Wednesday, July 18, 2012

MALARIA BITES!


 

You Won't Find This is my Book, Safari Jema, But This is the Real Epilogue to Spending Almost a Year in Africa.


    “I think I’m dying,” I said reluctantly to my husband.     
     We had been back from Africa less than a month and were Christmas shopping at IKEA, the Swedish everything-for-your-home superstore, when I was suddenly gripped by a horrible, squeezing, breath-stealing pain in my chest.  At first I thought I was having a reaction to a Swedish meatball I had consumed an hour earlier, but then I thought about my family medical history, mainly the chapter on heart attacks. “I really think I’m dying,” I repeated.
     “Here?  In IKEA?  It’s Christmas!” he said with disappointment.  We concluded long ago that it would probably be a Third World bus that would get us in the end, not Scandinavian furniture.  Then he asked, “On a scale of 1-10, how bad is the pain?”
     “Ten point three,” I whimpered. 
     Scott propped me against a double door refrigerator and said, “I’ll get the car.”
     After a few minutes I began to moan my way through the cutlery, gadget, and bedroom departments to the exit and into the car.  Even though I had discreetly removed my bra in the glassware department in an attempt to relieve some pressure, the pain was unbearable.  Flustered and anxious about what might be wrong with me, Scott went to a place he often goes to for solutions.  He drove into a Home Depot parking lot across the street from IKEA and called 911 from his cell phone.
     After Scott relayed my symptoms to the dispatcher, she told him to go into the Home Depot and ask for two things:  the exact address and a defibrillator. 
     “Great,” I gasped.  “The emergency operator thinks I’m having a heart attack too.”  As Scott disappeared into the store I imagined him at the cashier counter asking if they had a defibrillator and being told “Aisle 4.”  Despite my increasing discomfort, that made me laugh. Only it came out sounding more like “harg” than “ha.”  Soon a policeman appeared by my side and asked me not to move and, more importantly, to keep quiet. 
     A few short minutes later an EMT arrived and began asking me lots of questions while getting me into an ambulance.  The answer to one question in particular seemed to get his attention.  “Have you had any recent diseases?” he asked.
     I replied, “No,” then, “Well, we just returned from almost a year in Africa and I had malaria twice in the last seven months.”
The EMT looked up from his clipboard and said, “Wow!  Ten months in Africa?  What was that like?”
     I groaned.
     “Hmmm,” he said remembering why we were in an ambulance together.  “Malaria … I think you may be having a gallbladder attack.”
     Obviously I have no concept of my own anatomy because I pointed to a spot near my belly button and said, “But it doesn’t hurt there.”
     The hospital emergency room looked like a movie set with harried nurses too busy with too many patients.  Zoom in and I am on a gurney in the middle of the pre-holiday rush.
     As the gurney was bumped repeatedly by staff trying to negotiate the crowded hallway I said to the EMT, So we just keep being in the way until someone notices us?”
     “Yep,” he said finding a comfortable position for himself between a wall and me. 
     Timing is everything and with his skillful maneuvering of the gurney more and more into the horde, we were noticed by a doctor when she walked into my size nines that were hanging off the end of the gurney.  The EMT gave me an admiring smile as if I had planned the whole thing.
     Coincidentally, the doctor assaulted by my feet had just returned from Africa, so she too became focused on my bouts of malaria.  Or rather the medication I had taken for seven months to prevent malaria plus the meds I took to cure it.  Apparently, in addition to familial traits and diet, some medications can cause gallstones, including malaria drugs, which in my case were useless against malaria but did a fine job of making mush of my gallbladder. Anyway, six-and-a-half hours later at 1:30 in the morning it was confirmed by CT scan and ultrasound that I had, to use the exact medical term, “a whole lot of gallstones” trapped in a duct, which were affecting my liver, so the stones had to come out.  To cheer me up Scott said, “No wonder you look yellow.”
     Unfortunately there was a run on pneumonia that December eve so there were no beds available in the hospital.  I spent the next twenty hours on a gurney in the ER next to Ruben, a homeless alcohol-poisoned man who it turns out is a regular guest at the Redwood City Kaiser Hospital.  On the other side of me was a young man who gurgled fluid in his throat all night. Several times he tried asking the nurses, “Should I cough?” but they never heard him through the gurgle.  Finally, I couldn’t stand it any longer and from behind the curtain that separated us and in my best emergency room nurse voice I said, “For the love of God, man!  Cough it up!” It must have felt good because for the rest of the night at about five-minute intervals he coughed, spat and said, “Oh, that felt good.”  Gurgle.
     Meanwhile, next to me, Ruben putrefied his bed and the very nice nurses (honestly, the nurses there are great) while tending to his medical needs with compassion and professionalism said, “Ruben, you stink!  Give us your clothes, and we will wash them or buy you new ones.”
     “No!” said Ruben clutching at his shirt.  Impulsively and with very bad judgment, a nurse removed Ruben’s shoes.  I cannot adequately describe the funk that then permeated every inch of the ER ward, but two weeks later there was still some stuck to my back teeth.  Strangely, I didn’t mind.  As the Smell-o-Ruben reached me, I merely pulled the sheet over my head and sank into a drug-induced sleep.
     At the shift change in the morning, the aroma emanating from Ruben’s shoes and, well, all of Ruben, was the main topic of conversation and protocol between hospital staff.
     “Don’t you know?  You never remove the shoes!” chastised one nurse.
