Leukemia or Typhoid?

The doctor just called with the test results.

Since October 24th we have had this gy-normous question hanging over our heads:
                Does Jeff have leukemia or some other sort of blood cancer?
                Or . . . Did he merely have typhoid fever?

We got our wish!!  It was TYPHOID !!

His leukocytes and other blood numbers are now back to normal - PLUS the Ecuadorian doctor even did the test for typhoid fever but he apparently didn't notice the positive result.  He just told us to see a hematologist ASAP, that leukemia can progress quickly.

So at 2pm on that memorable day in Otavalo, Ecuador I immediately went to an internet cafe and began researching possible causes of his abnormal lab results.

In the meantime Jeff was in our hostel room, doing his best to connect to the airlines on Skype to see about flying back home immediately.

What I found in the course of my jet-speed research was that his symptoms directly matched the first week of typhoid fever.

What I had to get my brain wrapped around was this:  He didn't have ANY intestinal symptoms at all, and I've always thought that typhoid was an intestinal disease.  Yes, it does involve massive and even fatal intestinal symptoms - but NOT until after the first week of infection.  

By my calculations, Jeff was in his 4th day of high fever, severe headache and fatigue.  My research sources told me that many people don't have intestinal issues at this point of infection, while others may.

Everything fit together.  But if we were to run off to find a hematologist, it would be many more days or even weeks before getting treated (for the wrong disease), during which time the typhoid fever would progress into the life threatening stages.

So I ran upstairs at the hostel, convinced Jeff to get off of Skype, and explained my new theory of his condition.  We researched cures for typhoid, left the hostel to go to a pharmacy, and purchased the agreed-upon antibiotic AND lots more Tylenol for the fever.

By 4pm the same day as he'd seen the doctor and had the lab work done, he took his first dose of antibiotic.

Though he actually felt somewhat better the next day, it took well over a week for the fever to finally stop.  And we haven't known how his white and red blood cell counts have been doing after taking the antibiotic - until this morning.

We voted for TYPHOID!  And thank God, we won.

(Please do not attempt to do this trick in your own home.)

Now we can again finally enter the planning phase for our future life in Colombia.
Stay tuned for The Escape.

Cancel Uruguay

Days passed by while we just hung out in Otavalo, waiting to see what would happen with Jeff.  His symptoms seem to wax and wane but as long as he keeps taking acetaminophen and the antibiotic, he definitely feels better, though not cured.  At least he can get out of bed - AND go for short walks.

Heading off to Uruguay has become out of the question.  We were SO close to immediately returning to the USA just to get decent medical care.  Now, before doing anything big, we have to make sure he's really on the mend.  Taking another major plane trip wouldn't be a good idea right now.  That means cancelling our flight.  But that's okay.

So one day he woke up with some energy and decided he wanted to head off to Colombia.  That just means relatively short bus trips which he felt he could handle - plus he got really bored sitting still in Otavalo.  So north it was.

From the bus window, Colombia looked so much more interesting than Ecuador: cleaner, more colorful, much better maintained, homes showing love and pride, people more open.

We landed in Pasto, Colombia an a rockin' Saturday night.  Dang, that's a place to avoid.  Just a city out of control: bright lights, speeding cars swerving in and out, loud music from all sides, lots of people in the streets talking loudly.  The taxi driver made it clear that he didn't trust a single person he saw, calling them "ratones, todos son ratones." (Rats, they're all rats.)  "Guard your money, keep it under your shirt, hang onto your suitcases, don't trust anyone", were his parting words.

This seemed like a bit of a warning.  Jeff was feeling pretty good, thank God.  I backed into a storefront with the suitcases, Jeff went into the street to begin TRYING to flag down a taxi.  Finally he caught an empty one that knew of a hotel on the outskirts of town.

Taxistas are truly our best guardian angels.  Time after time these men have saved us.

We got our wish: a miniature sweet hotel with a locked front door: the clerk has to unlock it from the inside to let people in AND to let people out.  They seem to feel a bit insecure around that pueblo -and if THEY are that scared, we're a bit nervous too.

We Vote for Typhoid

The hazards of third world travel are many. But I've always had the illusion of immunity. I've never spent a day in the hospital nor had a serious illness.

That record still holds, but as I heard a distinct snap and lay in shocked agony on the ground with a painful sprain. I was absolutely sure that my run of luck was over. This was new territory for me, so I breathed through the pain, opened my eyes, and tested the ankle. What a close call! No bones sticking out, and the pain seemed manageable. During the next week I went through the stages of swelling and discoloration, and was able to restore normal strength and mobility.

Ecuador is not the U.S. You need to expect open holes in the sidewalks,and anticipate pushy drivers at all pedestrian crossings.

And then there are the various diseases to consider.

Hepatitis, Malaria, Yellow fever, Dengue fever, Typhoid, and the list goes on. We received all the necessary vaccinations in the US, except I was not able to take the final dose of Typhoid oral vaccine.

After visiting a jungle and eating two helpings of "street" food, I entered my 3rd straight day of splitting headaches and mounting fever. That missing vaccine dose was on my mind.

I found an excellent doctor who performed a series of lab tests, and reviewed all the results with me. All of this cost less than $40 and was completed in under 2 hours. This is what basic health care should be like.

The findings showed reduced leucocytes and platelets. There are a range of illnesses that will do that to you, including leukemia. The first doctor's conservative recommendation, was to visit a specialist or return to the US.

