My Dengue Journey

Everybody’s writing their Journey stories so here’s mine. This is the fourth time I’ve had dengue fever. According to what’s out there, there are 4 types of dengue. So I have apparently hit them all. Am I a world record or what? So unless they discover a fifth type that should mean that I am done with it and need never fear another mosquito!

Nobody writes much about what the dengue journey is like. You read about the symptoms of high fever, severe headache and backache but not much about the real, you know, experiential part of it all. Today is Day 6 of Round 4.

Headache. Oh yeah. All four times I had a headache. They say it’s often pain at the back of your eyes. Well this time it was the bones above my eyes, the bones below my eyes, the bones of my temples, the bones in front of my ears and my teeth. They hurt so bad I didn’t even notice the back of my eyes! Move your head and unnghhhhhhhhh!!!!!!!!!!!!!!!!

Lower backache? Oh yeah. Not as bad as the time I had it in South America when I had to grit my teeth and stop breathing just turn to the other side. This time I could still breathe when turning but it kept me rolling back and forth ever searching for some comfortable position.

Fever? Of course, that’s why it’s called dengue fever. Highest recorded this time was only 39.8 and that’s cuz a friend persuaded me to take paracetamol whenever it got above 39 (almost 103F). The record was the second time when it hit 41 (105+F).

Stomach pain? It wasn’t so noticeable earlier, it was a vague cycling from extremely hungry to nauseous to slightly painful and back around again. Now that the fever has broken those sensations have intensified. I don’t usually vomit as long as I don’t drink too much at a time. And nothing sounds good so no danger of eating too much. Besides, you get a weird taste in your mouth and if you do eat anything with chemicals in it the flavor of the chemicals is super enhanced.

Rash? Today I do have a rash but frankly I couldn’t really have seen whether I had a faint rash before that or not because when my fever gets that high my vision gets dim. Yeah, literally like somebody dimmed all the lights, including the sun, moon and stars.

What I don’t see mentioned in the medical literature is the weird mental stuff. It’s kind of funny but when you’re in the midst of it, it is not boring. Most of the time you’re lucky and just sleep or lose consciousness but sometimes you see weird things. Like, the time when my fever was 41 (105+F) I would see lots of ugly stuff, like heaps of squirming guts, mounds of worms, disgusting nasty things. If I opened my eyes and looked at something real it helped. But in the dark of a moonless night in a remote village you don’t see anything at all even if you do open your eyes. The only thing that helped was praying and forcing yourself to think about beautiful things like flowers, butterflies, clouds, etc. This time there was none of that but my mind was like incessantly nattering away at nothing, like it was busy-busy working on some urgent problem until I finally had to forceably shut it off and think consciously about something else. Later I was reading a weird email so long I couldn’t scroll long enough to ever get to the bottom and I kept finding it embedded and looped upon itself. The person it was from would never in a million years have been so verbose about anything! Of course in reality there was no such email but hey, I was READING it! I could give you a synopsis of it! That’s the weird kind of mental stuff you don’t hear much about.

The next step is wait and see if you get any of the the hemorrhagic stuff with it. So far on this journey I have been blessed and have not had any bleeding that I ever noticed, no gum bleeding or nosebleed or even noticeable rash. May God grant that this (hopefully) last stage of this journey also be so
blessed.

Do not let your cat sleep on your back

It all started one night when I was peacefully minding my business, snoozing on my stomach. For some reason the cat decided to take a nap on my back. Maybe he was lonely or maybe he felt cold, I don’t know. But since he’s hot and heavy I didn’t really want him there so I wiggled a little to get him off. Instead of getting off he dug his claws in. I know at least one claw went all the way thru my t-shirt!

Now a few weeks later, I have a huge, nasty, painful boil on my back – just below the shoulder blade where it is difficult to reach and impossible to see. They say heat is good for bringing a boil to a head. So for five long days I put hot water in a plastic bag, and tied it shut. Then I tied the bag into a sarong and hung it over one shoulder and tied it like a sash so that the bag would be on top of the boil. But after 5 long days it still hadn’t come to a head and I couldn’t lay on my back at all cuz of pain and swelling. So a couple days ago I finally went to a doc. She took one look and ordered a huge dose of antibiotic. Said she since there wasn’t yet(!) a head she didn’t want to cut until I’d been on an antibiotic for three days.

So here I am 2 days and several doses later. The thing has started to drain a little but is still very painful and still huge and I still can’t lay on my back. I don’t think it is an ordinary staph infection cuz the drainage is gaggingly foul smelling! I guess I'll have to go back tomorrow and see if the doc can drain it all at once.

