fresh fruit and veggies

Jan 21st, 2007, 09:50 PM
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fresh fruit and veggies

My Dr told me not to eat any fresh fruit or veggies (that's all I live on) that haven't been soaked for 20 minutes in iodine.He told me I'll be sorry if I do but I say why bother to go at all! I do know that my son was very ill in Mexico just with ice in his coke one time.
I want to drink cocnut milk lemongrass juice, and naam grachieb and the fantastic Thai salads...Do you all take preventative antibiotics? Or should I take a probiotic...?or just have cast iron stomachs
hypatia is offline  
Jan 21st, 2007, 10:16 PM
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To me your doctor sounds a bit over the top.

We have gone from being super careful to what many would call negligent. In our days of being careful, we suffered many stomach upsets, and all had Hep A in spite of the vaccine. At that time, we made it a rule to eat only piping hot food from reputable restaurants or packaged prepared things like yogurts that we bought in the supermarket. That approach didn't keep us healthy and we missed out on trying lots of things we wanted to.

Last year in Thailand, we decided to throw caution to the wind and eat whatever we wanted and to use our heads in making choices. We ate raw veggies, river fish, salad, street food...I wasn't sick, my husband was slightly sick, and my daughter was very sick...but the sickness was likely NOT from a food source but rather from a river they both swam in with elephants...and I did not.

We have all decided that using common sense works for us...we wouldn't eat fruit cut with a nasty looking knife on a disgusting board, wouldn't eat a portion of previously prepared food that is left to sit out as portions are sold, wouldn't eat fruit that spent the day in the sun, shied away from the delicious looking strawberries at Doi Suthep in CM because I saw the nasty bucket of water they rinsed the berries and spoons in...

The sickest I've been has been in Japan, where I have been hospitalized twice for food poisoning...and Japan is "hygenic". Once we ate at an Outback Steakhouse in BKK and I was very, very sick on the plane back to that case it was either the Outback Steakhouse or the Peninsula hotel, as we didn't eat anywhere else. So, you can never tell what is going to get you.
KimJapan is offline  
Jan 21st, 2007, 10:30 PM
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YOU CANNOT TAKE ANTIBIOTICS "PREVENTATIVELY", that is, you have to take them to attack the specific bacteria which you already have, otherwise they do no good. You have no idea of what microbe may be lurking in any vegetable, so taking even a broad spectrum antibiotic won't necessary kill it. Any doctor who will prescribe an antibiotic as a preventative measure is not doing you any favors. He may in fact be doing you harm, as it will kill off all the “good” bacteria in your gut which you need for digestion and to help fight infection too. He certainly is helping to contribute to the resistance of bugs to antibiotics. Get another doctor. (Some doctors here in Hong Kong prescribe antibiotics for colds; this drives me crazy and personally I think they should lose their license for this. The pharmacies are all in doctor’s offices so they make a fee on the prescription as well as the visit. But people want a pill and they are actually foolish enough to think that the pill is working.)

Yes, your son may have certainly gotten ill from ice in coke. Bacteria can grow in ice, and is in fact a huge problem; I am kind of surprised that you would not know this. A “preventative” antibiotic would not have prevented this, as it may not have been the correct antibiotic for the bacteria which was in the ice. It is not really a good idea to have ice in countries where you aren’t sure of the water supply. I am sure he wasn’t drinking anything but bottled water; so ice is the same thing.

You doctor may have been referring to FRESH fruits and vegetables. IMO you would not have an issue with cooked vegetables or with fruits which have a skin and have been peeled. I know many, if not all, people on this site have been to Thailand, but I don’t think too many people on this site have gotten ill. A mild stomach upset may have occurred, but that can happen from differences in food and water (or from spicy food) as much as from tainted food. I would of course be careful: no water from the tap, I would avoid salads and uncooked vegetables. I personally eat fresh fruits in Thailand, but you might want to limit those to fruits which have a heavier peel and which you have peeled yourself. There is no way that you are going to know that a fruit or vegetable has been soaked in iodine for 20 minutes unless you have seen it for yourself.

If you want to take a probiotic, that is certainly a natural way to help yourself and not do any harm, and it is much, much better than taking an antibiotic when you don’t have any actual sickness and killing off all the good bacteria in your gut which could help you when you are sick....

Cicerone is offline  
Jan 21st, 2007, 10:46 PM
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my brother worked in a restaurant and oftened told us that we would be disgusted to see how food was yes I agree.
But how in the world did you get hepA despite the vaccine? I got the typhoid shot last week and my arm hurt so bad I had to take a painkiller and put a heating pad on it for 3 hours.
I think if you've ever been really sick you are more likely to be careful.Just need some strategies
hypatia is offline  
Jan 21st, 2007, 10:50 PM
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No vaccine is 100% effective, and we had only had 2 of the 3 shots in the series at the time, meaning our immunity was less than optimal. Hep A is quite easy to get...anywhere.

Cicerone is quite right about the antibiotics. They are not preventative medicine.

