It’s hard to believe I have already been on Remote Year for a full month. Time is flying by, and there is not a moment of the day that hasn’t been filled with an activity. I’m having a blast, making new friends, and enjoying immersing myself in Malaysian culture. Mid-way through the month, however, my new lifestyle started to take its toll and my overall wellness was at stake. My iPhone started getting the white screen of death, and I jokingly said I was going through a digital cleanse. Then, the day after my Remote Year crew went on a Malaysian cultural tour (which you can read about here) and ate food using our hands, while sitting on the floor, my stomach started feeling a bit funny. It started with a few sharp, random pains in the gut that happened more and more frequently to the point where I started to think, ‘oh no, here we go’ – this might be a surprise cleanse.
Preparing for Traveling while Sick
I had already experienced ‘Bali Belly’ a few years ago after visiting a roadside stand and eating food from a buffet that had been sitting in the sun for who-knows-how-long. Prior to leaving for Remote Year, I visited the AITC (Adult Immunization Travel Clinic) in San Francisco to get any outstanding travel vaccines, stock up on Malaria pills, and get medication to treat traveller’s diarrhea (TD). I was prescribed both ciprofloxacin (cipro) and azithromycin for TD based on the fact that I was visiting so many countries across the world at one time and different medications treat different types of bacteria induced TD. I had also stocked up on several over the counter medications, including Imodium, Pepto Bismol, NyQuil, DayQuil, Advil PM, Advil. In fact, I brought so much medication with me that I joke I feel like a medical supply company – all in the interest of thinking I could avoid visiting a doctor for the year. Thus, when I started to feel the all-to-familiar belly aches I started taking azithromycin, thinking any symptoms I had would clear up within twenty-four hours.
Needless to say, after three days of taking azithromycin my symptoms continued to worsen and by Day #4, my little belly ache had turned into full blown TD to the point where I had to be near a restroom at all times. I was supposed to fly to Singapore for the weekend but after a sleepless night spent on the toilet I knew it was time to seek medical care and ended up calling both my travel insurance company, Travelex, and ISOS for suggestions on which doctor to visit in KL. I was pointed to Prince Court Medical Center, which was completely Western in its setup. I initially went in to get a few tests done, but they immediately admitted me to the hospital, which I thought was a bit overkill but here’s a video of me nevertheless from my hospital bed.
After a few hours of receiving drip for ‘severe dehydration’ (note – I didn’t actually feel that dehydrated compared to other times in my life!), they wanted to admit me overnight (for a casual $1,000 USD downpayment). That’s where I drew the line, and it became pretty clear to me that I was a money making machine for this hospital. During my 3 hour stint in the hospital bed, the nurse checked on me once and didn’t perform any of the tests I was anticipating (e.g. stool sample would have been obvious). I chose to check out of the hospital, and was charged $300 USD for my little visit only to walk away with more cipro and anti-nausea meds. I was furious and skeptical it would work. Sure enough, after 3 more days of cipro – I still felt exactly the same and exactly as dependent on the toilet.
So one week after my symptoms started and taking two rounds of strong medication, I went straight to a Pharmacy in KL after doing quite a bit of online research. I explained my symptoms directly to the pharmacist and shared that I was pretty certain that I had giardiasis – also known as beaver fever and typically caused by contaminated water. According to a few websites, roughly 90% of TD is treatable by cipro/azithromycin while 10% of cases are not, in which case its almost certain you have giardiasis. Thus, I explained what medication I was looking for and the pharmacist gave me a five day supply of metronidazole, which cost 10 MYR, or ~$2.50 USD.
The medication started to take effect almost immediately. The worst part of taking metronidazole is that it is pretty harsh stuff, and I could not drink alcohol for six days given the severe side effects of mixing the medication with alcohol. Moral of the story is to (a) stock up on medication if you can prior to leaving your home country, and (b) if you do need to seek out medical care in a foreign country, stay alert and do not just do what they say. Rather than spending $250+ USD I could have solved my problem for $2.50! I don’t necessarily advocate self diagnosing your symptoms or buying medication without a prescription, but be smart about the care you go after and do your homework. (c) Consider taking probiotics after finishing your medication. I did not realize how harsh the three rounds of medication I took were and probiotics helped me get ‘healthy bacteria’ back into my belly after nearly two weeks of feeling ill.