And so my friends, that is why you should never ever let your cat sleep on your back!

PS It was cultured and turned out to be something the doc had never seen - Morganella morganii. But very consistant with something a cat might drag in  - ughhh!!!

Green energy woes

It seems that we really are having an El Nino this year. We seem to alternate years, nothing normal anymore, just El Ninos and La Ninas. It hasn't been raining daily like it usually does and we have had to water the plants a couple times a week lately. We are told that the lake and river which provide almost all the power on this island are very low and so power has been cut back. Luckily this city has an old 40 MW Bunker-fuel plant as well that has helped pick up some of the slack. It is located less than a kilometer from our place and it has been running almost constantly for the last 3 weeks. It is extremely noisy and even at this distance there is a low pitched background thrumming that kind of gives you a headache after awhile. In fact, one of our neighbors is out house hunting right now because he can't sleep. He says not only is it noisy but it shakes the ground and even using ear plugs and closing windows and using air conditioner don't help. So they are scouting out a neighborhood out past the airport.

Today the power company said the allotment of hydro-electric power has been cut even more so they will have to start rotating brownouts of about 30 minutes duration. The local generator can be cranked up to 53 MW temporarily and when it does it REALLY gets noisy! But it can't sustain that level so eventually it drops back to 40MW and the noise subsides - a little.

So much for our green energy.

Avastin

No, it's not a nautical term. It's a medicine used for retina problems. Monday (Feb 8) I had Avastin injected into my eye – and I have survived to tell about it! What follows is the gory details of the injection. If you do not like gory details just skip this post! But I am writing it for others who may someday need such an injection.

In early January I noticed an area of distortion in the upper left quadrant of one eye. At that point it was not in the macula and did not affect reading. But since I am very myopic I am at risk for retinal issues so went to see a local retina specialist.

I kept hoping the distortion in my right eye would get better with conservative treatment (anti inflammatory drops) but after a few weeks the area only got bigger. Once I decided to go for the anti-VEGF injection I went to the one and only doc in town who does it – and found out I’d have to wait another week because the Avastin would have to be ordered from the capital city. Although I wavered again and again over the next week, the area slowly got even bigger until I was totally unable to read a clock or calander or recognize faces with that eye . Reading a computer screen was slow and difficult even with enlargement, it was like looking through dirty water at italic and other weird shapes with piecs of the letters missing. And of course it is my dominent eye so it keeps trying to take over. By the time Monday came I was ready, if not exactly looking forward to it. The doc had ordered eye drops to start 4 days before the injection and an extremely (excessively?) high power antibiotic (Levofloxacin). Seemed a bit of over kill and after googling Levofloxacin I’m sure my fingers and feet started feeling numb!

Day 1 On Monday after lunch I went and got in line. They took me first so no chance to ask anybody else how it went. I was gratified that they used good aseptic technique, anesthesia drops, betadine drops and a presumably sterile face cloth with only a hole for the eye. The doctor put on some kind of head gear as well (I couldn’t see well with no glasses.) I was told to look off to the upper left. I am very nearsighted and couldn’t see much in the dim lighting but found a piece of shadow I tried to focus on. They put a gizmo to hold the eyelids open and did some more touching of the eye, none of which was painful. The injection itself wasn’t very painful but I saw the swirling of the medicine go in and lost the shadow I was trying to fix my eye on. I’m afraid my eye moved a little as I ended up with a good sized blood clot on the white of my eye. They patched the eye and gave me a list of instructions – eye drops every 2 hours for a week while awake, an anti-glaucoma drug the rest of today and tomorrow. Continue with the antibiotic for 5 more days. no bending, strenuous exercise or activity, no lifting heavy things, avoid sunlight and dust, close eyes while bathing for next week, and come back tomorrow. (The needle was nowhere as big as the drawing shows and was inserted on the outer side not the top.)

Total cost was $760 which I paid in cash after it was done. (And that was the cheaper procedeure. Lucentis would have been over $2100!)

I felt okay but it was weird having an eye patched, you kind of lose distance perspective like stepping off curbs, reaching for things, etc. The eye was starting to ache by the time I got home but the anti-glaucoma pill really seemed to help. I ended up taking the patch off because what with wearing glasses over it my eyelids kept brushing it and it was annoying. I did find a piece of clean gauze in my cupboard to cover it that first night. I could see as well as before the procedure but the blood did look kind of gross and I had to wipe some clots away that ran down after I put eye drops in.

