Photos from past adventures…Prescription challenges while in lockdown…Improvising…

A lone female lion was stopping for a drink.  The edge of the open vehicle is shown in this photo, illustrating how close we were to her.

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This playful baby elephant we spotted in Kruger hangs on to her mom.

Since we were focused on today’s photos, we haven’t included a video today or any Kauai photos. Instead, here is a combination of images we posted five years ago on April 18, 2015, at this link and also last year on this date on April 18, 2019, at this link. We hope you enjoy some of these favorites that many of our readers may have seen in past posts.

Hippos along the Mara River while we were on safari in the Masai Mara.

Of course, being in lockdown right now prevent us from taking photos. We can’t go outdoors, and most wouldn’t be enlightened by seeing photos of a hotel, however appealing it may be. If, by chance, you are curious about where we’re holding out, please click here

As you can see, if you click the above link, it’s a charming hotel, but most areas are closed during this time. We only have access to the restaurant, the corridors on the fourth floor, and our standard room. Only one lift is in use which we never enter when occupied by others. 
Crocodiles sunning along the Mara River in Kenya.

Not only does being in lockdown in India present its challenges, but also there is the harsh reality that we may not have everything we need on hand.
For example, once every four weeks, I refill my pill case with three prescriptions I take each morning along with a handful of vitamins. 

Spread out through during the day, we each take 1000 mg of Vitamin C and an extra dose of Vitamin D3, both of which may improve the immune system’s ability to fight off colds and flu (so they say).

As shown here, the cheetah and leopard are distinguishable by the cheetah’s tear lines running down her face.

As I was refilling the pill case, I noticed I was running out of a proper dose of blood pressure medication which is Lisinopril 12.5/10. Amid the recent COVID-19 mayhem, I’d forgotten I needed to head to a pharmacy while in India, where prescriptions aren’t required for non-narcotic medications.

Many of us have heard that India produces a huge portion of the drugs used in the US and other countries with all the news lately. Thus, I wasn’t concerned about purchasing any medication while here from any popular pharmacy.

In the first 10 hours on safari, we saw the Big 5.  The black rhino is one of the Big 5.

Before lockdown, while on tour, we stopped at a pharmacy and explained exactly what I needed. The above described Lisinopril, which included 12.5 mg of HCTZ (hydrochlorothiazide) and 10 mg of Zestril in a combination pill. 

Unfortunately, they only gave me Lisinopril with 12.5 mg HCTZ)/5 mg Zestril. I need 10 mg Zestril. At the time, I requested additional tablets containing 5 mg Zestril to make up the shortfall. 

The pharmacist left for a while and returned with a handful of tinfoil-packed tablets with what I thought was the 5 mg Zestril. Foolish me, when I couldn’t read the tiny print on the tinfoil, I assumed it was the correct add-on. As I said, foolish me.

We couldn’t resist posting this contented lion who was, at the time, engaged in a mating ritual with the female about 15 feet from him, leaning on another tree.

I didn’t notice this error until yesterday when I started filling the pill case, running out of my old 12.5/10, and started including what I’d purchased here. I discovered using a magnifying glass that when the pharmacist took off for 10 minutes, all he collected was more of the same. I now have 100’s of 12.5/5.

They were a meager cost, so that I won’t complain too much. Besides, it was my error in not checking diligently enough for something so crucial in the long run. I don’t think the pharmacist did this on purpose. I believe he also thought this was the correct item when he, too, couldn’t read the small print on the tinfoil-wrapped tablets.

So now, the dilemma. It is legal to go out to a pharmacy here and straight back. But, with the escalating cases of the virus in Mumbai, the new India hotspot, there’s no way we’re going to stand in line at an outdoor pharmacy with sick people. I had to figure out a better solution.

Closeup of hippo face. Charming.

With the single pill at 12.5/5, there was no way to double up and then cut part of a pill. It would result in a really peculiar dose. I looked online to see dosing instructions for this drug at a few reliable US pharmaceutical sites but found no answer.

The question became, “Could I take two tablets resulting in a dose of 25mg HCTZ/10 mg Zestril? What would be the consequence of doubling the amount of HCTZ, which is a diuretic I need to control blood pressure, especially important in light of ongoing coronary arterial disease? 

A female lion looking for the next meal.  The lion is the second of the Big 5.

An idea popped into my head. I still had Dr. Theo’s email address I’d used when sending him updated photos on the healing of my legs before and after the two surgeries one year ago. I’d send him an email.

Within hours I had a response, and kindly Dr. Theo told me I could double up on the drug and take two for the total dose of 25/10, but it was imperative to check my blood pressure daily to ensure it didn’t go too low.

Fortunately, we have a sphygmomanometer, which we purchased as part of our medical supplies. I used it frequently after I had surgery, but seldom did it seem under control over the past few months, and I was feeling so much better.

Males lions are always on the lookout for a female making a kill.  Why?  So he can steal the kill from her.

I’ll start checking and charting my blood pressure before taking the higher dose (for a baseline). If my blood pressure gets too low, I can alternate between the higher and lower doses every other day to hopefully stabilize it enough until we get out of here and I can get the proper dose, hopefully in South Africa in a few months.

Oh dear, there are other items we need, but we’ll improvise to the best of our ability in the interim. We don’t want to risk going out in public. And, we hope you feel the same way too. Please avoid going out unless it’s absolutely imperative or life-saving. 
Stay safe. Improvise.

Photo from one year ago today, April 18, 2019:

Female lion showing off her tongue. For more photos, please click here.

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