A Malady in Mandalay

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Burmas flagPublished: April 14th 2012Asia » Burma » Mandalay Region » Mandalay
December 31st 2011

“You will definitely get sick,” asserted Jason (aspiringnomad) during our meeting at a sidewalk eatery in Bangkok prior to my Myanmar sojourn. My unspoken thoughts were “I almost never get stomach issues”, but in hindsight it was not episodes of frantic lunges towards toilets in Myanmar that should have concerned me, for what transpired was far more dangerous.

It commenced innocuously enough with spots appearing on the inside of my wrists twelve hours after arriving in Myanmar. My initial suspicion was a midge attack, with Elephant’s World or Hellfire Pass in Kanchanaburi, Thailand being the suspects. The angry and sometimes itchy red spots, subsequently appeared on my feet the following morning, but ominously appeared as irregular blotches of concentrated spots across my abdomen on the third day, and I unsuccessfully attempted to imagine shapes now tattooed onto my torso, much like finding animal images in the clouds.

Within a further 48 hours, the rash had completely spread across my body, except for my face and buttocks. My hands looked particularly frightful, so I considered wearing gloves, but doing so would have only attracted more attention and more questions, thus I dispensed with this idea.

Despite this inconvenience, my sightseeing through Golden Rock and Bagan proceeded without hindrance. However, this situation changed on the early morning train journey from Bagan to Mandalay, with the 200 kilometre distance along flat terrain being completed in a sluggish eight hours due to it playfully rocking on the narrow gauge. My condition distinctly worsened as the day progressed with the onset of a fever, a portentous sign of malaria. Upon awakening the following morning, I knew the situation to be serious, so after receiving the name of a recommended hospital in Mandalay via a call to the Australian Embassy in Yangon, I proceeded to seek answers.

The diagnostic experience was certainly different, for I was surrounded by seven junior medical staff all observing a consultation conducted in English by the Burmese born and UK trained doctor. I had experienced a similar number of onlookers in Yangon when exchanging US Dollars at a bank when 11 staff members surrounded me to gaze at this simple transaction. Unfortunately, a most frustrating aspect of this illness was now realised, for none of the five doctors and specialists I subsequently visited in Myanmar and Australia could provide a definitive diagnosis, but the initial prognosis being clearly the most likely – scrub typhus contracted whilst in Thailand. This potentially fatal ailment, caused by the bite of an infected mite, is so rare in travellers that few travel books give it much coverage – but most symptoms were present including fever, extensive rash, cough, sore throat, and muscle tiredness. Future diagnoses included a measles related virus, an allergy, and the highly implausible severe cold. Though diagnoses differed, all would concur with the first doctor I visited in Australia who quipped that my ailment was something “weird and wonderful”.

I have often reflected on what was certainly a fortuitous decision of mine in Myanmar. When the rash started spreading, I commenced a precautionary course of antibiotics from my medical kit. Though the importance of this action will never be known, it may have averted the worst consequences of scrub typhus, which has a significantly higher fatality rate when untreated with antibiotics. I wonder how close I came to never writing this blog.

In Mandalay, I was given a plethora of medication to alleviate my discomfort: antihistamines, throat gargle, a foul-tasting cough syrup and an anti-itch balm with a surprisingly pleasant odour. My condition severely impacted on sightseeing – with the intended two sightseeing days in Mandalay reduced to 60 minutes. Thankfully, I still visited the Kyauktawgyi Paya, whose glorious 20 metre Buddha statue is carved from a single piece of marble. Even more impressive was U Bein’s bridge, the world’s longest teak bridge at Amarapura. Measuring almost 1.2 kilometres, one could relax and observe a continuous passage of people walking or cycling along the uneven planks of its length. Unfortunately, the fever and fatigue caused my aptitude for photography to dramatically diminish as I would continually choose the wrong ISO, shutter or aperture settings on my camera.

