Monday, September 21, 2009

Malaria! The Side Effects may be harmful

Today I started to take my anti Malaria medication (Malarone).  Most of the ship has been informed they should consider taking it, most of the community will be on some form of anti Malaria medication for the next few country visits since we are going on safari’s in jungles, walking and taking hikes in remote areas of Ghana; safari’s in South Africa; visiting remote areas of India; same in Vietnam; the killing fields in Cambodia…you get the picture.  For the next several ports we will be visiting and we will be in high risk areas of Malaria exposure/contraction.

We also received a comprehensive hand out from our crack medical team on some of the side effects of the different varieties of anti malaria medications along with a schedule of when we should start taking the medication and if we should even be taking it.  For instance, when we travel to Vietnam we only need be concerned if we are traveling to the Western areas, including the central highlands and if we are traveling into Angkor Wat, Cambodia.

One of the other things in my role as Living Learning Coordinator has been to remind the residents on my floor to start their medication (if in fact they will be taking it).   Which, leads into a conversation of which medication they are taking and how long they should be taking it.   I then have to refer to the sheet given to us and reinforce the information on there, with an additional cautionary reminder.  See all of the literature I have read including a warning from my doctor states that one of the medicine’s side effects is that it “may” contraindicate birth control.  I always get stuck on that word “may”.  I don’t know about you but if I was a hyper sexed young adult on a ship going around the world with other hyper sexed young adults I wouldn’t want to bet all my chips on a “may”, and shouldn’t everyone be practicing safe chex in this day and age (you would think) but this is actually an issue (smh).  Who am I to judge ( I will leave that one alone).
Anywho.  All this talk of side effects got me thinking and of course I looked it up and came across some pretty interesting information (from Wikipedia), so this “may” or “may” not be accurate.  But Here goes:


 the risk of photosensitivity skin reactions is of particular importance for those intending long-term use for malaria prophylaxis because it can cause permanent sensitive and thin skin; may impair the effectiveness of many types of hormonal contraception

Permanent sensitive and thin skin? Trust me these folks skin does not need to get thinner.  So it looks like there will be some red folks on the ship for a few ports, but try telling them that as they hold court almost daily on the outer 7th deck (the pool deck)  di que “tanning” themselves in the African sun for hours on end.  And no matter how many times we tell them that this African sun is different than the Miami, California, even Carribean sun they don’t listen.  I think I already made my feelings clear about the “possible” impairment of the effectiveness of hormonal contraception, why I have to explain the importance of this to folks still baffles me.

Malarone:  (the one I’m taking)

Some people have difficulty sleeping (nightmares, incoherent dreams) while taking Malarone.

That is pretty cut and dry.  Needless to say its going to be an interesting night to get some sleep and in the event that it does not come well then hey, at least I will be wide awake for the 5:45 am sunrise over Ghana.

Lariam: Here is where it gets interesting...

known to cause severe depression, anxiety, paranoia, aggression, nightmares, insomnia, seizures, birth defects, peripheral motor-sensory neuropathy, vestibular (balance) damage and central nervous system problems. For a complete list of adverse physical and psychological effects — including suicidal ideation — see the most recent product information.

Ok does anybody else have an issue with the fact that this medication “may” cause suicidal ideation in some folks that are already anxious?   If that didn’t make me nervous well than reading this certainly did.

In the 1990s, there were reports in the media that the drug may have played a role in the Somalia Affair, which involved the torture and murder of a Somali citizen whilst in the custody of Canadian peacekeeping troops. There has been similar controversy, since three murder-suicides involving Special Forces soldiers at Fort Bragg, N.C., in the summer of 2002. To date, more than 19 cases of vestibular damage following the use of mefloquine have been diagnosed by military physicians. The same damage has been diagnosed among business travelers and tourists.

Ok so regardless of the medication, tonight I am sleeping with one eye open and a hand on my machete... damn!  I didn’t bring my machete with me.

My consolation is that tomorrow I will be in Ghana and most of the ship board community will be getting off the ship and venturing out on field trips.    I realized that I was signing up for an adventure I just wasn’t aware that I had to beware of side effects.

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