Things We Learned From the Travel Medicine Doctor: Laos/Cambodia Edition

One of the 217 things we’ve had to do to prepare for our trip to Southeast Asia was to book a visit with the travel medicine doctor.  This was a first for me, though I now know we probably should have gone before our honeymoon in Belize, but that was two decades ago and I didn’t know about such things back then.  Turns out ignorance really can be bliss.

Anyway, due to our teaching schedules, the husband and I met with different travel medicine doctors at different clinics.  As an Asia-traveling novice, I found the information enlightening, and thought I’d pass my new knowledge on to you, in case you’re pondering your first trip to SE Asia.  (Or in case you’re staying home and just want to have a laugh at all the crap I have to do, think about, and stress over that you don’t have to do, think about, or stress over.)  How applicable my findings are to countries outside of Laos and Cambodia, I have no idea, but as I said in This is Me – Warts and All…, I’m no doctor.  (If you need convincing, see my About page.)  What I’m trying to say is that however much you venerate everything I write, and deem it as credible as your own physician’s advice, you probably shouldn’t and it definitely isn’t.  Or in other words, this should not be taken as medical advice.  Go see you own doctor and leave me out of it.

Though the information we received was largely consistent, there were a few variations.  To make things easier, I’ve amalgamated the recommendations here.

#1 Bring your own toilet paper

I’ll admit, this one surprised me.  The rationale is that we may be hard pressed to find it, especially if we venture out into the less populated countryside, which we will be doing.  This is forcing me to consider not only how much toilet paper I use in a given week, but also to estimate how much toilet paper I may need should I be struck with a not altogether unlikely intestinal bug or food poisoning.  It also makes me question if my suitcase is going to be big enough, and whether I can find a creative way to transport it without taking up valuable luggage space.

Source: imgur.com

Also, what if the husband runs out but I still have some?  Do I share my precious stash?  Suddenly I’m grateful for our 37 hours in transit, which will give me time to ponder this moral – and marital – dilemma.  (Suggestions on how to let him down gently are welcome in the comments section.)

#2 Bottled water ONLY

• For drinking – Ok, I can get behind that.
• For brushing teeth – I’ll bet you 10,000 Laotian Kip ($1.13) that, due to force of habit, I pre-rinse my toothbrush with tap water at least once.
• For ice cubes – This is harder.  I not sure how commonly ice is served in drinks in SE Asia anyway.  Previous experience in other countries tells me not very much, but if I am served ice in my beverage, I guess I’ll have to inquire before sipping.  Here’s how I’ll have to do this in Lao:
• “ທ່ານສາມາດບອກຂ້າພະເຈົ້າໄດ້ບໍຖ້າກ້ອນນ້ ຳ ກ້ອນເຫລົ່ານີ້ແມ່ນຜະລິດຈາກນ້ ຳ ຂວດ?”

And Khmer:

• “តើអ្នកអាចប្រាប់ខ្ញុំបានទេប្រសិនបើដុំទឹកកកទាំងនេះត្រូវបានផលិតចេញពីទឹកដប?”

On second thought, maybe this’ll be a good time to try for a Guinness World Record: most consecutive days without drinking liquids.

#3 Bring duct tape

In addition to being one of those quintessential handyman tips (You never know when you’ll need some duct tape!), the doctor mentioned its usefulness in the event that the mosquito netting over our beds has rips in it.  (Dengue Fever, Malaria, and Japanese Encephalitis are just some of the insect-borne illnesses we have to worry about over there.)  Her tip?  Wrap it around a pencil.  The husband’s idea?  Wrap it around a water bottle.  (My water bottle is collapsible, so that’s not going to work.)  I do, however, wonder at proprietor’ reactions on finding their mosquito netting studded with bandages like a teenager’s face after his first, botched attempt at shaving.

#4 No salads

No salads?  No problem, at least until my decidedly un-salad-like meal arrives – as I’ve often seen in pictures – on a bed of lettuce, or garnished with raw vegetables and herbs.  This gets at what she is really saying: no raw vegetables.

Bai Sach Chrouk: An example of confusing Cambodian food.  Can I eat it or not??  Source: http://www.adventureinyou.com/cambodia/what-food-to-eat-in-cambodia/

#5 Hot food only

My doc just said “hot.”  The husband’s doc, who, it may be worth pointing out, is Laotian, emphasized just how hot the food should be: Piping hot.  Steeeeeaming.

