DON'T EAT THE CHEESE!

"Don't eat the cheese."

This bit of advice was given to me by Nina, a social worker I know from my job at the Worcester Juvenile Court.  Nina is from Peru, and has given me a lot of helpful tips in preparing for my upcoming trip to her native country.  I'd heard all the warnings about the water - don't drink it, don't brush your teeth with it, don't drink anything with ice cubes, etc., but Nina was the first to mention the cheese.  On a trip back home to Lima a few years ago, Nina ate some cheese which made her quite sick for two weeks and caused her to lose 20 lbs.  Of course, upon hearing that story, some of my more weight conscious co-workers quickly began placing orders with me to bring them back some of this Miracle Cheese. Probably not a good idea . . .

Getting sick on this trip is probably my greatest fear.  In addition to the potential hazard of getting the dreaded Traveler's Diarrhea from the water (fresh vegetables and fruit are also quite risky), there is the concern of "Soroche" or altitude sickness.  After spending a couple days in Lima, we will be flying to Puno and Lake Titicaca. (Peru is on one side of the lake, and Bolivia on the other; Nina tells me that Peruvians like to say they are the "Titi" side, and Bolivia is the "caca" . . . not sure how the Bolivians would feel about that!)  Lake Titicaca is the highest commercially navigable lake in the world, with an elevation around 12,500 feet, roughly 11,500 feet higher than what I am used to here in Massachusetts.  Most guide books advise taking it easy for the first day or so to give your body a chance to adjust to the altitude, but unfortunately we won't have that luxury.  It sounds like pretty much everyone gets some symptoms of the illness, but it can vary greatly in severity from person to person.

A local remedy for Soroche is Coca Tea, which is made from the same plant as cocaine, but is supposed to help reduce the symptoms without the harmful narcotic effect. As a more modern approach, my doctor, Dr. Morris Milman, gave me a prescription for Acetazolamide, which is supposed to help prevent the sickness.  Symptoms of Soroche include headache, fatigue, and nausea.  Possible side effects of Acetazolamide can include headache, fatigue, and nausea . . . And, in order for the medication to be most effective, I am supposed to start taking it 48 hours prior to hitting the higher elevation - thus creating the potential for me to actually be sick with the same symptoms for a longer period of time than I might be without it!

But I think my favorite solution to one of the symptoms of Soroche came from an attorney at work who told me to bring tampons, in case I need to stick them up my nose to help stop nose bleeds caused by the high altitude.  She advised me to the strings off first . . . 

Dr. Milman also set me up with an appointment with the University Of Massachusetts Travel Clinic.  I went to that last Monday, and met with a nurse practitoner who gave me the the familiar warnings about the water, the fruits, the vegetables, as well as other health risks and preventative measures.  She gave me a prescription for Ciprofloxacin, which I am too take if I am unfortunate enough to be stricken with the Traveler's Diarrhea  . . . and which has the potential side effect of causing diarrhea . . . and tendon ruptures, among other things.  I was also vaccinated for typhoid, and given the first in a series of three shots for Hepatitis B.  Obviously the Hep B vaccine won't prevent anything on this trip (the second shot has to be administered in a month, and the third six months after that), but the nurse practitoner said it was a good thing to have anyway.

Hopefully I won't have any health issues while traveling.  Between the prescriptions, the vaccines, the tea, not drinking the water and maybe even a tampon or two I think I'll be ok. 

Oh yeah, and don't eat the cheese . . .