Shots Before Peru

If I needed an indication that the trip to Peru was the real deal, something more than all the talk and half-assed notions of “doing something” after graduation, the clinic lent the coming adventure a certain degree of weight and importance. Previously, our endeavor had seemed very spur-of-the-moment, more of an idea than a certainty; now I was in a place with a man in a white coat telling me very seriously about the risks of travel and all the fun diseases waiting to jump me as soon as I got off the plane. The shots I was about to get in the arm were not made up. The risk of malaria from mosquitoes or cholera from the water was real.

It’s probably not good to think about The Heart of Darkness as a model for an upcoming trip, but I began to feel as though the story was getting a modern-day retelling in the doctor’s clinic. In the beginning of that fateful novel, the main character gets his head examined (literally) by a quack doctor who thinks that the jungle will drive him mad. This doctor was far less metaphysical, and his warnings concerned travel hazards like diarrhea and STD's—not the danger that Peru would steal my soul.

These words of warning were practical rather than deterring. The doctor was actually kind and helpful, and did not offer any discouraging words, even though I’m sure I came across as extremely naïve and perhaps dangerously unprepared for what lay ahead.

Doctor: “So where are you going in Peru?” (This should be the easy question)

Me: “Uh…”

Instead of telling me that I was a clueless idiot, he pulled up the CDC website to give me some of the safe travel info. I had read a bunch of the stuff he told me about questionable food and water from the Lonely Planet guidebook, but hearing it from a doctor made it sound far more believable and important. He also have me a travel medicine catalogue full of stuff like mosquito nets and water-filters that I could buy. I made note of what in the catalogue I had and thought of cheap alternatives to what I lacked. One item in the catalogue, oral rehydration packets, are useful to travelers because there is a good chance that they will get a visit from the enemy: Terrible Schitz. Still, a friend of mine who is also a doctor told me that one of the best things to bring on any trip is honey, which contains the perfect ratio of glucose and fructose to replenish the body’s stores after an explosive episode.

It is important to note that the yellow fever risk and most of the malaria risk in Peru lies in the jungle-covered eastern half. The highlands and mountains where it is too cold and dry for mosquitoes are supposed to be safe. Even though I thought that I would spend most of my time out of the jungle, I do want to go out to these regions, so I figured it was still worth it to get the yellow fever stab. Hepatitis A is also a risk I’d prefer not to take, so I signed up for that vaccination as well. I’ll admit, I am not a big fan of needles, but I’d rather suck it up here than experience some of the not so wonderful symptoms of yellow-fever or any other malady while abroad.

For malaria, I got a prescription for Malarone, one of the newer incarnations of anti-malarial medication, manufactured by GlaxoSmithKline. These pills, would have set me back about $150, but fortunately, they like everything else, were covered by insurance. There are lots of ways to fight malaria, but they all have drawbacks including the potential for heart-palpitations and vivid nightmares in the case of Mefloquine or allergy to sunlight and reduced bacterial resistance in the case of Doxycycline. Don't let my ability to name brands fool you; I have no idea how to weigh all of the benefits and risks of the different pills. The doctor recommended Malarone and I decided he must have been right because it the most expensive option.

Before the shots, I got a mini-physical so they would get an idea of my health. I was pleased to have a resting pulse of 52. In the account of his adventure to Peru, Hiram Bingam reports that his resting pulse was 70. Of course, after ascending to the higher altitudes, he reported that his pulse was regularly over 100. Given my father’s miserable experience on Aconcagua in Chile, I doubt that I will have any genetic advantage over altitude. When I get to Cuzco or Lake Titicaca, I’m sure that I will be huffing and puffing with all the other tourists. It turned out that I forgot to add the altitude drug Diamox to the list of prescriptions. When I discovered this later, I had read up on some of the drug’s side affects that included blurred vision, frequent urination and greater risk of kidney stones. I decided that I’d rather acclimatize naturally, which is supposed to be just as effective with time.

They had me waiting for some time on the little padded bench before the doctor finally came around with the shots. They went into the back of my arm and were not particularly painful. According to Max’s account, tetanus left him with a real ache, but I was already covered from an injection I received before college, so I missed out on that experience. Apparently, with yellow fever there is a small chance that the shot can kill you. In the event that I was one of the chosen few, the doctor had me stick around for about half an hour so that the staff would see it if I started seizing up. I dutifully took my seat back in the waiting room and flipped through a National Geographic. Fortunately, my eyes didn’t roll back into my head nor did I begin foaming at the mouth, and one more obstacle to going to Peru was taken care of.