#6 No street food

Seriously?! (Where’s an interrobang when you need one?)  I’ve been doing nothing but looking at pictures of and reading blog posts about Southeast Asian street food for the last 11 months.  This is like sending me to a tropical island and saying, “No seafood,” or to France and saying, “No croissants, wine, or cheese,” or on a Ben & Jerry’s® factory tour and saying “No ice cream.”  It’s just cruel!

#7 Expect some degree of gastroenterological upset even if you don’t eat contaminated food or drink contaminated water, due to the introduction of unfamiliar bacteria and microbes.

Great.  Just great.

#7 Eat only fruit you can peel

I forgot to ask whether she meant only fruit that can be peeled or only fruit that I have peeled myself.  The husband thinks it’s the latter.  I’m not sure, but to be safe, I think I’ll go with that.  That sure does limit the fruit I can eat over there.  Then again, given the likelihood of diarrhea on this trip and the laxative effects of “nature’s candy,” maybe eschewing all fruit for two weeks will be a gut-saving stroke of genius.

#8 Wash your hands frequently

Can do!  In fact, though I really loathe those bottled hand sanitizers (without rinsing, there’s no sense of completion), I bought some for this trip.  Fear of stomach bugs has driven me to extremes.

Source: amazon.com

#9 Don’t go barefoot

Note to self: Pack flip-flops for the hotel pool area.  *poof*  More precious suitcase real estate – gone!

#10 Be careful with swimming

What she meant was to avoid getting water in our mouths and resist the urge to swim in any bodies of water of questionable cleanliness.  Again, no problem, but it now looks like I’ll have to find a place for my hard-soled water socks on my burgeoning “must bring” packing list.  But what if my water socks displace a roll of toilet paper??

#11 And finally… diseases and defenses

• Rabies!  Three shots over 28 days, and if we go somewhere in the future where a rabies vaccination is recommended, we’ll need two booster shots.  Oh, and even with the inoculation, any animal bite or scratch must be treated by a doctor right away.  Without the inoculation, a bite or scratch is a medical emergency.  Once symptoms start:  YOU.  ARE.  DEAD.
• Japanese Encephalitis! Two shots over 28 days.  Again, I believe booster shots are in our future.
• Hepatitis A!  Two shots over six or so months.
• Typhoid!  I took pills (which must be kept refrigerated); the husband got the shot, which left the most necrotic-looking bruise I’ve ever seen on a human appendage.
• Malaria! Pills before, during, and after the trip, or, put another way: The gift that keeps on giving.
• Traveler’s Diarrhea!  Immodium® or Pepto Bismol® is essential but not sufficient.  We have been issued industrial-strength, prescription anti-diarrheal medication in the event we are hotel-bound with what the husband usually calls Delhi Belly, but has amended for this trip to Indochina’s Revenge.

So, you may be wondering, after all this, am I still looking forward to the trip?  Heck yeah!  I’ve been dying to go to Asia for years.  But I now realize two things.  First, I will need a separate, oversized suitcase for all my duct tape, toilet paper, over-the-counter meds, prescriptions, bug spray, and special footwear.  Oh, and sunscreen.  Can’t forget the sunscreen.  Second, this will not be a relaxing sojourn.  It’s not just all the cycling, hiking, and kayaking, which are the main activities around which this tour revolves.  The hyper-vigilance I’ll need to employ every time I eat or drink something, go for an innocent dip, see a cute animal or buzzing insect, and use the bathroom, is going to have me on wide-eyed alert for two weeks straight.  Oh, and did I mention the landmines?

Yeah, I’m going to need a vacation when I get back from this vacation.

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Read more about our Dust-Farm-Pail List SE Asia adventures:

• Things We Learned from the Travel Medicine Doctor: Laos/Cambodia Edition
• And We’re Off…
• Southeast Asia to Midwest America Jet Lag: What Fresh Hell is This?
• Blog Buddy Meet-up #1: Luang Prabang, Laos
• Laos, Days 1-2: Cycling & Sightseeing
• Laos, Day 3: The Journey to Nong Khiaw
• Laos, Day 4+: Hiking, Remote Villages, and One Really Bad Indian Meal
• Laos, Day 5: Queasy Kayaking
• Day 6: The Journey to Cambodia and a Meal for Adventurous Carnivores
• Cambodia, Days 7-8: Wat a Fabulous Couple of Days!
• Cambodia, Days 9-10: Spending New Year on a Sacred Buddhist Mountain
• Blog Buddy Meet-Up #2: Bangkok, Thailand