Tuesday, May 13, 2008

Med update

It’s been 2 weeks since I went to the regional house to recover from my ear infections and I’m still in Dakar. The pain in my ears is gone (mostly, except for painful pangs now and then), but the ringing hasn’t stopped and I’m really sensitive to loud noises and some vibrations. I’m due back to the Ear Nose and Throat Doctor tomorrow for a check-up. It’s possible that the ringing will eventually just fade away. Fingers crossed. But for the time being it’s just a really subtle high pitched constant ringing (sort of like how your ears feel after going to a loud concert). Some sounds are painful and make me cringe a bit, but other than that I’m back to normal. I’ll be in Dakar until the end of the week for my mid-service medical exam and then it’s back up to site finally (inchallah!). Because of the trauma to my ear drums though I may now be more susceptible to infection so I may be put on some kind of allergy medicine for the remainder of my service to keep the congestion down and the infections away. Anyway, I just wanted to post an update because I got a lot of concerned messages from people after my last post and I wanted to let you all know how I was doing. So thanks for the concern. After a nice long rest down in the lovely eternal springtime weather of Dakar I’m doing much better.

I’m still just hoping the ringing in my head will stop.

Tuesday, May 6, 2008

Ill health

I’ve been sick with various illnesses on and off for about the past 3 months. Nothing majorly serious, but the anxiety that comes along with being really ill, weak, dehydrated, uncomfortable, in sweltering heat, and so far from medical care makes even the mildest discomforts terrifying.

It started with the amoebas in February and then various other GI tract stuff, and now a full head double ear, soar throat, sinus infection that knocked me out and had me sent to the regional house on PC medical orders, with threats of a trip to Dakar.

I don’t think I paid enough attention to my health and my compromised immune system during and after I had amoebas which was why this last head infection got so out of control so fast. Under normal circumstances if I was healthier, eating better food, not physically exhausted and living in 120 degree heat, I probably wouldn’t have given ita second thought and fought it off within a day or two.


As soon as I was done with my last regional house quarantine (beginning of April), I went straight to help with training and then came up with new trainees for ten days where I played hostess to the 6 of them and got sick again immediately afterwards.

It started as a very painful sore throat and figuring I just needed to rest, I gave it the weekend. But by Monday morning I could barely talk and had white spots and infected tonsils so I called med, and was started on heavy antibiotics with instructions to rest and pleas from PC med to get to the regional house, to which I replied, “no, I have a lot of work to do” trying to make up for the 10 day hold I put on my work in order to help with training. But that night I was awake half the night with horrible ear pain and was essentially deaf in one ear. Great. So I doped up on decongestants hoping it would unplug with enough Sudafed and spent the day doing our radio show, being miserable, doped up on cold medicine and antibiotics.

Woke up the second night in excruciating pain in my ear neck and jaw and my ear draining fluid slowly all night long. Called med first thing in the morning and was told to get immediately to the pharmacy to buy a different anti-biotic and get to the regional house asap, and be on hold for a trip to Dakar.

I told myself I just had to get through my work for that day (2 important meetings I had been waiting a long time for) and could head to the regional house the next day. I went to the pharmacy first thing in the morning to buy the Augmentin only to discover that my town’s pharmacy was closed. Why? Because it just so happened that that day, all PRIVATE (yes, private, you read that correctly) pharmacies were striking. What were they striking against? For? I have no idea. They are a private business, how can they possible strike? The majority of their owners probably didn’t know either, they just heard the radio announcement.

Now if the public pharmacies at the health posts were worth anything this wouldn’t be such a problem. But they are stocked with almost nothing. I went to one at a regional hospital and all they had was painkillers. They didn’t even sell antiseptic or gauze. Private pharmacies are really the only option.

While I was standing there one of the midwives from the health post came over and asked the pharmacist to open up and sell meds to her sick patient, but he refused. I hoped there were no births that day, because the posts don’t have their own supplies, patients have to have friends or family go next door and buy everything they need including: IV catheters, gauze, etc. As my teacher friend said, “some people will probably die today because of this private pharmacy strike.”

I know we complain about our health care system in America all the time, and it’s the subject of all of our favorite academic journals, but you know what, we’re pretty damn lucky if you ask me.

