Malaria Update and Info

Well I'm very pleased to announce that I'm finished with malaria! Unfortunately I transitioned from malaria into a case of pneumonia. I'm still fighting the pneumonia but taking a turn for the better. Your prayers for continued healing continue to be greatly appreciated.

In the last week or so I've been asked quite a few questions about my malaria. Here are a few and some of their answers:

1. Isn't there a vaccine against malaria? Were you immunized? No, as of this time there is no vaccine that can prevent malaria. So no, I've not been immunized.
2. What exactly is malaria? It is a parasite that gets into the bloodstream. Because it is in the bloodstream and the red blood cells, it pretty much has effects on the entire body. The type of malaria I had is called Faliciparum and is actually one of the worst of the four types.
   
3. How do you get malaria? The parasite is carried by the anopheles mosquito. The mosquito bites an infected person and then becomes an infected carrier. It takes about a week to ten days before that mosquito can bite an uninfected person and spread the infection. Once an individual is bitten by the infected mosquito it takes a minimum of seven to ten days for the parasite to multiply enough for symptoms to begin.
4. Why is it that Westerners get so much sicker than nationals when they get malaria? I became so sick because of a few factors. Firstly I had never had malaria in my life and so thus I had not built up any immunity or natural resistance to the disease. My immune system was overloaded and didn't know how to effectively fight, causing me to become very sick. Secondly I had a resistant strain of malaria. So the first and even second-line drugs I was given were not effective in killing the parasite. I required the strongest IV therapies available in order to knock the parasite out.
5. What are the symptoms? Basically the worst flu of your life! It usually starts with a headache then moves into high fevers, chills, body aches, vomiting and diarrhea. Some people also get lung and kidney involvement. At it's worst it can invade the brain causing cerebral malaria which is often fatal. I did not get cerebral malaria. My fevers were staying in the 104 range while taking medications that are supposed to lower fevers. Because my immune system was so overloaded from trying to fight the malaria I also wound up with a urinary tract infection, respiratory infection and tonsillitis before I was admitted to the hospital.
6. Now that you have had malaria are you immune to getting it again? Unfortunately no, many of the cases that I treat at the clinic are individuals who have had malaria dozens of times. However, with each exposure to the malaria the immune system theoretically should be a bit stronger and more effective in fighting it.
7. Are there medications that can prevent malaria and do you take them? Although no drug is a 100% sure thing, there are medications that you can take to help prevent malaria. I highly recommend that anyone traveling to a malaria endemic area take these medications. However because I live in Kenya and plan to be here long-term it isn't so practical for me to be taking these strong drugs for every day of my life.
   

Hopefully this helps answer some of the questions you may (or may not!) have about malaria. If you would like more information you can click here and check out what the CDC has to say about the disease.

Malaria

The last ten days I have been battling malaria. This is by far the sickest I have ever been in my life. I started out taking first-line anti-malarial oral drugs. They had no impact and my fevers were soaring up past 103 so the decision was made to switch me over to Quinine. After three days on quinine I continued to get worse with temperatures rising above 104. At that point (on Sunday) the nurse who was treating me referred me to the hospital.

I was admitted to Medi-Heal Hospital in Eldoret shortly after arriving. My white blood cell count's were nearly four times normal. My malaria test was highly positive even after five days of strong treatment. I also had a urinary tract infection, respiratory infection and tonsillitis.

Within 10 minutes of my agreeing to be admitted I had an IV started and was given no less than six drugs. When it was at it's worst I actually dreamed that I was in heaven and was disappointed to wake up. After three days in the hospital I was starting to improve a bit and we realized that we wouldn't be able to pay the hospital bill if I stayed an additional night. So I fought to be discharged with my IV in place.

So for the last few days I've been receiving IV infusions from home. The fevers and chills are completely gone now. I'm just about as weak as a newborn kitten though. I continue to fight this respiratory bug and have a difficult time even thinking about eating anything. I would greatly appreciate your prayers as I continue to try to fight this thing.

All in a Day's Work

After a great trip to the coast with my hubby, parents, and baby sister I'm back to work. And let me tell you, work is in FULL swing! I'm on call for seven nights straight. The bummer about being on call here is that you still put in a full days work regardless of what happens during the night.

I'm hoping and praying for a restful night because today (besides being our second wedding anniversary) was a pretty full day at the clinic. Here are just a few of the MANY cases that I treated today:

• A retained placenta from a woman who delivered at home. She arrived on the back of a motorcycle and was half carried to the maternity ward. The blood dripping down her legs clued me in that it might be a complicated case. The removal (by yours truly) actually went very well and she was able to head home just a few hours later.
  

• The family who came for a follow-up visit for a wound. It was a crazy hand wound. I could see that it had been stitched all over the place. Turns out there was a family fight and the ladies hand got pulverized as a result. Oh, by-the-way, these people happen to be some of my immediate neighbors.
  

