Thursday, June 23, 2011


A couple of days ago (Thursday), I started my day off by getting four shots, two in each upper arm, way up into the shoulder, really. I actually had no anxiety about them, I only wanted to do what was right and healthy and I knew that whatever pain that might have been involved would only be momentary.

I was impressed by the operation of the place where I went, called "Passport Health". From my observations, it looked like a group of doctors, or maybe only one cleverly entrepreneurial doctor, alone, came up with this brilliant idea of creating a practice specializing in inoculations, mostly for travel, but a person could get there any kind of vaccination or required or recommended shot--flu shot, TB tests, children's required vaccinations prior to going to school, and so on. They, or the one doctor, had tiny little offices all over the city and wherever you lived, you would be able to find a location that was convenient to you. Not every location is open every day; the one where I went was open only two days a week. I presume that when they have busier seasons (peak travel seasons, school-starting, flu season, etc.), they may be open more frequently. The only people there this morning at the time of my appointment were me and the nurse who gave me the shots, which gave me the idea that all these satellite offices are controlled from one central office, so only a nurse to give the shots needs be in each location.

The office was decorated in a "travel" style that appealed to me; various travel posters for exotic locations, and native crafts and artifacts such as African masks or other carvings decorating the walls. In the office, which was also the injection room, there was a huge and very detailed map of the world that covered one whole wall and a third of each wall that was next to that one wall, so it was almost like a 180-degree map. I had a similar map in my bedroom growing up, which maybe helped feed my love for travel.

The nurse had for me an entire booklet custom-made for this particular trip with my name printed on the cover; a complete description of every kind of vaccination in general (what they were for, how they worked, under what circumstances you might need them, the recommended frequency of getting them, their side effects, what the diseases were like that they were to protect you from, and by what method you might happen to get those diseases (oral/fecal, body fluids, respiratory droplets, sewage, bad water, mosquitos, rabid animals, and so on). Then there was a section on Palau, where I was going, where there was even greater detail on the diseases that people get there and what inoculations were recommended for travelers going there. All this was very comprehensive and educational and useful beyond just the immediate travel needs.

Interestingly, some diseases that are "gone" in the U.S. are very much alive and quite dangerous in some other countries, such as ones that anyone my age already has an immunity to, polio, chicken pox, mumps, measles, German measles, and small pox. Based on my age, alone, the nurse knew that by law I already had had all the polio shots and a small pox vaccination, and regarding chicken pox, mumps, measles, and German measles, she asked me if I had had those in childhood (yes, I had) and therefore I was immune to them for my lifetime. I remember that in my childhood days, mothers would rush to GIVE their children those diseases when they heard that a neighbor child had any of them, because then their own children would henceforth be immune for the rest of their lifetime. Now, though, they have vaccines for children, so few of them ever have to have those disease, even the first time.

They did list one vaccination I had never heard of, one recommended for older adults to protect them from shingles. Apparently having had chicken pox does not make one immune from shingles, and the booklet said that 50% of people living up to age 85 get the disease. Really? Half? I had always considered it a rare but horrible event, but maybe as more and more peers become elderly, I will be hearing more about it. I now think I ought to consider getting this vaccination.

It's interesting that the prime time for getting vaccines is when you are very young and then when you are elderly. The very young makes sense in that if you are going to obtain a lifetime immunity, then the earlier the better. Vaccines for the elderly seem to be for diseases that occur more frequently when people are more susceptible to sickness as a whole.

So the shots I received were Hepatitis A, Hepatitis B, Typhoid, and the Tetanus, Diptheria, Pertussis booster that I was due for. The nurse told me that if I "didn't like needles," there was an option of getting both the Hepatitis A and Hepatitis B in the same injection, but that option cost $80.00 more. I surprised myself by saying, "No, thank you, I'll save the money and get the separate shots." And once I saw the final total for everything ($420, and none of it is covered by insurance), I was glad that I hadn't let it elevate to $500!

Whatever pain there was, 95% of it was the effect of the medication in my arm, not the needle sticks, which truly were very minor and one of them, I think it was the booster, had NO feeling of stick at all. And those that I did feel were injected so quickly that it was more like the in and outs of the needles was like your finger passing through a candle flame, too fast for the nerves to even register.

The soreness in my two shoulders, though, which continued to build up as the day continued (and I could still feel it long into the evening)...well, let's just say that I wasn't going to be doing any push-ups that night!

Due to having had these shots, I did feel out of sorts and maybe "put upon" that whole day at work. I would have been much happier just this once being left alone by all the cockroaches who continually make demands on me. It might have been better if I could have had a restfully productive day at work (which mostly means "no interruptions" and "no additional problems"), or else be able to go home early and just get into bed and read, but, no, there was no rest for the weary.

This inoculation office had "everything" to do with travel; they sold mosquito repellant (which I bought, as there were several mosquito-borne disease possibilities in the jungles of Palau for which there is no vaccine) and money belts and water purifiers and electric plug converters and any other thing a traveler could think of. They even would help you get your passport renewed or sell you temporary medical insurance for your trip. As I said, that doctor (I am pretty sure there is only one) was quite an entrepreneur, and I respect her cleverness.

I added to the mix a "diarrhea kit" that they put together all in a nice plastic carrying case, consisting of hygienic cleansing towelettes, oral rehydration salts, anti-diarrheal tablets, and six azithromycin pills prescribed by this one MD (a female). According to the booklet they gave me, if there is a chance of getting diarrhea due to a location you travel to, 50% of the travelers will get it. And just the misery of diarrhea when you are in a strange place can ruin the trip you paid thousands of dollars for.

While I was very happy to have completed this task, as I said a few paragraphs prior, I was not in a good mood at work afterwards, where it sometimes takes super-human patience to endure. So, my resistance was down. Yes, I have a "good job". The setting is wonderful, the co-workers are nice, the work isn't picking cotton or screwing on hubcaps in an assembly line or slaughtering animals in an abbattoire or rotting in a war zone somewhere. I have it quite nice, actually, but the ever-increasing workload, the constant problems flying in like a cloud of locusts from all directions, the ever-squeezing interference of government regulations and demanded compliance with draconian procedures, and due to all this, the resultant inability to meet ones own good standards anymore, is very wearing. I find myself experiencing something that I had never before experienced in my life, and that is that my brain just shuts down--it gets paralyzed. It is as if I am computer and too many concurrent operations have used up all of my RAM. It's peculiar to feel it and when I get into that "no more RAM" state and then one more demand gets put on me, I get angry. We continue to hear of the dangers of social unrest in America (which has actually already been happening in some cities) and I think anger and then physical violence results when people no longer feel that they have any other option; the threats against them become too much to bear. That "no more RAM" state is, for me, like being forced into a corner with no avenue of escape. Maybe that is another reason why I am looking forward to this trip so much; it, at least, for a brief while, WILL be an escape, and my very emotional survival depends upon it.

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