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Parasitic Occupation (Post #137)

Sunday, June 18th, 2006

Mike writes–

Oh, the things i`ve been through on this trip…

As Michele mentioned in Post #136, we didn’t do a lot of sightseeing in Quito. One reason is that we were dealing with the situation described below.
While we were in the Santa Cruise Island after finishing our Galapagos cruise on the Legend i noticed a zit or ingrown hair on the back of my neck just about an inch below the hairline. It seemed logical that it was an ingrown hair because just about 10 days earlier Michele had shaved the back of my neck. One night Michele attempted to squeeze the pus out of it but only got what appeared to be oil. oh well, i figured it would be gone in a week or so…

Well, by the time we were in Riobamba it was not gone. In fact, it had grown a bit and by June 9th (the same day we rode the train), it was a bulge about 2″ in diameter. “hmmm… maybe my ingrown hair is infected,” i thought. I was beginning to think going to a Dr. when we got to Quito would be a good idea. Then, when we got up on the morning of June 10th, i thought it seemed like it was shrinking a bit. “Maybe i don`t need to go to a Dr.” It is such a pain to go to a Dr. in a foreign country. I was also considering the difficulty the language barrier might pose to me in the Dr´s office.

After thinking about it some more while we were on the bus from Riobamba to Quito, i decided it would be best to just go to the Dr. After all, while i do believe i know a bit about medicine, i really didn`t know what this thing on my neck was.

After settling into our hostal in Quito, i went and asked the manager about what hospital would be best for me to go to if i was looking for English-speaking Drs. He recommended Hospital Vozandes which is a hospital the Lonely Planet guide book indicates is American owned (at least it was at the time the book was researched). I understood him to say that all of the Drs there are foreigners and they speak English. Great! The Manager called us a $3 cab to the hospital and off we went.

Upon arriving at the hospital, my hopes were immediately dashed. As i looked around in the reception area of the hospital, i didn`t see a single sign in English… Spanish, Spanish everywhere. I actually began to get a bit angry. I just had different expectations based upon what i understood the hostal manager to be telling me.

We waited in line for a few minutes and were told to walk down the hall to the right and go to the Emergency “room”. When we got there, i began to get more angry. It was totally unclear to me what i was supposed to do next. There was a nurse in what appeared to be an Emergency reception room. She seemed to be “receiving” patients but everything was being conducted in Spanish and patients seemed to be cutting in front of me. I guess i wasn`t being assertive enough. Finally i spoke to the nurse in broken Spanish about why i had come to the hospital and showed her the inflammation on my neck.

A few minutes later i was in the Dr´s office again trying to have a conversation with him about my condition. After having a look, he called another Dr. in the hospital who could act as an interpreter. She explained to me in English what was going on. Ok so, the Dr. was going to drain my abcess and send what he drained to the lab. While we were waiting for the lab results (to be ready 4 days later on Wednesday — which was also going to be our last day outside of the U.S.) they would put me on a course of antibiotics which might be changed depending on the lab results.

So next the Dr. removed whatever was underneath the skin on the back of my neck. Michele and i had already noticed that whatever it was, it felt pretty solid, not like the softer feeling one would expect from a bacterial infection. The “draining” of my abcess was, as of yet, the most painful experience i have ever had.  I was obviously unable to see what he was doing but i felt him repeatedly pull my skin up, scrape around with some sort of blade, dig in the center with another instrument, and poke a needle several times into my neck. He did not use any anaesthetic.
When it was finally over, the collar of my shirt was soaked with blood, and the Dr. had taped gauze to my wound. When he told me i could sit up, i saw the tools the Dr. was using. These included a pair of surgical scissors and a syringe among others. I also noticed the “test tube” into which he had packed the sample. It was about 6″ long, the diameter of my little finger, and it was packed full of blood and something the color of pus but seemed to be solid (or colloidally suspended).

Since the the Dr. and i weren`t able to communicate directly, he called in the English-speaking Dr. to translate again. The translator explained that what i had was most likely the larva of a parasite since the thing in my neck was hard and actually quite difficult to remove. I commented that i also noticed it was hard to remove (was it ever!). So, the course of antibiotics would stand but additionally, i was to keep this gauze over the wound to prevent the larva from getting oxygen. Allegedly they would die within 24-48 hours without oxygen and, when i returned on wednesday, anything still there could be removed. When i explained we were expecting to fly to the U.S. on Thursday, i was told that was no problem.