     When Ruben finally left with his latest course of antibiotics and the advice, “Ruben, you must stop drinking!” the cleaning crew came in and were ordered to give his bed a “terminal clean” which means, “If you can’t get the smell out, burn it.”  I think I can safely say that the Redwood City Kaiser Hospital is less one bed now.
     Periodically during my quality time with Ruben in the ER, a doctor came by and (while pinching his nose) said, “We are trying to get you a room.”  I really didn’t care because from the time I arrived the nurses never let the pain go over a four, and I was pretty juiced up on meds.
     After the doctor left, a nurse came in and I said automatically, “The pain is a five” and put my arm out so she could top me off.  But she wasn’t there for that.  She had heard a rumor that there was a bed available on the seventh floor.  She moved me back out into the hall to assume a position known as the In the Way Method of Health Care by parking me under the wall phone used by the administrative staff.  It worked and within a half hour I was moved to 751B between Ruth with pneumonia and Poppy, who seemed to have lots of things wrong with her but was there mostly because she had no one to take care of her at home.  She had a Southern accent and each morning when the attendants (angels!) came to bathe her she would say, “Durty’s bettah” and “I smell chitlins. Someone in here is cooking chitlins!”  If chitlins smell anything like the seventh floor of the Redwood City Kaiser Hospital, I don’t ever want to eat chitlins.  Not that I would ever eat pig intestine anyway.  Yuk.
     During the night a man in the next room had a bad reaction to his medication or to our health care system and began to kick and spit and call the nurses whores at the top of his voice. Boy did the nurses give him what was coming to him - nothing but compassion.  Oh, and leg and arm restraints.  Made me long for Gurgle Man.
     The next day, a doctor came in to tell me that a “procedure” was scheduled for the following morning to remove my gallstone roadblock.  He very thoroughly and professionally explained the procedure to me.  I would be sedated, and he would put a tube down my throat and into my abdomen.  He would make a small cut at the base of the blocked duct and the stones would drop into my intestine or stomach or somewhere.  “And then,” he said, drawing from his many years of medical training and experience, “the stones will come out in your poopie.”
     I was only nervous about the part when he said, “When we put the tube in, you will feel like you are gagging, but you must swallow to help the tube go down.”
     “I don’t think I’ll be able to do that,” I said.
     “Don’t worry,” reassured the doctor, “we will tell you when to swallow.” 
     The next day I received two injections that made me very sleepy.  I was transported to the procedure room and given more sleepy juice through an IV.   I remember telling the doctor, the nurse, the gurney driver, and the wall … “I don’t think I will be able to swallow.”  Then someone squirted liquid into my mouth that numbed my throat, and I said, “I on’t ink I an alow.”
     What turned out to be a half hour later but seemed like only two seconds to me I said, “When are you going to do the procedure?”
     “We already did it!  You did fine,” said the nurse, patting my arm and smiling at me.
     “You mean I swallowed?” I asked in disbelief.
Scott tried his best to get some of that magic drug that makes a half hour seem like two seconds and apparently made me an extremely appreciative patient.  According to Scott I rambled on and on, first to the doctor, “You’re the best doctor ever!” then to the nurse, “You’re the most wonderful nurse ever!” then to the gurney operator, “You’re the most skillful gurney driver ever!” then to the wall, “You’re the most plumb wall ever!”
     My third night in the hospital was uneventful but disheartening to my husband who showed up with a dozen roses thinking he could take me home.  Poppy tried to cheer up Scott by saying, “I’ll make you some chitlins!”
     I finally got to go home on Christmas Eve with the disappointing news that in a month they would remove my gallbladder.  It’s for the best, though.  I certainly couldn’t survive an attack like the one I suffered in IKEA while bopping around the developing world.
     It made me think.  Was this yet another souvenir of our ten months in Africa?  Or maybe all that gelato I ate in Rome on the way home does constitute a fatty diet.  Anyway, I am grateful it happened in America and not in Africa where I was thousands of miles from a doctor who could make stones come out in my poopie.
     As for any lingering effects of malaria, we both feel fine.  But the count and amount on the number of gallstones I had removed was twenty.  No wonder it hurt.  The operation went very well, I guess.  All I remember is trying to get out of my wheelchair at the hospital to give a lab technician the Ethiopian handshake.  The recovery was no fun at all.  Took a good three months before I could do a real sit up.  Food choices were rumored to be challenging, but the only things that I can’t eat now are almonds.  They didn’t tell me I couldn’t eat them.  I ate them and it hurt like hell.  That didn’t stop me from trying three more times though because I really like almonds.  So now they are on a list of things I don’t eat, which contains two items.  The other is cauliflower, which I actually could eat if I didn’t dislike it so much.
     As I recovered from surgery, I thought about the void left where twenty stones once were, and I wondered what would take its place.  Not liking the most probable space filler, fat, I decided that I would store something more positive where my gallbladder used to be. 
     You know that weird nice feeling when something good happens and your tummy flutters?  I decided I would store more of that feeling, more butterflies of excitement.  So when you get an excitement butterfly because you just found out your spouse or friend has surprised you, or your child has made you proud with a great catch or a good deed, think of me. Then think of Africa. I will be.








           

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