May and June were disquieting months. In May, Kate had keyhole surgery to remove part of her sigmoid rectum colon which was cancerous. It was a relief to find out later that her lymph nodes were benign. Dengue put me in hospital on 25 May.
While I was away, poor dad had to deal with contact dermatitis around his torso from a new washing detergent. Somehow that experience put him on another planet! Dad's 94. And then in June, mum joined me in hospital for her lung infection. In the meantime, Kate started to see spots in her right eye. She had gone for laser in March for a torn retina in her left eye.
In Kate's own words, " It is pouring!!" but I told Kate to just go with the flow of things. We did not know then that we were gaining strength for what was to come.
"The storms that threaten to destroy us,
God will use to strengthen us".
God will use to strengthen us".
-The Daily Bread, 20 March 2013
The Dengue Trail
But first my Dance with Dengue. I thought it might be useful to document my experience. There are notes taken from http://www.webmd.com following my writeup.
tues 21 may
9pm: severe vomiting. Head spinning. Had to sit on the floor. Couldn't do mum's night feeds (mum was on nasal gastric tube feeding)
wed 22 may
whole day: best described as a sinking, lethargic tiredness. Couldn't really function. I remembered saying to everyone "I've never been so so tired in my life, not even after 3 sleepless nights looking after mum". I just lay on the opium bed, listless. Lost my appetite. Could only stomach ice cream and biscuits.
thurs 23 may
Intermittent low grade fever: 37.5C
Again I couldn't really eat. More ice cream.Tiredness went away.
fri 24 may
Intermittent low grade fever: 37.8C tops
Again lacked appetite. Started taking isotonic drinks (found out that was the best thing I could have done).
Lost 2kg in 3 days.
Niece and I discussed possibility of dengue. Figured it was ok to see the doctor the next day when I went to the market. (Could have been a disastrous judgement error!)
sat 25 may
10am: in between marketing, saw the doctor, took blood test for dengue.
730pm: doctor calls to say platelets have dropped to 112 (normal min 132) and to go to A&E to do a Full Blood Count seeing that it was the weekend.
I hesitated and said maybe tomorrow. My niece and sister said "No Way. Go Now".
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| EDTU bed space-private,cheerful |
I went to A&E. Within half an hour I had gone through triage and was inside the holding room on a drip. Blood was taken and at 1030pm, the results came back. My platelets had dropped to 63. (Another warning: do not delay getting your blood test! Go to A&E if there's no alternative.)
I was transfered to the Extended Diagnostic Treatment Unit (EDTU) to wait out 24hours.
sun 26 may
My second blood test result came back. The cheeky ward doctor asked me to guess the number. I said 75, he said 23 and "up to the ward you go!" It was Dengue.
My friends (bless them for visiting and feeding me) and I joked about my prolonged stay in hospital.....that it was enforced rest for me. Going through my parent's Daily Bread Booklet, I found this somewhat apt quote:
"My Shepherd is the Lord who knows my needs
and I am blest;
By quiet streams, in pastures green,
He leads and makes me rest"
He leads and makes me rest"
-Psalter
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| not too many rashes |
And I was really very lucky. My bout with dengue didn't run the gamut of dengue symptoms. My fever was low grade and except for the one night of head spinning vomiting and that one day of terrible lethargy, I didn't experience the headache, aches and obvious rashes which normally accompany dengue.
However, this may not have been a good thing because my platelets had dropped rather rapidly and without outward signs I could have been lulled to complacency, delaying diagnosis and IV hydration---and that could have been fatal. The lesson learnt: DO NOT DELAY
mon 27 may
Platelets stabilised at 22
Had an altercation with the Ward Consultant. This Doctor with minimal bedside manners said I should go home when my platelets hit 30 because it was protocol. No explanation. Just protocol. Of course I hit the roof and said "No way. I am staying here until it reaches 100, protocol or not". I immediately went out to the reception area and said I wanted to change the consultant. As it transpired, it was consultant change day and I had a really nice lady doctor take over.
tue 28 may
platelets went up to 30. I was told in no uncertain terms COMPLETE REST IN BED. What? You may fall and have a stroke. OK! But back ache inducing it was to stay in bed. So I stayed in bed, but for only 1 day. I was also not allowed to move anywhere unaccompanied. Somewhat disconcerting having a shadow in the toilet! Luckily my platelets started to climb. Phew!