Day 2 went okay, still taking the anti glaucoma drug and high power antibotic and eye drops every 2 hours. When I went back the doc said to not get my face wet in the shower (now he tells me!) but just clean with a cloth and to wash my hair like in a beauty parlor, not bent forwards. Sigh! Do you know how many times in a day a person bends over? Especially a tall person in a short man’s country?? I mean, books off of shelves, getting clothes out of cupboards, pans out of lower cabinets, lower desk drawers. I even have to get on my hands and knees to plug my computer in! That’s not to mention feeding the cats, or picking up things I drop, making bed, etc. Good things my knees are still good as I get lots of deep knee bends in these days! My eyes seemed tired and so I rested in the afternoon and went to bed a little earlier than usual.

Day 3 no more anti glaucoma med and so far so good, no aching. I got my hair washed today with assistance. We did at the outside sink. It was a bit messy and I had to change clothes afterwards but it’s great to have clean hair. It could be my imagination but the distorted area seems slightly clearer, I can read enlarged fonts through it, in a way it’s like having my own private magnifying glass LOL! Though still distorted. Faces are still not recognizable but I can see that it is a face, it’s not just all grayed out. And I can now see the center dot on the Amsler grid. I’m to go back in 2 weeks.

Day 4. Woke up feeling better. The bloody eye feels less sore. The possibly imagined slight improvement is still there. Wondering about this antibiotic tho. Something is giving me a head ache and making me feel kind of buzz-headed and spacey. It’s hopeless to do serious work. The bloody eye is getting slightly yellow around the edges (I can’t see cuz that eye still has the gray spot in the middle of whatever I look at but Maret helped me take a picture of it.)

Day 5 Still have a slight head ache. Wondering if it’s ok to stop the Levofloxacin a couple days early? Vision in right eye is dimmer than left. Used to be the other way around. Letters are also bigger in the right than the left. It’s been that way a long time, long before this bleed started. I CAN read with the right eye – it’s still dim and distorted but I CAN read. Interesting that in passages colored with colored pencil I can’t see the color. Hmmm. But I CAN read it. My eyes don’t work together yet, though so I still feel like things are kind of out of focus. I am going out to a meeting today so we shall see how I do!

Day 14 Went back to the doc today. I feel like the vision has improved significantly, tho not as to what it was before all this started. The line of print I read in a book or the screen is straight and clear tho the line above bows upward and the line below bows downward. I guess the distance acuity isn’t quite as sharp as it was as tho since I am not able to read all the letters on the chart. This doc is Dr Brevity. He kind of grunts and says “It’s flat”. Wondering if that’s good or bad I asked what was flat. He said the macula is flat that it had been swollen last time he saw it. I guess that’s good! But then he greases up the eye with lidocaine gel and sticks his scope in it and grunts again. Then goes off and writes a note to the referring doc and says it’ll happen again. (!?) He sees a scar, a black spot. There’s lattice degeneration and atrophy at 6 o’clock. I can go back to the referring doc in 2 weeks and she can laser it. So I am befuddled. Is this something new again? Why are we suddenly talking about laser??? His brevity doesn't help.

I have spent a lot of time on the internet and don’t find much. It seems no one has definitive answers to my questions such as why did this happen? How can I prevent a recurrence? Is exercise okay or not okay and what kind is bad? Anything but contact sports? Or as one doc said, only slow gentle stuff like walking and Tai Chi? And what about heavy lifting - like heavy bags when travelling and hauling water and washing clothes by hand in the village and hauling stuff on a motorbike? Certainly the three docs I have seem so far all had different opinions as to what was even wrong, let alone how to treat it or what if anything I could do to avoid future problems. Sigh!

Raining in the dining room

Well it’s “raining” again in our dining area. The 2nd floor bathroom of the apartment next door is once again dripping into our place. We are optimistically hoping it is clean water. Most of the previous occasions have been. It somehow gets into the wall and ALWAYS drips down into our place instead of theirs. It would be so much easier if it leaked into their own place – then they would believe that there’s a problem. Sigh!

The handyman came by yesterday and tore out a piece of our ceiling. Ew, what a smell! It’s extremely mildewed and moldy with a hint of something worse. Obviously some slow leaking has been going on a long time to get that much mildew up there. But of course the worker was not able to see what the problem was. He could see where it’s running out of the concrete wall but of course since the pipes are in the wall in the next apartment he can’t see anything from our place. We told him that, after all we have been through this many times over the years but each new handyman wants to rip apart OUR ceiling and see for himself. I’m going to take pictures this time and hopefully save the next guy the trouble!

