Update on the Health Tally

Well, in case have wondered where I’ve been recently, the answer is simple: in bed. Much of that time, heavily medicated and on IV fluids.

This brings the official tally to:
Tropical diseases: 4
Jenna: still a big fat goose egg

Profile of the latest culprit? A particularly tenacious, aggressive little bacterial buddy commonly known as Pseudomonas sp., who found a comfortable habitat within the environment of my digestive tract. You may be interested in the general manifestation of this condition. While I could certainly provide the reader with detailed descriptions of fecal viscosity and the color palette of my vomitus, I’ll refrain.

Instead, perhaps I’ll give you a few of the more palatable features of my malady, and leave the rest to your imagination. Let’s start at the very beginning, “a very good place to start…”

Last Wednesday (August 13th) was the 25th anniversary of our Sololá bishop’s priesthood. In accordance with custom, a large celebratory mass was held in his honor. Since our bishop is a Jesuit, and the Jesuits are a particularly close-knit community with a heavy presence in Central America, the event was attended by somewhere around ninety priests. Thanks especially to their heavy involvement with the people during civil wars across the continent, many of these men are quite well known.

One of these Jesuits, a man named Ricardo Falla, is a friend of Sheila’s. He spent several years living with the Communities of Population in Resistance (actually, “Comunidades de la Populación en Resistencia, aka CPRs) during the 1980’s. These were non-violent groups of refugees who spent years hiding in the jungles. They suffered regular military attacks, bombing raids and massacres by the military. The government claimed that the CPRs were helping the guerillas, while they maintain that their only desire was to remain markedly Swiss in political involvement. I just finished one of Falla’s many books, “The Story of a Great Love,” which details his own personal experience with the “CPR’s” and how it affected him spiritually. It’s a great book, and I’m eager to read some of his other works. He’s mostly renowned as a sociologist, and has done a lot of research into how the war impacted the people of the country.

Falla is just one example of the fascinating, inspiring Jesuits who was at the Mass. In the world of liberation theology and Central American politics, many of these people are somewhat like spiritual celebrities. Knowing I’d be interested, Sheila invited me along. Wednesday morning, at the (ironically) ungodly hour of 4 am, we set out for Sololá, about three and a half hours away. (Why on earth it was a good idea to leave so early I have no idea, but it wasn’t up to me.)

I’d had an upset stomach the whole night before, enough that I wasn’t able to sleep, and the whole morning I felt pretty sick. However, I decided to blame it on the ridiculously early hour at which we’d began our day, and planned on feeling better once I woke up a bit more.

Sadly, my “plan” to feel better never materialized. By the time the Mass was starting at 10, I could barely stand to watch the impressively long, exaggeratedly slow procession of priests entering the cathedral. The crowded hot building, banging marimba music and thick copal incense had my head spinning, with my stomach following not far behind. Thoroughly embarrassed, I ran from the cathedral, barely finding a public restroom quickly enough to, as Nanc would say, “toss my cookies.”

Now, as you read this, you may be thinking “Boy, that doesn’t sound like any fun at all.” But unless you have first-hand experience with Latin American public toilets, I don’t think you have any idea how not fun it was. After paying my 1 Quetzal (15 cents) at the door (and, of course, receiving a receipt along with my several squares of tp), I hurried into the stall. As I shuffled into the baño green-faced and grimacing I was gawked at by three or four young men who apparently had little concern for the “Ladies Room” sign over the door. Wonderful. A captive audience.

They had no need to worry that the sounds of my efforts would be muffled; the tiny tin booth which housed my toilet provided excellent echo-chamber acoustics. The curious yet common phenomenon of an absent toilet seat applied to this bathroom, as did the equally ubiquitous overflowing toilet-tissue bucket. Flushing paper is, after all, unheard of in these parts.

You can hardly expect to have a can full of used t.p. to not house a burgeoning population of eager flies. So, of course, there was a multi-species element to my spectators. Sticky, filthy liquid of unknown composition coated the floor, papered with discarded bathroom receipts, and my door utterly refused to latch shut. All in all, I guess you could say it was a location conducive to feeling quite ill.

I spent the rest of the Mass prone, in the back seat of our jeep, developing fever aches and chills. The long drive home over impossibly pot-holed roads was nearly the end of me. I drifted in and out of awareness, no doubt moaning with every bump and bounce. By the time we arrived at the mission that night I felt like I’d survived war, or at least a demolition derby. I tried to go to bed early, only to find that lying down invariably incited angry abdominal spasms. I was quite sure, in my fevered delirium, that a young kangaroo was determined to escape from my pancreas, through my bellybutton.

Take a second. Reflect on that.

