Please do not skip your anti-malarials

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Sep 16th, 2005, 09:59 AM
  #21
 
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Kavey, our best wishes for your dad's speedy recovery.

Celia & Jim
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Sep 16th, 2005, 01:59 PM
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Thank you so much for the well wishes.
He has vivax strain but is not yet responding to treatment as expected. Complicated by some related problems with leaky/ overfluided lungs which are quite serious. Your thoughts are much appreciated.
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Sep 16th, 2005, 02:40 PM
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Kavey:

So sorry to hear about your father. I'm sure he will do well in time.

Sandi and Sundowner - from what I understand you don't take the same medication in higher doses but another medication. When Lariam was the only antimalarial prophylaxis, treatment for malaria was done with Malarone. If you read the blurb that comes with Malarone, it states you can't be treated for active malaria with it if you have taken it to prevent malaria. Treatment would probably be done with Fansidar or another medication.

Hope this helps.

Jan
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Sep 16th, 2005, 03:28 PM
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Kavey,
I'm sorry about your Dad contracting malaria. I hope he'll be better soon. My brother lived in Zimbabwe for 10 years and did take the anti-malaria medications for a while, then stopped. Of course he came down with malaria, although my sister-in-law didn't. I guess that one mosquito found him first.

My husband and I are spending 2 weeks in South Africa in October, traveling mostly by car from Joburg to Cape Town. Our primary physician here in the US didn't think the anti-malaria drugs were necessary (but I don't think he's ever been to the tropics). We took Lariam on trips to Zim and Mozambique a few years ago - no problems. In the 60's we lived in Liberia (it was nice then) and took Cloroquinine (I think that's the way it was spelled). No probems then too in 3 1/2 years. A friend didn't like taking any medications and she came down with malaria shortly after her baby was born. So it all points to prevention rather than chance.

The best for you and your father.
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Sep 16th, 2005, 04:12 PM
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The problem with many physicians in the states, they don't know anything more about malaria then what comes out of a book. They don't have a lot of call to diagnose and treat malaria. So you need to talk to a travel physician who is familiar with tropical diseases and the various medications. Even then , none are 100% effective.

treasuresofafrica
When you go from Capetown to Joburg. Do you go thru Kwa Zulu Natal. Mosquito control has gone by the wayside in most areas for other projects, so malaria is getting to be a problem again there.Its actually spreading. Not enough funding.

When you go to Africa, you talk to a expert on Africa. When you get antimalarials....? Fortunately, most of us travel during the dry season and in areas where its not a major problem.

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Sep 16th, 2005, 07:15 PM
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Just adding my best wishes for your father's recovery, Kavey. I feel foolish for stopping my malaria meds during the last safari and will certainly take this as a cautionary tale. Thank you for sharing.
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Sep 16th, 2005, 08:49 PM
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Sending healthy thoughts your way...hope your Dad is on the mend.

Brenda
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Sep 17th, 2005, 01:42 AM
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Thanks again... this morning's report is that the feeding line has restored a little of his strength. In terms of the malaria cycle today's meant to be a bad day, though yesterday was meant to be a good day and wasn't but I'm hoping today will be better than the last couple of days anyway.

I think there are so many myths out there about anti-malarial drugs. On one board I've had two peoplen suggest that they have been told, in one case by doctors, that the drugs don't prevent malaria (to any capacity at all) but mask the symptoms and make diagnosis difficult. From my understanding this is only true in cases where individuals fail to take the drugs regularly (missing doses because they forget) - in those cases they aren't properly covered so can catch malaria but are still on the drug so it may well be masked somehow.

Here, GPs that offer travel advice are able to get a regularly updated poster chart (and now also get the information via computers aswell) that shows not only countries but regions of countries and lists whether anti-malarial drugs need to be taken and which types are effective against the prevalent strains.

Make sure your prescribing doctor does have an updated copy of this information, it's readily available to GPs if they ask for it.
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Sep 17th, 2005, 02:19 AM
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Hello,

Another dangerous myth is that 'natural' supplements work just as well as the anti-malarial drugs. This may appeal to people who don't like drugs, but is a dangerous gamble which is not worth the risk. None of the 'natural' options have undergone the strict evaluation required of prescription drugs to evaluate their efficacy and side effects -- don't take chances with your health!

BTW, here in Oxford researchers are trialling a malaria vaccine. Touch wood for good results!

Cheers,
Julian
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Sep 17th, 2005, 11:51 AM
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Thanks folks.

Today was definitely better than last few days - he seems to be a touch more positive in attitude again and looking a touch more lively. He's still using a special oxygen mask and has various lines going in through his neck now rather than arm and a few other things that I don't want to get into. But the lungs have cleared up somewhat so he's breathing a touch easier. He didn't need the heated oxygen today, just regular stuff.

Whilst I was there during the afternoon the doctor in charge said that they'd decided instead of the feeding tube to try high calorie liquid drinks instead and Pop managed an entire one so that's good news.

Also the doctor suggested that the malaria should now be almost gone so it's now about dealing with the secondary stuff - breathing, lungs, strength etc. He also said he envisaged Pop being in hospital another 5 days or so - which doesn't seem so bad and seems a very positive thing to say - and he's a very considered and careful man - not one to throw out false hope. Anyway, Pop is still feeling utterly drained and having breathing trouble etc but seems to be looking forward towards recovery now.

I'll be back there tomorrow morning. Today I've been able to stop worrying about the possibility of the worst case scenario, and I can tell the doctors have too - there is a definite change in their attitude.
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Sep 17th, 2005, 12:02 PM
  #31
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Glad to hear about your father's progress--continued well wishes.
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Sep 17th, 2005, 12:59 PM
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Thanks Bat, and everyone, your good wishes are appreciated.

