Scary Skin

Today I did something very scary. I stopped taking my malaria medication. The following chain of events describes why.

A couple days before Brendan and I left Laos, I noticed that I had a funny bruise on my right forearm. It wasn't round like a typical bruise, but more like a series of small, splotchy bruises. They didn't hurt, so I wasn't terribly worried. Until I found more of them on my right ankle. And then on my left knee. On my left calf. On my right thumb. Upon closer inspection, not bruises at all, but purplish streaks and spots. Not itchy, not rashy, not anything special. Just... appearing. On my body. My body.

Obviously, I was dying.

Brendan didn't think I was dying at first, and waved off the right forearm as a fluke bruise I probably got from lifting my backpack (I bruise easily enough to make that theory not so farfetched). But once I'd developed enough physical evidence to show that I was indeed dying, he relented.

At this point, we'd just flown into Phnom Penh, Cambodia, which is a big enough city to house a few decent healthcare facilities. Our guidebook suggested a travel clinic not far from our hotel, so off we went to find out how long I had left to live.

At the clinic, I couldn't even talk to a doctor until I paid a $40 consultation fee. Fine. I'm dying. I'll pay anything. As we waited for my name to be called, a French guy walked in and told the receptionist he needed an AIDS test. Wow. Brendan elbowed me to stop staring. The receptionist called my name and I went into the office alone.

My doctor's name was Gavin Scott, world's most flamboyantly British physician. Comically so. He asked me a million questions about my medical history, where I'd been recently, what kind of person I was, the usual doctor routine. He wasn't too impressed that I'd been out of the United States for the past four months tromping through muddy jungles and picking off leeches, which was kind of a relief. Maybe I'm not really dying? Maybe this happens all the time, so often that it bores him?

Dr. Scott looked at my streaks under a variety of different lights. He stretched my skin taut to see if the spots reacted to pressure. He measured their lengths. He scribbled notes. He nodded and scribbled more. Then he took a blood sample to rule out a few issues like anemia and thyroid disease, told me I was probably not going to die, and promised to email me with the results in 24 hours.

In 24 hours, Dr. Scott's email said my blood was normal, and diagnosed me with chloasma, AKA melasma, AKA hyper-pigmentation, and offered no course of treatment other than to stay out of the sun. Rats.

Not satisfied with this resolution and still at the internet cafe, I decided to research the side effects of taking doxycycline, an anti-malarial antibiotic both Brendan and I have been on for the last couple months. Dr. Scott hadn't thought it was the culprit, but you know, why not. Doctors aren't always right. And lo and behold, what did I find? A very, very uncommon side effect described as "black and bluish bruising or discoloration of skin".

Bingo!!!!!

I hate you, Dr. Scott!!!!

So here's the thing. I don't want malaria. I really, reallty don't. But I really, really can't deal with skin problems. I'm a woman, for god's sake. Skin problems are never worth it. So, no more doxycycline. I'm just going to have to try not to get bitten from here on out. Like, ever.

Oh, and one of the other uncommon side effects of taking doxycycline is hair loss, so it goes without saying that Brendan has also decided to abandon treatment.

Wish us luck (we'll need it).

-Sarah

Comments

Sarah and Brendan,
First time writer, long time reader. Guys, I know that the side effects of Doxycyline might not be you cup of tea. I've personally never seen that reaction in practice, but I'm sure it's possible. I would suggest seeking medical advice and/or other treatment options. I won't give advice due to liabilty issues (aka my malpractice insurance would have a field day handling this one if I'm wrong). I can say that there are other medications that can prevent malaria, although they may be a little more expensive. I can tell you that treating malaria, assuming you survive, is expensive, and worth preventing. I'd also recommend checking the CIA's website. They used to have a comprehensive list of diseases common to foreign countries.
An ounce of prevention is worth a pound of cure. Anyway, good luck, and keep us posted.

Ok, I'm all for doing your own thinking, but stopping taking Malaria-preventive-medicins is stupid. Really. I have traveled around the world quite extensively, and the worst cases of malaria I have seen (apart from locals who, understandibly, can't take malaria-prevention their whole lives) were people who had stopped taking their anti-malaria medicin. Research other types of malaria-prevention (there are many different ones and they usually give you the strongest one 'just to be sure'), but don't just stop taking it. And yes, ONE BITE of a malaria-mosquito CAN be enough.
Honestly, I am not a big fan of medicins, especially if taken preventively, but (aside from AIDS), Malaria is the one disease I would do everything to prevent getting. Please. Your lives are worth more than your skin and your hair. Really!

PS It also depends on the regions you will travel. The types of malaria common in (SouthEast)Asia don't require as heavy a preventive medicine as do the types found in Africa. A lighter medicin maybe?

