Sunday, September 18, 2016

Anit-Malaria Meds and Side Effects

I know what some of you might be thinking about my previous post on Shots Needed for Travel and specifically Anti- malaria meds.  My cruising friend Sarah said "Be sure to check the WHO (World Health Organization) web site.  Anti-Malaria drugs can have some quite nasty side effects."  I had heard this before.  But what exactly does that mean?  A few nights ago several of us cruisers were talking about anit-malaria drugs.  It seems some malaria drugs can cause weird dreams and hallucinations.  Really?  I am currently reading a Margret Atwood book, weird dreams are a nightly thing.  Same is true when we binge watch Breaking Bad, Son's of Anarchy, Game of Thrones or even Madmen for that matter.  And hallucinations?  Ha - I went to college at K-State!  An 11:30AM Saturday football game with full tailgate will bring on some interesting hallucinations of fuzzy purple penguins for the late night trip home.  The 12:00 - 4:00 am watch on passage can bring about some really crazy hallucinations as well.  After seeing a military drone earlier in the day, I was convinced it was back and taking pictures of me in the cockpit during my overnight watch on the last passage into Trinidad.  It turned out to be lighting......I guess......lightning that flashed on a regular basis just like a camera flash.....hum?

Anyway, the directions from the doc on the anit-malaria meds are to start one week before we arrive to our destination and continue through our visit and then four weeks after we depart.  This should give us plenty of time to become fully aware and accustomed to any side effects.  One comfort is that the doc writing the malaria scrip is himself on the very same anti-malaria med having just returned five days prior from a bird watching expedition in Peru.  "I take the very same anti-malaria meds I am prescribing." 

All joking aside, we know there are side effects and we will be careful.  As Princess of the Mozzie bites, I don't really have a choice.  I MUST take anti-malaria.

Shots Needed for Travel

Look out world - have immunization logbook, will travel

NO - I am not talking about Jello shots.....although it is K-State football tailgate season.  Go Cats!  I am talking about immunizations.  Traveling around this big blue planet there many areas that require immunizations to help keep us healthy.  We want to stay healthy.  We are not anti-vaccination freaks out to infect others and spread.....oh never mind.  We got our Hep A and B as well as a tetanus booster when we traveling to The Bay Islands of Honduras in 2009.  For this season's "Don't Drink The Kool-Aid Trip"  d-oh.....I said I wasn't going to call it that......anyway.....for our Guyana trip, we needed to get Yellow fever and Typhoid shots as well as a scrip for Malaria meds.  Actually, it turns out that we probably should have had our Yellow fever shot for the southern Caribbean.  Side note -   When I originally booked our airfare from Trinidad to the USA back this spring, it made no special notice of Yellow fever.  However, when I went to triple check our reservation three days before our flight out, a popup appeared saying something to the effect of "You are traveling from a known Yellow fever region.  You may be required to show proof of your Yellow fever vaccination when entering the USA."  Rut-ro.  No time to get it now.  Fingers crossed, we were not asked when we landed in Ft Lauderdale.

Once we were back in KC this summer I did some inquiring about Yellow fever and specifically the yellow colored international immunization logbook.  However, I knew we would wait and get the shots back here in Trinidad.  1.)  Price - much cheaper in Trini.  More below on this  2.)  Healthcare professionals here in Trini are much more knowledgeable on Yellow fever here than in KC.  D-uh, of course they would be!  I don't believe there are many cases of Yellow fever in KC.

Last week we went to get our shots.  There are many places to go which include a local medical clinic but I wanted to be sure we could also get the official international logbook as well at the same time.  Running around getting shots and then going someplace else for the logbook and then back for it to be officially filled out all via Maxi Taxi's and walking in the heat of the day did not sound like a scavenger hunt we would be interested in.  Dr Stuart Millar was a one stop shop.  I booked the next appointment opening for two days later.

On Thursday, we took a Maxi Taxi into POS and walked several blocks to his office.  We arrived early just in case traffic was a mess and sweaty from the walk.  We didn't mind waiting as the office was nicely air conditioned and we were able to get in early.  This was despite the fact that the waiting room was fairly full.  It seemed nearly 1/2 of the people waiting were also there for Yellow fever shots, many had on official work clothes for the oil industry and this was the Yellow fever shot production line.  Dr Stuart was friendly but got right down to business.  Stick, stick, stick, stick....."now come in my office."  We chatted while he filled out our official international immunization logbooks and wrote out the malaria med scrip.

I was also fighting a lingering cough from something I picked up back in the USA.  He gave my lungs a quick listen and prescribed an antibiotic.  However at the end of our office visit he said "Oh wait a minute.  I think I have a box of antibiotics I can just give you."  He looked in one of the cabinets and came out with not just a sample but a full treatment dose.  "Here.  Give me the script back and just take these.  That will save you a few dollars."  

We were out the door before our schedule appointment time.  Nice!

Cost breakdown -
  • Johnson County Health Dept wanted $160 for the Yellow Fever shot.  *I didn't ask about Typhoid or Malaria pills.
  • Trinidad Yellow Fever shot $400 TT each or $66 US each.
  • Trinidad Typhoid shot $350 TT each or $58 US each.
  • Dr visit for cough $250 TT or $41 US.
  • FREE box of Augmentin (14 tablets)
  • Trinidad total $1750 TT or $291 US
  • Malaria med - Lariam 3 boxes $628.32 TT total or $95.00 US.  *Dr said "Whose name do you want the malaria scrip in?"  I asked "Don't we each need one?"  "Not necessary as you will just share.  I will make it out in your name."   Okay.  

What is Next - Guyana

Did you figure it out on your own?  Yes we are headed to Guyana.  For our American readers educated in public school we will wait a minute while you look that up on the internet. Go ahead.  I will give you a clue, we are NOT going to Africa.  Did you find it?  Guyana is on the northeast corner of South America.     