Walking away from the pharmacy, I was in total disbelief and feeling weak, and miserable but trudged through my first meeting and collapsed during the afternoon in my family’s house. Within 3 hours my other ear also plugged and was painfully pulsing. I was out of ibuprofen and still on the wrong antibiotics. I was so dizzy and off balance that I could barely walk. It was 115 degrees and I was miserable, in SO much pain and getting scared with how rapidly it was progressing. I called med in tears from the pain and got my closest neighbor (in the regional capital) to find an open pharmacy and buy my antibiotics, meet up with me in our nearest town that afternoon and bail with me to the regional house in the evening. This meant driving after dark, but it was so worth it.

As soon as I was on my way and met up with her and had the correct anti-biotics and Ibuprofen in my system, my anxiety started to melt away. Though the 7 hours it took to get to the house were miserable (waiting at the garage for 4 hours for the car to fill up) and then the drive, being in a cooler climate (it’s 200k West) with the comforts of the house, were totally worth it. Med called me first thing in the morning and tried to convince me to go to Dakar that day so that I could see an EMT the next day, to rule out permanent ear damage. I asked to hold off a few days, as I was feeling a bit better, and thought that getting in a car in the heat for a minimum 9 hour haul would make things even worse. So we agreed that I would be aggressive with the pain meds, the anti-biotics and hot compresses all over my head and we’d see how I was at the end of the weekend.

I spent those few days at the house laying around with hot compresses, sucking down soup and tea (still had the sore throat) and trying not to fall over (from dizziness and no balance cuz of blocked ears). By the weekend if I was not seeing significant improvement I had to get in a car to Dakar to see an EMT.

A few days later the pain was mostly gone, but the ringing in my ears was making me crazy and they were still plugged up, but not draining. The worrying part for me is that our PC med officer was concerned about permanent hearing loss/damage.

The whole thing just got so out of hand so quickly. It was like I had no immune system to fight off the infection. And I guess that makes sense because I never really got a chance to “catch up” before I took off working again. That, and I’m sure the dusty, windy, hot desert climate wasn’t helping my respiratory system much.

So on the weekend I hauled down to Dakar, and I now have to spend over a week here, waiting to make sure I get totally better. I went to see an ear nose and throat embassy doctor specialist who was wonderful and very nice. I am now on heavy antibiotics, steroids, and various nasal sprays and eardrops. My ears are still ringing, and sounds are muffled. Most of the pain is gone, but it comes once in awhile in horrible pangs. Yuck. I’m so frustrated and tired of being ill. It’s maddening to have to stay here when I have so much work that I want to get done in my town. But I’m going to be aggressive about getting rest and I want to get totally better. PC med is forcing me not to go back. My old self, (when I had an immune system that was worth anything) would just have pushed through it and gone back to site and kept on working, but I have had it with not feeling 100% and I think aggressive resting is the key. So I’m following up with the Dr. on Monday and I really hope the ringing, pain, and inflammation is gone by then. It’s starting to make me a little batty.

In any case, the whole thing was/is a little scary. Not because I ever felt like my life was in danger, but just because I felt so vulnerable and uncomfortable and without resources to make me feel better. So now I’m just waiting to see if the damn ringing in my ears will go away. I hope so, because it’s driving me slightly batty.

I now know to be more aggressive about my health and give myself greater windows for rest and recovery. And that even though it’s a haul, it is worth the trip to the house/Dakar just to get away and take the time to be healthy. Because as I’m always telling my elementary classes, if you don’t have your health, you don’t have anything.

My new goal is to stay healthy for the next two months until I can get back to America and have a month of R&R. It’s kind of a sobering thing to realize that I’m not invincible and that a hit to the immune system is something to take seriously when you’re living out here isolated and under rough conditions. Maybe I’ve just gotten so used to never feeling 100% that I’ve gotten lax and forget how hard on your system living the way we do really can be? Or maybe it’s just a fluke, but either way I’m going to be much more careful from now on…and cross my fingers that I don’t have permanent ear damage.

That, and thank my lucky stars that I have access to a proper, alternative form of medical care.