More on maladies

Never ever ever think that bringing a mass armamentarium of medicines is overkill. I’ve never been so glad for all the meds I packed. If anything, I just hope I have enough of everything to last me. Today was the first day I felt near normal. Five days ago, I started to feel worn out and a little achy. I chalked it up to the long, rough rides from place to place out here in the field, long hours, and maybe “that time of the month.” Ha. By the next evening when my driver dropped me off at my hotel late in the evening, I started experiencing severe chills. I had barely enough in me to make myself take a hot shower (thank goodness I was in Meru where the hotel is pretty decent). Then I collapsed under the covers in bed. I finally dropped off as somewhere in my befuddled mind I worried that despite faithfully taking my mefloquine (antimalarial) prophylaxis, I’d somehow (thanks to constant mosquito bites despite DEET) contracted malaria – great. I awoke a couple hours later feeling extremely hot. Now, I really started to worry. Eventually, I dropped off again. The next time I awoke, I felt neither chilled nor heated but instead, waves of incredible stomach cramping…followed by the need for the inevitable. I haven’t spent such an awful night in…..

The next morning, I downed copious amounts of loperamide (aka imodium), bismuth (aka pepto), and 2 gm metronidazole (this, at the strong recommendation of my WHO local colleague; although I had been inclined to take cipro – he insisted the former was the treatment of choice here) took some toast and tea for breakfast and met my driver for the horrendous ride to Tharaka to go help them in the polio immunization campaign. Somehow, despite a very touchy and queasy stomach not helped by sometimes roller coaster-like rides over the so-called roads, I made it through that day (my driver, sensitive to how I was feeling, tried to take some of the roads slowly and said later that I looked pretty awful – great; I really felt like death warmed over) .

The next night was only slightly better in that I didn’t suffer chills or feel overheated, but I had a fitful night thanks to constant searing stomach cramping despite having taken meds. The next morning I decided just to be on the safe side and started myself on a course of cipro – you know, being a doc and knowing the potential differential diagnoses is not always a blessing.

Who knows if the metronidazole or the ciprofloxacin worked to improve my symptoms faster? All I really care about is that I’m finally starting to feel something close to normal. The thing that worries me is that I’m only a few weeks into my three months here, and I had thought I was being so careful. Of course, there are a number of possibilities where and how I could have picked up the bug despite my cautiousness…the water I shower with despite being careful to try to keep it out of my mouth, the meals despite being mostly cooked or peeled fruit – still not a guarantee, and, of course, any one of the many kids with whom I’ve come in contact through my work here are just a few possible sources.

I really hate being sick.