Cautionary Tale: Malaria Drugs and Proper Usage

I'm going to give the moral of this story up front: when they say take meds with a full glass of water, they mean it.

I've been taking pills since I was young (I was a sickly child), and find it really easy to just pop em in and swallow. Excedrin, sinus infection antibiotics, vitamins, etc. - you name it, I'm comfortable taking it. This ease of taking pills has apparently resulted in a flippancy for proper pill protocol: I don't often drink much water when I take meds. Sure, I take a gulp or two just to make sure I don't taste the medicine in my mouth, but I had always been under the impression that the whole "full glass of water bit" was to prevent newbies from choking. Not so.

After a 2am flight to Casablanca, 11 am arrival in Marrakesh, and a day of touring the city, my mom and I were exhausted. When we finally got ready for bed, I lazily popped my malaria pill (doxycycline) into my mouth, took a gulp of water, and went to sleep.

2 hours later, I woke up with an excruciating pain in my chest, pressure in my back, and the feeling that something was lodged in my throat. I ran to get water, drank a whole bottle, but to no avail - the pain and pressure weren't going anywhere. After some frantic googling, I realized that I had pill esophagitis, aka, my malaria medicine had dissolved in my esophagus instead of reaching my stomach. Apparently, doxycycline has a propensity for causing this when: 1. not taken with enough water (check) and 2. taken right before going to sleep in a horizontal position (check). Since I couldn't sleep from the pain, my mom and I spent most of the rest of the night playing gin rummy in bed.

Some people describe the symptoms as a heartburn sensation, others as contractions in your chest (I've actually resorted to breathing exercises for women in labor to get through some of the more painful episodes!). The main point though is that it feels terrible and it sucks. For those who are brave of heart or glutton for gore, here's a look at what your esophagus looks like with the burns. At first I tried to push through the pain to eat some yummy foods (not a good idea, but I was in Marrakesh and wasn't about to miss out on couscous and tajine). I've since adopted the recommended bland diet for healing.

No food with seasoning, no caffeine, no alcohol, nothing fried, nothing too tough, nothing very sweet, nothing too hot, nothing too cold - essentially all of my favorite Ivoirian foods are off limits. I've mostly been eating the oh-so-balanced meal of white rice, yogurt, and an occasional bowl of apple sauce. I also take antacids before meals, sleep propped up in bed, and take all of my meds with at least one full glass of water. Slowly but surely, I'm seeing progress, and am looking forward to my celebratory meal of poulet braisé, attièkè, alloco, and beer to celebrate being 100% healed! 

To say the least, I've learned my lesson. I certainly hope this prevents someone else from making the same mistake.

With love and a full glass of water,