I was joined on this journey by Maureen from Kenya. With her shiny dark skin and tightly plaited hair, she became a tourist attraction in her own right. For the vast majority of Burmese, she provided their first encounter with an African, with one young woman stating, “I’ve seen people like you on TV!” which was presumably a compliment. When trying to explain her country and continent of origin, Maureen almost always received puzzled looks, but that changed when utilising Shakira’s official anthem for the FIFA 2010 World Cup, This time for Africa. Upon singing the refrain, Waka waka,
Mandalay street scene - MyanmarMandalay street scene - Myanmar
Mandalay street scene - Myanmar

As viewed from the train.
eh eh
, everyone’s face would alight with comprehension and they too would sing and dance to this globally recognised song. It even prompted one lady to exclaim to Maureen, “You are Shakira’s sister!” which was definitely a compliment.

My situation deteriorated rapidly back in Yangon. Had it not been Christmas, I would have departed to convalesce in a luxurious hotel in Thailand, but heavily booked flights and hotels prevented this option. At least the final Myanmar destination was conducive to recovery – Ngwe Saung (Silver Beach). The bus option was discounted for prolonged sitting was proving disastrous, so an expensive taxi was procured. The majority of the five hour journey was passed reclining on the back seat listening to the vehicle’s wheels skid worryingly across the road; and being too ill to instruct the driver to proceed at a safer speed, I relied on fate to deliver me safely to Ngwe Saung.

With destiny on my side, we reached the Emerald Sea Resort and my salubrious cottage, located a mere 15 second walk from the beach, was perfect for my needs. Sleep over the past two weeks was disturbed, as my usually vivid oneiric world was transformed into uncomfortable phantasms and altered reality, and the nightly hacking coughs compounded the problem. Thankfully, restful days listening to the breaking waves and breathing invigorating salt air partly restored my strength, with the fever, cough, itching and distorted dreams all subsiding.

I occupied a small portion of my time watching the government’s English television news, where lines of dutiful citizens celebrating seemingly inconsequential achievements were watched by stern officials. These possessed a style and narrative almost identical to the government television I witnessed in North Korea, and I suspect that one had heavily borrowed from the other.

After four days, I had recuperated enough to amble along the shore and squat in the surf, but when a powerful wave dragged me across the sand, it embarrassingly ripped open the rear of my board shorts. Thankfully the beach was almost always deserted, so I was able to scurry to my cottage without anyone witnessing the unsavoury sight of my bare buttocks.

Unfortunately, these health improvements vanished during my return to Australia; eight hours of torment on an exceptionally decrepit bus, and three flights totalling more than 11 hours proving most deleterious. During those first six weeks of 2012, my medical appointments in Australia outnumbered meetings with friends, and with all pathological tests reporting as normal, it alleviated any worries of permanent damage. I was proscribed doxycycline; though better known as a preventative malarial medication, it also eradicates scrub typhus. I was gravely informed by doctors and specialists that recovery would be slow, and though my recurring fevers finally subsided after four weeks, fatigue proved a significant and continuing problem. I effectively became a hermit since I live on my own and could only venture outside with difficulty. Cricket and NFL on television, coupled with my extensive book, music and DVD collections, ensured that boredom was never a concern.

Despite catching the illness in the first week of December, I only returned to part-time work on 29 February, with full duties expected to resume in June. However, I must carefully manage my activity for if I cross that undefined boundary of exertion, my energy dissipates, causing a debilitating fatigue lasting for days. The scars from the rash on my stomach are still visible; they should eventually fade, but if not, they shall remain a memento of my rite of passage to those who have suffered a potentially life-threatening illness whilst on the road. I was extremely unlucky to catch scrub typhus (comforting news for others), but also lucky that it was not a fatal dose – fortune does works both ways.

Thankfully I’ve nurtured a patient and positive outlook in life, for these are needed in abundance at present. Though it may still be months away, I can foresee a day when after grabbing my camera, packing my mascots, hauling my backpack and donning my hat, I will stride with a renewed vigour to further explore exotic and exciting lands.

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Shane Dallas
With redundancy payout in hand and with no itinerary and no destination - I wonder where the road will lead. Current Location: Astana, Kazakhstan My new website is now launched! thetravelcamel.com I am passionate about travelling to different cultures and countries. Here is an interview with from ABC radio in Brisbane, Australia on 22 July 2008. To listen, just click on the link below my photo. Confirmed Travel May-June 2013: UAE... full info
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Comments
Date: 14th April 2012

So glad you're okay
I've been following your travelblog since stumbling across it a few years ago, and glad to hear it will be continuing into the future. Rest up and get well soon!

