TheExpatJournals.com

WARNING: NOT FOR THE WEAK: Okay, I wasn’t going to post this because it’s so graphic, however, I can’t seem to help but write about everything. Be glad that you people are spared most of what I write!

This is what I wrote about how it felt to be ill and I warn you, stop reading now if you’re looking for pleasant. I only found one account online of a guy who wrote about his illness and because KC, a neighbor, had it when he lived up in Bocas, I was glad to have someone to call especially when the rash hit. Is this normal? Did you experience this? It helped me to know I wasn’t experiencing some unique symptom and KC, thank you for being there with info, support and Pedialyte!

I don’t know if fatique is a normal early warning sign, but I do know that for days before it hit, I couldn’t understand my own exhaustion. Granted, I was doing a lot of physical labor I’m unaccustomed to in order to thoroughly clean off the mildew and rust from every possession I owned after my two months in the breathable pit of water aka my apartment in La Cresta. So after two hours of cleaning one Saturday morning, all of a sudden I felt like I was going to faint. And no, it wasn’t the sort of `uh oh…I stood up too quickly’ temporary blackout. This was different. I’ve never fainted before in my life, but I knew that if I didn’t lay down, I was about to.

Within the hour, I was physically wasted. My temperature shot up and I couldn’t stand without feeling like I was going to pass out. I felt horrible. That afternoon, a friend brought me paracetamol in the form of Tylex (a miracle drug down here as far as I’m concerned) and a thermometer. My temperature was 104 and the entire back of my head felt like it would explode from the headache. I was shivering under covers in an un-air conditioned room and during the very brief reprieve from the fever that the Tylex brought, I would begin to roast and perspire as the temp dropped. My fingers ached and I just assumed it was from 4 days of sanding a hand-made metal painting frame that had rusted during the aforementioned 2 months. Then I began to notice how my hips ached, too. Another name for dengue is break-bone fever and now I understand why. There was no such thing as a comfortable position in bed and getting out of bed was impossible. I was pouring water and gator aide into my system and nothing was coming out. I have never in my life felt weakness like that.

When my son was born, it was 40+ hours of labor and once he was out, I felt my blood pressure drop. When they tried to place him in my arms, I did not have the strength to hold him. That’s the only other time I can remember feeling this weak. I couldn’t lift my arms let alone my entire body. I knew that if I did stand, I would faint. Food was a non-issue. Water was the only thing I needed. I tried watching TV to pass the time, but fortunately, for the most part, I slept. Day and night I slept.

By Sunday, I realized that if I turned my eyes in any direction, it was incredibly painful. Later I learned the term for this is retro-ocular pain….literally pain behind your eyes. That weekend is a bit of a blur in retrospect, all pain, fever, sleep and debilitating weakness. By Monday, the fever dropped to 102 and that felt like a huge relief. The weakness was still as crippling as it had been all weekend, but now, I was in a constant state of nausea and, oh joy, the diarrhea began, slowly at first but building up to around 12 times an hour within a couple of days.

It seemed each new miserable symptom had a 2.5 day life before it subsided just enough and just in time for the next new horror to begin. By Tuesday, it was abundantly clear to me that this was not the flu, it was not some stomach virus, it was nothing I had ever known before and it was very bad. I now looked like I had sunburn. As new miseries unfolded, I seriously began to wonder if this was going to kill me. And I didn’t know. And while I do know it would have been smart to go to the doctor, honestly, I couldn’t. I would have had to go in an ambulance because there was just no way I could possibly get to the doctor otherwise, not in a taxi and not even if a friend had driven me. I couldn’t stand up, sit up, or even lift my arms without the feeling of utter exhaustion.

And now, everyone says they would have helped. At the time, however, I could not think and the one friend I did reach out to was the one friend I could never in a million years have imagined not being there for me and she couldn’t be bothered. So, combined with how asking for help still feels like an imposition, I assumed I was on my own and `if you need anything’ meant `in theory’, not in application. So I poured myself into a taxi and went to the doctor. Got the thorough round of labs, a prescription for the nausea and returned home to sleep. She wanted to give me saline solution then because of how low my blood pressure was, but I didn’t want it given how difficult it is to get a vein on me and given the misery I was already in. That turned out to be a big mistake. This was the first time in my life I was dealing with dehydration that couldn’t be resolved by drinking fluids. This was dehydration I knew nothing about.

By the next morning, the weakness had me in tears. I couldn’t take it anymore, so this time, I met the doctor at the hospital and got 2 bags of saline solution via an IV drip. She told me I was a terrible patient and now I needed to listen to her. This was now Thursday and by the second hour of the IV drip, I felt ravenous, not surprising since I hadn’t eaten in 6 days. For the first time, after the IV, I had some energy and the weakness began to subside. Granted, I still felt terribly sick, but relative to how I had been feeling, this felt like a major improvement.

