the Sarah Illness Chronicles: day 1

I'm finally feeling chipper enough to blog! This whole time, I always had my cell phone nearby to snap pictures, even when I was feeling like sh--. Well, not during the worst, worst bits, but most of the time. I've got photos of just about everything, but I'll spare you the IVs and blood transfusion bag, and all that gross stuff, and try to give a more complete summary than what I have so far in my quick updates.

So...For weeks now, I've lost weight. I noticed one day several weeks ago when wearing a pair of khakis that I could quite easily just pull them off without even unbuttoning them. They'd never been tight before, but certainly not loose enough that I was at risk of getting pantsed. Not good. Justin, our family tailor, adjusted the button so they'd fit better. I told myself that I was just getting more walking and less junk food, and that was the reason for the weight loss. Also, I had a couple bad bouts of gastrointestinal disturbances since being here, but I took some medications as recommended by my doctor friend, Alison, and it cleared up. (Or so I thought?)

Also, I'd noticed I've had signs of anemia (essentially, not enough red blood cells)--shortness of breath, dizziness, weakness. I wasn't too concerned, because I am chronically anemic anyway, and this is easily remedied by taking over-the-counter iron pills. These are readily available in Pemba, and I even published a paper on this very subject earlier this year. So I should have know better than to skip any pills...but I did.

This brings us to this past Wednesday, when I started in with some more gastrointestinal issues. By late morning, I was feeling markedly lethargic, and spent the time just dying for our housekeeper to just finish up the laundry and go the heck home so I could go take a nap. She finally left, and I brought Juma into my bed with me so I could keep an eye on him while he watched a movie on his DVD player. Justin was at work still.

I started to feel feverish, and had Juma take my temperature with our nifty forehead thermometer. The electricity had been off for three days in our house because of a fallen electricity pole, so it wasn't helping that I didn't even have the fan blowing on me. Before Justin got home for lunch, the thermometer read 103 degrees Fahrenheit. And it felt like it, too.



Yikes. I managed to eat some lunch, knowing I'd need my strength. Justin convinced me to go get a malaria test at the clinic where he got his stitches a few weeks ago. It's a private clinic, so they have a few more resources than the public hospital, and Justin's friend works there, so we knew we'd get treated nicely, at least.

This is how I felt there:



They readily agreed to give me a malaria test, and failed to do anything else like take my history and vital signs, or consider any alternative diagnoses. I read a paper last year about how malaria is currently quite low in Zanzibar and Pemba, but doctors are still prescribing malaria drugs as if it was still infecting every other person. So I was quite skeptical when my malaria test came out negative, but the doctors still wanted to give me anti-malarial drugs. Not that the drugs would hurt me if I wasn't positive, but I wondered if it wasn't malaria, what was it? I didn't want to be sent home with drugs for a disease I didn't have, only to continue to be wasted by an unidentified problem. (This, by the way, will likely be one of the topics of my dissertation. Talk about participant observation!)

Anyway, the treat-the-malaria-and-see-what-happens-route won out, and I took some drugs that we brought from the US, and we know are very effective. We learned our lesson in 1999! Unfortunately, my stomach wasn't too happy about that, and they came right back up. The doctors decided to give me an anti-nausea shot in my bum, and I tried the malaria meds again after letting that kick in. Again, they came right back up.

I was obviously feeling terrible by this point, wondering what my real diagnosis was and how on earth I was going to get better if I couldn't take anything. I asked them to check if I had anemia, since I suspected I had, and I might as well check it while I was there. The test showed I was moderately anemic, borderline with severely. That gave me a pretty big shock, and it definitely showed on my face, because poor Juma just about started crying, worried about his mom getting better.

The doctors wanted to give me an IV to get some fluids in me, but I was worried that would only dilute my anemic blood further, so we just went home. (I could've had one, I wasn't that low, but neither me nor they knew that.)

Back at home, I collapsed on the couch directly under the AC unit, the only cool place in our house. Thankfully, the electricity had been restored while we were at the clinic. I lay there, wishing I was unconscious, until I couldn't hold it anymore, stopped by the bathroom for some more doubly fun times, and then collapsed in bed around eight pm.

Our friend and my co-researcher, Dr. Alison, heard about my woes and called to hear more and make recommendations. She said if I wasn't improving the next day, I was welcome to fly down to Zanzibar so she could keep an eye on me and refer me to the best Zanzibari doctors, or I could fly to Dar es Salaam, the main city on the mainland, for some even better care.

I stayed in bed for twelve hours, alternating between sleeping and thirstily sipping oral re-hydration therapy and water. I was able to keep the liquids down, and by morning felt better.

Which still wasn't even close to good.