Koh Chang: Self-MedicatingOn January 18, 2017 by Meg
As I said in my previous post about the Mercure, we had a very nice, restful few days on Koh Chang after our boat trip. The one hitch in the whole thing was that my girl, Katie, managed to get badly sunburned the last day on the boat. Her face was RED. It looked so very painful. She said it was ‘uncomfortable’ and that was it, but because of her medical issues in the past, we cannot rely on her pain scale to inform us about how injured she is.
This was confirmed when her face swelled up.
We had already been keeping her out of the sun, and she had voluntarily relegated herself to her room except for meals. I kept checking in on her, watching progress. We used aloe and a sunburn soothing spray I had picked up at the market beside the Mercure (leaving my shoes outside, and paying around the cat that had taken up residence on the desk).
For about 36 hours, I convinced myself…
I’m sure it’ll be fine.
Or at least that’s what I kept repeating in my head. Katie stayed in good spirits, but this is nothing new. She, to a remarkable extent considering circumstances, had stayed in good spirits through nearly 3 years of Trigeminal Neuralgia attacks and 2 brain surgeries. She once described a “2” on the 1-10 pain scale that rules the lives of pain patients as “a needle being shoved in my eyebrow, through my brain, and out the top of my head.” Such pain doesn’t warrant mention unless asked, and does not derail math homework. So we had to be careful taking her good spirits and activity level as indication that there was nothing to worry about.
She was saying that if the swelling didn’t go down, she would just paint herself blue and be a Na’vi from Avatar for next Halloween. And she did, indeed, look very much like a bright pink Na’vi.
Here is a photo for comparison (posted with Katie’s permission). If you don’t know her, people who do know her look at the photo and gasp (she doesn’t even look like herself!)
The swelling would seem to go down a bit, then maybe not so much… And then one afternoon she walked in for a meal, and clearly it was increasing and not decreasing. And that was when “I’m sure it’ll be fine” fell apart. Nope. Couldn’t convince myself. All my Mama alarm bells were going off.
It’s a complicated thing. While “uncomfortable” she is staying in good spirits, having meals with all of us. But her swelling isn’t getting better. Being on her face, around her eyes and nose, I’m starting to worry about airways. Honestly, I’m pretty sure this is from sun, but I’m not positive. Could something have bitten her without us realizing it? Or could she have brushed against some plant and be having a reaction? Absolutely. She did have half her face swell up from poison ivy once. Were we at home, with an urgent care down the street by Harris Teeter, we would have been there already.
Another layer is her past with Trigeminal Neuralgia. Her 2nd brain surgery (MVD, or Micro Vascular Decompression for the curious) was nearly 3 years ago, and she hasn’t had even a twinge of TN pain for quite a while (insert much celebration and happy dance here). But this, sunburn and swelling on the face is just a recipe for TN attack. So while I’m not saying anything to her about it, her father and I are on egg shells, not even saying “TN” but saying “You know what I’m worried about…” and “Yeah, me too.” It’s The Condition That Shall Not Be Named. If she were to have an attack… I can’t even finish that thought.
So, I’ve reached my line. My lovely hostess and friend understands completely when I tell her, and we look at each other blankly. So… what do we do here on Koh Chang? I mean, is this a find a medical center or hospital moment? No.
We decide, first, we will head to the nearest pharmacy. We leave the Dads with the kids, and head out.
First, we go to the front desk and ask them to call a taxi. Then we wait outside, and after some confusion about the whether this truck just sitting on the side of the road suddenly is indeed our taxi (it is) we negociate price, and hop in the back, and are off down the road. All we have told him is that we need to go to the pharmacy, he has nodded that he will take us there… we’re hoping we all really have agreed on what we think we have. We’re also hoping that the pharmacy isn’t across the island or anything. Either way, we are in the back of the truck and going.
Thankfully, about 5 miles down the road, we come in to “town” and spot a pharmacy, and our taxi pulls up right in front. We hop out, pay, and go in.
Pharmacies are a bit different in Thailand. It looks, inside, remarkably like a small pharmacy back home. Creams and lotions and neatly lined boxes. But if you go to the pharmacist and tell him/her your symptoms or needs, you can just purchase allergy meds or antibiotics or birth control or a number of other things. No prescription or doctor needed. Handy, as long as you really know what you need. Which we kind of don’t.
I know I want Benedryl. This could be some kind of allergic reaction, so let’s cover that base. After going through the items out and available to just pick up and pay, and discovering nothing Benedryl-like is an option, we go to the pharmacist. I’m armed with my trusty smart-phone which has brought up Diphenhydramine HCl as the active ingredeient for Benedryl for me to show the pharmacist. She looks at my phone, nods knowingly, punches some things into her computer. She then searches her behind-the-counter shelves, and brings out a box of pills. After verifying that yes, it’s just Diphenhydramine HCl as an active ingredient, I agree that is what I want. But then my friend and I consult and discuss, and what if this is just a reaction to the sun? How do I explain and cover that base?
So I pull out the photo (above) I had taken earlier in the day, and show that to the pharmacist, explaining in a short sentences with monosyllabic words, what was going on. The kind lady immediately nodded in understanding, giving me reassuring sounds and hand motions, and started going through her shelves of boxes again. In moments she is showing me a cream with a label that means nothing to me.
The box is in Thai script, as is most of the other information on the box. The one part in English is the active ingredient, Triamcinolone Acetonide. I immediately whip out the smartphone (seriously, how did we live before these amazing gadgets?) and Google tells me Triamcinolone Acetonide is a topical corticosteroid and is prescribed to relieve skin inflammation, itching, dryness, and redness. Well, that certainly seems like a good idea.
I buy two boxes of the Diphenhydramine HCl, and a tube of the Triamcinolone Acetonide, thank thank the pharmacist repeatedly, and we are back outside flagging down a ride back to the hotel. When we get back to the hotel, I pay the taxi, do some mental math, and realize the taxi to and from town and the bag of meds I have have cost me a total of around $18.
Thankfully, I’m thrilled to be able to tell you that one night of the Benedryl and cream, and the swelling went down significantly, and by the time we were leaving the Mercure, Katie just about looked like her normal self.
So just to review, kids. What did we learn in Thailand?
- When stranded on the back roads of a foreign country, feel free to flag down random trucks with men driving who don’t speak your language, and through much gesticulating assume you agree on where you are going, and hop in and go with them! (See <<HERE>> if you missed that story.)
- When bright red and swelling on a rural tropical island, proceed to the nearest pharmacy and self-medicate with Google as your guide.
I told you this trip would be educational.
I’m sure it’ll be fine.
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