Later that evening, we went to an internet cafe and did a google search on parasitic flys endemic to South America. The most likely candidate we came up with was the Human Botfly which you can read more about at this site . These creatures infest humans in one of a few ways. One way is that a fly catches a mosquito, lays its eggs on the mosquito and when the mosquito goes to bite a human, the human body heat causes the larva to hatch out of the eggs and burrow under the skin. They also allegedly lay eggs in clothing. When a person puts the clothing on, the eggs hatch and the larva burrow as with the mosquito bite.

Through our research online, we found that the larva use the hole they burrowed through to breath and covering this hole is the way to starve the larva of oxygen and cause them to come back to the skin`s surface in search of oxygen. They can also sometimes be removed manually but care must be taken to remove the creatures in their entirety and not leave any infection-promoting pieces behind.

At this point, we began to get concerned about whether the Dr. had done the right thing by attempting manual extraction. Furthermore, we weren`t confident the gauze was really going to suffocate these bastards. Seemed to us that air can pass through gauze. So that night and the following days we started taking the additional measure of smearing antibacterial ointment on the wound. Yes, we know antibacterial ointment isn´t going to kill a fly larva but the antibiotics of such an ointment is actually held in petroleum jelly (like vasoline). Smearing petroleum jelly on the breathing hole is one proposed way of preventing the larva from getting oxygen. We figured antibacterial ointment is just one step better because we would also be discouraging bacterial infection at the same time.

On Sat, June 10th, upon leaving the hospital i was told to come back on Monday, to get my neck cleaned, and on Wednesday, to get the lab results.

We went back to the hospital on Monday. A nurse cleaned my neck and put a fresh bandage on. About 30 minutes after leaving the hospital i started feeling bad. About 4 hours after leaving the hospital i had a high fever and chills. We decided to go back. This time 2 doctors examined my neck in the emergency room. Neither one spoke English so they got a 4th year med student to act as the translater. They gave me Tylenol to reduce my fever and after some discussion, said (via the translator) that they did not think there were any larva in my neck. After paying $15 for the emergency room visit, I was told to be sure to come back on Wednesday.

And so, this story is now coming to an end…

We went back to the hospital on Wednesday to get the lab results. The doctor we saw did not speak English but i understood about 90% of what she said. She told us the test results were negative for bacteria. This didn’t necessarily mean there were never any larva in my neck. However, she said there was no larva now and that no further action was necessary.
At this time (4 days after the last hospital visit), the thing on my neck is much smaller and seems to be diminishing. Although everything turned out o.k., i will probably never know for sure whether or not there were larva living in my neck. There was certainly something big there at one time but what that thing was will probably remain a mystery.

Quito, Ecuador (Post #136)

Friday, June 16th, 2006

Michele writes…

On the morning of Jun10th, we went to the terminal terriste (main bus terminal) in Riobamba to catch a bus going to Quito. The way it works in Ecuador (and many other South American countries) is that you simply go to the bus station and walk around looking at all the ticket booths and listening for your destination being called out. All of the bus companies have lists showing the times their bus goes to various cities. When it gets close to when a bus is leaving, a guy from the bus company will yell out the name of the city the bus is going to.
On this day, we arrived at the bus station at 9:26 and immediately heard “Quito! Quito! Quito!” We walked up to the man and he showed us the way to his company’s booth where we bought a ticket for the 9:30am bus. After purchasing the ticket we followed him to a spot outside the bus station and in approximately 1 minute, a bus pulled up and we got on.

The 4 hour bus ride from Riobamba to Quito was quite beautiful. Like many bus trips we’ve taken before, at each stop a bunch of people get on the bus walking up and down the isle selling things they have in their hand. They yell out the name of the item and you wave your hand if you want one of the things. About half of the time we can’t identify the thing they are selling but we know it is some type of food or drink. On this bus ride, we observed something not seen before. A man came on the bus and passed out a small book to everyone (except us – the only two gringos). He then gave a speech and people either gave the book back or paid him a dollar. Another time a man got on the bus and passed out necklaces to everyone (again, except us), made a speech and the same thing happened. Either people gave the necklaces back or paid him a small amount of money. We have taken buses all over the world but on this, our last bus trip, we saw this novel way of selling items and it was something we had never seen before.