• The mom who had her five-year-old stick out his tongue at me. She then explained "The witch did that to him." The tongue looked very normal to me so I asked her to explain. She told me that when he was bewitched he had stones and sand put in his stomach at the same time. She told me this had happened on Thursday. I asked her if she was sure there were stones and sand there; and if they were, how did the witch get them there? She told me that they aren't there anymore because the traditional healer removed them through the skin with his hands that same afternoon. So I verified, "you aren't actually here because of the tongue or the stones?" No, he has malaria. Go figure!

It certainly wasn't a boring day at the dispensary. Now let's hope for a nice, calm, and boring night!

Belated Birthday

William and I took Ashley out for a belated birthday celebration while we were in Malindi. We took public transport to Watamu and had lunch together. We ate at what William and I call a "Real Kenyan Place". We knew it was a real Kenyan restaurant because my conversation with the waiter went something like this:

Waiter: What would you like?
Michelle: I'll take the pizza (there are lots of Italians on the coast so pizza is findable there!)
Waiter: Our tourist season has been low this year so we aren't making the pizza
Michelle: Okay, then I'll have the chicken
Waiter: We don't have any chicken today
Michelle: Can I get the mushroom soup?
Waiter: We don't have that either
Michelle: What do you have today?
Waiter: Chips (french fries) and sausage
Michelle: That sounds great, can you add an ice cream?
Waiter: Sorry, we don't have any ice cream
Michelle: Okay, no problem, we will all have chips and sausage

I learned a long time ago when eating at a real Kenyan place to not even bother reading the menu. It's better just to ask what is actually available.

After lunch, Ashley and I went into one of the world's leading snake research centers. It was pretty amazing. We saw some incredible and deadly snakes. Ashley got to handle about four of the non-venomous ones.

Malindi Madness

What an amazing week it's been so far! I'm in Malindi (a coastal town in Kenya) with my hubby, parents and sister. My parents have a Time Share in America that they were able to trade a week in Palm Springs for the week here. So here we are in tropical paradise soaking in the sun.

Yesterday we decided to travel to Watamu in search of some good snorkeling. We found out that it would be $100 to take a taxi round-trip. That sounded ridiculous to us so we opted for public transport for less than a quarter of that cost. Now there is something you should know about public transportation in Kenya. It is way cheaper. I mean WAY cheaper than private. But I think that you just might pay for it in the years it takes off of your life. I think my parents should get an award for their incredible flexibility and good attitude about yesterday's journey.

I pulled this picture of a tuk-tuk off the web to give you an idea of what they look like.

We started by getting into two different Tuk-Tuk's. A tuk-tuk is kind of like a modified motorcycle that looks a bit like a motorized partially-enclosed-tricycle. The tuk-tuk drivers took us to the local stage where we could catch a matatu to Watamu. I realize I am speaking Greek here. So a matatu is a 15-seater Nissan Van. But let me tell you, they cram a lot more than 15 people in them.

Another picture off the web. Often they drive down the road at full speed with people hanging out the side.

My mom bravely climbed up in the matatu and then proceeded to climb in-and-out, in-and-out as passengers kept needing to disembark. We finally arrived in Watamu and were dropped off on the opposite end of town from where we needed to be. So after a lot of loud and animated discussion (At times like this I am SOO glad I have a Kenyan husband!) we got in some more tuk-tuks to be taken to the Kenya Wildlife Services (KWS) station. Along the way a boat captain heard that we were wanting a glass-bottom boat for snorkeling. So he jumped in our tuk-tuk and told us he would arrange for his boat to pick us up. We agreed on a price and proceeded to the KWS gate where we payed our entrance fees.

My assumption was that there would be a nice little marina or at least a gangplank of some sort where we would walk out to our boat and head out on our journey. Nada! We walked about half a mile to a totally deserted beach. We then waited on the beach for a half an hour as our captain kept promising us that the boat was on the way. Well the boat finally arrived and we waded out to it.



Then the motor wouldn't start. We sat in the boat for another 10 or 15 minutes while they tried to get the boat to start. It finally started and we were on our way.


We went to the old-coral-reef at the end of the Watamu Marine Park. Mom, Dad, Ashley and I snorkeled and enjoyed interacting with dozens of beautiful tropical fish. William admired the fish from the safety of the boat.

Heading back we basically did the same trip in reverse. We stopped for lunch at a restaurant on the beach. While we were eating, the fishing boats started coming in with the day's catch. We marveled at the tuna, snappers, and barracuda that were hauled across the shoreline.


On our way home we got mobbed with people wanting to carry our snorkel gear while trying to transfer from a tuk-tuk to a matatu. It was quite an adventure for Mom and Ashley! Luckily we were able to get the two of them in seats with the matatu driver of front. At one point on the journey home there were eight bodies in the second row (designed for three). Five adults, a kinder-gardener and toddler as well as a baby. At that same time there were three guys hanging out the open door as we drove down the road. After a minute or two a lady in the back row offered to hold the baby. So the baby got body-surfed to the back to sit on a strangers lap.

All in all it was a fabulous day! As I said before, I was impressed with how the Kerns clan held up in Kenyan public transportation. They are super troopers!