Can I also add that my dad, though in his early 60s and with BP problems and one specific, but treated heart problem, is not unfit in the slightest. He works out at the gym for an hour 5 times a week and is as fit as many men decades younger than him. He has high stamina too.

This malaria thing is scary wicked stuff.
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Sep 17th, 2005, 01:36 PM
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Glad to hear he is doing better.

Y'all have been in our prayers
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Sep 17th, 2005, 02:05 PM
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Hi Kavey
I have been in contact with some medical researchers in tropical diseases over the past couple years. After the malaria has been adequately treated, ask the doctors about erythropoietin treatment for your father. It should remarkably speed up the recovery. It has been demonstrated with patients in the past. I should also say it will add to the cost. The malaria parasites will have destroyed a significant number of red blood cells causing acute anemia. With erythropoietin, it will speed up the red cell production. The drug was initially aimed at cancer I think, and is finding uses today for other diseases like in AIDS and Malaria recovery.
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Sep 18th, 2005, 06:26 AM
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I'll mention it but he's in the infectious diseases unit at the London Royal Free Hospital so I'm fairly confident they know about best and latest treatment.

I do appreciate your advice and thoughts though.

I just got back from today's visit, I was only there for 4 hours today.

They didn't put any calories down the feedtube in the end as he's been able to take down some of their high calorie drinks instead - 1 yesterday and 2 today so far. They still have fluids going in but may remove those tomorrow.

My husband took mum to Luton when he dropped me off at 10.30 and she's aiming to go back this evening so will get a proper break. I just got home, my sister is there now instead.

Whilst I was there today they removed a few lines, removed the oxygen mask for the little tube that has bits into the nostrils (more comfy and less oxygen supplied too), checked his chest and said there was less cracks (or something like that - basically, it's cleared up a great deal) and also said the malaria is definitely being eradicated.

We asked the head honcho guy about the disease and he said there were 4 types of malaria; one malignant and 3 others of which vivax, which he has, is one. I asked, in shock, if the malignant one is even worse than this has been and they opened their eyes wide and said no, no, no, not at all. Usually the three non-maligant strains (including vivax) don't present like this at all and they usually see the patients as outpatients only; it's not usually this severe. My dad has been presenting atypically for vivax, which none of them has ever seen before, and has been presenting more like the malignant strain, but they know he definitely has vivax.

Anyway, further down the line they will give drugs to make sure it doesn't hide in the liver, which malaria can often do, and therefore prevent a recurrence in the future.

He's looking a little less exhausted and a little more himself today which is great!
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Sep 18th, 2005, 06:31 AM
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It's good to hear he's doing better. Thanks for the updates, Kavey.
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Sep 18th, 2005, 09:23 AM
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Hi Kavey,

Glad to hear your dad's doing better. I'm sure he's in good hands.

Cheers,
Julian
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Sep 18th, 2005, 12:36 PM
  #38
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Jan -

First thanks for reminding me about Fansidar... My response actually referred to Lariam, not Malarone.

In the case of two friends who came down with malaria years back had been taking quinine (that's way way back, or Lariam and were treated with heavy doses of "hair of the dog" as they say, and eventually, though with a few recurrences finally got the bug out of their systems. And a few folks we've met in Kenya had been treated with Chinese herbs and were fine in no time. So in all these cases, whichever protocol was used, seemed to work.

However, re your comment:

>>When Lariam was the only antimalarial prophylaxis, treatment for malaria was done with Malarone.<<

How could Malarone be used as a treatment, if Lariam was the only antimalaria med? I know Malarone hadn't become available (read: approved by the FDA) in the States till about 2000 or 2001... though earlier in Europe. But how much earlier to have been used to counteract Lariam/malaria? Lariam has been around/available/used way longer then Malarone's existence.

Kavey -

Glad to hear that your dad is doing better and in good hands. This incident is a good lesson/reminder for all. Though malaria meds are no assurance against getting malaria - which can remain in the body up to three years before presenting itself - should malaria occur, it's supposed to be a mild case. Yeh! Apparently not, as rare strains appear. None of us can be so cavalier to assume "not me." An inoculation can't come soon enough; even these are still only about 98% effective.

 
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Sep 18th, 2005, 01:08 PM
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Kavey, I too, am so glad to hear about your dad. But wow, he's really had a nasty time of it. I was asking Julian the other day about malaria meds, because I really hate taking drugs. I guess I won't be second-guessing this one.

Best wishes,
Sharon
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Sep 18th, 2005, 06:18 PM
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sandi:

I'm not sure of the exact dates, but I know prior to my 2001 trip Lariam was being used as a prophylaxis along with doxycycline, with Malarone only for treatment of malaria. It had not yet been approved for prophylaxis by the FDA. However if you are taking Malarone and get malaria, you have to be treated with another antimalarial drug and not Malarone. Perhaps that has now changed, but the last blurb I read with my medication indicated this.

I have asked some friends in Kenya in the travel industry (and better off than most) what they do to prevent malaria. They said nothing, they just figure about once every four years they will get it and as soon as they get a headache or neck pain they go to the doctors and get medication to treat it. After about three days they are back to normal.

I am one of the few people that goes against medical advice and don't take my antimalarial (and I work in a hospital - shame on me!). I know I am taking some risk. I take my Malarone with me just in case. However, during my eight trips I have always traveled during the dry season and I have never seen a mosquito or been bitten by any bug in Kenya. Were I to go in the rainy season I would definitely take it, and use lots of Ultrathon and spray also. Perhaps I am pushing my luck, but working in a hospital and seeing the numbers of medications people take, some unncessarily, I don't take anything unless I absolutely have to.

Jsn
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