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Medical emergency is condition where there is significant risk of death or permanent damage or organ damage within minutes. Eg :
- Severe Dehydration
- No urination for 24 hours
- Breathlessness
- Sharp acute Chest Pain
- Unconsciousness
- Thunderclapping headache
- Severe Headache with vomiting
- Fever above 40 degree Celcius
- Swelling limb with severe pain
- Arterial Bleeding
Medical Urgency condition where there is significant risk of death or permanent damage or organ damage within hours to days. Eg :
- Moderate Dehydration
- No urination within 12 hours
- Breathing dyscomfort
- Palpitation
- Severe Headache
- Sudden Hearing loss
- Fever 39 - 40 degree Celsius
- Swelling limb without or with minimal pain
- Seeping Vein Bleeding
Medical Condition that will not produce permanent harm in immediate future yet has to be dealt with to avoid development into urgency or emergency
Water Contamination (and how to detect it cheaply)
Indonesia, the country you stay in, has a serious problem with clean water. This is serious problem, especially where you stay :
- Near paddy's field / farm
- Downstream industrial complex
- Lots of your friend of community has diarrhea
Water contamination can be easily detected with TDS meter. This cheap device can be applied to tap water of your hotel of your restaurant?
Why tap water? Isn’t the problem is ice and drinking water? Yeah. That what the management what you to think because managing pipe cleanliness and filters cost a lot more than order clean ice and drinking water.
In reality, most if not all ice in Bali is clean. The reason being is that most restaurants bought their ice from third party companied who will run out of business really fast if their ice is contaminated. And drinking bottled water? Bottled water is clearly sealed under strict supervision of health ministry and industrial department. So…. Yeah! Ice and Drinking water is no problem!
Tap water however is big problem. Water filter is expensive, about Rp. 12.000.000 – 15.000.000 installation and about same price for yearly maintenance. Working with this price, most establishment cannot have competitive price, therefore you consumed contaminated water?
How to consume contaminated water?
It will be incredible expensive to wash your salad and meat with bottled or filtered water thus I wash your raw food with tap water. This is COMMON PRACTICE. This is where contaminant like bacteria, virus, parasite egg, chemical contaminant touched your food. It stays there…
Overcooked meat will produce tough, barren inedible meal, and overcooked vegetable is soggy and tasteless. Thus, your meal is likely to be medium rare to rare. I bet your health that parasite eggs are still there if it was there before cooking. Also, cooking does not clean out chemicals and metal contamination.
Bon Appetite….
How you know if she / he left you a souvenir? Sexually transmitted diseases are scary for many reasons. Let me tell you some of it :
1. Incurable (HIV, Herpes, Hepatitis B)
2. Dormant until it is lethal (deadly) or causing permanent injury (HIV, Hepatitis B, Syphilis)
3. Hard to differentiate among themselves (Trichomonas, Gonorhrea, Chlamidia)
4. It affects your fertility (Pelvic Inflammatory Disease)
Now...now... there is number 5. Number five is expensive to detect and accuracy of most cheap tests is not reliable
This Article will talk about them one by one and how it affects you. This list is on priority, which means that in my opinion disease on top is more dangerous than the one on the lower part.
Wait... Isn't HIV is more dangerous? I believe hepatitis B is more dangerous because it is like 50 - 100 times more contagious than HIV while retaining its hiddenness. Hepatitis B in South East Asia is a bit different. It is more silent while be more cancerous for your liver.
Other than its covert operation, hepatitis B is scary because IT CANNOT BE CURED and resistance to anti-virus is common. The only way to live longer with hepatitis B is early detection and prompt treatment, possibly life-long.
GOOD NEWS : The test of Hepatitis Antigen is cheap and accurate
This is the superstar of of Sexual Transmitted Disease, considered to the most frightened disease in the world. This is not wrong. I don't think I need to explain here how dangerous HIV can be for you. Instead I will go through practical part which is testing.
HIV has 2 kind of testing which is Antibody and PCR test. Antibody test while cheaper has bad accuracy considering the consequences of false negative or false positive. Best and accurate way to detect HIV AIDS is PCR test thus earlier anti viral therapy can be initiated early.
