Oh Dengue

With each inhale I feel my engorged spleen and liver scrape against my ribcage. I can’t look left nor right because each movement in my eye socket is wrenching. My hips endure what seems like the weight of a semi-truck and head-to-toe I am speckled in a burning rash. Chills and heat flashes ebb-and-flow throughout my body and I can’t make my mind up; am I cold or hot?

As I sit in the crowded Emergency Room awaiting my official Dengue Fever diagnosis, next to a man holding his detached left thumb in a Ziploc bag of ice, on the day after Christmas and the day before my departure for Africa, I question if my trip to visit my best friend Adrienne in the Dominican Republic was worth it. My lightly tanned face and blonde streaked hair say yes. But something tells me that my near hemorrhaging internal organs disagree.

Dengue Fever is transmitted through female Aedes Mosquitoes. It is a disease that is endemic to various tropical regions of the world and incidences soar particularly high during times of heavy rain. The symptoms include, but are not limited to, sore eyes (check), joint and muscle aches (check), pounding headaches, fever, chills, a body lathered in rash (double check). The incubation period is about a week and the virus itself thrives on its host anywhere from 7-12 days. According to the CDC, 95% of those diagnosed with Dengue Fever will recover with no lingering hazards. If one were to have the unfortunate luck of getting the illness a second time, death is not uncommon.

Stark fluorescent lights and the hum of blood pressure monitors send my thoughts back to the scene of the crime. Trekking the back route to the famed 27 Charcos, a popular set of tiered waterfalls in Santiago, seemed like an efficient idea. By tromping through dense swamp instead of taking the main paved road, would give more time at the falls. I realize that by saving two hours that day cost me seven today.

The shortcut concluded to be a bad idea. My hands acted as flyswatters, slapping every inch of skin, but attempts at mosquito genocide were pathetic. I could have counted nearly 80 bites in the first fifteen minutes; I was the sweet-blood feast they had been waiting for. Their tiny, unassuming physique masked a ferocious demeanor. I looked around to see if my companions were also victim to prey, but they seemed unbothered. Mosquito torture: party of one.

In addition to being an all-you-can-eat buffet, the mud was so thick and sticky each step forward was really two steps back. Are we getting closer? Are we moving? I felt like I was on a Nordic Track exercise machine, moving in place but going nowhere. From that moment on, the excitement of being in a tropical jungle was jaded.

The ‘tour guides’ (local cane workers paid to show tourists the route) could have each posed for the cover of firefighter calendars, they were that good looking. It was biceps for days. Muscle, finely sculpted and magnified with bronze, Caribbean skin. When the path got too difficult to individually manage, one would simply pick me up and throw me to another, like a juggling pin. At first it was fun. I felt weightless and small. But, as the day went by, their hands were landing in inappropriate places; a little too high on the thighs and the sweet spot of my mosquito bites. And once they start itching, I can’t stop scratching.

I used to think there was nothing more uncomfortable than itchiness. I would rather chew and swallow living insects than suffer the wrath of an incessant itch. If I had to choose between having chronic strep throat once a month for the rest of my life or a prickly sun rash once a year, I would choose the strep. Basically, I wouldn’t wish itchiness on even my worst enemy.

But than I got Dengue Fever, and itchiness met its match.

So now I sit with pending blood samples in the lab, a bag of IV fluids flowing through my veins, dressed in a starchy buttoned gown. I am telling the on call doctor the onset of my symptoms and how miserable the last three days of my life have been.

“The pounding in my head is worse than any migraine I have experienced. I haven’t slept through the night in 72 hours; I ache everywhere. I am pretty sure I have Dengue Fever, “ I say. “My eyes are sore and I read on the Internet that that is a sure sign. Look at all these bites.”

“Hmmm, ok. When was the last time you had intercourse? Any unprotected sex?” he rebuttals.

What does he take me for?

“No, of course not,” I answer as I blush. “I also read that the joint and muscle aches generally come a day after the headache starts with Dengue. The headache started on the 23^rd and the aches came on Christmas Eve.”

“Riiight. What about drug use? Any exchange with used hypodermic needles? Were you sharing syringes by chance in the Dominican Republic?”

“Umm, no. I don’t do drugs,” I shoot back defensively. “But from what I gather, I am almost certain it is Dengue Fever. I was there just after tropical storm Olga hit, and Dengue was all over the place. And I am supposed to leave on a plane in the morning for Africa…to climb a tall mountain.”

He looks at me with assurance. “You know, we also call Dengue Fever break bone fever. If you had it, I think you would be in a lot more pain than this.”

“Oh. Well good then. Maybe it is just a bad flu.”

“No, I have discussed your case with the Infectious Disease doctors and we think it is either Leptospirosis (a common bacteria found in fecal matter of hoofed animals, transmitted through water) or HIV (a disease there is no cure for.)”

