Wednesday, September 21, 2011

Why legs? Why?

Two nights ago, might have been the longest night of my life. Maybe. At least the top 5. It was Monday night and was on day 3 of malaria. Although I was tired, I was feeling ok so since I was supposed to work in the evening, I headed down to the hospital at 2:30. My friend saw me walking down the hall and as soon as he saw me he started waving at me to leave and go home. I put up a small fight but my heart wasn't really in it because I was still feeling a little run down so I went home. I was so grateful that evening because it was really nice to rest for one more day. That evening at about 7, 8 pm I was feeling awesome. Since I hadn't slept well in the last 4 nights I decided to take a Benadryl, knock myself out, get a good nights sleep and be back to 100% the next day.
I took my Benadryl at 9:03pm. I tucked myself into bed at 9:40pm. And I turned. And I turned. Back. Left side. Stomach. Right side. And repeat. What's wrong with me? Why am I so restless? After 2 hours of this, I decided to get up and take another Benadryl. Really knock myself out. I also took some Tylenol because...well, it was my new best friend and I remembered from grad school that sometimes if old people are having trouble sleeping it's because they're in pain and Tylenol can help. Well, I am almost 30 so if it works for them, maybe it will work for me. Also, my legs felt really weird. They were tingling and would occasionally have little bursts of pain that would sometimes make my leg shoot out almost involuntarily. Eh?
I laid in bed for the next hour, it all of the sudden struck me. Mosquito repellent. Because I was planning on working that evening, and because I am now terrified of mosquitoes, I'd doused myself in the stuff before going down to the hospital. Maybe a little TOO much. So at about 12:30 I got up to take a shower and scrubbed scrubbed scrubbed my legs to try and get all the DEET off. There, I thought. That should be better.
After another hour and a half, it hadn't changed. But I'd began to notice something. The pains only came when my legs were still. As soon as I moved them they'd be better for about 5 seconds or so, and then the pain/tingling would come back. So as long as I kept moving my feet every five seconds, I was good. But that isn't all that conducive to a good REM cycle. I tried to do a little tap tap of my feet to see if that would be good enough to keep the pains away...not so much. As I was telling this story to my friends in the hospital, we were all laughing at the thought of my legs shooting out involuntarily from pain and trying to sleep while still moving my feet.....but I'll be honest, at 2am I wasn't laughing.
Although I've never had this problem before, I thought this sounded like Restless Leg Syndrome.....because that's exactly what it felt like. My legs were annoyingly restless! Google time. The Internet is AWESOME here at 2am by the way! (And by awesome I mean it takes 2 minutes to download a page instead of 8). Anyway, as I as reading, some of the causes that stood out to me were
1. New illness (check).
2. New medication (check).
3 Stress (check).
4. Iron deficiency anemia. I went into the bathroom to look at my conjunctiva. Nope, pink as ever. Ok, so it's probably not that one.
Then I went to the cures.
1. Lots of drugs that I don't have here.
2. Massage- I started rubbing my legs.
3. Stretching- I went back to my cheerleading days and started doing all these leg stretches, while still continuing to massage them at the same time....all on my bed....under the safety of my mosquito net.
3. Walking- By 4am with no improvement, I decided it was time for a walk. I walked down to the hospital (although I didn't go in because I didn't want to answer the questions about why I was creepily walking around at 4am). Was that enough walking? The Internet didn't specify the distance I needed to walk for a cure.
4. Warm baths- I don't have a bathtub so when I got back from my walk I heated up some water and just kind of poured it over my legs. As good as I'm going to get.
Hopeful, I headed back to bed. None of my remedies worked. I laid there until 7 and decided it was late enough and went over to the doctor's house to say "What the heck is wrong with me?????" and "Is this going to last forever?????"
After talking with them, we decided that it might have been caused by toxic DEET exposure (he knew of someone who was admitted into the ICU after putting mosquito repellent on in July when it was really hot, causing her pores to be open and absorb a lot). Another possible cause was the fact that the day before I had taken
a. Artusunate for my malaria
b. Keflex for my knee infection
c. Bactrim for my ear infection
d. Benadryl to knock me out and
e. Tylenol for my aches and pains. Since I usually take NO medicines, it might have just been too much for my body to handle.
Anyway, I am SOOO happy to report that last night my legs stayed right where they were supposed to and nary a tingle was felt. I am now considering myself officially cured from malaria (I know, I know, it's with me for life) and am back to normal!! Thank you Jesus!

Sunday, September 18, 2011

Mal. Aaaaaaaria.

