Experiences of a med student with an incurable travel bug.

Archive for the ‘Laos’ Category

Cholera Sucks

Today’s lectures explored the variety of nasty little bacteria that are infamous for their ability to ravage the intestinal tract. Diarrhea, dysentery, typhoid fever, plain old food poisoning, and my personal favorite — cholera.

My avid fans (all two of you) may remember that I got really sick in Laos while traveling this summer. Looking back on that post I realize how much I downplayed my illness, mostly to prevent panic of those back home. Now that everyone knows I made it home safe and healthy, I’ll divulge the dirty details from that experience in a bit. (Those of you not morbidly amused by disgusting things may want to skip the descriptions.)

Anyway, as we watched and listened to the “bug parade”, as our prof called it, of all the little nasties that make you sick to your stomach, I was trying to guess which one made me sick in Laos. The standard traveler’s diarrhea caused by E. coli is statistically most likely, but it didn’t adequately fit my symptoms. Nor did dysentery or typhoid fever.

You know what did fit? Exactly? The same disease that’s currently wreaking havoc in Haiti — CHOLERA. (For those who, for some reason, don’t trust wiki, feel free to peruse the WHO or the CDC websites.) Contaminated food or water? Check. Infection resistant to antibiotics? Check. Expelling liters upon liters of clear fluid from both ends for days? Check.

Told you it was gross.

I’m really lucky that I didn’t land in the hospital needing IV hydration, though for a while it seemed like an inevitable eventuality. I tried to force and keep bottled water down, but that was a major fail. Instead, I forced soda and powdered Tang (which I initially mocked my travel buddy for buying two countries earlier because it looked disgusting, but the electrolytes saved my butt) down my throat to get some hydration, glucose, and electrolytes back in me, and fortunately that got me through.

It started to clear up after about three days, whether on its own or in part due to the cocktail of ciprofloxacin, azithromycin, pepto bismol, and immodium and tums I’d been ingesting* I’ll never know. I’m just glad — and lucky — that my immune system kicked it before the cholera kicked me.

*Don’t try this at home.

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Laos

There will be just this one post on Laos, and then it will be on to Thailand!

Upon arriving at the little Luang Prabang airport, we set out to find a tuk-tuk to town, expecting to be ambushed the minute we stepped out of the parking lot gates. Strangely, this didn’t happen, so we ended up hopping in a more expensive minibus with a batty old man to get to town. At least, we thought it was more expensive, until we took a tuk tuk around town looking for a hostel; turns out, all the transportation was more expensive than it had been in the previous two countries. After looking at a few different guest houses and then checking out restaurants for dinner, it became apparent that everything was more expensive there. Not unmanageable, but it reminded me of the little towns along Cape Cod — very nice, pretty, and quiet, but not exactly a place meant for a backpacker’s budget. Area tours were likewise more pricy than we were hoping to pay, but we found a decent deal for day of kayaking that we signed up to do the next day.

Dinner that evening was meat on a stick from the night market plus a blueberry jam and fruit crepe with a mixed fruit shake. Unfortunately, one of these items was harboring some unpleasant bacteria that gave me food poisoning for the entire rest of our stay. Not. Fun.

The next day brought torrential rain for our kayaking adventure on the Nam Ou River. By the time we left (I made them wait to leave because I’d seen lightning and wasn’t about to hop straight into the river), I was felt like the food poisoning was starting to ebb and that I would hopefully get better through the day. Oh how wrong I was. The hour plus ride in the covered back of a pickup definitely tested my nausea before we even hit the water. On the bright side, though, the rain did start to let up along the way and it was a much more pleasant downpour by the time we got started and continued to lighten throughout the day. We kayaked about eight kilometers that morning, crossing several sets of class two rapids. I loved the rapids and we got through them all fine, but the two Brits with us capsized within seconds of entering both the first and second ones; the water was super warm, though, and the guides got them back in the boat pretty easily so it wasn’t too bad.

Around noon we arrived at a beach where we had a picnic lunch. The lunch, a spread of traditional food including sticky rice and several main dishes, looked delicious, but I never found out; my gastrointestinal tract decided to start working in the opposite direction at that point, so I skipped the lunch. We then walked up to a very rural village where the Low Land Laos and Hmong people live together. It was interesting to see the two cultures living side by side and hearing how they interact. After that it was back to the river for the last seven kilometers of kayaking. The scenery along the entire journey was stunning; the river wound between awesome mountains that were covered by lush green jungles. The weather created a fog that spiraled around the peaks, creating an incredible scene.

I am very glad that we did the kayaking; the breath-taking views were ones we wouldn’t have gotten elsewhere and it was a cool trip, but I was so glad to get back because I was miserable by the end. I spent the rest of that night and almost all of the next day in bed, only keeping 7Up and eventually a piece of nan down the entire time. By the next night I was able to venture out for some great onion soup and garlic nan from the Indian place directly across from our guest house, but I really didn’t fully recover until mid-afternoon the next day. Note: apparently this little area of Laos must be Ciprofloxacin-resistant. Thankfully I was able to take Azithromycin that last day, otherwise my first stop in Thailand would have been to get an IV for dehydration.

Lunch on our last day was a honey and fruit crepe with incredibly strong, delicious iced Laos coffee. Of course the power went off just before we were going to use the internet, so we camped out on the porch of our guest house and read during those hottest hours of the day. After a while we wandered around the little city some more, perusing the selections at a used book store (they wanted more for their beat-up paperback copies of the Twilight books than I paid for my brand new hardcovers at home, sheesh) and then exploring the temples around the city center. We caught the Floating Buddha display, a collection of photographs within one of the temple’s grounds, just before it closed, and then walked one last time through the night market before a dinner of fried noodles with chicken and veggies.

Finally, it was time for our 12 hour bus ride to the Huay Sai at the Laos-Thai border. This bus ride proved to be the worst one yet, by far. The narrow roads wound in and out, up and down through the mountain passes, never getting far without hitting a massive pot hole. I was laying on the back seats of the bus and was launched — literally launched, often a good foot or more — off of the seats. Needless to say, there was little sleep to be had on this particular night bus and we were all a little worse for the wear by the time we made it to the border. Everything got easier from there, though, and we quickly passed through immigration, ferried across the Mekong, and arrived in Thailand around 9am on June 6th.