A Bout of Salmonella in Bangkok
No one wants to get sick. Yet, it seems as if illness has been a common theme in my travels thus far. Between colds to travelers diarrhea to strep throat, I’ve had my fair share of sicknesses in the past six months. Most have been minor annoyances. I don’t like being sick, I complain about it. And, I’m a bit of a hypochondriac (I can hear Jason saying, “a bit, ha!”) so I tend to overblow my illnesses at times and become paranoid over things like having the feeling of a lump in my throat (the entire goddamn day long) or minor twinges of pain in my chest (chest pain = immediate emergency, except when it doesn’t).
Yesterday was a test of my mild paranoia gone right! A few weeks back, due to those weird twinges of chest pain, I decided we were going to Bangkok and I was getting a female cancer screening. In the US, I’ve had serious trouble getting physicians to perform breast exams on me and I cannot fathom why. It’s something that if I don’t ask for repeatedly they will not do. Having a young cousin who had breast cancer makes me exceptionally aware of the risks and there just seems to be no reason other than prudishness or laziness for them not to examine me. So, I scheduled for the full package, far more comprehensive than a GYN visit in the US is, and one that would only cost me ~$217 in total (without insurance) and booked the flight.
Jason wasn’t too happy about my trip plans. He thought it was a waste of time and money to entertain my deluded phobia and that it interrupted our plans to do something more fulfilling than going back to a city we both didn’t really enjoy. Still, we went. Upon arrival I felt fine, just a little touch of diarrhea, which is so normal at this point that it’s to be ignored. However, on our second day here I developed a fever and knew it. You don’t need a thermometer to know you’re feverish, you can feel it all over your body. With fever, and diarrhea now every hour or so, I began to feel completely terrible. My heart rate soared while laying down, my body ached, and at times breathing wasn’t as easy as I’d wanted it to be. That night, I didn’t sleep at all. Every time I began to fall asleep I’d jolt up. It was like my heart wouldn’t slow enough to even let me rest. By 5:30 a.m. I was done trying. Jason and I had a 6:30 a.m. alarm for my previously scheduled appointment for that day, so I just stayed up till we had to go.
Upon arrival I told the receptionist that, yes, I am here for an appointment, but I’m not feeling well today. This is Thailand, English isn’t their first language and often times it’s limited at best, so they basically said, “We’ll do the cancer screening first, than check you up”. OK, I wouldn’t do it in that order, but I’m not going to argue because I’m in a safe space now. I go back to get my vitals check on and, low and behold, my blood pressure is up and my heart rate is 144 bpm. Upon sitting, two nurses come back over to me to check my vitals again, because they probably thought they didn’t get a good reading. Nope, reading worked, I’m just ill.
I am called into a doctor’s office that’s more office than anything else and sit down at his desk. He doesn’t touch me, except on the wrist to feel my heart rate, when I tell him in the past few weeks I’ve had heart palpitations and my heart rate is high now. He does listen twice with a stethoscope to my lungs. He asks me why I’m here, “Well, it’s for the female cancer screening, so they said I’ll do that first.” “No, you have an infection and if we do the screening the test results won’t come back properly. We’re going to admit you to the ER, are you OK with that?” I guess I am now!
When I was a little girl I twisted the chains of a swingset together at my grandmother’s house and looked up. Rust sprinkled like dust into my eye. I had to go to the ER to get it taken out with a magnet. I’ve had surgery before, minor but still surgery. I’ve been to medical clinics at few times. But, I’ve never been admitted to the ER. This wasn’t the plan for the day!
In ER admitting, they do a quick EKG (I don’t know this at the time, questions are hard to ask and are often met with nods or vague answers) and then I am fitted with an IV. Someone with much better English comes to me and tells me I’m staying overnight, so would I like a private, semi private, or dorm style room? I’m overwhelmed, Jason isn’t allowed in this area, and I feel like crap so I don’t know the right answer, but opt for the private room because we have insurance and, at worst, it’s $100 a day for the room, food, and 24/7 nursing care (not including meds). I am wheeled up fairly quickly and get started on some antibiotics and IV fluids to rehydrate me. The room is large, has a private bathroom, and accommodations for Jason to sleep on the couch. There’s a table and the food isn’t half bad actually! While I’m reluctant to eat at first, knowing what will happen, I realize I should because I’m in good hands and haven’t had a meal in well over a day. I settle in.
