Malarone Side Effects - Malaria Medicine and Me

One of the Centers for Disease Control (CDC) recommendations when traveling abroad, and especially in India is to take an anti-malaria medication regimens like Mefloquine, Doxycycline, or Malarone. While not always 100% effective, they are helpful in preventing Malaria resulting from mosquito or other bug bites.

Due to it's somewhat documented lower incidents of side effects, I elected for Malarone (Atovaquone and Proguanil) on each of my three trips to India. The regimen starts 24-48 hours before exposure and continues 7 days after exposure.

Gladly, I just completed my prescription for this last trip and it could not have been sooner. While I had not noticed specific side effects from the medication in the past, given the way I felt this week -- I was wondering what the side effects were and if I was suffering from them.

A little more information on Malarone:

Malarone is a antiprotozoal medication. Antiprotozoal is a type of medicines that is used to prevent and treat malaria, a red blood cell infection transmitted by the bite of a mosquito. This medicine is the combination of two medicines, atovaquone and proguanil.

These are the "known" side effects of Malarone":
More common
Abdominal pain; back pain; coughing; diarrhea; dreams; fever; headache; itching skin ; lack of or loss of strength; nausea; muscle pain; sore throat; sores in mouth; sneezing; vomiting

Less common
Acid or sour stomach; belching; blurred or loss of vision; disturbed color perception; dizziness; double vision; flu like symptoms; halos around lights; heartburn; indigestion; loss of appetite; night blindness; overbright appearance of lights; sleeplessness; stomach discomfort, upset or pain; trouble sleeping; tunnel vision; unable to sleep; weight loss

RareDiscouragement; fear; feeling sad or empty; irritability; lack of appetite; loss of interest or pleasure; nervousness; trouble concentrating

It would seem that from the way I have been feeling the past week, that I have had both more and rare symptoms or side effects with this particular prescription of the Malarone pills: lack or loss of strength; nausea; acid or sour stomach; stomach discomfort, upset or pain; irritability.

While I initially thought the "lack of loss of stength" was due to jet lag, at this point it still continued 6 days after the trip -- I am now thinking it may be related to the Malarone. Plus, in addition to the rest of the symptoms it makes sense. Oddly, on my previous two regimens of Malarone, I had no noticable symptoms. Hopefully it only takes another day or two for everything to work itself out.

Have you used Malarone or another anti-malaria medication? If so, let me know about your experience below with a comment. I have not decided yet if I will look at another regimen for the next trip to India.

This post is not meant to represent medical advice, rather just my own personal experience with anti-malaria medication and Malarone. Please consult your doctor before choosing Malarone or any other drug. This site assumes no responsibility for the use of this post outside of anything other than a journal of personal experience.

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Working! Blackberry 8800 GPS Internationally in India

Great news to report on my recent trip to India in terms of the GPS working internationally on my Blackberry 8800 (Other models include the 8820, & 8830). If you recall from my trip back in July, I tried several times -- but could never get an accurate GPS signal in either Germany or India. After the success I had in Cancun, Mexico -- I decided it was worth another try in India to get some sort of GPS signal reception.

This time, after some fiddling with -- I was able to get the GPS to work. However, it was not easy...the good news is that once I finally located the GPS signal, it worked consistently.

When I walked off the plane, I immediately had phone service in Germany (Vodafone) and India (Air-Tel) along with data service. But GPS did not work immediately in either location.

How did I get it to work?

Well, the famous Blackberry 3-finger salute. A reset of the entire device by simultaneously holding down ALT+CAP+DEL seemed to resolve the issue. After approximately one minute for the device to reset, it started to pick up the necessary GPS signals from the satellite and I was live in India!

I ended up using the GPS device with Google Maps for the majority of the trip in Bangalore. While I was not driving, it gave me a much better perspective of where I was in the city of Bangalore. For how chaotic the city was -- the Google maps were very detailed, even down to many of the side or unlabled roads. This makes it easy to understand where you are in the city. An added benefit of the mapping in Bangalore, India is that it includes a number of notable sites as icons on the maps such as temples, parks and other places of note. Great, especially if you are out sight-seeing.

In some of the more remote areas of the country such as Coimbatore, the maps are no where near as developed. Some of the main routes into and out of the cities are included, but not a lot of the streets around town.

Still, it was a great relief to get ths Blackberry 8800's GPS working in India. It only took me two trips. If you are running into any problems with your GPS internationally, I would recommend the ALT+CAP+DEL 3-finger salute a try before you get too frustrated!