The worker was uneasy about disturbing the neighbor, after all it’s not dripping into THEIR dining area. He suggested things like cutting a hole in our upstairs floor. Can’t imagine what good that would do, if he can’t see through the hole he already made in the ceiling he won’t see anything additional through a hole in the floor! The water pipes are embedded in the concrete wall – and the waste pipes are above the neighbor’s ceiling.. (I can just see somebody staggering out of bed and falling through a hole in the floor upstairs!) His other suggestion was to chip through the concrete wall from our side to try to get at the neighbor’s pipes.. (Just what we need, a window into the neighbor’s bathroom.)

Sometimes the best thing to do is to just go in your office, shut the door and play a computer game.

Distortion of reality

It’s been a wild week or two around here in the third of my worlds. Two weeeks ago I noticed an eye problem. At first I thought it was due to fancy graphics on a website I was reading but then noticed ALL the windows on the computer were like that. Even the clock across the room looked dented in on one side. Being still a bit jet-lagged it took me awhile to figure out what to do. To make a long story short, I finally got in to see an eye doctor the following week and the next day had some tests. To see a doctor you find out his or her clinic hours and then show up early to get your name on the list. First come first serve. Even coming early doesn’t guarantee you won’t be waiting 3-4 hours on a hard, crowded bench in a tiny hot waiting room.

Having diagnostic tests is always an interesting experience. But even finding this place was an experience. I just kept asking security guards all along the way. You had to wend your way through the hospital and find the back door, go down a dirt alley out to a paved alley and kitty-corner across to what looked like a parking ramp. People I asked insisted the eye place was in there and after wending my way thru rows of cars in the semi-dark saw that there were indeed signs of a building back there. I guess they didn’t want to waste space and so built a parking ramp right at the front entrance. The eye place was cheerfully painted and lighted inside and was well air conditioned. The waiting room was much bigger than clinics around here usually are so I didn’t even need to worry about my knees blocking anyone’s way.

One test involved using a dye. Before the test they wanted to make sure I wasn’t allergic to the dye so they injected a small amount of the dye into the skin of my arm – like a TB test. The guy said it would sting a bit – yikes! He wasn’t kidding! I was NOT prepared for the excruciating pain~ all I could do was try to breathe like they teach women in labor to do. It left a fluorescent green welt on my arm the rest of the day.

Anyway the tests went fairly well once I figured out that when the technician told me to look right or left she usually meant HER right or left not mine. They had been saying I needed a companion to go home (maybe because people come out of there disoriented not knowing which direction was really right and which was left?? Ha, ha!). But since I felt fine I just got a taxi and went home. They gave me the results on two CDs so naturally I copied them and had fun looking at them on my computer.

So far treatment is anti-inflammatory eyedrops that give me a headache. It isn't doing any noticeable good but at least it's not invasive! I still haven’t heard what the doctor thinks is causing the bleeding. Sigh! I sure hope it improves in another week or so and no further treatment is needed. Meanwhile I’m chowing down the green leafies and antioxidents.

Choices, TV, Noisy houses and snow removal

Sometimes people ask what my impressions are of the first of my worlds after having been away for awhile. There are many but here are a few:

People seem to value lots of choices, unending choices in fact, at least over trivia. Coffee shops added another choice since my last visit: dark, medium or light roast. Even sandwich shops- you think you ordered a number 2 and solved all the choice issues? Oh no, you are still asked what kind of bread (6 choices) what kind of cheese? (4 choices) what do you want on it? (10 items to choose from, onions, olives, pickles, tomatoes, etc) What sauces? Mustard? What kind (3 choices of mustard). But not done yet, do you want it heated? Here or to go? Yikes!

Go down the cereal aisle in the grocery store or the soft drink aisle. Guess that says a lot about people's diets, huh? (Here it would be the powdered milk aisle or the junk food aisles.) It's not just food, there are endless cable TV channels, books, movies, magazines.

Some things, however, offer few choices such as the color of cars or the color of siding on new homes. Curiously clothing also offered few choices in style or even color. Example, women's winter tops were long sleeved but way too low in the neck. What's with that? This isn't Florida! And there were only certain colors available, didn't matter what store.

Yet other things offer no choices, such as political parties. The only thing different is the rhetoric. Actions and outcomes are the same.

Television? Unbelievable. Does anybody really watch it anymore??? News-tainment about the fallen hero of the day. And scaring people about the flu. Commercials? Lots of prescription drug ads, all of which have long lists of horrendous side effects including death and suicide.

