let's do some shots!

DISCLAIMER: some of the links herein and after are not for the squeamish.

There is this eerie moniker in the infectious diseases field called, "Sub-Saharan Africa," and that is precisely where I am headed.  There are all sorts of crazy tropical illnesses in addition to things like malaria that we Ohioans don't have to deal with.  Thankfully, the magnificent folks over at the CDC provide country specific, "Health Information," pages.  Put another way, I'm trading lions, tigers, and bears for nematodes, protozoa, and flies, oh my!

There are many precautions and preventative measures that one should undertake before a trip to Sub-Saharan Africa.  Thanks to the international community in Columbus and the global reach of the University, I had no issue scheduling a travel health appointment.

So on December 11th, I trudged over to the Student Health Center for my tune-up.  I woke up a little late that morning and had woefully overestimated the temperature; making for a flustered, cold Zach on arrival.  I settled in the waiting room and undertook normal actions: people watching, casually eavesdropping, and reading outdated magazines.  As I was now contemplating what this appointment would entail, the ladies at a nearby nurses' station started to discuss how much they are attracted to Pitbull.  As someone who considers Don Draper central to my self-image, I have some especially serious disdain for the poor grammar cows of Chick-fil-A and everything that is Pitbull.  So flustered, cold, waiting Zach is now officially on tilt and frustrated with the world that this, "artist," has enamored fans...but I digress.  Soon enough, thankfully, my name was called and I was off to the exam room.

I found myself in a standard examination room with a genial, middle-aged nurse practitioner with curly hair named Sandra.  We reviewed my medical history and medication list.  I received a cursory physical exam.  This was all well and fine but we were skirting around the crux of this whole deal: HIV and vaccines.

HIV/AIDS is a very real concern in Angola.  Estimates of HIV infection rates range from 1.6% to 9.4% of the population (c.f. 0.3-1.1% in the USA).  Working as I will in an environment prone to contact with body fluids and blood, it will be as important as ever to take proper precautions.  In the event that I am exposed to the human immunodeficiency virus, I left my appointment with a prescription for a, "HIV PEP Kit."  This Post-Exposure Prophylaxis Kit is a 7-day course of HIV medication that attempts to prevent infection after exposure.  As if this isn't crazy enough, if I am indeed exposed I have to get back to the U.S. to continue medication within those seven days!  I promise to wear gloves and avoid needle sticks...

Does anyone actually know the answer to, "when was your least tetanus shot?"  I had performed the always onerous task of assembling my vaccination record from PDF's on my computer, tattered cards initialed in 2005 documenting something or other, and a printout from the College of Medicine.  Wading through this mire it emerged that I was due for four vaccines: yellow fever, hepatitis A, typhoid, and polio.  That's three shots and a set of pills folks.  I decided that I was not interested in coma, death, delirium, diarrhea, and/or paralysis and so agreed to treatment.

Sandra thanked me for my cooperation and wished me well on my trip.  I was then led down the hall by the incredibly bubbly Lisa who was to poke me with needles.  Lisa was hilarious and of recent African descent herself.  She had lots of questions and was just a genuinely great person.  In my rush to make it to the appointment, I had skipped breakfast.  This terrified Lisa.  She claimed to have had many patients pass out after receiving the hepatitis A vaccine and so insisted that I lie down on a gurney in order to receive safely.  I obliged but was taken aback when she proceeded to put me in DEEP Trendelenburg position.  Two shots to my right arm and one to left.  I felt totally fine and found it a little funnier than Lisa when I feigned weakness on standing.  With that, I was free to go: prescriptions in hand, shots in arms, and Pitbull still spewing some rage in my head.

Fast forward a couple weeks as I am now sitting at the kitchen counter in good old Lima.  Thanks to the Affordable Care Act and the fact that I have not yet turned 26, I now set out to fill the prescriptions on the parental insurance plan.  For those that have, "jobs," and, "benefits," please know this is a FANTASTIC feeling.  So I call up Medical Mutual and price them as follows:

Vivotif $46.86 (typhoid vaccine)

Kaletra $753.33 (HIV medicine)

Combivir $218.92 (HIV medicine)

procholperazine $1.77 (anti-nausea)

I do not exactly have $1,020.88 sitting around.  Congratulations to the family on having met our deductible for the year and to me for not procrastinating any longer than December 27th because I paid a grand total of $0.

There you have it!  I am vaccinated, medicated, and prepped to face all the germs that Angola might care to share.