Oxygen 2

When I posted the picture of myself with oxygen and told you about my headaches, a lot of you wrote back worried I’d have a blood clot in my brain or that I had terrible altitude sickness. Even my son Eli wrote me and said, “Take the fucking medicine.”

Some of you told me I should just rest for a few days—yeah right…and who exactly would teach my class and run this retreat? I’m not that sick.

I want to assure you I don’t have serious or dangerous altitude sickness. I’ve continued to have headaches on an intermittent basis since I arrived in Peru a week ago, but I have none of the signs of severe altitude sickness: “severe shortness of breath, confusion, difficulty concentration, lack of coordination, a staggering walk, extreme tiredness, severe headache.”

However, I did email my travel doctor (who as of yet has not written back) to ask his advice. I’ve talked to Brenda, our guide, who is very well trained, and she isn’t worried. I’ve been able to teach and to participate in everything and to enjoy every moment here in the Sacred Valley. I just have a headache–sometimes.

Although my lack of adjustment is annoying, I don’t believe it’s dangerous.

However, last night, I did decide to revisit my prescription to Diamox which I carried here . It’s been sitting in the bottom of my suitcase in a zip-lock bag along with my malaria medication for the Amazon. (I haven’t decided whether to take that either).I pulled out the paperwork for the Diamox.

The first page , it said that Acetzolamide (the other name for the drug) could cause drowsiness, that I should take care when operating a vehicle (no problem there; I wasn’t planning to drive), and that alcohol and marijuana might intensify this effect. (No worries there. I wasn’t planning to indulge while in Peru.)

It said not to take aspirin while taking the drug. That I should avoid excessive exposure to direct or artificial sunlight (Would the ever changing weather in Peru protect me?), that the drug might cause dizziness, blurred vision, and headache. Really? Headache? I was taking it precisely to get rid of a headache.

It said could take the medicine with or without food. And that I should “read the boxed warning information for this medication.”

I moved on to those—the fine print—the warning information that had come with the medication. I read on. “To prevent altitude sickness, start taking acetazolamide 1 to 2 days before you start to climb. Continue taking while you are climbing and for at least 48 hours after you have reached your final altitude. You may need to continue taking this medication while staying at the high altitude to control your symptoms.” Well, it was too late to take it before I reached this altitude. I wasn’t climbing. I’d already been here for a week.

I read further, scanning the rest. Mostly people take Diamox for mountain climbing, not touring at 9000 feet. Everyone had assured me I wouldn’t have a problem at 9000 feet, but here I was, not fully acclimated.

I honed in on the long list of possible side effects: “Dizziness, lightheadedness or increased urination may occur.” How could I possibly pee any more than I already was? I was drinking more than 2 liters of water a day– more like 3 or 4. “Blurred vision, dry mouth, drowsiness, loss of appetite, stomach upset, headache and tiredness may occur. If any of these symptoms persist or worsen, notify your doctor or pharmacist.” Yeah, right.

“Tell your doctor right away if any of these very unlikely but serious side effects occur: increased body hair, hearing loss, ringing in the ears, unusual tiredness, persistent nausea/vomiting, severe stomach/abdominal pain.

“Seek immediate medical attention if any of these unlikely but serious side effects occur: easy bleeding/bruising, fast/irregular heartbeat, signs of infection (fever, persistent sore throat), mental/mood changes (confusion, difficulty concentration) severe muscle cramps/pain, tingling of the hands/fee, blood in the urine, dark urine, painful urination, yellowing of the eyes/skin.

“A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: blisters/sores in the mouth, rash, itching/swelling (especially of the face/tongue/throat, severe dizziness, trouble breathing.

“This is not a complete list of possible side effects. If you notice other effects not listed above, consult your doctor or pharmacist.”

Oh great.

I turned to the pill bottle itself. The original dosage written on the label said to take a pill twice a day. I’d written over that in thin black Sharpie, “Take half a pill twice a day.” That had been the dosage given to me by Dr. Dover.

I decided to take half a pill once a day since my symptoms weren’t severe. Someone who’d responded to my first blog post said that’s what they took when they were mountain climbing and they were the only person on their expedition who didn’t get sick. I know that taking advice from someone who responded to a blog post probably wasn’t a good idea, but I decided to try half a pill once a day and see what happened. I wanted to be sure I didn’t have any trouble with the medication before I commited to it fully.

I rarely feel the impact of any medicines. I figured I’d be fine, but I didn’t want to take any chances.

Fortunately, I’d brought a pill cutter with me, also in the bottom of my suitcase.

I opened the ridiculously large prescription bottle to take my first half pill. And inside were only 7 tablets. 7 Tablets? By Dr. Dover’s instructions, that would only last three and a half days.

I still had two more weeks here. The last five would be in the Amazon and altitude wouldn’t be a problem there. By taking half a pill a day, I could stretch my se out for a week—it would run out just about the time we reached Cusco and 11,000 feet–the place where my head felt like it was being squeezed in a vise. Why did I only have seven pills? Had the pharmacist been chintzy? Made a mistake?

I went through the notes I’d taken in Dr. Dover’s office the day Karyn and I went to get our yellow fever vaccine for the Amazon, last July. I’d scrawled on the back of one of his information sheets, “Take Diamox the day before going up to Cusco, just for a few days.” That’s why there were only seven pills. I was only going to be in Cusco for three days. One the night before, and one morning and night while I was there.

But I was having symptoms now. Perhaps someone else in our traveling community would have a prescription they weren’t using. Maybe I could find enough pills to last me all the way through Cusco. Ours was a very generous community. Three days into our trip, there are still two people with lost luggage. Yesterday, I ended writing group early and asked each of these travelers what they needed. The group offered socks, deodorant, a tee shirt, sunscreen, an extra pair of hiking boots, even underwear. This was a very generous group—in a short time, we’d already gelled as a community. People were definitely looking out for each other. Probably someone would have some extra pills.

I cut my first pill in half with my handy-dandy pill cutter and downed it with some water. I woke up with a dry mouth and no headache. I’ll let you know how it goes from here.

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