About 2 weeks ago, I fell down while walking to church. For those who know me well this won't really come as a surprise. In high school I was "voted" most clumsy which if I remember right really just involved my friend who was the editor of the yearbook sitting around telling the rest of the staff all the times I'd humiliated myself in the last 4 years. (Amy...correct me if I'm wrong.) :) Anyway, I fell down. I scraped my knee. No big deal. Well, about 2 weeks later part of it still wasn't healing so although I was hoping my superb immune system would mount a last ditch response, I finally broke down and started taking antibiotics.
This led me to think about the medicines I've had to take while here. I had a whole blog written in my head about how the medicine I've had to here hasn't been for the crazy things like malaria, dysentery, typhoid, etc. but for things like an infected scratched cornea, a perforated eardrum (twice) and now for a silly little fall.
So I had the blog written in my head and was getting ready to post it when I go it. IT. Mal. Aaaaaaaria!!! (Earlier this year I went to a lecture on malaria by a malariaologist?? and that's how he said it. In the scary ghost stories by the campfire voice.)
I stopped taking my malaria medicne a couple months after arriving in the country. Before you go postal on me (Aunt Berta), let me explain. I really really really like my liver and kidneys. And I couldn't find any studies that showed the long term effects of taking an antimalarial. Since I could potentially be here for lots of years, I was leery about taking them for so long. I've heard some horror stories about patients on dialysis who SWEAR it was because of the malaria med they took. Anyway, upon the advice of some friends, I went and picked up a bunch of malaria test kits and anytime I feel weird...even if it's just a headache, I do a quick test. My plan was to most likely get malaria eventually but catch it early so it doesn't kill me.
On Saturday I wasn't feeling too bright. But I could account for all of my symptoms.
1. Every muscle in my body aching.- On Friday evening I returned from a road trip which had me on the worst roads I've ever been on here....for 7 hours. Of course I'm achy.
2. Headache.-The last three times I've gone on a road trip I've gotten a really bad headache. I think it's because I don't drink a lot (not a lot of rest stops in Sierra Leone) so I get dehydrated.
3. Lightheaded/nauseated.- I hadn't slept well the last two nights so I knew I was tired. And my symptoms weren't that bad so it could totally be attributed to fatigue.
4. Fever. I checked my temp and it was 101.2. This would normally be a dead giveaway since I don't remember having a fever....ever. BUT I have this dang infection in my knee so....
Anyway, I did my little test and sure enough, positive. But BARELY!! I think I did catch it pretty early.
I took some Tylenol and started my malaria treatment. About 40 minutes later I started sweating profusely when my fever broke. But I felt a TON better! The fever was gone, the aches were gone. In fact, I went back down to the hospital because they were swamped and I told my friend I'd come help if I could. However, after a couple of hours I started to feel not so awesome again so I went home.
Tylenol is my new best friend. It was incredible to see the difference that it made. By that evening, I could tell exactly when my four hours were up because at about 3 hours 45 min. my fever would start going up, the achyness would come back and I'd want to throw up again. But after I popped a pill, I'd start feeling better soon! As I went to sleep, I thought "Hey, this malaria isn't too bad...."

That night was a rough one. Even though I've been giving Tylenol to my patients for years, all of the sudden I couldn't remember if the max dose for 24 hours was 2 grams or 4. I knew my spleen was already taking a hit from this malaria so I didn't want to mess up my liver too so I didn't take my Tylenol when I probaby should have. I didn't really sleep that night.

I also discovered that I'm not a very good patient. At one point I was shivering so bad and figured I had a temperature but instead of doing what I always tell my kiddo's moms to do (tepid sponging, take the winter hat off, etc.) I went and got my sweatshirt, blanket and socks on. I was sooo cold! Temp: 103.3. Oops. I didn't care. Definitely time for some Tylenol....liver damage...who cares? An hour later I was drenched. Tylenol, you're awesome.

In the morning, I was tired but feeling better. I was able to stop my Every 4 hour Tylenol schedule. I did "call in sick" for the first time in my life, but I don't think people would have known I was sick if they hadn't announced it in church. :) I had lots of visitors come to say "Osh ya?" (It means.....I'm sorry for you! I've said that to hundreds of first time having it said to me!) :)

Anyway, it's now almost 4am and I've been up for a couple hours. I couldn't really sleep and my fever went back up again but not nearly as bad as last night. All in all I'm thanking God so much for his protection! I know malaria is nothing to take lightly but I'm thankful I didn't get too sick and now have some antibodies! So thanks so much for your thoughts and prayers! In terms of getting a disease that I've seen kill so many, I'm very very blessed!