Not an old wives tale

[InternationalTraveler 282]

Spent most of last week incarserated in my own home.

Last Monday morning I was struck down with food poisoning whether it was from something I ate or drank I have yet to establish the cause….this time it will probably remain a mystery.

The last time I determined it was from the mussels I consumed from a Bang Saray sea food restaurant….not once but on 2- different occasions…..i am a sucker for punishment.

Normally my first reaction is to dive for my tried and trusted LOMOTIL… somewhere in the medicine cabinet or in my travel bag…..on this occasion panic set in as I only had one strip of pills left.

Due to my traveling commitments anytime / anyplace /anywhere for the last 20- odd years I have made sure I had a copious supply of these pills. Also keeping my parents and the TGF with a supply.

Anyone familiar with taking these knows they are very small white pills and only one is sufficient to stem the flow.

Due to previous arrangements the Tuesday had been allocated for a round of golf at Mountain Shadow Golf Club.

Not wanting to let down my partners and the last time I played there was 12-months ago carding a hole in one on the short 5^th hole par three.

Having taken 4- tabs….just a bit of overkill to be sure to be sure…. all was well as we set off for the day.

Having played at a different venue the previous week and walking the course I was still raring to go after completing the 18- holes….this week was a little different.

It dawned on me at the half way stage, that I was completely exhausted…the legs had gone and the body was weak….probably severely dehydrated.

If I had been playing alone I would have paid off the caddy thrown the clubs in the car and headed for home.

However, doggedly I stuck it out and completed the course, to make matters worse it was a slow day with a Thai 5-ball in front and around 5- hours later we were finally in the car heading back to Pattaya.

That evening I was in bed by 8pm.

Having slept for around 16- hours over the next few days…..running out of my favorite brand and resorting to the local concoction of Diarine seemed to do me no good.

Having rejected the Imodium which was the only other poison of choice but this always gave me stomach ache each and every other time it was tried.

Having consumed 4-boxes of crackers and a dozen or two bananas and no sign of respite the TGF came back from the garden and stuck some leaves in front of my face…saying don’t worry darling I am not trying to kill you…I want you to live till you are at least 80…well at least she was looking after her own interests….bless her.

Not being a herbivore or goat, these did not exactly look appetizing to say the least…maybe with a spread of jam or marmalade…I may have given them a try but mushed up into a hot drink I succumbed….to be honest at this stage I would have tried anything…..4- cups of mush later…

A day later I woke up feeling like a new man like it never happened.

Being pretty disciplined in my ways, i gave the beer another days grace touring around at least 15 pharmacies all over town eventually finding that LOMOTIL is only available at the Hospital. Trying to buy this over the counter there was not possible without seeing the doctor….at a cost of 950 baht.

Eventually tested the San Miguel in the evening 7-days later.

Made a mental note to buy boxes of LOMOTIL the next time I am in another third world country.

 

If anyone knows where you can get this over or under the counter in Thailand a nod is as good as a wink.

 

PS , By the way…. those wanting to know how the 5^th hole went …well I made the green in one and 3-putted for bogy.

 

Also being the cautious type of guy…. I looked up a piece from Wikipedia.

Guava leaves are used in folk medicine as a remedy for diarrhea and, as well as the bark, for their supposed antimicrobial properties and as an astringent. Guava leaves or bark are used in traditional treatments against diabetes. In Trinidad, a tea made from young leaves is used for diarrhea, dysentery and fever.

[jimbowx 341]

International traveler,

 

My travel doctor recommends Azithromycin 250 MG. Take 2 then one a day for 4 more days. You can get them over the counter in Thailand cheap (350 Baht). If you are not in Thailand She recommends Ciprifoxacin HCL 500 MG every 12 hours for 10 days. This (at least for me) works way better than LOMOTIL. Lomtoil solved the problem be I feel like crap for a couple days. The Azithromycin handles it (maybe not quite as quickly) but I feel normal.

[nkped 1,208]

Lomotil contains atropine. I'm sure there are one or two other BMs who first/last heard of atropine in chemical warfare training in the military as the content of the injector you stuck in your thigh because you had been exposed to nerve agents. I don't think so, particularly not self-prescribed.

[yorta2 712]

I picked up a severe strain of crapping in India in the early 70s when serving in the Navy. I was prescribed Lomotil by the Naval doctor on board, and it was suggested I immediately take 10 of them and see what happens.... They worked, but the other advice I got was that if I felt really dizzy and a bit spaced out, I was probably suffering early stages of atropine poisoning, but 10 tablets probably wouldn't do that. I was fine. I used these tiny tablets for years after that, if I found myself in the same state.