The weakness of antibody test is that human body has different capacity in producing HIV antibody and this antibody concentration might be too low to be detected (False negative). On contrary, antibody test is not ideal because sometimes (more often than not) test device detects other antibody as HIV antibody creating false positive result.
For the sake of public health care cost management many countries suggest antibody test instead of PCR test. Since you pay out of pocket, and it is your life, I think you should know why.
Syphilis is famous, but no longer as dangerous as it used to be. Early detection warrants early treatment and prevents early injury to your BRAIN. But, postponing this test is very dangerous because if you had it and you forget, you will be permanently injured.
there are 2 test for Syphilis
1. TPHA : Antibody last for a long time answering : "Have you ever got syphilis?"
2. VDRL : How musch / strong is syphilis antibody in my blood?
Sadly, to current date, there is no good test to measure treatment success, even though resistance is rare albeit theoretically possible.
Extra precaution for female, while male syphilis lesion is easily detected due to obvious shape of external genitalia, female syphilis lesion is harder to be detected and recognized clinically. Lesion is vague and painless.
Herpes will not kill you unless you have HIV / AIDS, even that at its terminal phase. Herpes is more annoying than deadly. Treatment is cheap and also, annoying, to be taken 4 times daily for 10 days. More expensive treatment is more convenient, twice daily, 2 tablets each.
The bad news is herpes test is expensive consist of IgM and IgG antibody. This test while is not important for you to test yourself. It is important to test your partner, unless you love someone so dearly that you are willing to have herpes with him / her.
Other characteristic of herpes is that it can be on any surface of your body, from anus to eyes. Painful defecation at anal to blindness are a real danger if herpes happened to be on your anus or face.
Herpes detection contained prolong antibody (IgG) and short term antibody (IgM)
I put these trio into one box for their similar symptoms, pain, itchiness and discharge. There is no way to know which one is which.
Bad news about these infections :
1. Test is mandatory
2. Complicated test
3. Ability to spread
Chlamydia can be dealt with oral medicine, while gonorrhea requires injection and trichomonas with anaerobic antibiotic that will not work with either chlamydia or gonorrhea. Bottom line is that, these three require specific treatment each for its own. It is NOT SAFE to start any treatment without identification. The last thing you want in your medical history is antibiotic resistance sexual transmitted infection.
Second bad news is tests are complicated and expensive. For gonorrhea and chlamydia, we can do PCR, from cervix or vaginal swab. Cheaper alternatives would be microscopic analysis for gonorrhea with terrible and various accuracy. For chlamydia, the alternatives would be antibody test. Same with other antibody, this test is not as accurate as we'd hope. If body hasn't produce enough antibody to be detected, result will be false negative. Trichomonas detection is through discharge swab for microscopic examination.
The last one, if you already have symptom it is likely that condition has been there for quite sometimes. Left untreated this 3 bacteria can spread to blood and other other organ at relatively fast pace, causing severe blood infection with ambiguous treatment option for doctors. Scenario number three gets even more serious if you have predisposing condition
If any of infection above reach your internal sexual organ such as uterus, fallopian tube or up to ovaries, your fertility is compromised and your life and financial are very much threatened. It is dangerous just to buy antibiotic at pharmacy and took it when your have pelvic inflammatory disease. Unresolved infection will cause scarring in your pelvis and long term cancel your hope for offspring. If infection spread this far, you need consultation with gynecologist
Beware! Sexually transmitted disease just like any environmental derived infection rarely came alone. I might trust her but, do you trust her previous partner? Did she get tested months after last sexual relationship?
Not to demonize any one or lifestyle, but sexual transmitted disease travel in group. Those with hepatitis B slept with those with HIV then slept with those with chlamydia, over period of time. Thus, when you got Chlamidia, it is rational to think, is she came alone?