Noisy houses. Furnaces, water heaters, sump pumps, blowers, beepers, buzzers, dingers, etc. My first nights back here– as I wake up at 2 and 3 am – by contrast were pretty quiet. The house was totally quiet other than my fan and out my open window all I could hear was the Swiss neighbor's cuckoo clock, a distant dog barking, a few leaves rustling in the breeze. That's it.

Snow removal is amazing. After the Christmas storm I saw thick ice on the highways mysteriously GONE overnight! I saw snowbanks being loaded up in trucks and carted away, and other snowbanks literally shoved back from the edge of the roads.

Nothing new in the public bathroom scene. It seems that everything that could be automated already has been. I did notice that in my home state 9/10 bathroom stalls had the TP very low down making it difficult for tall people to reach. Not so in other states. Maybe the state legislature was bored last summer???

"Suicide" drugs

What is with all these suicidal drugs???!!

I am amazed at the countless TV commercials for various prescription drugs. The commercials spend maybe 5 seconds telling what the drug is for and then 25 seconds hurriedly reading a long list of horrendous side effects such as liver failure, edema, coma, death, mood swings, elevated blood pressure, weight gain, and suicide. And suicide is what they all have in common! There are various drugs- antidepressants, drugs for arthritis, bipolar disorder, anti-smoking and more. And suicide is a possible side effect of all. One's distinct impression is that the side effects far outweigh the benefits. Are they really hoping to boost their sales??? Or is there some other purpose for these “ads”??? Creepy!!

Is your laptop overloaded?

According to an article I read recently:

The wealth of media in modern life means the average person is bombarded with enough information every day to overload a laptop computer, a study has found.

Yes, I am feeling that bombardment! Being in my home country for a short visit I am playing catch up with a lot of people. When you don’t see people very often you have a lot to catch up on. And so you are taking in all the latest on what people are up to, their kids, their jobs, spouses, health, hobbies, etc.

Plus there is a lot going on right now politically that even Congress seems unable to keep up with (and it is their full time job!)

Advertising in this country bombards from all directions. Even people like me that try to avoid TV still find our mailboxes loaded with ads. Everything you buy from groceries to electronics comes complete with more coupons and ads trying to get you to buy even more.

As I near the end of my time here I am starting to think about the details of packing and departure. With email and cell phones you are only a text away from issues and events on the other side of the globe. A recent email regarding future visa options has sent me scrambling to collect and “authenticate” some documents.

And I did notice that it is Christmas season which adds a certain amount of time constraint to finish certain things before the holidays.

So I do feel somewhat fragmented and distracted as I think about details of packing and shipping, work plans for the next few months, national and international trends and crises, visa stuff, and whether I should even bother trying to do Christmas cards or just make it New Years’ cards, and Christmas preparations. All of that interspersed with thoughts of the people I wanted to see, books I had wanted to read, events back in the second and third of my worlds, etc.

My “laptop” does sometimes feel like it’s overloaded!

Shooting trouble

In this the first of my worlds, government and business procedures and processes are usually clearly spelled out. You are given an exact list of requirements, documentation, etc and told that the processing takes 5 working days or 10 working days or 6 weeks or whatever. And mostly it does. But in my other two worlds things are much more fuzzy. I have had to develop a technique of on-the-fly problem-solving and trouble-shooting where I don’t wait around for complete understanding because things are only completely understood in hindsight if even then. Just muddle your way through it and figure it out as you go and have no expectations as to time constraints.

Imagine my surprise when I suddenly am in such a situation here! I am supposed to switch to a different kind of visa. The consulate requires “document authentication” of things like transcripts, diplomas, birth certificates, etc. The first step is to get the documents notarized. Sounds simple. Weeeeeeeeell, not according to the 4 notary publics I talked to yesterday! Somehow the list of requirements given by the consulate does not communicate enough to me or to the 4 notaries I have talked to so far, nor to some colleagues who are also spending their Christmas season gathering documents to authenticate. I spent a couple of hours on the internet trying to get some clues plus a couple of hours on the phone and emailing colleagues to see if anybody else has come up with ideas. So far it seems that I am out in front trouble shooting on my own.

But I am not too stressed out. Annoyed, yes, but not stressed. After all, I am used to this. I just have to resign myself to spending a fair amount of time on the phone and internet and running around and just hope most of it is done before Christmas! Who knows, the answer might be just around the next corner or in the next phone call!

And if it doesn’t get finished by the time I leave? Then I guess I keep working on it from a distance!