[Grandpollo 366]

International traveler,

 

My travel doctor recommends Azithromycin 250 MG. Take 2 then one a day for 4 more days. You can get them over the counter in Thailand cheap (350 Baht). If you are not in Thailand She recommends Ciprifoxacin HCL 500 MG every 12 hours for 10 days. This (at least for me) works way better than LOMOTIL. Lomtoil solved the problem be I feel like crap for a couple days. The Azithromycin handles it (maybe not quite as quickly) but I feel normal.

For simple E. Coli 500 mg. twice a day for 10 days is far too much Ciprofloxacin

 

500 mg one time as a loading dose, then twice a day for up to 3 total days by which it should have passed and if not see a doctor. If it is protozoal Cipro won't do a thing. Doctors can test the poop.

 

Alternatives,( usually not necessary) could be TMP-SMX or Doxycycline. Stick to Cipro.

 

Azithromycin does not yet have an accepted treatment regimen, risks C. Difficile and is almost never the drug of choice anyway. Keep it simple. Three days of CIpro.

 

Lomotil is a controlled substance which is why you find Imodium everywhere and Lomotil in hospitals. It has atropine in it which can be of some risk for some people. It also has drug interactions with several drugs people may routinely take.

Edited February 5, 2014 by Grandpollo

[Gary 4,132]

I am lucky that I can eat nearly any type of food here in Thailand except those green mussels. The sickest I have ever been was caused by green mussels. It took three times from three different restaurants to know exactly what was making me sick. When I say that I was sick, I mean that I was afraid that I was going to die and then I was afraid that I WASN'T going to die. All three times, I was on the bathroom floor and had it coming out of both ends at the same time. The people I was with had eaten the same green mussels and suffered no ill effects so I am sure the mussels were fresh and not spoiled.

[globaljonesey 6]

Spent most of last week incarserated in my own home.

Last Monday morning I was struck down with food poisoning whether it was from something I ate or drank I have yet to establish the cause….this time it will probably remain a mystery.

The last time I determined it was from the mussels I consumed from a Bang Saray sea food restaurant….not once but on 2- different occasions…..i am a sucker for punishment.

Normally my first reaction is to dive for my tried and trusted LOMOTIL… somewhere in the medicine cabinet or in my travel bag…..on this occasion panic set in as I only had one strip of pills left.

Due to my traveling commitments anytime / anyplace /anywhere for the last 20- odd years I have made sure I had a copious supply of these pills. Also keeping my parents and the TGF with a supply.

Anyone familiar with taking these knows they are very small white pills and only one is sufficient to stem the flow.

Due to previous arrangements the Tuesday had been allocated for a round of golf at Mountain Shadow Golf Club.

Not wanting to let down my partners and the last time I played there was 12-months ago carding a hole in one on the short 5^th hole par three.

Having taken 4- tabs….just a bit of overkill to be sure to be sure…. all was well as we set off for the day.

Having played at a different venue the previous week and walking the course I was still raring to go after completing the 18- holes….this week was a little different.

It dawned on me at the half way stage, that I was completely exhausted…the legs had gone and the body was weak….probably severely dehydrated.

If I had been playing alone I would have paid off the caddy thrown the clubs in the car and headed for home.

However, doggedly I stuck it out and completed the course, to make matters worse it was a slow day with a Thai 5-ball in front and around 5- hours later we were finally in the car heading back to Pattaya.

That evening I was in bed by 8pm.

Having slept for around 16- hours over the next few days…..running out of my favorite brand and resorting to the local concoction of Diarine seemed to do me no good.

Having rejected the Imodium which was the only other poison of choice but this always gave me stomach ache each and every other time it was tried.

Having consumed 4-boxes of crackers and a dozen or two bananas and no sign of respite the TGF came back from the garden and stuck some leaves in front of my face…saying don’t worry darling I am not trying to kill you…I want you to live till you are at least 80…well at least she was looking after her own interests….bless her.

Not being a herbivore or goat, these did not exactly look appetizing to say the least…maybe with a spread of jam or marmalade…I may have given them a try but mushed up into a hot drink I succumbed….to be honest at this stage I would have tried anything…..4- cups of mush later…

A day later I woke up feeling like a new man like it never happened.

Being pretty disciplined in my ways, i gave the beer another days grace touring around at least 15 pharmacies all over town eventually finding that LOMOTIL is only available at the Hospital. Trying to buy this over the counter there was not possible without seeing the doctor….at a cost of 950 baht.