Great photos and travel blog(s)! You guys are lucky, smart, and cute. Keep taking your pills and stay that way.

RIP Sarah

I just discovered your blog a few days ago when I decided to check out what other blogs ivillage offered besides my favorite, "Embedded in the 'burbs"- which is what you two are anything but. I'm now hooked on both blogs! Who could have predicted that I would start following you two at such a critical point in your travels? Deciding to discontinue your medicine is evidently more serious than you thought, according to Rich R. et al. Celery made me LOL. She/he may have Halloween on her mind; however... have you reconsidered yet?

Where are your pics I hear about?

I have the same thing you have sarah I don't think about it at all as a disease but just take your meds also make a podcast to let peeps know wats up. peace take care eat vegatables and drink ur milk

You just took one giant step towards death....but at least you die together....unless brendan manages to escape.....good luck though

Don't die!
Look up the fun bits of malaria and see if they sound more fun than the side effects of your meds.

hint: one is becoming romantically familiar with the bathroom... and you guys are in countries where they poop in a hole!

every time I've been on doxycycline for travel my pharmacist has told me to avoid the sun...ie wear sunscreen, protective clothing,hats,etc.. I've had the discoloration reaction before--I started using sunscreen It seemed to help. Remember hair loss and hyperpigmentation is reversible-- the ravages of malaria are not. Please Be Careful, We'd like you to come home.

I think that with your quitting the meds. You will need to change your other blog to the traveling Morons and not the Morans. Please start taking the meds again we miss you both and want to see you on TV again. You only have a short time left until you return to the states. Would you rather wear makeup or be to sick to attend the wedding?

Stay well and please post more pictures.

When I travel to malaria infested areas, my doctor always gives me Aralen (chloroquine phosphate). Easier on the system and just as effective. Doxycycline is a miserable drug to take as a prophylactic.

Well Sarah, if you die, make sure Brenden emails some pix of what you're being buried in..you know..for the website.

I just started reading and I LOVE your blog! I just read all of your archives and can't wait to hear more! Stay safe (and healthy)! :D

Skin problems suck...malaria sucks worse I'd imagine. I know you guys are having a hoot and all, but I miss you guys on AOTS. Sure, they do an alright job now, but you guys were pros.

I agree with the other posters. Don't be so vain as to forgo malaria prevention for your skin's appearance.

Also, I find it quite upsetting that you'd be compelled to stare at someone getting an AIDS test. Anyone who is sexually active should have one.

oh bullshit all you other posters, i've been to where sarah is on 3 seperate long trips and only took malaria meds for a short time on one of them until the side effects got too bad. all the times there i've only met one other traveller who even bothered to take them. stayed in a fight camp in thailand and none of the other fighters were on them, tell me, what are the locals on every day? nothing.

That's was scary, I am glad that you are OK.

the pill can cause chloasma too

When I went to Africa for the UN I had a similar experience and in fact all of the UN employees had STOPPED taking their malarial pills. I developed a lump in my breast, my brother who never had headaches started having migraines, my father had some reactions as well. Our helicopter pilot had halucinations so as you can see, most of the employees found the side effects more drastic than if they'd stop taking the pills all together.

it's your choice don't let anyone call you an idiot for doing what you have to do. especially if they've never had to deal with it.

Gadzooks, Dr. Scott is still in Cambodia!? After he was arrested for paedophilia and convicted of rape we all thought he'd be deported after his incarceration.

Unless you plan to venture into areas where malaria is endemnic I hope you decided to get off the meds. The only tropical vaccinations that are real imporant are yellow fever (Africa), cholera and hep. And if you hadn't completed your hep series before you left it's too late to start now. I've been living in Asia for almost 20 years and malaria isn't a concern in the more developed areas you've been traveling. If you're trekking in a malaria hot spot then you ought to really consider the anti-malarial meds. Repellant and a mosquito net are quite effective in rural areas. This website provides reports of malarial hot spots: http://www.fitfortravel.scot.nhs.uk/. Compare it to your itinerary and then make the call.

I had to take anti-Malaria for a trip to Africa. I stopped taking it because it made my mind race and I am pretty sure I was about to become a mad-woman. Weird stuff. Fortunately, I was in Africa during their winter so the mosquito situation wasn't bad and I didn't get sick during the last week of my trip that I wasn't on the meds.

Happy travels!

All medications have side effects. Even taking too many Naturopathic vitamins or drinking too much water results in death. WBR LeoP

I hope you have Marriage Insurance. Sounds like you may need it if you choose to stop the meds. Alot of people never even knew Marriage Insurance exist, or furthermore knows what marriage insurance is all about, I didn't. This Insurance protects you and your spouse from financial loss due to cancer heart attack, stroke or other debilitating illnesses. Might want to check it out for what its worth. www.marriageinsurancecenter.com