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| infected IV canula site on Left Hand |
platelets :56
The site of my IV canula became infected and my adventure with surgery began. The Ward Doctor, a not terribly patient friendly lady, was going to send me home with Scar Tissue Cream. I showed the Consultant my hand and she instantly called in the Reconstructive Hand Surgery Consultant. He said it was better to operate than try to get the bacteria out with oral anti-biotics because of my dengue bout and compromised platelet count. There was a strong chance the vein was infected and would eventually be taken out. The bacteria was Staphylococcus Aureus.
2pm that afternoon, I went for surgery under local anaesthetic. The wound was not stitched up as the surgeon needed to check in a couple of days if the bacteria had been removed.
Question was---why did the IV site get infected? My body or the hospital? For 60 seconds I contemplated making it an issue but then decided I needed to heal, not introduce more toxins in my body!
thurs 30 may
platelets :108
fri 31 may
platelets : did not take blood for dengue.
Back to the Operating Theatre. The infection seemed to have spread as there was redness up 75% of my left forearm. I did not ,of course know, the surgeon had removed my vein but when I heard him say "culture the specimen", I knew the vein was out! And it was a 7.5cm long wound.
sat 1 june
platelets : 220 Green Light to Brush My Teeth....home free (from dengue i.e.)
mon 3 june
Surgery to check if the wound was free from bacteria and to stitch it up. I had 14 stitches and trust me, while it was not terribly painful, it was no day at the beach either as i could feel the needle going in and out at certain points. I supposedly had local anaesthetic???
tues 4 june
Discharge Day
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| mum the piglet and me the rabbit in hospital together |
BUT I didn't leave the hospital. Mum was admitted on 1 June and we were, for 3 days,neighbours in the same ward. Mum was discharged on 15 June. We went home in an ambulance. Around dusk, the next day, mum lost her battle with pneumonia.
In retrospect it wasn't about Dengue or the Scar. It was about the gift of time. 14 very precious days with mum. Continuously on oxygen, mum endured many needle pricks for blood tests and IV antibiotics and somewhat strained and rapid breathing with the slightest exertion. Mum's quiet and dignified response to her situation was a beautiful lesson in acceptance and surrender. This helped my family members and I sadly but warmly embrace mum's death.
Dengue fever is transmitted by the bite of an Aedes mosquito infected with a dengue virus. The mosquito becomes infected when it bites a person with dengue virus in their blood. It can’t be spread directly from one person to another person.
Symptoms of Dengue Fever
Symptoms, which usually begin four to six days after infection and last for up to 10 days, may include- Sudden, high fever
- Severe headaches
- Pain behind the eyes
- Severe joint and muscle pain
- Nausea
- Vomiting
- Skin rash, which appears three to four days after the onset of fever
- mild bleeding (such as a nose bleed, bleeding gums, or easy bruising)
Sometimes symptoms are mild and can be mistaken for those of the flu or another viral infection. Younger children and people who have never had the infection before tend to have milder cases than older children and adults. However, serious problems can develop. These include dengue hemorrhagic fever, a rare complication characterized by high fever, damage to lymph and blood vessels, bleeding from the nose and gums, enlargement of the liver, and failure of the circulatory system. The symptoms may progress to massive bleeding, shock, and death. This is called dengue shock syndrome (DSS).
People with weakened immune systems as well as those with a second or subsequent dengue infection are believed to be at greater risk for developing dengue hemorrhagic fever.
Diagnosing Dengue Fever
Doctors can diagnose dengue infection with a blood test to check for the virus or antibodies to it. If you become sick after traveling to a tropical area, let your doctor know. This will allow your doctor to evaluate the possibility that your symptoms were caused by a dengue infection.Treatment for Dengue Fever
There is no specific medicine to treat dengue infection. If you think you may have dengue fever, you should use pain relievers with acetaminophen and avoid medicines with aspirin, which could worsen bleeding. You should also rest, drink plenty of fluids, and see your doctor. If you start to feel worse in the first 24 hours after your fever goes down, you should get to a hospital immediately to be checked for complications.Preventing Dengue Fever
There is no vaccine to prevent dengue fever. The best way to prevent the disease is to prevent bites by infected mosquitoes, particularly if you are living in or traveling to a tropical area. This involves protecting yourself and making efforts to keep the mosquito population down.To protect yourself:
- Stay away from heavily populated residential areas, if possible.
- Use mosquito repellents, even indoors.
- When outdoors, wear long-sleeved shirts and long pants tucked into socks.
- When indoors, use air conditioning if available.
- Make sure window and door screens are secure and free of holes. If sleeping areas are not screened or air conditioned, use mosquito nets.
- If you have symptoms of dengue, speak to your doctor.
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