As someone from a fairly sedate country with fairly sedate diseases, I have long felt that the tropics have a near-monopoly on the nastiest, most horrifying infections, including the ones that lay eggs in your brain.
That said, during my nine years in this part of the world I’ve managed to only be afflicted with fairly prosaic infections: a good number of bacteria have crawled their way inside my respiratory tract; I’ve had to receive enough rabies and tetantus shots to inoculate an accident-prone elephant; and perhaps I’ve had a horrifying mini-stroke or two, give or take. But as far as I know, nothing has ever laid its eggs inside my brain.
However, last week I received a bit of a crash course in tropical diseases. It started off innocently enough: at my work Christmas party on December 21, while entertaining my colleagues with my karaoke renditions of The Little Drummer Boy, The Christmas Waltz and other seasonal classics, I started feeling a bit weak. By the time I made it home a few hours later, I felt certifiably gross, and wasquite feverish. I slept until late the next morning, thinking it was one of those quick-to-come, quick-to-go flu infections – the kind where the primary symptom, extreme tiredness, leads elegant into the best treatment, bed rest. After about twelve hours in bed I did feel better, but later that day the fever attacked me with renewed vengeance.
Now I was getting worried, and realizing that this wasn’t the usual 24-hour wonder flu. Was this leptospirosis? I had some scratches on one of my feet, and a typhoon had recently brought a lot of rain, and I’m sure my feet ended up in a few big puddles. Or could it even be malaria? I had been in the jungles of Sumatera a month before, so anything was possible.
That night I went to the nearly empty ER of a nearby hospital to find out. Sadly, the blood work showed no bacterial infection – I had been hoping for a nice, non-drug-resistant bacterium to absolutely flatten with high-grade antibiotics, but I would not be given that satisfaction. They also gave me the tourniquet test for dengue fever, which basically means squeezing my arm until I complain loudly, and seeing if my complaints were accompanied by telltale discolourations on my skin. However, nothing showed, and the doctor told me to come back the next night if the symptoms persisted.
After another 24 hours of burning and turning in bed, I returned to the ER to find out why my body was still so damn unhappy. Finally, the doctor requisitioned dengue tests, and after experiencing a sudden rush of nausea I crawled into bed to wait for the results. The hospital lab was already closed, so they had to send my blood who-knows-where. After two hours, the results were delivered with a long face: I had dengue fever, a mosquito-borne viral illness that makes life miserable for millions of city-dwellers in the Philippines and around the tropical world.
Dengue fever?! Much like encounters with ghosts, dengue had always been something that seemed to happen with alarming frequency to my Filipino friends, but never to me. After rebuffing an offer of hospitalization – preferring to be miserable in my own damn bed – I slinked home, trying to wrap my head around the diagnosis and what it meant.
Dengue is extremely common in the Philippines – and, I believe, has become even more widespread in the last few years. But in spite of how common it is, my bedridden research also informed me that there’s not much that can actually be done to treat it. Basically, they do a lot of tests and nod their heads sagely while you consume cubic metres of water and just try to get through the damn thing. If things are dire enough, they’ll hook you up to a dextrose IV or give you transfusions to offset all the platelets leaking out of you.
I was in bed about 22 hours a day, with aching legs, mild headaches, and almost nonstop fever. Sometimes I was asleep, and sometimes I was squinting at my phone, reading more Cracked.com articles than was medically advisable. Sitting up was a chore, eating was a wearying obligation, and bathroom breaks were a dazzlingly frequent byproduct of my water therapy. Christmas Eve and Christmas Day were spent this way, with the added trauma of my dear housemate repeatedly saying “Merry Christmas!” to me as I rolled uncomfortably around in my bed. (Considering that she helped me get through the whole miserable ordeal, I guess I’ll forgive her!)
I also returned to the hospital for blood work every 18 hours or so, watching my platelets plummet lower with each fresh drawing of blood. And each time, I received fresh insistence that I should absolutely, positively get myself hospitalized. And each time, I politely scoffed at the idea of spending a whole bunch of money (whether my own or my insurance company’s) just to receive treatment for a disease that has no real treatment. I could administer cutting-edge water therapy just fine in the comfort of my own bed, thank you very much.
Eventually, I started avoiding consultations with the doctors and going straight to the lab window to get my latest Complete Blood Count. The lab staff were, at least, uniformly kind and gracious as they delivered the bad news each time. Each lower number forced me to again wonder if this was what would finally change my dengue from the garden variety into a hemorrhagic nightmare of bloody nose, bloody vomit and bloody stool. And each lower number forced me to again consider committing myself to Asian Hospital, a nearby hospital in Alabang which is known for its price-gouging, but which seemed like the best place to receive an emergency transfusion of platelets without picking up a bit of HIV in the process.
Luckily, after four solid days of abusing my poor bedsheets with my ceaseless rolling-around, my fever began to subside and the aches grew milder. And, most importantly, the prospect of an unhappy insurance company was averted. When my platelets rose for the first time – albeit modestly – I whooped with joy as the lab tech handed me the results. The fact that recovery is accompanied by ugly rashes, which for one night made me itch worse than I ever have in my life, only slightly detracted from the celebration.
A few days after my recovery began, I was able to resume my old life, albeit with a bit of lingering fatigue, and still without my old legendary enjoyment of food and drink. Presumably my body had to do a bit of work to vacuum up all the plasma that had leaked out of my veins and into my body cavity, but at least I didn’t experience any symptoms related to that particular cleanup job.
I can only hope that paranoia will not be the main lasting legacy of this dengue fiasco, with each tiny mosquito bite leading to fresh worry as I wait for it to explode into a new dengue infection. The fact that repeat infections of dengue are much more likely to come with bloody, messy, horrible complications doesn’t help. At least a dengue vaccine will be introduced to the Philippines this year, except that it doesn’t sound like it will be entirely effective. I’ll still be first in line, though! Because I want to spend my next Christmas wondering what presents people gave me, instead of wondering whether I’m going to suddenly start bleeding from my bowels.
Happy New Year, everyone!