You’re probably not going to be surprised, then, when I tell you that the vomiting which ensued was more a reaction to pain than to nausea.

I spent the entire night suffering through periodical (in the trigonometric sense) bouts of pain, followed by trips to el baño, where my body spared no expense in ensuring my discomfort. I wondered, as I rose from my sweat-drenched bed every twenty minutes, what grave sin I was currently being punished for. Perhaps the bishop had called down God’s fury in response to my fleeing like a pagan from his celebratory Mass? I probably made a mental note to write him a letter of apology. The specifics of that pledge were lost in my haze of febrile hallucination.

In the early hours of the morning, my salvation arrived in the form of Anabella, a sweet Guatemalan doctor who happened to be sleeping in the dormitory next to my room. She’d heard my moaning, groaning and constant lavatory usage and came to investigate. Anabella was immediately concerned by the state which she found me in, and set into motion a battery of tests and treatments. Sheila came immediately, and has consistently played the role of concerned nurse-mother from that moment to the present.

Blood was drawn, fecal samples were taken, injections and pills and intravenous tubing and all-natural teas smelling of illicit drugs and tasting of pond scum were administered. I was visited by a dizzying rotation of doctors, nurses, cooks, pharmacy technicians and medicinal plants experts, each presenting treatments, advice and general concern. I was considered a candidate for hepatitis, Dengue Fever, kidney failure, gastric ulcers, and E. coli or Salmonella infections. Unable to force poo colonies to grow faster than their own volition, we had no choice but to wait several days until the fecal culture provided us with concrete evidence regarding the enemy.

I spent most of the next few days in a listless miasma (thanks, Microsoft Word synonym finder!). I’d begin to feel better until I ate, or moved, or thought about eating, or thought about moving, and then everything would spiral back downhill. As abdominal palpations continued to elicit tears into my fourth day of convalescence, an ultrasound was ordered.

This meant a forty minute drive over the bumpy roads to Mazatenango, where Sheila and I sat several hours in an overcrowded waiting room. To pass the time, we had more blood drawn, and found that my white count had actually risen after three days of steady intravenous antibiotics.

As the radiologist squirted ultrasound goo onto my bloated belly, I couldn’t help but think “Well, I suppose this could be worse…” Apparently thinking along the same lines, she peered at me over her glasses and stated in a quite matter-of-fact fashion:

“Pregnancy. You don’t have that problem, do you?”

It didn’t take her long to decide, however, that the offending article was not a baby, but my appendix. The first time I’d heard this possible diagnosis, images of emergency abdominal surgery in a third world country began dancing through my head. It wasn’t a pretty sight.

This little diagnostic imaging adventure, my first ultrasound to date, set in motion a somewhat scary cascade of reactionary events. The grayscale picture of my right lower abdomen crowded with inflamed tissues sparked several hours of intensive scrutiny regarding my condition. Was it appendicitis? We drove back to Santo Tomas, wondering, and by the time we’d arrived Sheila decided she’d better consult with a surgeon friend in Mazatenango. Describing the whole scenario to this doctor, he immediately drove all the way to Santo Tomas to examine me, concerned I may be somewhere near an emergency state.

By now, I was feeling much better than I’d been the past few days, and was pretty certain it was probably just a severe intestinal infection. The somewhat aggressive reaction on the part of Sheila and the doctors, however, did have me a little shaken.

It didn’t take Dr. Fidel from Mazate long to decide that I looked much too good to warrant a diagnosis of appendicitis, and my pain was probably a result of severe dehydration. At one point, after all, my blood pressure had dipped to 80/40. He prescribed several more bags of IV fluids, these ones enriched with potassium, and continued antibiotic treatment.

The fecal culture which had been returned earlier that day finally revealed the face of our enemy: villainous Mr. Pseudomonas aeruginosa. Everyone has been somewhat mystified regarding my contraction of this particular bug – it’s an opportunistic colonizer who usually shows up in hospital patients who’ve been on heavy doses of antibiotics, and is known for being remarkably drug resistant. How or why it’s in my belly is a mystery. The only thing we know for sure is that it must have come from food I ate at the school, which means I’m probably not safe to dine with the girls. I’d been carefully avoiding anything which wouldn’t have been boiled for extended periods of time, but apparently that’s not enough.

Now, nearly a week later, I’m mostly recovered. I don’t have much energy still, but I can hold down a full meal and drink enough tea to keep myself hydrated. I’ll probably be back at the school soon, and there will be some changes in my eating habits. The Tuesday before I got sick, I passed my bowl to the cook at lunch time. She returned it, a cow-hoof planted firmly in the middle of my soup. It won’t be so hard to say goodbye to her cooking, really.