It’s been 10 days since I’ve been back from Cambodia. It was bittersweet leaving. I spent the first few days back just being grateful for the simple joys in my life, like warm showers and filling foods, lol. My last night in Cambodia, I felt a throbbing pain and itch in the back of my second toe (on my right foot) that woke me from my sleep. I assumed it was just a mosquito bite and thought that was a really weird and annoying place. I gave it no further thought.
On the plane ride home, it was progressively getting itchier. There were also blister-like bumps on the bottom of my left foot that were painful. Again, I didn’t give it too much thought…I thought it may just have been from overexertion and my feet needed a rest (what with all the hiking I was getting into, lol). In a few days time, the pain in my feet was immense and I could barely walk. Blisters had formed on my second toe and in the space between my big toe and second toe.
I thought maybe it was athlete’s foot and I was having an allergic reaction to the fungus. I tried so many different natural remedies: tea foot soak, vinegar foot soak, saltwater foot soak, tea tree oil, Vicks, etc. Nothing was working and it was just getting worse, progressively traveling to different parts of my feet. One night, the throbbing pain in my second toe was so bad I actually cried and debated going to the ER. It felt like I was going to lose the toe.
The night passed and I went to a walk-in clinic in the morning. The doctor came in and I removed my socks. She looked disgusted, which I thought was unprofessional. You expect a doctor to care and remain impartial about a situation. I got the sense that she didn’t want to take responsibility for my condition and was just trying to usher me out. She spent no more than 5-10 minutes with me. She said she could give me antibiotics but she doesn’t know what it is and the ER could quickly tell me something. She asked what I thought it was, and I explained my athlete’s foot theory. She believed I had picked up some sort of a bacterial infection from Cambodia, but she does not think it’s athlete’s foot. Real helpful, lol.
On to the ER. There, I became grateful for my own condition. In retrospect, it really wasn’t as bad as what some other people were there for. One little boy was wailing out in pain every few minutes. One lady was coughing up such a storm she was short of breath. A young man was in crutches and complained of severe foot pain. Some older gentleman was in such pain he kept shouting “oh f**k” every few minutes. A security guard told him he couldn’t shout that because there were children around. His wife explained that he had suffered from a stroke and he was in immense pain, and she could not tell him to stop shouting out in pain.
I waited there for 6 hours. The first doctor that saw me showed no reaction to my feet, which I appreciated. She thought it was from the Cambodian heat and walking too much. This was something my mom thought of as well. I knew in my gut that it couldn’t have been it. It just didn’t make sense. She left and brought in a more senior colleague for a second opinion, who gave worse suggestions than her, lol. She thought it was scabies. My doctor said she could bet $100 that it wasn’t, as I didn’t have it anywhere else on my body. The second doctor also liked my athlete’s foot pitch, which I was leaning against at this point.
The first doctor got me to explain the kinds of things I was doing while in Cambodia. Where I went, what I did, etc. She said she was going to refer me to a dermatologist and didn’t want to pop the blister, as it was filled with clear fluid and so wasn’t infected. She’s scared it could be a parasite. The moment she made that suggestion, I knew in my heart that was it. When we were heading back during the jungle trek in Koh Kong, the path we had taken was covered with water. The guide explained that it was high tide season, and we all just took our shoes off and walked through. I knew this had to be where I contracted it.
She kept saying she didn’t know, she was unsure, that was worst-case scenario, etc. None of that was helping me. I needed facts, I needed to pinpoint the problem, and I needed a solution. She wasn’t telling me anything definitive, and how scary does ‘parasite’ sound!? The dermatologist was going to be gone for the next week, so so much for that emergency referral. She says a specialist in parasite and infection would be able to see me, but it would take several hours. This option makes more sense to me than a dermatologist anyways, so I wait. In this time, I do a bunch of research and find out about cutaneous larval migrans (hookworms). I know this has to be it.
Hookworms are parasites in dogs and cats, which they excrete via fecal matter. This can then contaminate soil, water, etc. Humans are ‘dead-end’ hosts for hookworms. This is why the lines in my feet are the hookworm ‘traveling,’ trying to find a way in. When it can’t, it eventually dies itself. However, this can take up to 4-6 weeks. In that time, it can invade your intestines and even your lungs. Coughing is a result of it invading your lungs. When I finally see the specialist, I explain everything to her and that I think it’s hookworms. She agrees and prescribes a 3-day treatment of Mebendazole (an anthelmintic).
Currently, my feet are in less pain and it doesn’t feel like my toe is going to fall off anymore, lol. The itching is especially unbearable at night and disturbs my sleep, but isn’t so bad during the day. The top of my feet sometimes feel like they are burning.
I was disappointed by how long the entire process took, and the lack of care, urgency, and insight. Still, I am thankful I was back home for treatment as I do not know what would have happened if I was still in Cambodia. Tourists should be very careful of where they walk barefoot, as they can even contract hookworms from walking barefoot on the sand at a beach. If I let my condition continue to worsen and didn’t seek answers, it could have been a lot worse for me. I’m on day 2 of treatment and have one day to go. Stay safe!