Eventually tested the San Miguel in the evening 7-days later.

Made a mental note to buy boxes of LOMOTIL the next time I am in another third world country.

 

If anyone knows where you can get this over or under the counter in Thailand a nod is as good as a wink.

 

PS , By the way…. those wanting to know how the 5^th hole went …well I made the green in one and 3-putted for bogy.

 

Also being the cautious type of guy…. I looked up a piece from Wikipedia.

Guava leaves are used in folk medicine as a remedy for diarrhea and, as well as the bark, for their supposed antimicrobial properties and as an astringent. Guava leaves or bark are used in traditional treatments against diabetes. In Trinidad, a tea made from young leaves is used for diarrhea, dysentery and fever.

 

Very likely.............

[jimbowx 341]

Grandpollo,

 

Sounds like you have specific knowledge. I will confess I do not beyond that I went to a travel Doctor for shots because I was going to an area where Yellow Fever is possible. She was specific about asking where I travel beyond where I was going on this trip. When I mentioned Thailand she said Thailand was an exception to the Cipro advice she had given me and recommended a Z-pack. I didn't ask why Thailand was different. Maybe she thought I'd get the clap and was short cutting things.

 

Also I was basing my Cipro 2 a day for 10 days on the number she gave me. You could be correct and she just gave me more than I need.

 

I will say I have gotten the runs and an upset stomach twice while in Thailand and used the Z-packs both times. Within a day the runs were gone and I felt fine. I guess it could have gone away on it's own but before I used the meds it did not.

[Grandpollo 366]

Grandpollo,

 

Sounds like you have specific knowledge. I will confess I do not beyond that I went to a travel Doctor for shots because I was going to an area where Yellow Fever is possible. She was specific about asking where I travel beyond where I was going on this trip. When I mentioned Thailand she said Thailand was an exception to the Cipro advice she had given me and recommended a Z-pack. I didn't ask why Thailand was different. Maybe she thought I'd get the clap and was short cutting things.

 

Also I was basing my Cipro 2 a day for 10 days on the number she gave me. You could be correct and she just gave me more than I need.

 

I will say I have gotten the runs and an upset stomach twice while in Thailand and used the Z-packs both times. Within a day the runs were gone and I felt fine. I guess it could have gone away on it's own but before I used the meds it did not.

 

You need a new (travel) doctor. Food poisoning in almost all cases is E.Coli. Cipro is the magic bullet. Three days is all you need. If it goes beyond that then see a physician. There is no "Thailand" exception. If she's a travel doctor she should keep up with the CDC who say clearly that Azithromycin is not subject to an agreed protocol for diarrhea (and since Cipro works and is safe and cheap, why bother?) That is just silly, to be honest. You will see regional antibiotic recommendations for Gonorrhea, or you used to when it became resistant to Cipro, and you will see specific anti-malaria prophylaxis for different parts of the world due to resistance to the treatment by the strains of Malaria.

 

Azithromycin is not and has not been the drug of choice for E. Coli. Cipro is and is far less risky. It (Azithromycin) is used primarily for Chlamydia and in that case it is taken as a single 1000mg dose.

 

Taking antibiotics incorrectly (and that means either the wrong one for the bacteria, or too much of any antibiotic) risks C. Difficle which is a horrible diarrhea that is very hard to treat, can be fatal and is usually avoidable.

 

There are lots of other reasons for the shits when traveling, including drinking, stress, time zone adaptation, that go away promptly with no treatment at all. The best treatment is really fluids and rest. People on holidays don't want to wait, so Cipro taken responsibly, is usually a simple and safe treatment. What you would have experienced in the past is self-limiting diarrhea that was not helped by the (wrong) antibiotic. This is pretty common. In that case the Cipro is much safer and a lot cheaper, even if it too is unnecessary.

 

If people get the trots a lot when travelling and eating food, there is an oral vaccine called Dukoral that reliably prevents E.Coli caused diarrhea and also provides complete immunization against Cholera, which is not a huge risk in Pattaya or much of Thailand.

 

Did she ask if you had the complete Hepatitis vaccinations? A is prevalent from dirty food handling and B is prevalent from sex workers. Even if you have been, she should have asked or she's further negligent.

Edited February 16, 2014 by Grandpollo

[jimbowx 341]

Thanks for the information. Yes she sorted out the Hepatitis vaccinations as well as a couple of other things, I'd need to it up to determine what all was covered.

 

I have also been prescribed Azithromycin for sinus issues I have or at least had fairly often. I keep some on hand in case I get the sinus issues while traveling.