Day 11: April 14, 2014
I wasn't the least bit prepared for what my body had been
trying to tell me the night before. I
woke a little bit after midnight feeling MISERABLE. I had fever, obviously, but couldn't check it
as I had no thermometer. I also had the
beginnings of what would wind up over the next 36 hours as being the WORST
chills of my life. My skin felt like it
was burning up.
I spent a fair portion of the night in and out of the
bathroom, and after a back and forth struggle, something along the lines of
ETEC made its return with a vengeance.
What bothered me most thru the night were the fever and chills,
however. I fell asleep, but whenever I'd
wake up to try to use the bathroom or just because I couldn't sleep, I would be
uncontrollably shivering all over. Worse
yet, it was the middle of the night, and I had no Tylenol or Motrin, so it was
up to my body to get a hold on whatever was causing the fever.
I decided at around the 5 am bathroom trip that I was NOT
going to work the following day. At
about 7:30 I got out of bed simply to ask someone for Motrin, and Carmelle
fortunately had some. I spent the
remainder of the day cycling between lying in bed, waking up to take Motrin,
and in the bathroom. When my fever was
under control, I felt okay-ish. However,
whenever it returned, I felt HORRIBLE.
Even worse still, it appeared that the Motrin was only lasting a couple
hours as the shaking chills would return in about that amount of time. My day was essentially this: sleep unless A)
taking motrin or B) in bathroom...and mostly it was just sleep.
As the afternoon went on, I realized very quickly I was not
taking in nearly enough fluids to keep up with what I was losing thru fever,
bathroom trips, etc. I texted Carmelle
to pick up some sprite, fanta, etc to help encourage my intake, and she agreed
to on the way back from clinic at the end of the day. Water just didn't sound good, nothing really
sounded good. I didn't want to eat or
drink, but that sprite and fanta sure sounded good.
Finally about 6 PM or so, Carmelle arrived at the house and
with her the fluids. I was continuing to
make frequent bathroom trips, and so was eager to get some fluids in. The sprite actually tasted pretty good, and I
downed about half the bottle in no time.
Then it was time for another trip to the restroom, AGAIN. This time, and fair warning this is TMI, as I
sat in the restroom, I began to feel nauseated.
Eventually it became appparent to me that throwing up was
inevitable. I finished as fast as I
possibly could and stood up just in time to throw up into the sink.
I was broken. I
moaned and cried out as I threw up. I
hadn't felt this bad in a long time, and to do it so far away from home and the
security blanket of family and the American medical system was even worse. Finally, after a few rounds saying hello to
Ralph and Barfolomew, I felt a little bit better. As I walked out toward the living room to be
where someone could see me, the stomach rumbled again and I went for the front
bathroom. After finishing up what seemed
like my 10th toilet trip of the day, I just wanted to sit somewhere and just be
still. I stood up, and obviously too
quickly, because as soon as I did by head became incredible light, I felt
really woozy, and I realized that I was either going to be taking myself to the
floor voluntarily or involuntarily. So,
it was kind of a mix. I sat and then
quickly lied down on the threshold of the bathroom door. After a few seconds I called out that I
needed to talke to someone, and when my housemates saw my pitiful self on the
floor, we all decided it was time for backup.
In a few seconds, I was having a phone conversation with
Jason while lying on the floor. He and
Liane decided they'd come over and bring some IV fluids and Zofran to try to
tank me up...a little concierge medicine in the middle of Tanzania. After hanging up, I slowly sat up and then,
with help, stood up and walked to the couch.
I felt better after the whole ordeal, but still obviously was behind on
my fluids.
In the 45 minutes or so that it took Jason and Liane to run
to the pharmacy for supplies, I started to feel a bit less terrible. Once they arrived, we talked about what had
been going on, and they opened up a large kit of supplies (like a medical
Batman utility belt). Soon I was a veritable pharmacy. I had cipro, 4 and 8 mg Zofran,
acetaminophen, azithromycin, some oral rehydration solution packets, etc. Then it was time for the IV, for which I was
so very thankful.
The good Dr. Jason helping fix me up.
No pain no gain
It took three different attempts, and let me tell you, I underestimated the pain of placing an IV...I mean, it's not terrible, but it's not like a vaccine or anything. On the third attempt, Jason had his line (and some good blood return as well that poured down my arm and onto the pillow, as I now proudly show as a souvenir on my pillowcase), and my fluids were hanging from a nearby light fixture on the wall.
Success!
It's fewer attempts than it would have taken me, to be sure!
Overall, I took what I now realize was 16 mg of zofran (yes,
my heart never went into V-fib from an excessively long QT interval) and got 2
liters of LR over the next 2 hours. Also, my rapid malaria test was
negative...ha! When they finished, my color was back (per my housemates), and I
felt loads better. Armed with a some
meds, a rehydrated mind, and enough fluids running through me to last at least
till AM, I felt fine when Jason and Liane left.
It had been a little medical party, and as the fluids went in everyone
sat around and drank tea, chatting about this and that. I pretty much just sat.
As the day ended, I sipped on fluids (no chugging and
vomiting for this guy, thanks) and rested on the couch. Deciding I would rather be as visible as
possible, I started the night out sleeping on the couch.
The joys of being a doctor, and having doctors as friends.
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