A new doctor, Doctor Nick, comes in hours later to tell me I definitely have a bacterial infection and he highly suspects it’s e. coli. It’s very common in this part of the world and easy to treat. Most people don’t even seek medical treatment for it (although, to be fair, I didn’t exactly seek it either, but I’m glad I got it!) they just suffer it out with fever and sickness for a few days. He says they’ll do a stool test and he’ll be back in the morning to confirm exactly what’s wrong.
During the night I have one more battle over my fever, but quickly overcome. By midnight I’m declared fever free with a great blood pressure and heart rate! I can rest easy, until 4:30 when they wake me up for vitals again. No problem. I fall asleep quickly and get about 6 hours in, which is nice compared to none the night before.
After eating some breakfast the doctor comes back (“Hi Dr. Nick!”) and tells me, actually, I have Salmonella and not E. Coli. This is my second bout of salmonella in my life, and the second time I needed IV treatment for it. The first time I was in Ocean City, MD, on a vacation with my friend Stacey. I’ve got to say, it was rougher then than it is now, mostly because we waited days for medical treatment and I was throwing up too. My mom thought, “It’s a stomach bug, you’re fine”, but with no improvement it was determined I am not fine and in fact needed some interventions. Some people react more strongly to certain bacteria than others, and for me salmonella is particularly potent.
Because Salmonella is an infection of the walls of the intestines, and because it causes blood in the stool, the doctor has asked me to stay at the ER throughout today. Our flight to Krabi isn’t till tomorrow, so sure, why not! Our hotel room really sucks anyway, and our neighborhood has either really expensive food or the highest concentrations of prostitutes outside of Pattaya. So, we stay one more day and I will make fully sure that the salmonella is kicked out of my system before going off to other tropical lands. At least this isn’t malaria or dengue. We have one more month in Southeast Asia (which includes India) so we’re going to double up on bug spray and I’m going to be extra vigilant about what I eat and where it comes from. Thank goodness Jason isn’t sick like me also, or we’d be sharing a room!
Thanks to all my friends who sent me well wishes! Being sick in a foreign land is scary. Being sick in America without adequate health insurance is really really scary. Being sick is just plain scary. I truly hope this is my last bout of illness on this adventure.
UPDATE: After spending ~72 hours in the hospital I’m back at the hotel room, just 24 hours prior to our flight to Krabi. The doctor released me, saying the salmonella is on the mend and I should be fine after taking my course of antibiotics. My only real complaint from the hospital is their lack of english language skills among the nurses, which made it scary when I felt I had a problem that I couldn’t articulate well. Thankfully, I wasn’t in much need to worry. The nurses were incredibly sweet and took excellent care of me. Jason even got them a basket of treats as a thank you gift 🙂 Dr. Nick was completely willing to answer every question I had and even helped me resolve an ongoing medical complaint that I was having with the throat lump. When I told him I was nervous about the course of antibiotics that I’m on due to the risk of tendon damage (news is out this week about it that scared me) he knew exactly what I was talking about and assured me the problem is rare, happens in people who are generally older and/or have taken this kind of antibiotic over and over again. He made me smile many times over.
For my care, I put an ~$850 deposit down. Upon checkout today I got back $221 and that’s after I was able to do the female cancer screening. That means for a three day hospital stay, out of pocket, with 24/7 nursing care, a private room, meals, and tons of drugs it cost me just about $550. Are you shocked and awed at the US medical system after hearing that? I am.
We weren’t going to go to Bangkok, but I’m so glad we did, because apparently I had been harboring the infection for a few days and by the time we got here it was ravaging my body. The doctor told me today, “I’m glad you came in, because your white blood cell count was really high! Normal is about 6,000 and yours was 16,000. If you didn’t come in today, you’d have come into a hospital soon enough and might have gone septic, which requires a 7 day IV treatment.” Whew! So glad I had the appointment and trusted my instincts to make it a priority to take care of myself.
Thanks again for the thoughts and well wishes! I feel so loved, even being so far <3
