By Canadian Press

Ontario woman nearly dies — twice — after snake bite in Thailand

Jun 28, 2019 | 1:26 PM

Shalabha Kalliath’s legs buckled as pain shot through her body during a walk on a beach in Thailand.

When she looked down, a small snake dangled from her right big toe. She was able to slam it against a wall in Ko Phi Phi before collapsing during a vacation late last month.

“I swore at it and I fell immediately,” said the Ontario woman, who came close to death twice — once in Thailand and then again after a flare-up in Canada — after the bite from a Malayan pit viper.

“I felt horrible, I was nauseated and unable to move.”

Someone else killed the snake that day. Its identification, by a Thai medic, would later help save the 26-year-old.

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After being bitten, the recent engineering graduate of the University of Waterloo said a friend and a stranger helped her to a nearby clinic on the idyllic Thai island where one doctor told her she could die.

“I’m thinking, ‘some context might be nice,'” she said, recalling that she felt her mental faculties failing and was unable to process the possibility of dying.

Doctors at the clinic told her the venom had made its way into her blood and she needed the antidote — antivenin — which they didn’t have. Kalliath said she was then taken to a hospital for treatment.

“That was a disaster,” she said, describing doctors and nurses as the facility as very laid back. “It was the worst hospital I could imagine.”

At one point, Kalliath said a doctor told her that “people die, it’s part of life,” to which she responded “well I don’t want to.”

Kalliath said she was told her leg might have to be amputated. She also couldn’t remember where she lived or where she was, so filling out the health insurance form was impossible.

She called her father, a doctor working in Brunei, who helped as much as he could. Her friend called her father, a doctor in Oman, who also helped triage the situation.

At some point, doctors at the hospital finally administered the antivenin, she said, adding that she was in and out of consciousness by that point.

“They asked if I wanted more antivenom and morphine,” she said. “I have no idea, I’m an engineering student.”

Kalliath said she started feeling better after a second dose of antivenin. Anti-nausea medicine and morphine also helped.

By her second day at the hospital, she begged a doctor to allow her outside and a friend was able to take her out in a wheelchair, intravenous lines and all, to a bench on the beach. She got a burrito, they played games and a doctor sat nearby and watched, she said.

The situation improved further and Kalliath said she was soon discharged and cleared to fly home, so long as she kept her leg elevated.

But problems cropped up again once she returned to Waterloo, Ont.

Kalliath said she was hit by moments of “extreme weakness” and urged by her father to see a doctor. She eventually went to a walk-in clinic on June 7, where she was immediately sent to the emergency room at the Grand River Hospital.

“In the ER, they took blood and freaked out,” she said. “They were surprised I was still alive and said I could have hemorrhaged at any time.”

It turned out that the snake venom hadn’t completely cleared her system — doctors told her they believe some remained trapped in swollen tissue — and had made her blood incapable of clotting. She said she was told she could bleed to death internally from even a minor fall.

While Kalliath was placed in intensive care, physicians rushed to find the correct antidote in Canada, calling the Ontario Poison Centre, which reached out to the Toronto Zoo.

The zoo said Malayan pit viper antivenom was available at a zoo in Texas, but that would take about 12 hours to reach the hospital.

What the Toronto Zoo did have was a selection of antivenin used for bites from North American pit vipers, such as the copperhead and the cottonmouth. Both the zoo and the poison centre decided using the North American antivenin was the best bet, said Andrew Lentini, the zoo’s senior director of wildlife care and science.

It worked.

“This antivenom has components in it from a closely related group of snakes, so that’s why it seemed to have worked in this case,” Lentini said.

Kalliath is now on the mend. Her foot remains swollen and she’s still on anti-inflammatory medication but she said she feels much better.

“I feel extremely lucky,” she said, adding that she wanted to move on and focus on finding a summer job. “I was super delayed in applying to jobs. I need to start earning some money!”

Liam Casey , The Canadian Press