on being sick abroad

I’m a strong believer in the power of sleep and ibuprofen.  Headache?  Head to bed early and pop a couple pills.  Back pain?  Same deal.  Fever?  Again, early night and two tablets.

But after my latest fever stint hadn’t disappeared after five days of first rearing its ill-timed head – Eid break, with lots of work on the to-do list – every nurse I had called back home had switched from that rest-and-ibuprofen tune to one of getting myself to a doc, pronto.

And after a slew of tests and a few days of waiting, back came a positive typhoid test and a doctor’s order to be admitted to the hospital – immediately – for a hefty dose of intravenously-administered antibiotics.

Typhoid.  One of the many vaccines I had gotten sometime in the past few years, part of the laughably long list for which the Resident Nurse at Somerville’s Harvard Vanguard had called me a pin cushion.  And one that is – take note travelers – only 50 to 80 percent effective.  Meaning not very.  And especially not during South Asia’s monsoon season, when the prevalence of diseases like dengue and malaria and hepatitis and, you guessed it, typhoid tend to spike.

So after nearly two weeks of trying to navigate this whole sick abroad thing, here’s a few notes that I’ve collected on the experience thus far, for any expats or long-term travelers or others who might just be interested in knowing what negotiating healthcare abroad is like.

A quick disclaimer – I am not a professional or expert on any of these things (you knew that!), and these are just a few of my own personal recommendations, things I would have found helpful in knowing a couple weeks ago.  Hope you find them to be so, too.

1. Have a medically-knowledgable someone you can call back home.  Whether it’s your general practitioner, or your lovely aunt who happens to be the world’s best nurse (thanks, Auntie Mariann!), having someone who knows more about health and sickness than you do is not just reassuring, but can be downright vital in deciding what’s the best course of action to take.  Plus, it just makes you feel better knowing there’s someone on the other side of the line.

2. Go into the doctor sooner rather than later.  Yes, it’s a pain, especially if there’s traffic and it’s inefficient and takes all day.  But having test done and results analyzed will (likely, hopefully) make for a faster diagnosis and less stress for you and all interested parties.  Maybe it’s nothing!  But maybe it’s not.  And for some illnesses, timing really is everything, and the sooner you can catch it the better.

3. Don’t just go to any doctor.  If you’re really sick, it’s worth calling your health care provider from home (or a family member’s, or a friend’s if you’ve given yours up) and seeing if they can refer you to someone in their international network, if they have one.  Otherwise, do some research online or ask around locally before making an appointment with someone.  Not all doctors are created equal, and the right doc can mean the difference between a real diagnosis and an order to just go home and sleep it off.  Which in some cases, you can’t.

4. Come with a copy of what your ‘normal’ blood results are, if possible.  Good for comparison’s sake, as not all reference ranges (the ‘normal values’ you should fall within on diagnostic tests) are the same for all people all the time.  A lot of healthcare providers now have online centers at which you can create an account and track your health history; check and see if yours does, and if they do, set yours up and get tests and vaccine information from as far back as possible uploaded.

5. Get international health insurance.  Just do it.  If you’re abroad in a disease-prone place for long enough, there’s a pretty good chance that you’re going to get sick, and it’s probably going to pay for itself in the end.  So.  Just do it.

6. If you have a bacterial infection, have a test done to see which drugs it is susceptible to.  I think it’s called a ‘panel’, and it’s important in determining what treatment you need.  For example, the South Asian strain of typhoid is resistant to Ciproflaxin (known to most as cipro), the antibiotic of choice prescribed by most doctors back in the US for most all bacteria-related travel ails.  Which means it just wouldn’t work on the strain of the disease here, and so you need a different drug.  Most doctors will automatically test for drug susceptibility when they do your bacterial culture, but it’s worth asking for it just to be sure.

Which brings us to…

7. Ask questions.  And don’t feel dumb or embarrassed for doing so.  For me personally, just being informed makes me feel better, and most doctors will be quite understanding – and even amused – at the string of questions fired off by a wide-eyed foreigner.  They know you’re far from home, they know you’re not used to this, and most likely they know the answer to what you’re wondering about.

And that’s all I can think of for now.  There is far more advice to give, and much of this many would consider excessive, but again, a few extra queries and a bit more info can’t hurt, ya?

Time in the hospital has put me in the market for entertainment – music or emails or  blogs or articles or whathaveyou – so if you have anything good, or have been feeling like writing an email, feel free to send it over my way.  And thanks to everyone who has been checking in from so many miles away, it absolutely brightens days in Room 2435.


10,000 words: a journalist’s to-do list

Stumbled across this great blog – 10,000 words: where journalism and technology meet – in looking for audio slideshow software tips, and now can’t get enough of their recs. They have a great checklist of to-dos for aspiring journalists, and I wanted to pass along a few of the better, and more manageable ones.