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Bangalore Arrival, Leela Palace Relaxation

This morning pretty early, around 1:20am – I arrived at the Bangalore airport to what I would normally call “Southern California” weather. Nice and cool with relatively low humidity. I performed my usual couple of tasks there, hurry down the stairs, get through initial customs, change $200 USD to Indian Rupees, and stand next to the luggage conveyor belt.



Given my late arriving connection flight – I was wondering if my bag was going to be on the flight at all. I did not have to wait long as my bag was one the third one off of the Boeing 747-400 jumbo jet. It was ice cold too, if I might add. I grabbed the suitcase off the belt and waited for my colleague Mike Owen to get his. Of course his had to be one of the last ones off.

Then Mike and I went through the second customs area to greet our contact from the Leela Palace Kempinski , Bangalore – which enables you to avoid the masses outside the airport in the scramble to locate your drive. Or worse, hail a cab. Initially, the representative from Leela did not have the confirmation for the transfer for either Mike or I. Still he went ahead and escorted us out quickly to the private cars that the Leela Palace use to transfer people from the Bangalore airport to the Leela.

The Leela Palace Kempinski was even closer to the airport than I remembered. Within five minutes we arrived – I handed out a couple hundred rupees to the drive – and we went inside to check-in. Seated in the beautiful lobby, they quickly checked us in and handed over our keys. Since I was going to stay a day longer than Mike, but the hotel was full – I put in a priority request for Wednesday night, hoping that I would not need to transfer hotels.

When I arrived into the room, I was pretty relieved. Based on the poor experience at the Chauncery Pavilion a few months prior – the Leela met my expectations and had a room worthy of note. Much like you would find at any resort in the United States. I quickly headed to bed to get some rest.

In the morning, we met up for breakfast and enjoyed the buffet at the Leela Palace. While expensive at 690 rupees, or about $17.50 – the buffet is special enough that it deserves mention. It was great to enjoy the various mix of Indian and American breakfast items and fresh fruit, all outside on the patio in the warm Bangalore morning.

After breakfast it was off to a couple of familiar sites for myself – since it was Mike’s first time in Bangalore and I was more interested in relaxing – we visited both the Lalbagh Botantical Garden, the Bangalore Palace, and finally the Karnataka government buildings.

I enjoy visiting with people whom it is their first time in India. I think the first day is a lot of fun, especially when riding in the cars. Those who are not used to the type of traffic and close driving quarters that exist – generally are pretty nervous in the car. A “veteran” of three trips to India now, it seems to be part of the norm for me.

After our quick “programs” for the day, we resisted the urge to take a nap and headed down to the pool. The pool at the Leela is equally impressive with its clear blue water and resort feel along with poolside massages. There is a little dining area where we grabbed a table and hang out for the rest of the afternoon enjoying the sun and fresh air.

After a small snack for dinner, I headed off for bed – dead tired from the journey and trying to stay up late enough to not wake up at 4:00am in the morning.

I am looking forward to the upcoming work week and hopefully missing any jet lag!

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Close Call in Frankfurt, On to Bangalore

When I went to sleep last night after a lengthy meal on the plane, I was going to have plenty of time to spare once I landed in Frankfurt. This morning as I woke up for breakfast it looks like it will be a close call once we arrive into the airport to make the transfer.

On a side note, it feels like all they do is constantly feed you on these business class flights. After four optional courses of food for dinner, now here comes a large breakfast just four hours later. Now on the Bangalore flight, it looks like a three course lunch and a four course dinner. I will likely decline most of this food – how can anyone eat this much (4 large meals in 20 hours) is beyond me – and I like to eat a lot of food.

Because of inclement weather in Frankfurt, we are delayed by an additional 25 minutes into the landing – making the landing at 12:00pm, just 30 minutes before the flight departure for Bangalore. Luckily the gate is in the same terminal meaning that I will not have to run. Hopefully my luggage makes it with me to Bangalore – fingers crossed.

Once we finally land and I get off the plane, there is a Lufthansa representative there to escort the 5 of us on the LAX --> FRA flight over to the Bangalore gate. We all make it onto the plane and have an easy time boarding since everyone else is already on the plane.

Apparently, we could have taken more time – several other flights were delayed inbound to Frankfurt so we kick back and relax for an additional 20 minutes while everyone boards.

I am planning on this flight being both a productive and relaxing flight. I slept most of the LAX --> FRA flight to get myself on the India time zone more easily. On this flight I plan working on a couple of posts (including this one), catching up on email, and reading the book – “Searching for God Knows What” by Donald Miller – the author of “Blue Like Jazz”. I started it a couple of years ago and never made the time to finish it. So I am starting over and strongly desire to finish it this trip. I will let you know how it goes.

