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This story has a happy beginning and a happy ending, but a lot of struggle in the middle.
I went on vacation to Cambodia with one of my friends who has family in Cambodia. We traveled all over the country. I met her family; they don’t speak English and I don’t speak Khmer (Cambodian) but we traveled together. I saw ancient temples, war prisons, lots of shopping markets and I got to swim in the sea. I went there fully prepared for travel. I have traveled often and to some not so well traveled places. I went to the travel health clinic at the Department of Health before my trip. I got all the vaccinations I needed. The nurse gave me anti-malaria pills because part of the country where I would be is at risk for malaria. I took those religiously. I tried to be careful with what I ate and drank. I only drank bottled water, I brushed my teeth with bottled water. The only non-bottled drink I had was fresh coconut which they would cut the top off right there and put a straw in it and give it to you to drink. It was amazing! I only ate cooked foods. No fresh vegetables that may have been washed in contaminated water. A lot of food in Cambodia is rice or noodle soup that comes with a plate of fresh leafy vegetables that you add to your dish as much as you like. I never ate those, but only the vegetables that were cooked into the dish. I ate a lot of tropical fruits which I love, but they all had thick peels, so they wouldn’t be contaminated. I loved access to fresh food every day. It was so healthy! Drinking coconut for breakfast, eating dragon fruit, mango, pineapple everywhere I went. The food was good too. A lot of rice, noodles and vegetables with a little meat. There were also these really amazing Cambodian sandwiches that I ate often in the food markets.
The trip was amazing. I took all typical precautions while traveling. There were some wild bus rides along the way, but I came back home safe and sound. The day after I got back I started having severe stomach pain and diarrhea every time I ate. It wasn’t bad the first day and I thought it was just my body adjusting to being back and eating more American style food again, but after two days it wasn’t getting better. My stomach pain and cramping were getting worse. I was scared to eat anything because it all made me sick. The travel nurse had given me medication in case of severe diarrhea on my trip. I started taking it, but after 3 days (which were all the pills she gave me) my symptoms were no better. I had pretty much stopped eating and was just drinking juice and Gatorade. I felt awful and was so tired. I went to see my primary doctor and he prescribed another medication that I started taking. It helped a little as in I could now eat toast and crackers, but after a week I realized I was still having diarrhea and severe stomach pain and I really wasn’t able to eat, so I went back to the doctor.
The doctor prescribed another medication. He thought I had a parasite because of the severity and length of my symptoms. The medication the doctor prescribed was not covered by my insurance. I asked the pharmacy how much the medication would cost out of pocket. They told me they only had half the pills prescribed and it would cost $2000 out of pocket for only half the pills! There is no way I could pay for that. I decided I needed to go to the hospital because they would have to give me medication.
This was Friday night I found out I couldn’t get this medication, so I decided to try to sleep that night and go to the ER in the morning because I didn’t want to be awake all night waiting in the ER. I was so exhausted I fell asleep by 8 pm (I hadn’t eaten solid food for 2 days again because it was painful), and I woke up at 3 am and couldn’t go back to sleep. At 4 am I decided to get dressed and go to the ER.
My ER visit was not as bad as I expected. The front desk workers were friendly, the triage nurse saw me right away and when she was finished she sent me for bloodwork and urine sample right away. Then I waited awhile, which they told me I would. After about 1.5 hours they took me into the ER where I gave them a stool sample to test. The doctor told me he would give me a different medication, one that is commonly prescribed for international travelers with these symptoms. I wasn’t there too long and went home by noon.
I made another trip to the pharmacy that day and this medication was covered by my insurance! This was the medication that finally helped me. After two straight weeks of constant diarrhea and not being able to eat it finally stopped. However, this was not the end of my journey toward health. I was still scared to eat and unsure what to eat so I made an appointment with a dietitian (who happens to be my office mate) and she helped me eat again! She gave me supplements to help with my digestion and to give me the nutrients my body was lacking from not eating and having prolonged diarrhea. I got progressively better week by week.
The dietitian helped me find foods that I could eat once the diarrhea had stopped. I thought I knew enough that I should be able to figure out how to eat, but I was so weak and tired, and I wasn’t eating the correct foods. She helped set me on the path to eating again. It was a slow process and took about another month before I could eat normally again.
Two months later and I still had to be careful of what I ate and how much I ate at a time, but slowly I continued to get better. It took nearly two months for me to be able to go to the gym and exercise, which I love to do (I’m a physical therapist, I love physical activity). It also took nearly two months before I went out with my friends on the weekends again. It was difficult. I am not used to being sick or being the patient. I am usually the one caring for others, and I was trying to continue to care for them throughout this time, but even my work hours were minimal due to lack of energy.
I share this story for those of you who have chronic illness that makes you re-direct your life and activities. I know my illness only lasted a few short months, but it gave me even more compassion for my patients who have chronic illnesses. I had to learn how to ask for and accept help from others. I had to return to exercise very slowly. I had to think about what tasks were most important to complete each day since I had a limited supply of energy. Some days I would only be able to cook food. Some days I would only be able to do my laundry. Showering took effort and used a lot of my energy in the first few weeks.
I learned a lot through this experience. I wouldn’t wish it upon anyone, but it did give me even more compassion and empathy for my patients with chronic illnesses. As of this writing I continue to have to plan my meals and think about what I am going to eat. I need to make sure I get enough sleep at night in order to have energy to do my work. I continue to take many supplements prescribed by the dietitian and I continue to heal with guidance.
If you have a chronic illness that has a physical component I can help guide you with appropriate exercises and stretches. If you need a dietitian to help with any digestive issues I would highly recommend Eat Freely Nutrition in Long Beach, CA. Continue to search for the health providers who will listen to your story and help you along the path to healing. The journey can be long, difficult and lonely but with the right people guiding you there is hope.