From Blog: A Malady in Mandalay
Date: 14th April 2012

Scrub typhus?!
Wow, what an illness to get - a Christmas to remember but not for the good reasons. We really hope you are well on the way to recovery and the fatigue is becoming less as time is progressing. Good luck with the recovery and take it easy!

From Blog: A Malady in Mandalay
Date: 15th April 2012

A Christmas to Remember
Thanks for the wishes. As you correctly guessed, it was a different Christmas to what was originally planned, but at least the beach front cottage was spacious and very comfortable!

From Blog: A Malady in Mandalay
Date: 14th April 2012

Even Sick with Scrub Typhus....
You managed to get some stunning shots and wow that rash was really impressive!

From Blog: A Malady in Mandalay
Date: 14th April 2012

That rash...
Ali, it was actually worse on my torso, equally bad on my hands, but less on my arms and thighs. The rash was so bad on my feet that it caused all of the skin from there (including the soles) to peel off in pieces the size of coins. Thankfully, this painless procedure revealed much cleaner skin.

From Blog: A Malady in Mandalay
Date: 14th April 2012

Now that is a story
So glad you are on the mend. Thank goodness you had some antibiotics with you and had the sense to start taking them. We knew you were not feeling well but didn't realize how bad it had gotten. Take care.

From Blog: A Malady in Mandalay
Date: 15th April 2012

Thank goodness for antibiotics
A salient lesson for all travellers, always carry a course of antibiotics! I previously did not believe that antibiotics were essential for one's travel medical kit, but that opinion has certainly changed!

From Blog: A Malady in Mandalay
Date: 14th April 2012

:)
So, what was the cause of the illness that has lasted for months? I havent read this blog yet, so dont know if the answer in there.

From Blog: A Malady in Mandalay
Date: 14th April 2012

''scrub typhus''
Goodness me! I thought, there are only 2 types of Typhus. This is one I didnt read about, when trying to figure out what mysterous illness I caught in Thailand.

From Blog: A Malady in Mandalay
Date: 14th April 2012

A choice of typhus
Prior to my experience, I never knew that there was multiple typhus strains either - and the type of infection appears determined by whether you are bitten by either a tick, flea or mite.

From Blog: A Malady in Mandalay
Date: 14th April 2012

So now we have the details of why the doctors wouldn't let you travel to KL for the 10th anniversary party...
We didn't know how close to death you came! Despite all that, you have taken on increased Moderator responsibilities on Travelblog; for which we are thankful. Take care of yourself to prevent a relapse.

From Blog: A Malady in Mandalay
Date: 15th April 2012

A close call
I only realised how serious my situation was when my doctor instructed me in late March to remain at only 20 work hours per week until early May (five months after the initial infection). Upon leaving the appointment, I began thinking, "Wow, I must have caught something extremely bad, something far worse than I had previously suspected."

From Blog: A Malady in Mandalay
Date: 14th April 2012

Good luck!
Wow, good luck with the healing. Hope to have you back among the travelling community soon! Great pics.

From Blog: A Malady in Mandalay
Date: 15th April 2012

Rejoining the travelling community
Thanks for your wishes. I will definitely travel again, but my plans for 2012 have been delayed and are now more modest; thus initially travelling to the Pacific Islands that are much closer to Australia before attempting something more ambitious.

From Blog: A Malady in Mandalay
Date: 14th April 2012

Good to know you're ok
Hi Shane, glad to finally know the full details of your illness as I was in a hurry the last time we bumped into each other. I had similar rashes upon my return home to Australia from my trip to the Philippines which started on my arms then spread down to my legs and feet. I didn't get a definitive diagnosis from the doctors but the suspicion is some type of food allergy. Hoping for your full recovery. Take care

From Blog: A Malady in Mandalay
Date: 15th April 2012

Rashes
A doctor in Yangon thought it could be an allergy combined with a cold, but that wouldn't explain the month long recurring fever. A doctor in Australia said if it were an allergy, the itch would have been intense, whereas they were merely annoying. Incidentally, I'm looking far healthier than our unplanned meeting in the mall a month ago.