As an aside, I do not think all foreign hospitals are that bad. One of the vaccines I was recommended prior to leaving the U.S. was Japanese Encephalitis, which costs about $300-500 USD for two doses in the U.S., that lasts for two years. I waited to get the vaccination in Malaysia, and I’m glad I did. I visited the Petronas Towers Medical Center, and the prices were incredibly reasonable with excellent care. For a one dose shot that lasts for five years, I paid $30 USD.
Float Therapy and Cleaning Out Your Ears
Surprise cleanse aside, I did have the opportunity to work on my personal well-being and health in Malaysia. Thai massages, reflexology foot baths, and foot fish pedicures were available on nearly every corner of KL – at least near the city center where I lived. I love a strong massage and had a decent 90-minute Thai massage for 120 MYR, or roughly $30 USD. Tipping is not included or expected, so the price you see is what you pay. I ended up getting three massages during my stay in Malaysia – two Thai and one reflexology foot/leg massage. During one of my side trips to Penang, my friends and I also all tried ear-candling. The massage therapist rolls up a piece of wax paper, sticks it in one end of your ear, and lights the other end on fire. The ‘candle’ or rolled wax paper creates a low-level suction that removes debris and ear wax from your ear, which you can see pretty clearly when the paper is unfolded at the end. I enjoyed the experience and would definitely do it again though the verdict is out more broadly on whether it actually works, and it is not recommended by doctors!
Finally, one other wellness practice I tried was a sixty minute float therapy session in Penang at Float for Health. Tim Ferris talks about float therapy in his book Tools for Titans, and it is comparable to taking psychedelics or deep meditation. It apparently takes a few sessions to feel the full effect, but it was an interesting experience nevertheless. Upon arriving at Float for Health, my friends and I were each given a private room with a large, swimming pool-like bathtub filled with 500kg of Epsom-salt, saturated into 800L of water, about 12 inches deep. Epsom salts are found to stimulate lymph drainage, and promote the absorption of Magnesium and Sulphates, which help relieve stress, improve circulatory health and flush toxins from the body.
Flotation is supposed to feel like floating in the Dead Sea or mimic the womb. Before you get into the tub, which is kept at body temperature, we had to bathe and cover any cuts with petroleum jelly. Once you’re ready to get in, soothing music started to play and the lights slowly went out. I was a bit nervous to get in, at first, but the feeling is so cool. You literally can’t sink even if you wanted to. I spent the first 10-15 minutes just flipping around, trying to sink and couldn’t. About half way to three quarters of the way through, I finally started to relax, and it felt like I was flying through space, falling backwards, and generally just relaxing. Just as I was starting to relax, the lights came back on. It was a great intro to float therapy, and in the future it is recommended you experience a 90-120 minute session to fully relax.
Tips for Staying Healthy While Traveling
- Stock up on vaccinations and medication needed for TD (as well as other OTC medications you might need, including Imodium for light upset stomach aches, and NyQuil to help you adjust to the new time zone the first few nights of your trip). Here’s a good travel smart health kit list from the CDC.
- Start using probiotics before your trip, to ensure healthy bacteria is being used to digest the water and food in your destination. Another tip I heard is to simply eat yoghurt every day while traveling to get the live cultures from the local dairy products into your system.
- If you do need to see a doctor, call your travel insurance company to see where they recommend going. As an aside, I used Skype credit on my computer to call the U.S. number of the insurance company and paid a few pennies for advice. Be on high alert for money making schemes run by the foreign hospitals.
- If all else fails, speak to a local pharmacist for guidance on what needs to be prescribed and by whom.
- When in Asia, do invest in a massage and be adventurous – try a service like ear candling or float therapy.