Destination Mike: January 2010

A week ago, I went to the clinic for my first ever travel health consultation so I really didn't know what to expect.

The doctor was ok... he was perhaps a bit unorganized and rushed, but maybe that's because it was after 4 on a Friday afternoon and there still were patients coming in after me and he was running behind schedule. I would also be in a rush to get out of that office if I were stuck in it all day! I say he was rushed because he very quickly went over a bunch of things and actually didn't ask if I was allergic to eggs until the second needle was already inside me.

We reviewed my rough itinerary for my upcoming trip to South America and the doc recognized a few of the places from his travels and briefly shared his experiences.

I explained to him that I might be in the Amazon rainforest for up to a week (as my group is still figuring out all the details) so he prescribed me 15 Malarone tablets since you take one the day before entering the malaria zone and continue for 7 days after leaving the zone.

I also noticed that he prescribed 6 tablets of Cipro for traveller's diarrhea. I don't recall him talking about it but maybe he did in passing during his "sales pitch" for the Dukoral doses or maybe it was just me not paying much attention to his Cipro comments because he didn't provide any new info that I haven't read about elsewhere. I haven't gone out to get the prescriptions filled for the Malarone or Cipro so I can't comment about their prices. I'm assuming there's a short-term expiry date on the Cipro so I'll get it filled just before the trip.

So it came out as follows:

Consultation - $30
Injection Fee - $10 (I assumed beforehand that this was 10 bucks per shot but he only charged me once)
Vivaxim (HepA / Typhoid) - DIN 0224 8361 - $95
Yellow Fever - DIN 0042 8833 - $120 (includes the yellow card to keep with your passport)
Dukoral - DIN 02240 7208 - $40 per dose x 2 doses - $80
Diphteria / Tetanus / Polio - $0 (covered by provincial health insurance plan and includes the orange Immunization Record card)

For a grand total of $335 for the day (not including the prescriptions for the Malarone or Cipro).

He got all excited when I confirmed that I had a health insurance plan as he said 80% of the costs are covered by my health plan and then he brought up the Dukoral... lol
The secretary wasn't too optimistic about that 80%... so we'll see what happens on that front.

The HepA is good for 1 year.
Typhoid for 2 years
Yellow Fever for 10 years.
Diphteria / Tetanus / Polio for 10 years.

Looking at the receipt, there's a number of different vaccines available for Typhoid and the Hep's. I thought I read that there's an oral typhoid vaccine that lasts longer than the shot since it's live vs. the killed version in the shot and I confirmed that after the doctor's visit. This web site has good info about various travel vaccines. In retrospect, I should have asked the doc about it. Since the HepA and typhoid are in one shot though, it's probably cheaper so that's probably the reason for him recommending the combo shot or maybe he's just in cahoots with one of the pharmaceutical companies ;)

He didn't mention anything at all about HepB until I brought it up. He assumed I already had it as I went to school in Ontario. He said I should have gotten it when I was 15. The immunization record card he gave me afterwards says something about Grade 7 which brings back some memory of a vaccination but I thought was for meningitis. Anyways, since I couldn't recall this shot, he filled out the requisition form for the HepB blood test to see if I already have immunity. I got that test done last week and haven't heard anything yet.

He also assumed I was up to date with my tetanus shot. When I brought it up, he made a comment under his breath and then said something to the effect that my family doctor isn't doing her job... anyways, he gave me the D/T/Polio shot.

When I asked about altitude sickness, he said it wasn't a big deal when he was there as the pills are meant for people ascending quickly on longer treks at higher altitudes and 4200m is nothing extraordinary. He said to just take a day to acclimatize in Cusco (I'm leaning more on the side of 2 days just because I hear there's stuff to see and do in Cusco and we probably want to get over the long flights). Though after speaking to a friend about her experiences, I think I might go to my doctor and ask for some pills.

He also gave me the handout and booklet which I've haven't had time to look at too closely yet but it looks informative at quick glance.

The injection areas were just a bit tender for a few days but no bruising.

Destination Mike

Innoculations for South America

So it begins...