All cruise lines have doctors on board, but who are they there to protect, the cruise line or you? Two months ago, I was a passenger onboard a Mexican Riviera Cruise. In the middle of the night—on Christmas morning to be exact—I woke with the worst stomach pain I have ever had.

The pain wouldn’t subside, so I sent my family off to spend Christmas without me. I spent hours suffering before I struggled to my feet and took myself to the Medical Clinic onboard.

While I am not Lady Macbeth, I am religious about using antibacterial hand-wipes. I watch what I put in my mouth in every port, avoid any water not in a bottle, not only in all ports but on the cruise ship as well. I’m cautious about the food I order.

There were signs in the infirmary about norovirus, known as the Plague of the Cruise Industry. I overheard a one-sided conversation with a woman who was trying to argue her way out of her 24-hour-quarantine status as she was feeling better and wanting to spend Christmas outside her stateroom with her family. Although part of me heard her conversation, I was in so much pain that the implications went right past me.

The doctor was very nice, courteous and extremely frank. He touched my stomach and abdomen, which was very sore, asked me a few brief questions as to whether or not I had a history of ulcers or gastric reflux.

Not wanting to ruin my holiday, the physician indicated that rather than diagnosing me with an impending norovirus (whatever I had, it was too early to call) he would do me the favor of writing “reflux” as the diagnosis in my chart. He told me to enjoy my freedom while I had it, because once someone is diagnosed with norovirus, they are quarantined in their room for 24 hours. “As it is a virus,” he explained, “there is nothing you can do but suffer with it for the 24 hours or so that it usually lasts.”

For those of you that may not know it, the Center for Disease Control (CDC) requires a cruise ship to put a 24-hour quarantine on anyone suspected of having a gastrointestinal (GI) illness. The ship doctor assumed I was coming down with norovirus, whose symptoms include nausea, vomiting, diarrhea, muscle aches, stomach cramping, some headache and fatigue.

I returned to my room and suffered, but unlike most, I didn’t suffer for 24 hours. Instead, I rode waves of excruciating pain for an agonizing 3 days. I was certain that I did not have norovirus but rather food poisoning. I knew the ship was far more interested in protecting themselves than helping me with my food poisoning.

As I was the only one in our party who was sick, I tried to remember every meal I had in an effort to finger the culprit. I could only identify one dish that I had eaten, which nobody in my family of six had either ordered or even tasted.

My pain, which began in my upper stomach in waves, moved lower. Then it would move back to my stomach again. It would move to the right and then to the left. It got worse and worse. It was hard for me to understand the need to quarantine anyone with this, as I couldn’t move anyway— moving only made the pain worse.

Then the vomiting began. I couldn’t hold anything down for 2 full days. I couldn’t even tolerate a sip of water. The constant dry heaves caused horrific neck pain and stiffness. I rate my stomach pain as 9 to 10 out of 10.

I considered going to back to the infirmary for an IV, as I knew I had to be horribly dehydrated, but I didn’t want them to quarantine my whole family. They thought I had norovirus while I thought I had a very serious case of food poisoning.

I don’t recall ever feeling sicker. Only the morning that the cruise ended did the pain stop. I went home, ate very lightly and spent a few more days recovering.

So life went on and all was well until last weekend. Then those stomach pains began again, but thank God, not with the same intensity. This time, the pain was a 3 out of 10 but it was the same type of pain as I had on the ship, just far less acute.

Knowing this was certainly NOT food poisoning, I watched myself over the weekend. On Monday, I called my internist and insisted they get me into a gastroenterologist immediately.

Maybe I picked up a parasite during my cruise, but now that I was at home, I was determined to get some answers.

Luckily, one of the medical assistants at my doctor’s office used to work for a GI doc, so they saw me that afternoon. By now, it hurt to walk. The gastroenterologist and I discussed the all the possibilities. He thought it could be a parasite, which would require massive doses of antibiotics, but he also thought it could be any number of other things that only a CT scan would show.

As I was scheduled to go out of town that week, I pressured the front desk staff into checking my insurance immediately so I could get authorization for the CT scan immediately.

The staff fought with me about not having time and explained that they only had time to obtain authorizations in the mornings but I refused to leave. I told them I was going to sit there until they received my authorization, which is exactly what I did. An hour and a half later, I was off to Cedar Sinai for my CT Scan. Three hours later, I was in surgery for an emergency appendectomy.

The surgeon explained that from the looks of my appendix, this was not the first time it had been inflamed. In fact, he thought that not only was it very likely but probable that what I thought was a case of food poisoning, was really appendicitis. 

That cruise ship doctor should have ruled out appendicitis!  It is scary that an appendix has to rupture before a cruise doctor will take a serious look at you.  I have to wonder if there is even an actual protocol for evaluating the different between norovirus, food poisonings, appendicitis, ovarian pregnancies, etc?

Maybe I should have gone back to the infirmary during the trip but when a doctor tells you there’s nothing he can do about it anyway, you tend to take their educated word for it.

But now that I have had major surgery, I felt compelled to write this article to make sure that readers realize that the cruise ship is often looking out for their interests and not necessarily yours.

I was very lucky. Looking back, I realize I could have died. I wonder how life threatening an illness has to be to get the cruise doctor to think outside the norovirus box.

By Elyse Friedman Caiello