  • Start a blog and post at least twice a week
  • Shoot 100 amazing photos and post them on Flickr
  • Improve at least 5 Wikipedia entries
  • Create an audio slideshow using Soundslides
  • Shoot and edit a 3-minute video and post it to YouTube
  • Create and maintain a Delicious account with at least 50 links that you find interesting
  • Create an online portfolio
  • Learn another computer language besides HTML (e.g. XML, PHP, MySQL)
  • Learn how to create a basic slideshow in Flash
  • Subscribe to at least 25 non-journalism blogs using an RSS reader
  • Record, edit and embed a 3-minute piece of audio.
  • Interview 10 people using a handheld audio recorder
  • Create a multimedia project that incorporates, video, audio, and text

Check out the full list here.

Showed it to Jess, who said, “oh this list makes me nauseous…sooo much is expected of journalists – who will not get paid nearly enough for it all.”  True!  But who doesn’t love a challenge?

commentary, music

the top of 2008

i’m a real sucker for top-albums-of-the-year lists, and so here’s my contribution to the internetz pool – twelve albums that meant something to me this year, for one reason or another. read on…

sam cooke, the man and his music
i’ve always loved oldies, but it was more of a passive love that i only sought out on the radio while driving. but, last winter break i raided my dad’s cd collection and came back with a slew of jazz and oldies greats. sam cooke proceeded to win my heart and speakers in no time.

miles davis, kind of blue
again, acquired from raiding my dad’s phenomenal cd collection, this album perfectly complemented the snowy days in the early months of 2008. i started listening to this album around the same time miriam and i got christmas lights in our room, and the combination was just too much for the romantic in me to resist. so i didn’t.

lemon jelly, lost horizons
introduced to lemon jelly by – believe it or not – gary knight, i can’t listen to these tracks without thinking of the angkor temples or late night editing at the fcc in siem reap. that alone would be enough to get it onto this list, but it certainly helps that the music is awesome, too. that one’s for mort.

broken social scene, you forgot it in people
this album took many listens to get into, but boy oh boy am i glad i stuck it out. this is one that you can and should play straight through, and the interplay of all the different instruments and vocals work fantastically.

st. vincent, marry me
recommended by dear stm, the title track off this album has my top four things needed to make a song great: handclaps, female vocals, horns, and strings. not only do annie’s piano riffs and haunting voice never fail to please, but she also wears the cutest darn dresses. yes!

rilo kiley, execution of all things
i never quite understood that rilo kiley had more (and better) albums before more adventurous, which was the first one i listened to of theirs. my obsession with these songs started at the tail end of 2007, where jenny lewis’ strong vocals helped push me through a crazy finals period, and then continued on into 2008, as i slowly came to love each and every track.

various artists, you’re not alone
this isn’t an album anyone else can buy, but rather a phenomenal mix by mr. furman that fills you up exactly like the title promises. i’d tell you the tracklist but shhh! it’s a secret.

various artists, arts & crafts – vol. 4
given to me by my sophomore year roommate, miriam, for my birthday after i had repeatedly professed my love for the canadian indie label, i actually didn’t pull it out of my drawer until early 2008 (lame!). but, after the first play, i kept it on repeat and couldn’t get enough of the the other lovely artists of a&c (new buffalo, los campesinos!, jason collett).

the decemberists, the crane wife
yes, i’ve had this album for years, first listening to it obsessively during my freshman fall at tufts. perhaps it was nostalgia, perhaps it’s just because this is a fantastic album for autumn, but whatever it was, i revisited the crane wife in fall 2008. with that came a newfound appreciation for this incredible album – “crane wife 1 and 2” walked me home many a late night, and it’s certainly an absolute favorite.

the hood internet, mix volume one and two
turned onto these fellers by a friend, and oh my are they everything i could possibly hope for in music. my humble theory as to why i fell so hard for these albums? acoustic/indie/folk music often has the lovely melodies and lyrics that i miss in those great rap songs, which have the beats that the aforementioned mellower tunes lack. mix them together and – perfection!

radiohead, in rainbows
i, like everyone else, adore this album – but unlike most others, i’ve never been much of a radiohead fan before. well, it didn’t take many listens to this album to make me one, and here i am, albeit a few years late!

coldplay, viva la vida
okay, i admit it, i harbor an unwavering love for coldplay and all music they create. granted, my heart is still with parachutes, but every time they produce a new epic and soaring album, i swoon and regress to my early teen years when i first heard the scientist and made this video. sigh.

so there it is! grab a copy of these if you haven’t already, and give them a couple spins – i hope you’ll enjoy them as much as i have. thanks for reading!