How you know if he / she left you a souvenir? Sexually transmitted diseases are scary for many reasons. Let me tell you some of it :
1. Incurable (HIV, Herpes, Hepatitis B)
2. Dormant until it is lethal (deadly) or causing permanent injury (HIV, Hepatitis B, Syphilis)
3. Hard to differentiate among themselves (Trichomonas, Gonorhrea, Chlamidia)
4. It affects your fertility (Orchitis)
Now...now... there is number 5. Number five is expensive to detect and accuracy of most cheap test is not reliable
This Article will talk about them one by one and how it affects you. This list is on priority, which means that in my opinion disease on top is more dangerous than the one on the lower part.
Wait... Isn't HIV is more dangerous? I believe hepatitis B is more dangerous because it is like 50 - 100 times more contagious than HIV while retaining its hiddenness. Hepatitis B in South East Asia is a bit different. It is more silent while be more cancerous for your liver.
Other than its covert operation, hepatitis B is scary because IT CANNOT BE CURED and resistance to anti-virus is common. The only way to live longer with hepatitis B is early detection and prompt treatment, possibly life-long.
GOOD NEWS : The test of Hepatitis Antigen is cheap and accurate
This is the superstar of of Sexual Transmitted Disease, considered to the most frightened disease in the world. This is not wrong. I don't think I need to explain here how dangerous HIV can be for you. Instead I will go through practical part which is testing.
HIV has 2 kind of testing which is Antibody and PCR test. Antibody test while cheaper has bad accuracy considering the consequences of false negative or false positive. Best and accurate way to detect HIV AIDS is PCR test thus earlier anti viral therapy can be initiated early.
The weakness of antibody test is that human body has different capacity in producing HIV antibody and this antibody concentration might be too low to be detected (False negative). On contrary, antibody test is not ideal because sometimes (more often than not) test device detects other antibody as HIV antibody creating false positive result.
For the sake of public health care cost management many countries suggest antibody test instead of PCR test. Since you pay out of pocket, and it is your life, I think you should know why.
Syphilis is famous, but no longer as dangerous as it used to be. Early detection warrants early treatment and prevents early injury to your BRAIN. But, postponing this test is very dangerous because if you had it and you forget, you will be permanently injured.
there are 2 test for Syphilis
1. TPHA : Antibody last for a long time answering : "Have you ever got syphilis?"
2. VDRL : How musch / strong is syphilis antibody in my blood?
Sadly, to current date, there is no good test to measure treatment success, even though resistance is rare albeit theoretically possible.
Herpes will not kill you unless you have HIV / AIDS, even that at its terminal phase. Herpes is more annoying than deadly. Treatment is cheap and also, annoying, to be taken 4 times daily for 10 days. More expensive treatment is more convenient.
The bad news is herpes test is expensive consist of IgM and IgG antibody. This test while is not important for you to test yourself. It is important to test your partner, unless you love someone so dearly that you are willing to have herpes with her.
Other characteristic of herpes is that it can be on any surface of your body, from anus to eyes. Painful defecation at anal to blindness are a real danger if herpes happened to be on your anus or face.
Herpes detection contained prolong antibody (IgG) and short term antibody (IgM)
I put these trio into one box for their similar symptoms, pain on the penis, and discharge. There is no way to know which one is which.
Bad news about these infections :
1. Test is mandatory
2. Complicated test
3. Ability to spread
Chlamydia can be dealt with oral medicine, while gonorrhea requires injection and trichomonas with anaerobic antibiotic that will not work with either chlamydia or gonorrhea. Bottom line is that, these three require specific treatment each for its own. It is NOT SAFE to start any treatment without identification. The last thing you want in your medical history is antibiotic resistance sexual transmitted infection.
Second bad news is tests are complicated and expensive. For gonorrhea and chlamydia, we can do PCR, from urine. Cheaper alternatives would be microscopic analysis for gonorrhea with terrible and various accuracy. For chlamydia, the alternatives would be antibody test. Same with other antibody, this test is not as accurate as we'd hope. If body hasn't produce enough antibody to be detected, result will be false negative. Trichomonas detection is through discharge swab for microscopic examination.