The idea came about in the fall of 2015 while we were still in Trinidad.  Our good friends on sv Ocean Rainbow returned from the Nereid's Rally to Guyana, Suriname and French Guyana.  They had a spectacular time.  "Hum?" we thought.  Then fellow cruiser and dockmate Bruce on sv Wild Matilda came over for dinner.  During the evenings one of the many of the interesting things that came up was Bruce's previous trip to Guyana.  A group of 9 cruising sailboats went there four or five years ago.  "I am thinking of going back." he said. " Really?" we thought.  As often is the case after an evening with Bruce, we added Guyana to our list of Sail To And Explore places.  *Oh man, is that list growing!  I believe this is how most cruising plans are made, you hear first hand from another cruiser about some really kewl cruising grounds and BOOM now you have to go.  At least that is how our plans seem to develop.

Soon everyone sailed off to different points on the compass.  Around February, I had to do some major flag repair to our Caribbean courtesy flags.  While I had the material out I went ahead and made the courtesy flags for Guyana and Suriname, just in case.  When I finished I said to Tom "Shall we go next fall?"  He said "Why not.  We've got the flags now."   While we are not big rally people, we were interested in the Nereid Rally based on the report from sv Ocean Rainbow about all the fabulous side trips.  However, that rally was leaving Sept 2nd 2016, with my parent's 60th wedding anniversary in late Aug, there was no way we would be back in time to have the boat ready to join that rally.  Oh well.  We would just go later by ourselves. 

On a whim and I emailed Bruce pics of my Guyana courtesy flag asking "Are you still thinking about going?  We're are leaning that way."  He replied "I don't know.  I hadn't given it much more thought."   Further inquiry discovered that others were thinking of heading back to Guyana - sv Liahona,  and sv Persephone as well as some newbies like us.  So here we all sit in Trinidad prepping to head to Guyana at the end of September or beginning of October.  The excitement is building as we count down the days and cross things off the Must Do list.  The big items for us are:  New boat insurance and thus survey and thus hauling, immunizations and malaria meds, new chartplotter installed and rain catcher.  Of course there are many other items as well but those are the biggies.

Now I am going to give you some basics.  This info comes from the cruisers that have been there before, and the internet.  I also got a ton of good info from fellow cruiser Sarah off sv Cape.  Thank you Sarah!

The trip from Trinidad to our destination is approx 350nm.  We will motor east along the top of Trinidad and then once we clear the corner of Trini, we will head SE.  We will be heading up the Essequibo River approx 45 nm to the town of Bartica.  I take it the Essequibo is big like the Mississippi and similar in color.  Reports are that charts of this area are not very accurate - sailing over land type inaccurate - yikes!  Luckily, those that have gone before have charted the waypoints.  We plan to anchor off Bartica and base out of there.      

Why are we going?  Guyana is reported to have one of the last remaining untouched jungles in the world.  On travel writer called it the "Lungs of the World" kewl huh?  They are trying their best to preserve and protect that.  However, they are a poor country with immense pressures for development of the jungle.  Who knows how much longer it will be there.   

So the basics - this is for you dad.
Guyana is approximately the size of England (83,000 sq miles) with a population of 750,000 to 800,000 people.  Or slightly smaller than Idaho.  The third smallest country in S America behind Suriname and Uruguay.  Georgetown is the capital.  The bulk of the population lives along the Atlantic coastline with the bulk of the interior of the country sparsely populated.  43.5% of the population is east India, 30.2% is black (African), 16.7% mixed, 9.1% Amerindian, .5% other.  It is the only English speaking country in South America.  While they were previously an English colony as British Guiana, they have been their own country of Guyana for 50 years.  FYI - 2016 is the 50th anniversary celebration of self rule as a country.  The same is true for me as I will be celebrating my 50th bday in Oct.  Religions 30.5% protestant, 28.4% Hindu, 8.1 % Catholic, 7.2% Muslim, 1.1% Jehovah's Witness, 17.7% other Christians, 1.9% other, 4.3% none, 0.0% Jim Jones Peoples Temple.  55% of Guyanese live abroad.  Gold, diamond, and bauxite mining, and sugar are the main industries with hardwood timber, rice and fish/shrimp as well.  But according to all the research, the natural wonders are the real gift of Guyana.  75% of the country is covered in rainforest. 
  • A birder's paradise with more than 800 species of birds from 72 different families.  High on our list is to see the Cock of the Rock bird.
  • The Giants of Guyana:  Jaguar -S American's largest cat, Giant River Otters - world's largest and rarest otters, Harpy Eagle - S American's largest eagle and most powerful raptor, Arapiam - world's largest fresh water fish, Giant Anteater - worlds largest anteater, False Vampire Bat -largest in S America, Capybara - world's largest rodent, Green Anaconda - world's largest snake, Black Caiman - world's largest of subfamily Alligatorinae (alligators and caimans), Giant S American River Turtle - world's largest freshwater turtle and finally the Victoria Amazonica Lily - world's largest lily.  Whew!
  • Kaieteur Waterfall is the world's widest, single drop waterfall, falling 741 feet - four times that of Niagara Falls.  However only one of 300 waterfalls in Guyana.
  • Many, many, many other "creatures" can be found in Guyana - howler monkeys, golden frogs, red-billed toucans and blue morpho butterflies just to name a few.
  • Terrain is mostly rolling highlands, coastal plains and savanna in the south.
  • Elevation mean is 207 meters.  High is Mount Roramia at 2,835 meters 

I am not sure how much internet we will have while there but rest assured that I will be blogging our adventures the whole time we are there and posting as internet allows.  So stay tuned and follow along as we make our first trip to South America and Guyana.