So now I’ve dealt with more fever, agonizing joint and eye pain, non-stop nausea and diarrhea occurring roughly 60 times a day. I said to one friend, “If I’m standing, I’m either coming from or going to the bathroom.” Because dengue is viral, it will not respond to antibiotics, so the only recourse is to let it run it’s course and do your best to treat the symptoms, as unresponsive as it seems to be to anything you actually do use to try to treat the symptoms. Up until this point, the best I could do was knock myself out and sleep. I still had some vicodin left over from the abscessed tooth and thank God! Fuzzy and out of it is the only way I survived the first week I think.

So now it’s Thursday night, Day 6, and I’ve had a half day of something akin to relief from the misery. Little did I know what lay ahead. By now, I had read about dengue online and had some idea of what I was dealing with. I had `Classic Dengue’, the kind you want if you gotta have dengue. One of the symptoms is `a rash’. I can’t say that conjured up any particular type of alarm because given what I had just come through, how bad could a rash be?

Now I know. Thursday night, I began to feel like I was being pricked by a needle here and there combined with a little itching, but I was still so relieved from the re-hydration that even drinking Pedialyte was tolerable, well, except for the Pina flavored type which literally made me vomit, so I was stuck with `regular’ which tasted like salty water, a taste better served chilled. BTW, I learned that sugar, ala Gatorade, is a big no-no in terms of what I will now tactfully term `fluid loss.’ And without any food in my body, I had nothing but fluids to lose. I was given strict orders of no sugar — no fruit or fruit juices, with Martinelli’s apple juice being the sole exception, no fried foods, no cheese, no milk, and basically dry or boiled foods.

THE rash…As Friday progressed, so did the rash. My skin looked severely sunburned and white spots began to appear. Around my ankles and feet, there were red spots. I write this on Tuesday and the rash is still very present. Aesthetics are one thing, but what I could never have imagined was the discomfort, a mild way of putting it. It was like being stung by a thousand little bees under the covers and each one causing itching. Worse than that were the palms of my hands and soles of my feet. There is just no way to get graphic enough to describe that particular misery. It was as though my palms and soles were completely cracked, raw and itching all at the same time. I couldn’t use my hands and walking was virtually impossible, forget about wearing shoes of any sort, even bedroom shoes or flip flops were far too painful. If I moved my toes or fingers, it felt like the skin cracked open. Friday night, I went to wrap a potato in aluminum foil to bake and grabbing the foil felt like grabbing a handful of razor blades. That is not an exaggeration. I had to constantly remind myself that whatever I touched wasn’t doing the kind of damage it felt like it was doing. I half expected to look down and see my hands shredded, but they never were…they just felt like they were. Standing in the shower with the tiny tile pattern was torture on my soles. I was amazed by how incredibly sharp the edge of a pair of flip flops felt, but any particle of grit under my foot on the floor was agonizing. The only semblance of relief I got from this particular symptom was to soak my feet and hands in ice water, something very difficult to achieve since lifting a pitcher or popping ice cubes out of the tray required using my hands and I think I’ve accurately relayed how that felt.

That Friday night was the worst yet. Due to my palms and soles, sleeping was out of the question and the retro-ocular pain was still so severe that my normal balm of television was relatively useless. Not even Vicodin did the trick and I finally took a Melatonin in hopes of it just knocking me out…no such luck. Saturday wasn’t much better, though now I did have an appetite and the `fluid loss’ was less severe. As I had said, each day brings it’s own new horror and this `rash’ seemed the most horrible symptom yet. A rash! I still couldn’t believe a rash could be like this. By Sunday, the impact of touch on my palms and soles finally diminished and while still swollen, red, and itchy, at least I could once again sleep as long as I propped my feet up on a pillow so the heels weren’t digging into the mattress. Now it was just very itchy and like Thursday night, occasional needles pricking my skin here and there.

By Monday, Day 10 after the onset of the fever, I finally felt better. Nothing was now strong enough to create misery, however, I still felt quite weak and doing just a little wore me out. It’s now Tuesday and the rash is still present, though my palms and soles are better and the skin isn’t as red for the most part. I do still itch and do still feel some nausea and I do still feel tired very easily, but it’s such a relief to not feel as bad as I did that I no longer even care about these minor symptoms.

For more information:
Centers for Disease Control and Prevention, Dengue Branch
2 Calle Cañada
San Juan, Puerto Rico 00920-3860
Telephone: (787) 706-2399; FAX: (787) 706-2496

Post Note: The question I had about how long the rash remains…Seems the white spots keep getting bigger and bigger until the red pigmentation is replaced by my normal shade of white. So this could take a minute at this pace. Thankfully, each day it does seem to prick and itch less and less.