Monday, June 03, 2013

Question/Answer #2: Was It Scary Getting Malaria?

I recently wrote a blog post requesting submissions for questions to be used as writing prompts, so here's the next in the series of posts I am calling "Question/Answer." 

Question: Was getting malaria scary?

So I got malaria last fall. Was I scared? Not really. Malaria is a dangerous disease, and in these parts it certainly wreaks lots of havoc. Many people die of malaria, but with proper (and simple) treatment, it generally lasts only a week or so. It’s no fun and can make you miserable, but if you have access to the right medication and a decent immune system, you’ll survive. That’s what is so tragic about the number of deaths from malaria ever year, primarily children, who are particularly susceptible.

But back to the original question: I was not really scared.  When you look at the potential symptoms, I had a fairly mild case. I had an inkling I was infected after a day or two of a weird headache that was coming in waves. I was really tired and noticed I as taking really long, really intense naps. I was fatigued and couldn’t make it through an afternoon without crashing, and when I would I was entering REM sleep for hours at a time. After a few days of this, the headaches kicked in and I suspected malaria. I went to a lab in town, gave a blood slide, and lo and behold, I had malaria.

Now, I take a low-grade antibiotic as a preventative measure (and this method is very debated among the ex-pat community due to concerns of eventual resistance to the drug). Our nurse in the US said if we took a prophylaxis we would never get malaria. The long-time folks out here in TZ just laughed and laughed when we repeated that fact to them.  They told us everyone will eventually get malaria regardless of the meds. It’s just too prevalent, and we live in Tanzania’s hot zone for infections (the Lake Zone), but the meds will prevent cerebral malaria, which is nasty and much more fatal, evidently.

So I got a blood slide, bought some medicine for US$5, and just two doses cleared me up. I took it seriously, but any of the numerous times I’ve had strep throat were much much worse than the malaria. It sounds exotic and scary, but with proper treatment most folks will be fine. In reality, everyone seems to have malaria here, and for most people it’s just a fact of life. Nets are available, but many people don’t use them, and you can’t just sit under a net from dusk until dawn. And the locals don’t always have the leisure that I did to take a break, get rest, and recover. People get malaria and go work their farm because they have no other option. It’s not healthy nor is it recommended, but it’s hardcore, to be sure.

I’ve also had worms. Ascaris. I was feeling tired again earlier in the year, so I should have suspected something was up again. But it wasn’t until…

[Those of you who are squeamish should skip the next section.]

…it wasn’t until I pulled a 7-inch long worm out of my butt one morning that I thought “Hmm…I think I might have worms.” You think having a cup of coffee in the morning will wake you up? Try the worm method. You’ll perk up pretty damn quick. Anyway, three days of meds and I was fine. I told two long-time residents that I had worms and they both gave me practically the same response, word for word: “Welcome to the club!” Everyone gets worms here.

The worst? Amoeba. It also makes you very tired and can give you headaches and diarrhea. But the worst thing about the diagnosis is the treatment: Flagyl, or some variant thereof, is a terrible, potent, strong, and sickening medicine. I lost about 8 lbs in a week because of my inability to eat anything and my inability to stop crapping. The meds cause terrible, strong, nauseating headaches, gives you diarrhea, and causes a nasty, metallic taste in your mouth that takes days to wear off. It got so bad, just putting the medicine in my mouth made me gag and/or vomit. I’ll take malaria over amoeba any day of the week.

While all of the above was concerning, none of it was “scary,” per se. Do you know what WAS scary? Nothing too exotic at all: having an asthma attack. You can buy inhalers here in Mwanza, and I have one with me at all times. Recently, the change of weather flared up my allergies, which in turn flared up my coughing, which kicked my asthmatic wheezing into gear. I was lying in bed in the middle of the night, after having woken up wheezing, waiting for the inhaler’s medicine to kick in, and I thought about how in the States, in a worse case scenario, I could get to an ER and get a breathing treatment immediately if the situation ever called for it (and one time several years ago, it did). But it occurred to me that here in Mwanza, a breathing treatment would very likely NOT be available, and if it was, it may not be administered in a timely manner. THAT was a scary realization. Without an inhaler (which are available in town) I was facing a life-threatening scenario. Something so mundane-sounding, like asthma, and something so exotic-sounding, like malaria, can both kill you if you can’t get the treatment.

I recently read the transcript of a speech given by Dr. Paul Farmer where he describes findingsomeone who was at the point of death from an asthma attack. After a few puffs of an inhaler, the man immediately began recovering. Something so simple, but something out-of-reach to the ill man. So as I lay in bed thinking about my health, it wasn't the scary sounding disease that was giving me concern; I was my boring-old, 100% treatable illness that had me worried. And it gave me a moment’s pause, after I took a blessed inhaler puff, as I reflected on how lucky I have it and how hard it must be for so many people around the world who still must contend with the reality of lacking adequate treatment on a daily basis.


Erica said...

When I told Ariel about your worm her response was "I bet that felt really good."


Kristi said...

I agree with Ariel. Lovely description of your journey into the world of one illness after another.