KimJapan is offline  
Jan 21st, 2007, 11:09 PM
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no actually my Dr did not recommend antibiotics fact there are some I cannot take anyway..I am actually against them and won't take them for sinus infection.
yes Cicerone...I really knew better but was jetlagged and ordered a coke(should have said sin hielo) but before I knew it he had sipped half of it..All it takes is one time forgetting.I was thinking about getting some XIFAXAN just in case.
So the iced drinks are out..Thai iced tea and the green onions and bean sprouts on Phad in the world can you not aviod eating some fresh vegetables?
hypatia is offline  
Jan 22nd, 2007, 12:20 AM
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I too think your doc is a little too over cautious.Preventive medication with the use of antibiotics is not advisable.Specific antibiotic is prescribed for a specific illness.Its better to carry prescribed antibiotics,'just in case'.
Cut fruits and veggie is best eaten in upscale restaurants ( make sure its washed with water if possible)if that could bring peace of mind.There is an element of risk involved in travelling & the single biggest risk would be from water(or ice) than food.Take the basic precautions & enjoy your holiday.
harsha is offline  
Jan 22nd, 2007, 01:02 AM
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harsha, how do you carry pre-prescribed antibiotics "just in case"? The only way to know the correct antibiotic to take is to take a stool sample (or throat swab, etc), culture it, and then you would know the precise bacteria you are dealing with. Otherwise you are potentially taking the wrong medication and not doing yourself any good. A doctor who would prescribe antibiotics without doing the proper testing either just wants to get you out of his/her office because he/she thinks you are a hypocondriac or he/she is incompetent. In either case, that doctor has no concern for your health. Get another doctor. It is irresponsible doctors like that that are contributing to the resistent strains of infection.

It is a good idea to travel with something like Immodium for diarea which you can take to relieve symptoms, and then get an antibiotic if you really really feel you need one and you don't feel better after a few days. Your body can usually repair itself fine with rest, fluids and some immodium or simiarl anti-diarrea medicine.

There are very, very limited cases where pre-prescribed antiobiotics are appropriate, like for heart patients and for dental work for some immune supressed patients. They are NOT appropriate for travelers who may pick up things like Ghiardia, a fairly common parasiste here for which a very specific antiobitic is required to kill the bacteria.
Cicerone is offline  
Jan 22nd, 2007, 01:50 AM
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In Thailand, ice is factory made from purified water for use in drinks. You can identify it because it has a hole in it, looks like a cylinder. Shaved or crushed ice might be questionable, as it might come off of a block that wasn't intended for consumption, but the cylinder tubes you get pretty much everywhere are just fine. As far as fruit and raw veggies go, we had more trouble when we avoided them, so now we eat them. We do tend to eat them in the more upscale places though, and when eating street food, eat only the freshly prepared hot food.

If you are sick in the vomiting, diahrrea, fever kind of way, see a doctor, who will give you a broad spectrum antibiotic. They may or may not take a culture...but in any case, that culture takes time, and doctors don't withhold treatment waiting for the culture. They can get a pretty good idea of what kind of infection you've got based on your symptoms, how they presented, and bloodwork (which takes about 1 hour to process and most of the time allows doctors to know if your infection is viral, bacterial or other). You will always be told to come back if your condition worsens or fails to improve in 24 hours (meaning the antibiotic isn't working) and you will always be told to take all of the medication even if you feel completely recovered.

I would say don't worry yourself sick over this or you will never enjoy a meal. Eat, drink with reasonable caution...but try to maintain can get sick anywhere, even at home. .
KimJapan is offline  
Jan 22nd, 2007, 03:40 AM
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You can use ice at any of the upscale hotels or restaurants. It's from purified water.

At good restaurants, the salads are most probably OK. We always have Pomelo salad. Also, if your hotel has a breakfast buffet, the fresh fruit section is probably safe. In fact it's one of the joys of Thailand.

We've eaten everything in our 5 trips and never had a problem. This is true even though Beth has a sensitive tummy.

Remember, Thailand's tourist trade is a significant part of their economy. They can't have Farangs getting sick on a regular basis.
Gpanda is offline  
Jan 22nd, 2007, 07:57 AM
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We always bring antibiotics with us on trips just in case (have only had to use them once) Travel doctor should know the best one to prescribe.

We do eat fresh fruit/veggies, but with caution. (In India we were really careful, in Thailand much less so and in Cambodia I got sick for the first time from food - jackfruit from a local market was the culprit.)

I took probiotics for a month before our trip, which many say helps your body cope when traveling. I'm not sure if it helped or not, but I think it's still worth trying
zoomoozophone is offline  
Jan 22nd, 2007, 09:05 AM
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Has your doctor ever traveled???

You should know what routine food and water precautions are so that you make conscious choices about what kinds of risks to take.