We arrived in Quito in the early afternoon and were relieved to see our bags were still under the bus. We caught a cab into the Mariscal area, which is where all the backpackers stay. I had previously reserved a “mini-suite” in a hostel for $32/night. This price is quite expensive for Quito backpacker land but we wanted to have a (relatively) nice place to stay during the last few days of our around-the-world trip. Hostal Alcala was a great place to stay. Our room was very large and it had a refrigerator, cable TV with lots of movie channels, a bathroom and several closets. The hostal served a nice breakfast each day (included in the price) and there was a computer with free internet access. Perhaps best of all, there was a flowering tree outside our room where a couple of hummingbirds seemed to live. Each day we spent a few minutes watching the hummingbirds, marveling at their wingspeed. Here is a picture of our favorite guy, who reliably sat on the same branch every day:


So, what did we do in Quito? Well, not much. We had planned to do a couple of day trips out of the city but never did (for reasons we will explain in blog #137).
Still, on a couple of occasions we went to some different markets to look for souviners. One day we also walked all around the Mariscal (aka New Town) area and went to the park. On another day we ventured into the Old Town area which is full of gorgeous architecture. In the Old Town we ate lunch in one of the huge cobble stone squares, had dessert at a heladeria (ice cream shop), and visited two churches. One is shown in the photo below. As you might imagine, one minute after I took this picture it started to storm. Although Quito (at an altitude of 9348 ft.) lies almost directly on the equator and the sun felt like it was burning a hole through our heads when it was out, each day in the afternoon a thunder and lightening storm kicked up for about 30 minutes. Then the sun came out again. So, this photo of the basilica was taken minutes before one of these daily storms.

The rest of the time in Quito we did things like meet traveling friends for dinner, hang out at the nearby internet cafe, and watch movies on one of the 10 movie chanels available on the TV in our room. These activities were not quite as exciting as riding on the roof of a train or swimming with hammerhead sharks but we both agreed that after traveling for 373 days, we just wanted some down time before returning to the U.S. and ending our around-the-world trip.

Riobamba, Ecuador (Post #135)

Sunday, June 11th, 2006
Michele here... As Mike wrote in the last blog we arrived at our not-so-great hostel (Ecuahogar Hostel) in the suburbs of Guayaquil on Tuesday, June 6th. The main reason for staying at this place was because it was close to the ... [Continue reading this entry]

Galapagos Islands, Ecuador – Part VI (Post #134),

Thursday, June 8th, 2006
Our last full day (May 31st) on the Legend, after visiting Espanola, we skipped the afternoon excursion to the interpretive center on San Cristobal.  We figured we had already seen the Darwin Center at Puerto Ayora and the interpretive center didn´t ... [Continue reading this entry]

Galapagos Islands, Ecuador – Part V (Post #133)

Thursday, June 8th, 2006
Michele writes.... We woke up May 30th to find the Legend cruiseship was anchored in a giant volcanic crater.  When we went up to the ship deck we found we were surrounded on all sides by Genovesa island except for a break ... [Continue reading this entry]

Galapagos Islands, Ecuador – Part IV (Post #132)

Thursday, June 8th, 2006
On May 28th both of our excursions were to the island of Santa Cruz.  Of the Archipelago, Santa Cruz has the largest population with the largest city on the island, Puerto Ayora, having about 20,000 inhabitants.  The morning excursion was to ... [Continue reading this entry]

Galapagos Islands, Ecuador – Part III (Post #131)

Wednesday, June 7th, 2006
Mike and Michele write... On the morning of May 27th, we arose at our normal early hour, had the buffet breakfast and disembarked for the island of Santiago at 8 a.m. We arrived on a beautiful black sand beach and did an ... [Continue reading this entry]

Galapagos Islands, Ecuador – Part II (Post #130)

Wednesday, June 7th, 2006
Mike writes... Our first excursion from the M/S Galapagos Legend was just 2.5 hours after getting onboard.  This was beginning to look like what we experienced in the Amazon Basin -- we would be very busy with excursions.  Anyway, the first ... [Continue reading this entry]

Galapagos Islands, Ecuador – Part I (Post #129)

Wednesday, June 7th, 2006
Michele here...writing from the Galapagos Islands. On Thursday, May 25th, we boarded a plane going from Guayaquil, Ecuador to the Galapagos Islands (Ecuador). We have been looking forward to going to the Galapagos Islands since the beginning of the trip and there ... [Continue reading this entry]

Guayaquil, Ecuador (Post #128)

Monday, June 5th, 2006
Mike writes... We landed in Guayaquil, Ecuador in the early afternoon of May 22.  We didn´t yet have a place to stay so I used a call center in the airport to call a couple of places listed in our guidebook.  ... [Continue reading this entry]