(This is the first in a series of posts by Kristin about health challenges while traveling)
Chileans have a saying: “En la enfermedad, hay salud.” Recently, I’ve had the unfortunate pleasure of learning the meaning of that phrase — “in sickness, there is health.”
Almost two months ago, while we were in Easter Island, I (Kristin) developed lower back pain on my right side. I ignored it, assuming the red-eye flights in economy and hard guesthouse beds were to blame.
Once in mainland Chile, we headed to the small town of Pucon, 485 miles south of Santiago. We planned to spend two weeks there, studying Spanish, climbing the active Villarrica Volcano and swimming in the many lakes in the region. We’d rented a small apartment and were looking forward to a taste of normal life after five months of travel.
Unfortunately, I had a very different experience in Pucon. Within 24 hours of our arrival, I was running a fever of 103° F, which made my body shake violently. Within 48 hours, our doctor in the US, who kindly responds to email from her patients, strongly recommended I go to the hospital.
A small town largely dependent on tourism, Pucon does not offer much in the way of medical care. Residents told us they avoid the local clinic if they can. But I felt sicker than I’d ever been in my life, and I needed to see a doctor quickly.
I had a high fever when we arrived at the clinic, and I slumped into a plastic chair, ready to lie on the floor if necessary. Luckily, the nurses took pity on me and called an English-speaking doctor to come in from home to see me.
He examined me, ordered the only tests he could – blood work and urinalysis – and then put a rush on the results. When they came back, he told me I had a severe kidney infection, which can lead to life-threatening sepsis if untreated. He wanted to hospitalize me immediately.
I found that idea terrifying. Despite the brusque competence of my doctor, the care I’d received did not inspire confidence. No one had taken my temperature, blood pressure or pulse, and, more concernedly, none of the staff wore gloves. The nurse who drew my blood had a very hard time finding a usable vein, and I was stabbed brutally and repeatedly. Colorful black and blue bruises lined my arm for weeks.
In short, there was no way I was being admitted. Sensing this, the doctor gave me another option: an IV loaded with antibiotics, followed by bed rest and Cipro twice a day. I’d need to return for more tests in 2 days. If my fever did not respond to the drugs, he warned, I’d have to be hospitalized. Despite the surroundings, I’m grateful to this doctor, as we’ve since learned he prescribed precisely the right treatment.
Jeremy served as an amazing nurse, walking 40 minutes round-trip to the grocery store every day for drinking water, juice and food. He even made delicious homemade chicken soup and popsicles.
He also spent a lot of time on Skype, talking to our concerned parents and to our travel health insurance company, International SOS. This company proved to be incredibly helpful, providing nurses we could speak to by phone 24 hours a day, information about the hospitals in the area and coverage of our medical expenses. For the stress relief alone, I’d recommend every long-term traveler invest in some form of insurance, no matter how tight their budget.
After three days my fever disappeared, but despite the following two weeks on antibiotics and bed rest, I was still experiencing other significant symptoms. Given my lack of improvement, we returned to Santiago, where I could see a kidney specialist.
Santiago’s Clinica Alemana, considered one of the best hospitals in Latin America, is an impressive place. Housed in a modern building with wall-to-wall windows offering views of the Andes, Clinica Alemana made me feel like we’d jumped centuries into the medical future. Its International Patient Services Department provided English-speaking staff who scheduled my appointments and coordinated with our insurance company. Helpful guides led us around the huge facility. I’ve never experienced such VIP service at a hospital before.
Thorough, kind and knowledgable, the doctor recommended a computerized tomography (CT) scan with contrast dye. The results, available the next day, were immediately emailed to me. (I was also given access to a personalized web page that stores my CT images and test results, an amazing resource to share with doctors in the US.)
A few days later, we returned to the hospital for a follow-up, and my doctor greeted Jeremy and I with kisses on the cheeks, like we were old friends. She sat with us for nearly an hour, drawing pictures of my organs to explain the results of the CT scan. Ultimately, she gave me a relatively clean bill of health and wished us well. After four weeks of bed rest, 23,000 milligrams of antibiotics, 4 visits to 3 different doctors and 6 medical tests, I started to feel somewhat better.
So how did I get such a severe infection in the first place? More common in women than men, kidney infections can be caused by a large number of factors, from poor hygiene to catheters, and it’s hard to pinpoint a source. However, I have a strong hunch (although I’ll never know definitively) where mine came from: swimming in this beautiful but apparently polluted lagoon in the Cook Islands.
I’ve since learned the government of New Zealand, among others, is investing millions to improve the lagoon’s water quality. With no warning signs posted, most travelers have no idea of the pollution, worst after heavy rains. But it’s unlikely that many will get as sick as I did. As one doctor told me, my case was “highly unusual.”
Despite the challenges, we were overwhelmed by the kindness of strangers in Chile. In Pucon, the manager of our apartment building offered to drive us to the nearest large hospital, hours away; the owner of our language school volunteered to act as a translator during a doctor’s visit; and Jeremy’s Spanish teacher provided her mother’s recipes. We were moved by the concern and generosity of these Chileans and many others, and it made us feel less alone so far from home.
When we left Chile two weeks ago, I thought my medical misadventures were behind me. Unfortunately, some of my symptoms have returned, and I’m currently undergoing more tests, this time in Buenos Aires (more on that soon). It’s been a scary, frustrating experience. In the last few months, I’ve realized that blind, stupid luck plays a much larger role in my health – and our trip – than I’d like to admit, no matter how many smart choices I think I’ve made. I suppose therein lies the art of travel: respecting the risks, doing your best to prevent them, and exploring the world while you can.
(For the continuation of Kristin’s health story, read this post)