In Thailand, I have ice that is commercially made (cylindrical with a hole in the middle)as I know it is made with purified water. I do eat lots of fresh fruits (buy them whole and peel them, often your hotel may furnish you with a basket of fresh fruit), I eat salads and vegetables at places I feel confident of (my hotel, restaurants I frequent). I DO NOT buy the peeled fruits in the plastic bags as I know people who have gotten sick from those.

While some people swear by probiotics, the research on them indicates that they do nothing to prevent stomach problems, but they do help you recover faster from them.

I have to say that in 20+ years of going to Thailand, I've never gotten sick. If in doubt about something, don't eat it. Take it slow - often initial stomach upsets are caused by change in time zones, unfamiliar spices, more fruit than usual, etc.

I do always carry immodium and an antibiotic (Cicerone, it is typical for a travel med doc to provide an antibiotic "just in case" The person should have explicit instruction about when/if to use it).
Kathie is offline  
Jan 22nd, 2007, 07:36 PM
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Thank you so much ...the Dr was the health dept guy who is in the immunization clinic...I'm going to ask my gastro guy he's from Nigeria...

Can I drink the milk out of a coconut? do the hotels serve the naam grachieb??

Kim hope you are right and I will look for the hole!.Cicerone a wealth of info and I will ask for a stool or at least a blood test at the hospital ..Kathie I feel a little more reassured.The rest was good advice.

Oh I forgot to mention I have IBS..back to Walmart for more poise pads..when I get back I will do a trip report of the area's hospitals and sevices....boy I hope I'm joking!!
hypatia is offline  
Jan 22nd, 2007, 07:45 PM
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Fresh milk out of the coconut should be fine. (Just note how it has been opened)

With IBS, I'm sure you'll have to be careful, but go slow and let your body tell you what is ok.

If you do get sick, the best hospital in Bangkok is Bumrumgrad. The prices are very reasonable and the care is excellent.
Kathie is offline  
Jan 22nd, 2007, 09:17 PM
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One tip our travel clinic nurse offered was to pack some powdered Gatorade or the equivalent, in order to have a way to replace electrolytes if you do get significant diarrhea. That said, in Bangkok we ate fresh salads and fruits without peels in hotels and restaurants without any problem.
lskohn is offline  
Jan 22nd, 2007, 09:29 PM
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there is only water in the coconut. The milk is made from mashing the meat of the coconut.

hawaiiantraveler is offline  
Jan 24th, 2007, 01:08 AM
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We are traveling to Bangkok, India and Nepal and our doctor recommended we take the Cholera vaccine... we checked and found cholera was no longer a real issue in these countries, BUT... our clever doctor told me to read further and sure enough it has been found that the vaccine - Dukoral - gives 85% protection against Ecoli! -We've decided to give it a shot and I'll report back if it works for us or not on our return. ha ha
Cosmo is offline  
Jan 24th, 2007, 02:35 AM
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We never had a problem with fresh foods in Vietnam and China, but I note you eat nothing but fresh fruits and vegetables, which is not a healthy diet and may have weakened your resistance.

Americans seem to have a need for ice in their drinks, but you may be able to overcome this. Cold beer is readily available throughout Asia. The idea of travelling around with a supply of antibiotics (or "probiotics", a term I'd never before heard) seems so ultra-cautious - I'm trying to be polite here - that I'm tempted to suggest just staying home. Seriously, I don't know how you can relax and enjoy a trip when you have to spend so much time worrying about what you ingest.

The only places I've been sick from food have been in my native Australia and the USA.
Neil_Oz is offline  
Jan 24th, 2007, 03:44 AM
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Enjoying local food is one of the great things about traveling. If you take medication like Dukoral you will at least get some sort of protection. I have bought lots of fruit in Thailand and Malaysia and some of them (like rambutan, mangosteen etc) are covered with a skin and you have to peel it before you eat it...hence it should be clean enough to eat. Thailand is used to tourists and in tourist places I think they make good food with clean water etc

Have a great trip and hope that you get to eat lots of great food

Gard - trip reports and pictures
gard is offline  
Jan 24th, 2007, 10:29 AM
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Neil...I must clarify..I will going on a company function.I choose to stay for Thailand and am motivated.I obviously won't stay home and wait to die..haha

I do have health issues (IBS and gerd and allergies to antibiotics etc)so I must be as careful as possible.Some people may say eat no fowl(Bird flu), pork(parasites), beef(mad cow)or fish (mercury), don't go around people (SARS),dont breathe (pollution),do go to the cities(bombs) don't fly, etc etc etc...
I have assessed the risks and I find the most danger to me personally realisticaly is gastro/intestinal...But if I go I cannot avoid every risk..

the Phrase "that's all I live on" means I eat a lot of that and try to go easy on the carbs...I eat all manner of protein!! not a vegan

"I don't know how you can relax and enjoy a trip when you have to spend so much time worrying about what you ingest" how true!! but thats my life!

Thanks Gard...I am going to take iodine and if I was tempted to try fruit( from the store) I would soak in iodine.
I would love to get the Dukoral but my health dept said it is not available yet here.
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