We land in Bangalore on Sunday, November 11th – so some details will follow there. One difference on this trip is that we are getting a direct transfer from the Leela Palace Kempinski rather than having our driver. With this, we avoid the throngs of people outside the airport with lists of names that take you a half-hour to locate yours. We’ll get out driver for the week tomorrow.

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Learning to Fly on Lufthansa

We took off from Los Angeles about 15 minutes ago and it has been an educating day for me.

For my flight to Bangalore today, I decided to get to the airport a little earlier than usual so that I could take some conference calls and answer emails from the comforts of the Star Alliance lounge. With that idea in mind, I headed for LAX at around 8:15am, expecting to arrive at the International Terminal around 9:30am – also missing the majority of the morning traffic rush by heading through Malibu on Pacific Coast Highway.



I did arrive at the airport close to the time that I was expecting and found a little surprise. The ticket counters at the Los Angeles airport do not open until shortly after 10:30am. So with that in mind, I jumped into the line just before 10:00am. (Later I realized that with only 3 flights or less a day out of Los Angeles, it probably makes sense for them not to be open.

As I was standing in line, I noticed on the departure board that the flight was showing a 1 hour and 20 minute delay from the expected departure time of 2:30pm. I started to think the my connection in Frankfurt might be closer than I expected, but since I had 2.5 hours to grab a beer, bratwurst, and pretzel – I figured the worst I was going to sacrifice was the food.

However, that change when I reached the check-in counter and the agent told me – you are going to miss your connecting flight to Bangalore – but we can re-route you through Mumbai, let me take you to the ticket counter. I did not quite understand, but was quickly ushered over to the ticketing agent. The ticketing agent was a little more patient that the check-in agent and said that only the Hyderabad connecting flights would be missed. The other agent had been grossly misinformed.

Whew, I was then able to change the seating arrangements, taking care to insure that if we have a fighter jet escort again over Iraq that I would have a window seat to see it and take a picture.

I learned another lesson that the Star Alliance lounge at LAX. Unlike all the other Star Alliance lounges I have been to, being Star Alliance Gold does not get you into the first class lounge. It had worked in Delhi and Frankfurt in the past, apparently not in Los Angeles.

A few hours passed by in the lounge.....

The flight ended up being a little more delayed than first expected. Once the flight arrived it turned out our boarding time started at 3:40pm. Then an additional delay occurred in which customs agents stopping three families from boarding the plane lead to an overall departure time of 4:57pm.

Now it is getting a little too close for comfort. The only good news is that today’s flight is relatively short (9 hours, 40 minutes) due to some good tail winds. Let's hope we can make up some of that time -- there is nothing like running from one gate to another on an international flight.

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Back to Bangalore - Here We Go Again

As I mentioned at the beginning of this month, November will be a month with a good amount of travel, including my second trip this year to India. This time I will be heading back to Bangalore for three business days, and then heading down to Coimbatore for two business days before heading back.

Initially, I had thought about taking the western route through Singapore just for the experience. However, a couple of complications arose causing me to once again take Lufthansa through Frankfurt. The first problem was that the trip looked to be about 8 hours longer each way – when you are going for a week, every hour counts. Secondly, a co-worker that is traveling with me had already confirmed the route through Frankfurt. Other benefits of the Frankfurt route include German beer, bratwurst, brezel (pretzel bread), and of course Ashley’s favorite – genuine Hairbo Gummi Bears – actually made there in the EU.

I am looking at this trip quite a bit more apprehension than my last trip. On my last trip, I did not do too well with the food in southern India. That resulted in a couple of wasted nights and going through my full dosage of Levaquin that I had successfully avoided on my first trip back in 2006. I have a couple of ideas of the specific causes to my illness – but nothing I can be sure of, so I will be a lot more cautious this trip. I will also be packing a great assortment of snacks in my carry on bag – just to be on the safe side. On a side note, any good recommendations for places in the Bangalore & Leela Palace area?

Some better news on the hotel front, I went ahead and booked myself at the Leela Palace in Bangalore. Last time we stayed at the Chauncery Pavillion and it did not rank high on my list. The Leela has an outstanding reputation and is actually 45 minutes closer to the offices I am visiting than the Chauncery. That adds up to 1.5 hours extra a day – and when you are only there 3 days, that makes a whole lot of a difference. One little difficulty however, is that the last night before I fly out to Coimbatore – the Leela Palace is booked, so as of now I am booked at the Mapple, which looks nice on the Internet. I will try to get extended while in Bangalore, we will see.

