Last Tuesday evening I was feeling particularly tired. But it was the last day of school and the students would be leaving in the morning. I figured I could use the coming vacation days for rest.
Wednesday morning I planned to wake early to see off the students, but I couldn’t get myself out of bed before 8. By that time, most of them had gone. As evening came, I started to get a little headache, but I figured it was just lack of sleep and everything would be okay in the morning.
I awoke during the night with a full headache and covered in sweat. By the time morning arrived I was exhausted. And the headache just wouldn’t go. I moved to the couch, brought my pillow, and proceeded to sleep most of the day. Each time I awoke, I was dripping with sweat, often from the oddest places: my knees, my arms, my neck. But never my armpits :-) By now I had developed a fever – about 101, and my body ached like I had the flu.
That evening a colleague dropped by and when he saw my condition he asked why I hadn’t gone to the hospital (here it seems, when anyone feels even the least bit ill, they go to the hospital – they also have a ‘public option’ but I digress). I insisted that I just wanted the day to rest and that if I still felt bad in the morning I would see the doctor.
I sweat through the night and in the morning called my colleague and said, “I need to go to the hospital.” The fever was still there along with all the other symptoms, and now I had bad diarrhea.
The doctor listened to my symptoms, took my pulse and BP (no temp though), and sent me to the lab for blood work. An hour later: no malaria parasites in your blood screen. but the doctor said he was sure it was malaria and had me take an injection in the rear, and sent me away with three days of oral drugs.
The next two days were painful. The type of headache that makes you sick to your stomach, and comes on like a knife in the eye any time you stand or sit. Between that and the unbelievable amounts of (smelly) perspiration pouring off my body I was quite a mess.
Sunday I went to bed around midnight (after sleeping all day) and woke up at 1:30…in the afternoon. 13 1/2 hours later!
That night I fell asleep around 1am and woke up 11 hours later.
Then finally Tuesday morning I woke up at 8. Stood up, and the headache was gone! All the symptoms were gone. Amazing how fast everything went away.
So, now Cori and I can look back on our time in Ghana and compare malaria stories:
“How about the sweat?”
“Oh yeah! So much sweat. And the headache…”
“Yes! The headache: the worst!”
A Real Malaria Tragedy
Of course malaria isn’t a disease to joke about, considering it kills millions of people each year, and can have terrible side-effects. Case in point: This young woman from Chicago, Dawn Dubsky, a four time marathoner, pediatric nurse, and world traveler, who visited Ghana in 2007 to learn about textiles, and a month later had all her limbs amputated after contracting the disease. There’s a two-part feature about her trials in the Chicago Tribune from which comes this description of the disease:
The invasion begins the moment an infected mosquito starts to feed. The insect's saliva carries a few dozen or so malaria parasites, which resemble microscopic earthworms, into the body of their new host. Within an hour, the circulatory system propels them to the liver.
There, they penetrate the cells of the organ and multiply. It is painless. For about a week, the host doesn't feel a thing.
Then the swollen liver cells rupture, dumping swarms of hungry parasites into the bloodstream. They enter red blood cells, growing fat on oxygen-carrying hemoglobin before replicating again.
The cells bulge and explode, sending forth new waves of attackers, and the cycle repeats. By the time the host notices that he is unusually fatigued, the incursion has become a takeover. Hundreds of millions of malaria parasites can be swimming in his veins and arteries.
Sometimes malaria even turns the host's body into the enemy. The immune system counterattacks with such ferocity that it becomes an even greater destructive force than the parasite.
Experts say someone with a severe case in the developing world probably would die before the disease displayed the full range of its power. That's the thing about Americans who contract malaria. Technology can keep them alive long enough to find out just how bad it can get.
Too sick to be afraid
Dubsky felt drained as the retreat neared its end. When her plane took off for home, she dozed for nearly the entire 22-hour journey.
The weariness lingered after her return on a Tuesday, but she wrote it off as jet lag. It wasn't until that Friday, 13 days after she had been bitten, that she knew something was wrong.
She dragged herself to her shift at Children's Memorial but grew steadily weaker throughout the day. Her stomach soured. Her head felt as though it was being squeezed into pulp.
She left early and got a few hours of sleep at home. When she woke, drenched in sweat, she took her temperature. It was 103 degrees.
Early the next morning, she took a cab from her Lakeview apartment to Northwestern Memorial Hospital and told the emergency room doctor what she thought was happening. A blood test confirmed it, and Dubsky left the diagnosis on a friend's voice mail:
"I got da malaria!" she said in an exaggerated Chicago bray.
Though her family and friends raced to the hospital, Dubsky wasn't terribly worried. The infectious disease specialist who examined her on Saturday afternoon judged the case to be "uncomplicated," with no sign of shock or other serious symptoms. Only 2 percent of Dubsky's blood cells were infected (it can go up to 50 percent).
The doctor prescribed a standard treatment: a week's worth of quinine sulfate tablets. But quinine isn't easy on the stomach, and Dubsky repeatedly threw it up. She insisted on getting her medication through an IV, but hospital staffers said taking it by mouth would work faster.
After a wretched night of shivers and chills, Dubsky grew far worse. Her fingers and toes tingled. Her blood pressure plunged. Jaundice turned her skin as yellow as old newsprint.
Worse, a test suggested the onset of DIC, or disseminated intravascular coagulation, in which the body's blood-clotting system spins out of control. It is a major complication: Doctors sometimes joke grimly that DIC stands for "Death Is Coming."
Late that afternoon, Dubsky's hands felt like clubs, her lower legs as though they were encased in ski boots. She hobbled to the bathroom but was unable to urinate, a sign that her kidneys were starting to fail.
On her way back to bed, Dubsky peeked in the bathroom mirror.
"Mom, look at me," she called out.
Her mother glanced up. Dubsky's lips had turned blue.
A few moments later, Dubsky's breathing grew labored as tiny blood vessels, dilated by her body's wild response to the infection, leaked fluid into her lungs. It was a harbinger of septic shock, a potentially fatal condition.
Hospital staffers raced Dubsky to the intensive care unit, where she signed papers directing the physicians to do all they could to save her life.
Her brother, Tom, a pipe fitter and former junior hockey player, wept as he begged Dubsky to fight. Her mother, kneeling at the foot of Dubsky's bed, sobbed that she was terrified.
"Mom," Dubsky replied, "I'm too sick to be afraid."
It was the last thing she would say for weeks.
Eventually Dubsky’s arms and legs had to be amputated. She is now learning to walk with prosthetics, and she has even started a running team called America Against Malaria. She’s attempting to provide bed nets and malaria education to Ghanaians.
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