Friday, 23 November 2012

Illness, Injury and medical precautions

Plan a trip anywhere, and the health question is likely to come up. 'What happens if' type things sneak into your mind and if you're not careful, can make you paranoid and scare you silly. But in reality, it really is not that big an issue.

Both Nadine and I are just normal, regular women. Neither of us are super fit but we are basically OK, and generally healthy. Neither of us is prone to any particular condition, common or uncommon, or any regular medication, although both of us have various injuries existing but healed injuries that still need occasional managing. Nadine has a knee injury and a back niggle from a bike accident, and I have a shoulder/arm injury from a pushbike argument with a car. But that is it. Yet we did this trip with no backup or specific training, and no particular planning, proof that it is possible to just get on and do what you want to do, regardless of the gadget and bike assumptions that some people seem to swear by.

Having both ridden in Africa earlier in 2012, we had already had a number of jabs for things like Yellow Fever, Typhoid, Polio, and Hepatitis. These are things that we knew about and knew we would be going into areas where they were common, so it made sense to get sorted before we went. It also meant that by doing so, we would not be taking away vaccine and medical treatment from locals who needed it yet had no other opportunity to get it.

Some of these jabs were free from the NHS, whilst others were done for a fee by the Superdrug Travel clinic. Jo and Julie at the Clinic in Croydon were excellent and went out of their way to identify danger areas and find information on managing conditions for us. That really helped put stuff in perspective too.

Meningitis was another jab we had. We knew that on the Africa trip, we would be in and around a hospital where medical cases were routinely mixed, and quite possibly would come into contact with carriers, so it made sense to have this. But just before we went, the Muslim Council for Great Britain sponsored an initiative to inoculate anybody going to Muslim countries in an attempt to reduce the spread of meningitis at the hajj or routine  religious gatherings. The existing vaccine stopped you getting a particular strain, whilst this one also stopped you carrying it, which again made sense as neither of us wanted to get Meningitis, let alone transport it across the world and into places that we travelled through, either in Africa, Europe or Asia.

The big one though was Rabies. At £150.00 for three jabs, it is quite expensive and it only buys you 24 hours to get help and possibly survive should you get infected, as opposed to dying a painful death on the spot. But we knew we would be out in the wilds and likely to encounter fierce dogs, so we decided to have it. And nowadays, its just three simple injections in the arm, and not a painful ordeal with along needle as it used to be.

Once we had done that, we needed a sensible and manageable medical kit that wouldn't get us into trouble. We both needed painkillers for our existing injuries, but some common medicines ( stuff containing codeine for example - a common ingredient in many over the counter medicines - is dodgy  in some places) and even alcohol wipes are illegal in some countries and if caught, jail is the likely result, so we didn't want to go down that route. And we had limited space, so anything that could be put to double use, and could be used for anticipated incidents was preferable. Nadine - being a nurse - was in charge of this.

We took two bandages and a roll of sticking plaster, anti histamine cream (for bites), painkillers as above with prescriptions, and a letter from our doctors, all stamped with surgery stamps just in case. Former Soviet block countries love stamps on paper, even if they can't read it - looks good and official. We also had some saline wash for cleaning road rash injuries and washing sand out of eyes, some sutures and some diarrhoea pills. A roll of gaffer tape which was also good for general fixing of bikes and luggage and a good supply of rehydration tablets completed the set up.

We took Zero rehydration tablets, and had had Nuun in Africa. Both were good but the Zero was cheaper so that is why we took them, and they really saved us on several occasions.

Dehydration will  make you feel rubbish, and that in turn will affect your thought process, reaction time and judgement, all of which are crucial on a bike. It will also give you a headache, but its not just a question of replacing fluids - you need to replace minerals too, which these tablets contain. So every morning, we took one each in a litre of water, and again at lunch and in the evening. We took more if we had vomited or had upset stomachs too or if we felt tired or not quite right. And they worked.

But however much you prepare, you can still get ill. We didn't fare too badly on that front, although both of us did feel a bit rough at times, and had heatstroke, despite drinking plenty, being covered up, and resting.

We kept an eye on what we ate, avoided stuff if we didn't like the look of, and cooked our own food much of the time. And we weren't silly with drink either, which is quite easy to fall into if you get caught up in the vodka drinking ways of eastern Europe and Russia.

I don't eat meat but knew that I would probably have to on this trip; either that or starve. Nadine, however, will eat anything. But I'm not precious about it and abstain because I don't like it very much. But for me was a bit of a trial because I knew that it would probably be too rich for me, especially if it was greasy. So when I did have to eat meat, I made sure that it was as well done as possible, and I didn't have too any problems. And fish is not an option as I hate it and it hates me, although I did accidentally eat it twice in Russia and was immediately violently ill afterwards. But the allergy excuse works well if put on the spot and you really can't do the expected thing or avoid it beforehand.

Then there are injuries. Given the type of trip we were riding and the roads and terrain we were encountering, a crash or two was very likely. And with motorbike crashes, injuries usually result.

But again, we were sensible and didn't worry too much about what could happen. Some of the driving in countries like Croatia and Albania, Russia and Georgia was appalling and I think that both of us half expected to have an encounter at some time, and were half prepared to sort the other one out. But we rode carefully and had some close calls, but no prangs which was good.

I did fall off and injure my arm though. It was a slow speed tumble on gravel and sand on a particularly bad road in Kazakhstan, and the bike just went from under me, tangling my left arm as it did, and catching my wrist. I knew I had done something to it as it hurt, and my hand and fingers swelled.  I got my wedding ring off before it got really bad, but I couldn't grip the bar nor turn my wrist and I knew it was broken, although I wouldn't admit it. I think I thought that if I did, it would somehow be even worse. But Nadine made a back slab and bandaged it on and we carried on riding. There was nowhere to get any medical attention anyway, and that's probably all they would have done, had there been.

I did eventually go to a hospital about a week later where the rather blurry X-ray revealed nothing, so I was able to keep pretending. But the silver lining was that it was my left hand and there is no clutch on the bikes were were riding. Had it been my right hand - my throttle hand - that would have been difficult.

We fared well for the rest of the trip, although we both got a flu like thing in China. I wasn't too bad but Nadine was very ill with a high temperature and the shakes, but we were holed up in an air conditioned hotel by then, so we managed it with Paracetamol and fluids, and lots of sleep, which she excels at anyway.

The dilemma for me though was that it was three days before we flew home and if I found a doctor, it was possible he would declare her unfit to fly but it was unlikely I would be covered to stay behind and look after her. There was no way I would have left her but it would really have complicated things with tickets and visas, so I decided to keep a careful eye on her and she how she went; if she had not improved by the morning, I would get medical help. Fortunately, she was better when she woke up although still not good but she by resting and drinking plenty of water with rehydration tablets,  we  were able to get the plane as planned and get home OK, although it took a good two weeks for both of us to get fully better.