Wednesday, July 24, 2019

Yes, There's an App for that

They were prompt at the travel medical clinic so I did not have to wait. I sat down with the nurse and handed her my immunization record I had gotten from DHEC. She compared it to the rest of information I had submitted online. Certainly this was going to be quick and simple, I thought, after all we had to go through getting ready for Ecuador.  She looked up. "OK, you have had your Hep-A and Hep-B, so you only need the second doses of those."

"Second doses?" I asked.

"Yes, they are 2 part immunizations." She looked down again. "But, your Tetanus, Tdap, and MMR are up-to-date. This doesn't show polio? Have you have your polio immunization?"

I laughed, "Yep, when I was 4 or 5 on a sugar cube."

"Well, you need a booster - a Polio shot."

"OK," I said wondering what had happened to the sugar cube.

"And, Typhoid, I don't see that on your record."

I was clueless. I could not tell you whether I had had Typhoid or Bungee Bungee or Jungle Fever. It was all Greek to me. "If it's not on that record," I said, "My guess is that I haven't had it."

She laughed and continued down the list, "Yellow Fever? It says you have had it. Does your yellow card show that?"

"What yellow card?"

She looked a bit perplexed. "The yellow card that stays with your resume. You know, the official record of all your immunizations."

I briefly remembered a yellow card but several weeks ago when I last used my passport, I knew it wasn't with it. Dear God, there had been at least 3 moves since I had last seen that piece of paper. Optimistically, I said, "I'm sure I have it somewhere."

"Well yellow fever is different from most vaccinations, the vaccination has to be verified by the provider before it can 'officially' be added to your yellow card." She smiled, "Well, just staple your old yellow card to the new one I will give you today."

"I know I have had that shot because we had an issue finding the vaccine and finally ended up in Columbia before we did."

"Perhaps we should make an appointment for next week. If you cannot find your initial yellow card, then you can get the vaccine then."

"That sounds good." Finding the yellow card or not, I had no intention of getting that shot again. I knew I had already had it, yellow card or not. But to humor the nurse, I made an appointment for the following week.

She printed off a sheet of paper and handed it to me. "I just want to review what vaccines you are going to get today and have you sign this before we proceed."

I looked at the list which was longer than I thought. In addition to the vaccinations we had discussed, she had added a Malaria Rx and a round of Typhoid medication. But it was the bottom line that caught my attention. "Good grief, this is going to cost me as much  one leg of my airfare for this trip."

"I'm not surprised. Oh, and, that total does not include the cost of your Malaria prescription."

I signed the paper, the nurse pulled out the vials of medications and needles, and we proceeded. When that was finished, she handed me a small plastic bag.

"This is your Typhoid medication. It is very important that you carefully follow the dosing instructions. You need to take 1 capsule every other night for 8 days. You need to take it exactly 1 hour after you have eaten and at the exact same time each night." She handed me a chart. "This will help you keep up with your dosing. Or, there is an app for your phone that will remind you when you need to stop eating and when to take your medication."

"Okay," I said.

"It comes with a cold pack since it is a live virus. Don't let it get above 47 degrees."

Then she carefully filled out a yellow card, listing each immunization on a separate line, which she then signed her name beside each and gave it an official stamp. "I'm going to list that you have had the yellow fever vaccine, but because we didn't administer it, I cannot sign or stamp it to make it official."

So I left their office with a bag containing a travel booklet on Brazil, the temperamental Typhoid medication, and a new precious yellow card.

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