“I am sorry. Did you say HIV?” He had to be joking. My pulse tripled in those flailing moments. Of course I would be the first person ever to get HIV from stubbing her toe or something benign like that.

“Well, all your symptoms are manifesting like they do with HIV. So we can’t rule it out. Also, with all the water activity you took part in, leptospirosis is a possibility. Either way, we don’t think it is Dengue Fever.” As he walks out, he casually blurts out “and I don’t think you will be going anywhere tomorrow.”

The memory of the waterfall hike resurfaces and I glance at my swollen belly. Anxiety begins to brew and I am now convinced, backed by a potential diagnosis of HIV, that the trip was not worth it.

The IV bag finishes and the nurse hangs another. I watch the water slowly drip in the chamber and wonder why I am not feeling better. I thought IVs always make you feel better?

“I am sorry,” she says. “The tubes of blood that I sent to the lab somehow got lost in route, I am going to have to poke you again for another set.”

Defeated and angry and sad and in pain, I dig deep for a bit of understanding. It takes me some time but I offer her my left arm and tell her where she can find a good vein.

“And I am going to have to get a sputum culture with these Q-tips. No biggie, just a little bit of your boogers.” She takes the metal prongs, lightly covered with a cotton tip and jams it so far up my nostril I believe she pokes my brain. (Itchiness and dengue fever I would like you to meet a metal-pronged Q-tip, your match.)

As an educated, cautious and logical person, I knew I didn’t have HIV. My disappointment wasn’t that I would be nursing a fever with a diet of Tylenol and clementines for the next few days. It was that my year-in-the-making plan of hiking Mt. Kilimanjaro with my family in Tanzania was no longer in my future. Regardless of my properly named illness, I knew that I wasn’t strong enough to survive a flight of 16 hours. I wasn’t even strong enough to walk up a flight of stairs let alone the worlds’ tallest freestanding mountain.

A few more hours pass. I think about how I will spend my New Years, as there will be no celebrating. I ponder how disappointed Charlie, my younger brother, will be when I tell him he can no longer throw a rock concert in our living room. He was the only immediate family member not going to Africa and he was ecstatic about having the house to himself. An older sister has foiled his plan yet again.

Now two bags of fluid have infused. There is nothing more they can do for me and it is time to send me home. The infectious disease doctors stroll in. One rests on the edge of my bed, another sits on the rolling stool and the third stands against the wall; a team of white with no answers.

“We are sure you do not have HIV, “ says the youngest looking one on the bed. “You don’t have any gastrointestinal symptoms, so we are nixing leptospirosis. We are 95% sure you have Dengue Fever but we won’t know your viral count until mid January. Now, as far as your trip to Africa, we aren’t saying don’t go. We are just saying don’t go tomorrow.”

Dollar signs start popping up in great hues of fluorescent green. All of a sudden, the IV bags are blocks of gold and the Ibuprofen pills are hundred dollar bills. I have no health insurance. Tomorrow the travel insurance goes into effect but today I am without. I realize that I will pay a couple thousand dollars for a verdict that I already knew.

The one on the stool chimes in. “Dengue Fever is a virus with no medicinal cure. It will pass but it will be intolerable. Just treat yourself to a cocktail of painkillers and drink plenty of water. No alcohol.”

I ask them a plethora of questions. Will my liver be ok? How do I prevent it from happening again? Will I ever see the normal color of my skin again? They tell me that DEET should be my closest companion while in Africa as the four strains of the virus swarm that continent as well and I will live to see my organs normalize.

“You are lucky,” the older, standing man says. “Stronger forms can lead to Dengue Hemorrhagic Fever which is uncontrollable internal bleeding. Very deadly.”

“Actually, you are lucky…that it is not summer when the US mosquitoes are rampant…for me to pass it to others,” I say with a laugh. Elated that I was right and without a fatal disease in need of quarantine, I was able to lighten up.

We joke around for another five minutes. They ask about Africa and are baffled when I tell them my 50 year-old mother will make the Kilimanjaro ascent, probably faster than anyone else. I ask what the worst infectious disease case they have ever seen was and they go into gruesome detail. They were trying to make me feel better even though they knew I was bummed.

At home I take a warm bath then snuggle in my moms bed to watch her pack. Her enormous bag is sprawled out and all the insides are stacked in piles. I try to do her a favor by sneaking the items away that I know will weigh her down but she panics and throws it all inside. We discuss how I will join the group on the second half of the trip, just in time for the safari and the beaches in Zanzibar and the hopeful end of my Dengue course.

I pop some Tylenol. Is this the universe telling me I need to slow down? A hard reality when you are an un-caged bird. Dang it.