to write about this, after I have put some distance between myself and this whole crazy, stressful, yet, I hope and believe, ultimately positive experience.

To keep my mind off the current situation my mind has turned to some of my past experiences when I have found myself a bit more than just under the weather while overseas. The pre-Foreign Service, pre-Medevacs times.

There have been those days when I just did not feel right. You know those days, they happen to everyone. But when you are traveling or living solo in a foreign country those days may feel all the more bewildering and lonely.

So there was that time I had my appendix out in Japan.

In January 2000, a few days after returning to my teaching job after a lovely Christmas and New Year’s getaway to Australia, I came down with an excruciating stomach pain. It started an hour or so after eating, the pain building by the hour. Eventually, convinced I had a terrible bout with food poisoning, I called my Japanese friend Tomomi who called the local ambulance to collect me.

I lived in the small town of Kogushi, which in Japanese means “little stick,” (which I found rather appropriate) located on the famous San-In coastline of Yamaguchi prefecture. I was half way through my third and final year of teaching English at the local high school. I not only taught at the school up the street but once a week, on Thursdays, at another high school in the next county over, and alternating on Tuesdays a school for the deaf located about 45 minutes away, and the local hospital school. The hospital school was adjacent to the small county hospital, and this is where the ambulance took me.

Tomomi, a student in my three times a month adult class, who had become a close friend, however met me at the hospital to assist. Though I had thought it to be a very bad case of food poisoning it turned out to be appendicitis; I was scheduled for emergency surgery the following morning.

I learned a lot from my time in Japanese hospital. I quickly learned the Japanese words for IV, pain, nurse, doctor, and all manner of hospital-ese. I have forgotten them all except for “appendix.” Pronounced “moe-cho” I thought it sounded like “mo-jo” and I like to say I had my mo-jo removed in Japan. I also learned how amazing a health care system can work. The ambulance, albeit in a small town, arrived quickly, and was also free. My whole bill came to about $800. This included the operation, my two days in a private room, and four days in a shared room, everything. As an employee through the Japanese Ministry of Education, I was enrolled in the Japanese national health care system. Because my bill was less than $1000 I had to pay upfront, and then seek for reimbursement. To do so I filled out two pages, front and back, of simple paperwork – my name, address, date and type of illness, the procedures, the hospital information, and then the information of my post office savings account. Within ONE WEEK the entire amount was reimbursed directly into my account. I am still in awe of this efficiency all these years later.

Then there was that time (or rather the two times) I came down with food poisoning in Nepal.

On my next to last day in the country my two travel companions, A&P, and myself decided to celebrate with dinner at a recommended Western-food restaurant. P and I ordered the same delicious chicken dish. It was scrumptious. Then the next morning, around 6 am, my stomach cramped up. Bad. It was race to the restroom time. Again and again. Thankfully I had one of those wonderful backpacker rooms with the tiny bathrooms, which allows one to uh, excuse me, well, you might know where I am going with this. (If you have been a sick backpacker abroad with one of those closet sized rooms then I am sure you and I are on the same page).

After hours of this I walked, or rather crawled, up a flight or two to A&P’s room to discover that P too had had a disagreement with dinner. I had planned for a final day of sightseeing before heading to the airport the following day, but the most I did was walk really, really slowly to a place where I could buy beverages to keep me alive curled up in my room. A&P stayed on another few days and A took P to the doctor who confirmed food poisoning.

That was in the Spring of 2001. Fast forward to Fall 2002 and I find myself back in Kathmandu for a week. I planned to finally take the trip out to UNESCO World Heritage Site Boudhanath Stupa and then Pashupatinath, Nepal’s most important Hindu temple. These were the same sites I had missed the previous visit and to celebrate my plan I went to the same restaurant and also had the chicken. Was it really so shocking that in the middle of the night, around 1 am, I woke up with a familiar and unfortunate feeling? I tempted fate and it came back and bit me.

Yet I was determined. Though up most of the night with my, uh, issues, I dragged my weak, dehydrated self out to Boudhanath and then for extra measure walked the 2+ kilometer walk to Pashupatinath. The walk revived me some and my initial impressions of the temple were positive; it was colorful and the cultural importance and the comings and goings fascinating. However, then the smoke from the funeral pyres started to get to me, my stomach reminded me of its’ earlier malcontent, and I unfortunately caught site of a body part in a pyre alongside the river and I knew I had to get out of there.

I suppose getting food poisoning twice by the same restaurant in Kathmandu trumped the time I came down with a terrible bout of stomach issues following a cooking class in Thailand. I did not know whether to blame the green papaya or chicken from the wet market or my preparation of said items.

And then there was the time I came down with the mumps as an adult…

Yes, you read that right. And yes I did in fact receive the MMR vaccination as a child.

After I returned from that second bought of Nepalese food poisoning, I had a weeks of finals in Singapore, and then I flew to Bangkok to begin approximately seven weeks of backpacking in Thailand, Laos, and Burma for winter vacation (oh, I miss graduate school). In Bangkok my jaw started to ache, in a way it had never ached before. The following morning before I flew to Chiang Rai I had a lump on my jaw and felt queasy. By the time the plane landed I could hardly stand and my jaw had swollen even more. I made it to a guesthouse, checked in, got my pack to my room, and then stumbled down to the front desk area to ask if there were a clinic nearby. When I explained I could not walk to one even 500 meters away, a man in the lobby jumped to his feet and declared he would take me on his motorbike. He not only took me to the clinic, but he also waited with me and during my appointment, took me to the pharmacy, and then back to the guesthouse. When I tried to offer him payment he stated he was a Thai policeman and that is job was to help people. Awesome.

The doctor had told me that I had “mume.”which seemed a mysterious illness indeed. I put on a hoodie to cover my misshapen face and then secreted out to an Internet café where I used one of those online medical sites to input my symptoms and voila – mumps. I made sure to purchase a fair amount of beverages so that once again I could sequester myself to my room. I also bought a packet of pumpkin seeds – one of my favorite backpacker snacks – and after eating maybe three of them that caused my jaw to throb for hours afterward I was very, very sorry.

I read my Paul Theroux book and played many, many hands of solitaire with the deck of cards I used to always carry in my pack. After a week I felt well enough to move on – to the Thailand/Laos border to continue my trip, including a two day slow boat down the Mekong River.

Besides these rather unforgettable experiences I have had a few other opportunities to experience medical care overseas – I had my first sigmoidscopy in Tunisia, an emergency doctor visit in Singapore when my fever spiked and my hotel implemented their SARS protocol (I was SARS-free), my first pregnancy ultrasound in Jakarta, and a fun emergency room trip in Tasmania the night before a half marathon.

Thinking over all of these experiences reminded me that while I did feel pretty awful at the time, I did recover. And I shall recover from this too (the procedure was successful and I am on the mend). And maybe someday I will be able to write about it.

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