For a lousy 2 hours I thought I was looking at blood cancer. Starr went into high gear and we found that my exact symptoms, including the blood labs, indicated typhoid exposure.

We vote for typhoid.

We obtained the recommended antibiotic simply by telling a pharmacist what we wanted and how many doses. Once again, this system works for me. No delays, faxes, or insurance involvement, and all at a vastly reduced cost.

Today my headaches are gone and my fever is backing off. We'll stick around here for a day or two to make sure all is well before moving on.

So the stakes are high. Stay vigilant and you will enjoy your trip to the max. Get careless or think you are in the U.S. and your trip, or your health, can be ruined.

As careful as I usually am about my health - I get it, and I won't forget it.

Slow down

Unfortunately Jeff hasn't been feeling well for the past few days.  He's got a bad headache and a fever.  We thought it would pass but this morning it's no better.

Today begins the search for a doctor in Otavalo Ecuador.

Ayampe

The bus driver stomped on the brakes and his assistant yelled out "Ayampe!"while waving at Jeff and I to get off the bus here.  We hustled out, retrieved our pull-along suitcases then . . . looked around.

Damn!! It happened again! We got dropped off in the middle of no where with no clue. 

Counting: two empty bamboo framed taverns, a couple of signs, a muddy, long side road, - and US holding the bags, bewildered.  I hate it when this happens - but this is NOT the first time and we're getting better at thinking on our feet.

Ayampe: a sweet piece of jungle paradise meeting white sand beaches surrounded by prideless poverty.

A sign: Finca Punta Ayampe had an arrow pointing down a long, very muddy road toward the beach.  We stood on the roadside, looking at our wheeled luggage thinking, "Holy Crap!  Is this really happening?"

Then a man walked up to us offering to call the hostel to pick us up.  Oh thank God!  Yes, please, that sounds like a great idea.

This 3 story, timber bamboo construction hostel, Finca Punta Ayampe, is awesome - highly recommended.  A spacious room on the 3rd floor with a terrace and a full view of the beach below, costs $18/person/night.  We slept to the music of the Pacific Ocean waves, crickets, and cicadas.  Dreamland.

Meals, if desired, are quite affordable, dead fresh, made to your liking and by far the most wholesome, tasty food we've had yet.

This place feels like we're visiting friends, complete with an English speaking host to catch us up on the local happenings.

Until we got to Ayampe, we've seen very few birds - quite concerning acutally.  But in Ayampe there is considerable bird action going on: hummingbirds, some the size of a large bumblebee, pelicans, frigates, multitudes of colorful songbirds, and a huge eagle-thing perched on a snag at the beach.

White sand beaches, nice waves, tidepools, lagoons, surrounded by primitive shacks: a haven for surfers in the hot season - though thankfully this is the off season.

Snails Grandotes

Imagine a snail that grows to be over 3" long.  Now imagine an army of countless millions of them.  That's what showed up in Ayampe beginning about 6 months ago.  Our host explains that these are African snails brought to Ecuador by a rice grower.  he thought they'd irradicate some kind of pest problem - but to no avail.

When it didn't work, he released them in the wild.  Now they're everywhere eating everything in sight.  When birds eat them, they die of some unknown toxin so it's doubtful that people should eat them.  I'm sure there should be a movie about this.

Two nights here and our host hauled us back to the mail road to catch yet another bus going up the coast of Ecuador.

Down to the Sea.

Leaving Cuenca and the highlands behind we bus down the Yunguilla Valley which passes through a series of bio-zones from over 8,000 feet down to the coastal plain covered with banana plantations since United Fruit Co. (Chiquita) ran the show many moons ago.

The first section down from Cuenca reminds me of Switzerland with dairy cows grazing on green rolling hills. Then the terrain steepens and vegetable and fruit farmers cling to the hillsides. Soon we see sugar cane, avocado, and mango.

We found a hostel in Santa Isabel midway down the valley and ate a nice dinner of goat and chicken near the highway. The owner of the restaurant began varnishing tables near us as we ate. Mixed with diesal fumes, clouds of road dust and dogs running around, this made for a different dining setting, to say the least.  Que sera. The hardships of the road get pretty spicy at times.

Immediately upon leaving in the morning the road dropped steeply down through an arid region of acacia and cactus. We follow a muddy brown river down into the cloud forest. Everything is green. Bananas grow like blackberry vines. The jungle is rampant and dense. The clear streams we cross flow out of side valleys populated by indigenous people and accessed only by foot path.

We bus through the coastal plain and advance to Guayaquil eating mandarins, fresh cheese, whole wheat buns, and studying our Spanish - with some movie blaring over the speakers.

The Guayaquil Bus terminal is unbelievable. We'd been warned many times that this is a dangerous place with thieves all over.  But what we found is a place  more modern than the best US air terminal, with hundreds of buses arriving and leaving every hour for all parts of the country. Inside the food court we find delectable espresso, chocolate brownie, and spinach quiche. Surely we have earned this!

We are now enjoying another internet-free night in the Hotel Cisne in the decidedly Ecuadorian town of Santa Elena. After a list of bus transfers, we are almost on the coast.

We've had our roast chicken dinner at a sidewalk table, watched a city park youth dance competition, and spoke with another enthusiastic young man about his favorite places in Colombia. This town has much more life than any place we've been.