The last one, if you already have symptom it is likely that condition has been there for quite sometimes. Left untreated this 3 bacteria can spread to blood and other other organ at relatively fast pace, causing severe blood infection with ambiguous treatment option for doctors. Scenario number three gets even more serious if you have predisposing condition
If any of infection above reach your testes / balls / scrotum, your hope for descendant is significantly compromised
Beware! Sexually transmitted disease just like any environmental derived infection rarely came alone. I might trust her but, do you trust her previous partner? Did she get tested months after last sexual relationship?
Not to demonize any one or lifestyle, but sexual transmitted disease travel in group. Those with hepatitis B slept with those with HIV then slept with those with chlamydia, over period of time. Thus, when you got Chlamidia, it is rational to think, is she came alone?
Prolong Cough
I am assuming you are here after visit to multiple doctors, clinics and pharmacies. Also, I believe this cough last longer than 1 week. This is prolong or possibly chronic cough.
There are 4 common cause of prolong cough especially in Indonesia : Asthma, COPD, TB, and Infection
Asthma (Environmental Irritation)
I am not going to lean strongly toward asthma definitional characteristic. What I am saying here is that Indonesia, including Bali is a tropical country with no regulation regarding plantation or air pollution. This is directly impact your lung's health. Air pollutant and dust can trigger asthma and or bronchial / lung mechanical irritation.
Haven't you notice, dust flying high in front of you house / stay and lots of pollen fly from backyard? Yes, sadly in here lung irritations are everywhere, including and not limited to mold behind your wall and smoking person around. No regulation here to protect you, you are on your own in these contexts.
Best cure, if this is true is often involves changing accommodation to better and often more expensive one.
Chronic Obstructive Pulmonary Disease (COPD / Emphysema)
If you are smoker or asthmatic, COPD (emphysema in old language) is a serious problem. Chronic Obstructive Pulmonary Disease is a permanent injury / disability in your lung caused by multiple factors, often times by chronic exposure.
Solution includes inhaler, that is hard to find in Bali and has to be specialized ordered from Jakarta. Even worse, goes untreated or wrongly treated, COPD and cause deadly exacerbation or complication
Tuberculosis
Indonesia is rank three behind China and India in case of Tuberculosis. I truly don't know where you've been, BUT if you had been to poor community or slump in south east Asia (regardless how long ago), you need to have test for tuberculosis. Do have to tell you the danger of disease that wiped out many communities and inspired hundreds of mythical creature and lore?
Tuberculosis is dangerous for it subtleness. It makes you think, I am too mild to pay for medical, but this felt not right. By the time you decide to pay for your medical, you will be very contagious and probably has hole in your lung. The key element is exposure. If you are likely to be exposed, get tested!
Other Infections
You had been to multiple clinics and consumed multiple antibiotic, how do you know if the antibiotic works? Maybe it worked, partially.
Lung is peculiar organ that have great potential as a haven for viral and bacterial growth. Full of oxygen, complicit immune system and spacious room allow many microorganism to flourish at the expense of your life. Also, lung has limited antibiotic concentration worsens the chance for antibiotic resistance treatment.
In terms of viral infection, lung immune system often mistaken antibody against viral infection as foreign enemy. Let us say that lung defense ministry is running with almost always bad intel against virus, thus friendly fire is more than common causing various symptom (including cough).
Is there any cheap and fast solution to this? No. There are multiple tests to ensure correct diagnosis and obviously will cost more than what you wish it to be. However the good news is that this is not deadly symptom most of the time, so you can delay few weeks until you reach your country and undergo comprehensive tests and management there.
Indonesia is famous for 5 infectious disease : Tuberculosis, Hepatitis B, Dengue, Malaria and Salmonella (Typhoid).
Dengue is a deadly infection. Dengue kill its victim by bleeding and shock. Dengue virus decreases platelet number, substance that prevent spontaneous bleeding in Human. Lower your platelet, closer you are to eternal rest
There are many cases medical procedure may endanger patient's life in case of dengue complication
Correct Diagnosis, As soon as possible. If you have fever, it is imperative for you to take proper test
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