For the first time I will be visiting the city (hard to call it a town) of Coimbatore. We have some operational groups down there and it will be the first time to be able to greet them and see how they are setup. What I am really looking forward to here is that the parents of one of my employees here in the United States are in Coimbatore. They will be coming to pick us up and take us to their place for a meal. I am pretty excited about that!

While I am not overall that excited for the trip, it is coming up really quick. In fact, I leave this upcoming Friday – November 9th, land in Bangalore on Sunday, fly to Coimbatore on Wednesday, and then fly back to Los Angeles on Friday – arriving at LAX on Saturday the 17th of November. It promises to be one quick trip!

On a side note, one benefit of the trip is that it will put me over the 100,000 mile plateau and 1k Premier status on United. The only reason that this is good news is that if you have to fly a lot, you might as well get something for it.

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Blackberry 8800 – Will my GPS Work Internationally? Not in India.

Well, at least do not count on it.

Without first checking the United States military and policy on the use of the Global Positioning System (GPS), my assumption was that the GPS system in my RIM Blackberry 8800 would work both in India and Germany. Since Google Maps had pretty good coverage, I was looking forward to the GPS assistance. It seemed reasonable that since it uses satellite coverage to locate the signals that they could still be located in India.

In fact, BlackberryCool posted just a few days earlier that Air-Tel, which is the cell phone provider in the Bangalore area (Hutch is another popular wireless carrier in India) was announcing their own GPS Navigation software for the Blackberry 8800 series of phones. GPS must work there, even on the US phones, correct?

However, while I was in India I could not get any GPS signal. I knew that my TeleNav GPS Navigator probably would not work since I configured it for the USA, but I assumed I would get some signal. Nope, nothing, zilch. By going to Options --> Advanced Options --> GPS I could not get latitude or longitude information or locate any satellites. Through Google Maps I tried as well, but the error message that kept coming back – “Signal to weak to determine location”.

This was not just in Bangalore, but also occurred in New Delhi and Agra. Bummer, on a couple of occasions it would have helped!

Has anyone else tried the GPS internationally? Did I miss a setting change? Let me know with a comment.

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Leaving New Delhi

I’m sitting in the Oberi Clipper Lounge here at the Ghandi International Airport here in New Delhi, India. A benefit of my Star Alliance Gold status with United Airlines, Lufthansa gave me entrance to this, yes clap you hands now, a non-smoking lounge. What an unexpected relief.

On my previous visit here to New Delhi, there was a different lounge (currently called the Port Lounge) that was unbearable if you do not like smoke. And, I do not like smoke. I was mainly expecting to spend the time waiting in the main boarding area given with the extra time before the wonderful 2:25am departure for Frankfurt.

I ended up getting to the airport in record time, but for a few minutes I did not know if I would even make it here tonight. After confirming the 10:00pm pick-up time (allowing 1-2 hours for possibly bad traffic) with the driver after our trip to the Taj Mahal, I mentioned I would re-confirm at 9:30pm given the experience the previous night with no driver.

So, Jonathan and I spent the day relaxing around the Hilton Trident Gurgaon – 9:30pm rolled around. I called the mobile number of the driver, no answer and no voice mail. Called the bell desk and asked if the driver had checked in – no luck there either. 10:00pm rolls around and the same things happens. No driver, no car. Now I am getting a little worried – how am I going to get to the airport since there are not a line of taxis outside and the hotel does not provide transportation to the airport. Then, I call the driver’s company to see if they can track anything down.

15 nervous minutes pass and then both the hotel and the driver’s company call to say the driver is now there. Apparently his cell phone was just on silent and he did not get the calls. Whew, a relief. In the end it did not matter one bit, there was no traffic to the airport – it only took 15 minutes, and the lines were relatively short to clear immigration to get to the lounge – with an extra 3 hours to spare.

The only bad note about the lounge is that the wireless Internet access if jacked up. Basically, I tried to purchase and hours worth at rs.42 (about $1 USD), but the registration died before I could even get to the payment page. Perhaps that is better anyways. Unfortunately it means that this posting may get a little delayed, perhaps until tomorrow in Germany?

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Agra and the Taj Mahal

Visiting the Taj Mahal is a magical experience right out of a fairy tale. That being said, it is not a trip for the faint of heart. This would apply to you, especially if you get nervous about head-on collisions, accidents and tight spaces.

The trip for Jonathan and I started out at 1:50am, just some 90 minutes since we arrived from Bangalore and had our New Delhi cab experience. We’re planning to meet his brother and some one he works with at the Taj Mahal since they are in Delhi as well – a nice coincidence. Our driver, Kamal’s car is a standard compact c