On Malarone

Another thing I should mention: the anti-malarial drug Malarone.

Mike and I are taking a daily Malarone pill to prevent malaria, since all of India is a malaria risk zone. There is nominally less malaria in the area around Bangalore than in both northern India and the more rural parts of India, but the prophylaxis was highly recommended, so we went ahead and got it.

I learned a lot about malaria while researching the various prevention drugs. Essentially, they work by keeping a constant level of malaria killing drug in your bloodstream. Malaria is caused by a parasite that is carried by mosquitos, and no vaccine exists. It is of course still possible to contract malaria while taking Malarone or another similar drug, but it is much less likely.

We went with Malarone over two typical alternatives, Doxycycline and Mefloquine, largely because it has fewer side effects. (Of course, it is also the most expensive, at around $8/pill. Thankfully my program reimbursed the cost and Mike’s insurance let him pay about half that.)

Now, for the fun part: I can’t swallow pills. Never could. And yes, I’ve tried. I swallowed a tic tac once, after trying for some time. Thought I was going to choke and die, and gagged on water (thus spewing it everywhere) for a minute afterward. My gag reflex is just super twitchy. I chew my food into teeny bits and can’t swallow anything without swishing it around in my mouth first. So naturally, my first question was: do they make Malarone in a chewable or liquid form? Answer: nope. Wait, really? Virtually every drug I’ve ever needed to take, from benadryl to antibiotics, has come in either chewable or liquid. You just have to keep asking. I worried that this meant it was a time-release capsule, and seriously researched the other two drugs to see if they came with a chewable or liquid option. No dice. But the Malarone literature (even for the pediatric version!) says that the tablets may be “crushed and mixed with some condensed milk” for anyone who has trouble swallowing them. Shoot me now.

So every evening around 7:30pm, I unveil my new trusty pill crusher and pulverize a Malarone tablet into a nasty neon yellow powder (think turmeric, but disgusting). I then mix it with a single serving of Nestle “Real Mango” or “Real Strawberry” Yoghurt and enjoy. Mmmmm, bitter yellowish-tinted yogurt, with an h. (Mike takes one gulp from his water bottle and kindly helps clean my pill crusher.)

But then the fun begins. We hadn’t really noticed any side effects from Malarone, but travel will wreck havoc on anyone’s system without the help of drugs. We’ve had our share of upset stomachs and lengthy bathroom visits, but nothing too terrible, and usually these seem correlated with a periodic overindulgence in spicy curry rather than a daily pill. But after being here for some three weeks, it hit us: we are having Malarone dreams.

You know those nights when you sleep reasonably soundly, but all night long your brain is actively playing back one epic, jumbled saga after another? That is every night on Malarone. It’s like the dreams run back to back in snippets, never really connected; essentially they’re an amplification of what my normal dreaming is like. It’s hard to explain. All of the snippets are very vivid, and make sense as they occur, even though on hindsight they’re largely nonsensical. Normally I might recall having one or two dreams like this per week, and they would last for what feels like the majority of the night. On Malarone, there are upwards of a half dozen of these each night, and while I may not remember what they were all about, I always remember that they happened.

The worst of it is that these dreams are genuinely fun. It’s like I’m starring in my own set of movie trailers that play one after another! None of them have been disturbing or violent or even really frustrating. Why is this so terrible? The problem is that I really don’t want to get out of bed in the morning. Another 20 minutes of shut-eye means another mini movie trailer of awesome. Pretty much every time. It’s worse than when you have to drag yourself out of bed at an ungodly hour on a frigid morning.

So if you’ll excuse me, I think I’m due for a nap.


On bathrooms

Thus far in Bangalore, I have had the good fortune to always encounter a western-style toilet when the need arises. I fear I may not be so lucky when we travel to a couple different places the next two weekends, but believe me, my fingers are crossed!

The caveat, of course, is that one must always carry toilet paper. And be prepared to use it to wipe down a thoroughly soaked toilet seat before sitting. I honestly have no idea how people (and women, in particular) can use a toilet, splash some water around, and go on their merry way. Um, dripping wet, much? I guess in a humid climate without A/C you’re always dripping? Regardless, this seems to be the preferred technique, at least judging by the ubiquity of butt hoses and distinct lack of TP.

For more insights on this all-important topic, including a photographic example of the aforementioned “butt hose,” check out this blog post I stumbled across.