I just got back from seeing my rheumatologist, and I have four band aids sticking to different appendages.
My main reason for going today was to get my vaccinations and a stockpile of medicines to take with me 'just in case' when I leave next month for South America!
I am officially naming this my 'I have RA, but RA doesn't have me' (har har) trip. I've had wanderlust since about as far back as I can remember, whether it was dreamily wandering around my neighborhood on my bike as a kid, or jetting off some place exciting like Moscow when I was in high school, and then further afield to places like Kenya and Brazil the last few years. When I was first diagnosed with rheumatoid arthritis, the idea of not being able to take off and travel anymore felt crushing, so I determined that, RA be damned, I didn't care, I was NOT going to stop going to far off places just because I had RA.
When my friend E. sent an email out in January declaring that it was high time she get herself out of the country again, and asking who else wanted to join her, I emailed back instantly that I was in. We landed on South America since the US$ might still be of some value there (though barely), and neither of us have ever been. We quickly began putting together a pretty ambitious three week trip, covering much of Peru, including Machu Picchu, the Amazon (hell, yeah!), Cusco and Lake Titicaca, where we will cross over into Bolivia to see a few places there and spend time on many of the islands on the Lake. From there, we'll fly to Iguazu Falls in Argentina for a few days before ending up in Buenos Aires for just under a week.
When I talked to my rheumatologist about the trip a few months ago, she said she wanted me to see an infectious diseases doctor to figure out what immunizations I should get and other considerations given my new superfun illness. (RA is a high-maintenance disease, I gotta say.)
So off I went to the infectious diseases doctor. Perusing the DISEASES bookshelf at various Barnes & Nobles around the city had made me feel like a bit of a social pariah, but walking into the INFECTIOUS DISEASES department at a major hospital made me feel downright suspicious. I mean, walking into that waiting room, you can't help but look around and wonder what's going on in there (and that everyone is also thinking that about you). Is everyone else in there because they are aiming not to get one, or do they have some kind of crazy, bizarre bacterial thing going on that I just can't see. I noticed I was breathing more shallow than normal and trying not to touch anything while I waited. I was (surprisingly) quickly called back, where I discussed my RA, my current meds, and my trip with the doctor.
He determined that I'd need Hep A and Typhoid for this trip. Luckily, I had had a yellow fever vaccination three years ago when I went to Kenya, and it's good for another few years. Since it's a live vaccine, I won't be having one of those again as long as I'm on enbrel. (Note to self: get thee to all the yellow fever places in the world within the next five years...) I was totally bummed to find out that I wasn't on a high enough dosage of plaquenil for that to protect me against malaria, it's original use, so I will have to take other malaria pills while I'm in the Amazon. (Of course, if I was on a high enough dosage of plaquenil, it probably would detach my retina, so on second thought, I'm ok with the other malaria pills.)
So all of this leaves me sitting here with four band aids visibly stuck all over my body, some with cotton poking out from underneath. (I gave myself my shot this morning and had blood taken, along with the two vaccines). I look pretty sexy, for sure. (Maybe this will inspire some original pick up lines tonight when I go out with some friends, like 'Hey baby, why so sick? And what can I do to make it all better?' We'll see.)
My only lingering medical question regarding my trip is this: I read on one internet forum for arthritis that the 25mg shots don't, in fact, have to be kept cold all the time. They ideally should be, but if they are left out at room temperature, it just means their expiration date is no longer valid, and they'll only be good for another 45 days. If this is true, my traveling just got a hell of a lot easier. I can't imagine that keeping them on ice while in the amazon jungle is going to be all that easy. My doctor is going to see what she can find out, but has anyone else heard this or know anything about it?
Either way, a month from tomorrow, I'll be off!!!
PS: I'm planning to post when I can at internet cafes along the way about how the trip is going!