From Blog: A Malady in Mandalay
Date: 15th April 2012

Urghhh.....nasty!!!
Well, I'm glad your are now firmly on the mend. If anything, it will make a great story for the grandchildren, nieces, nephews etc :)

From Blog: A Malady in Mandalay
Date: 15th April 2012

A tale to remember
Sometimes tribulations make better stories than triumphs. I'll only be able to recount this experience with fuller fondness once my health is completely recovered.

From Blog: A Malady in Mandalay
Date: 15th April 2012

Hope you're getting better
The probability of something like this happening to me while travelling I usually don't even think about, but now that I've read about your ordeal, I might not be able to ignore it the next time around. Good to hear that you've been recovering and planning your next travels. But watching NFL? You must have been seriously delirious, mate... ;) Cheers, Jens

From Blog: A Malady in Mandalay
Date: 15th April 2012

NFL Delirium
If our paths ever cross we must watch some American Football together so I can enlighten you on the dark practices of an NFL game - you may even become a convert! :-) If that fails, then I'll try cricket instead.

From Blog: A Malady in Mandalay
Date: 15th April 2012

RELIEVED AND OPTIMISTIC
Work ethic is the key to recovery...relieved you have that in spades...optimistic you will be on the road again soon. Now Shane...your reputation did not need the impetus of a near death experience...from a rare exotic debilitating disease...with photos of rashes that make one gasp...to enhance your reputation...but as you have...Well done...Well endured...Really pleased you are on the mend.

From Blog: A Malady in Mandalay
Date: 15th April 2012


Just looking at this photo sends shivers up my spine. Nothing against your lovely toes, of course. I'm really looking forward to you getting 100% better so you can share less-harrowing, but equally exciting adventures again. Hopefully, you're past the baby-steps and recuperation will speed up!

From Blog: A Malady in Mandalay
Date: 16th April 2012

it sucks to get ill on the road
glad you're okay, hope you get well soon! x

From Blog: A Malady in Mandalay
Date: 17th April 2012

Glad you are OK
That was a frightening read for any traveller, but beautifully written nonetheless. Talk about dedication Shane, you're still taking great shots while obviously very ill. It makes the reader thankful for good health, but at the same time realise a severe illness while travelling could happen to anyone. I hope your recuperation back in Brisie continues to progress well.

From Blog: A Malady in Mandalay
Date: 28th April 2012


Shane...you write very well, and I actually felt itchy and uncomfortable by the time I finished reading about your "adventure". Now that your on the road to recovery, I wish you continued good health and many more travel blog entries! Candee P.S. The picture of the rash on your feet was alarming!

From Blog: A Malady in Mandalay
Date: 16th May 2012

Well done for sticking it out
Glad to hear you were able to get some medical treatment in Myanmar. We did hear the closest port was Thailand. Catching a flight out to seek medical help is always a last choice decision and to then not be able to get out would've been a little scary. We travelled to Myanmar in February and fell sick to suspected rancid duck on my birthday. Fortunatley/Unfortunatley we'd booked flights from Mandalay to Lake Inle which was 1 hour taxi with a 2 hour airport wait, 1 hour flight, 1 hour taxi all while swallowing suppressants and trying to not throw up anti nausea pills. It is an awful thing to move when you feel like ass and to watch my partner throw himself out of the taxi when it stopped at an intersection to lie in the dirt retching while kindly Burmese men tried to lift him because he did want to move anymore was a scary thing. We spent days vomiting, shaking, feverish, diarrhrea and nautious so we gave into recuperation. We didn't see much of the lake but thankfully had a medical kit and kindly guesthouse owners and a quiet house who brought up home made lemonade every couple of hours to keep us hydrated. Several days later we were well enough to move again... slowly. Thankfully for us after 2 months we were feeling almost 100% again. At least we had a good idea of what was wrong with us! I hope your recovery goes well, you definately have the most interesting tropical illness I've heard of people catching when they travel.

From Blog: A Malady in Mandalay




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