Categories
Nairobi

Nairobi

I’m in the Peace Corps office now, killing time while some other volunteers are in a meeting.

So far so good.  The infection looks like it losing the battle against the antibiotics, and now I have a free day in Nairobi.  I’m thinking of buying as much Dr. Pepper and and as many tortialla chips as I can find, and then I’ll be heading back to Mombasa tomorrow.  I look presentable enough to attend Sunday’s wedding I think, and if all goes according to plan I’ll be wearing a traditional outfit of some sort, so I’ll be sure to bring my camera!

Categories
Mombasa

Turns out I just have… Strep?

From the lab results:

Gramstain: Gram positive cocci present
Culture: Moderate growth of streptococci species

Huh?  I had to look it up.  It appears that I probably don’t have a Staph infection after all— I have a Strep infection!  I was not previously aware of this, but Strep can cause a number of problems, ranging from strep throat to scarlet fever to the rare “flesh eating disease.”  As a result I have now switched antibiotics—again—this time to Levofloxacin (500mg).

I’ll be travelling to Nairobi tomorrow to be inspected by doctors trusted by the Peace Corps, just to be safe.  I get to stay in a hotel and have a toilet and a shower, which is very exciting.  If all goes well, I’ll get back to Mombasa just in time to attend my first Kenyan wedding!  I bought the gift today, so I’ll be ready.  Things appear to be on the upswing.

I told all the other teachers today what was going on, and everyone was very kind.  My neighbor even brought me bananas and milk.  Your comments here (as well as your concerned phone calls) are also much appreciated.  It’s an odd state of being, knowing that I have an infection that could become very very bad, but also knowing that I can only do so much about it.  I alternate between doom-and-gloom and flippant fatalism.  I tend to write my blog in the latter mindset.

Here’s a medical timeline for those concerned.  Hopefully this meticulous documentation turns out to be a waste of my time, and that this thing gets knocked out by this round of antibiotics, but it seems worthwhile to elicit any opinions.

  • July 1: Begin feeling occasional shortness of breath at random times during the day.  Definitely nothing I’ve felt before, but not terribly alarming either.  I assume I’m holding my breath due to stress (and maybe I am).  Have a small shaving cut close to lip that is stubborn and won’t heal.  Not noteworthy at the time.
  • July 3: Notice small bump on arm, visit doctor.  Diagnosed on the spot as having a foliculitus infection, due to the appearance of a tiny bug bite in the center of the bump.  Begin taking Augmentin and Cataflam.  I forget the dosages.
  • July 10: Antibiotic treatment complete.  Visit doctor again, who concludes that the infection is gone and all that remains is an “antibioma” that will go away on its own after two weeks.  I am given the option of having it removed if i don’t want to wait, but I want to avoid getting a scar.  Begin applying Mupirocin to the area.
  • July 21: Almost two weeks later… bump almost gone, but slight arm pain begins.
  • July 24: Pain spreading and feeling sharper.  Notice a new tiny bump on upper arm, under the skin, that cannot be seen, only felt.
  • July 25: My original shaving nick is still there, and just a tiny bit worse.  It’s been scabbing and flaking with no progress.  New, small red spot also appears on face.  First arm bump is growing again.  Doctor diagnoses small arm bump as swollen lymph node.  Large bump is drained.  Lymph node returns to normal size.  Blood tests show no obvious reason for shortness of breath (blood sugar levels OK, etc.)  Begin taking Flamox (250mg) and Lysoflam.
  • July 26: Lip swollen due to my sloppy application of Mupirocin on original shaving nick.  Goes away same day.  I continue application on Mupirocin on face more carefully.
  • July 27: Dressing changed on arm.  Infection is back.  Incision made and infection removed in entirety, including antibioma.  Culture taken.
  • July 29: Dressing changed again.  No sign of infection rebuilding in arm.   Culture results reveal streptococci.  Stop taking previous medications.  Begin taking Levofloxacin (500mg).  Continue with Mupirocin on face.  Face still the same—two red spots, but both seem to be drying up.  Still sometimes short of breath.  Headache.
Categories
Mombasa

Revenge of the Infection

WARNING: I won’t get into all the gross details, but this is mostly a medical post.  You’ve been warned.

So I wish I could say that I’ve been a good, effective teacher and that I’ve been focused on exams week, but it’s not true.  In fact I’ve been missing quite a bit of class recently.  Last Friday, two weeks after I finished taking antibiotics for the staph infection on my arm, I finally got tired of the area around the infection becoming more painful every day.  Additionally, and only possibly related, I had been fighting a general sickness around the same time, blowing my nose a lot, etc, and I found myself sleeping more than usual and taking deep breaths for no apparent reason, as if I’ve been holding my breath, which I might attribute to stress were it not for timing—the infection had definitely started growing again.

The doctor that the Peace Corps normally uses was unavailable, so I visited the Mombasa Hospital Outpatient Facility (AKA the ER, or as it’s known here colloquially, “Casualty”).  In my first real experience with hands-on medicine in Kenya, the doctor suggested that it would be best to take a culture sample from the infection to have tests done, since it’s apparently resistant to the first antibiotic I took.  That sounded like a good plan, and he did the procedure himself, which was quite disgusting.  After he finished cleaning the wound and bandaging it, he looked down at the biohazard bin where everything had been thrown away and said, “Oops.  We forgot to get a sample.”

So I left the hospital with bloody gauze on my elbow and a "best-guess” antibiotic prescription in hand.  That was Saturday.  Today I went back for my scheduled cleanup/gauze replacement, but also armed with additional questions about what appeared to be some smaller infections developing around my mouth, and was treated to a confusing game of find-the-paperwork, in which I was asked questions like, “Who bandaged that for you?”

“You did.” I would say, “Here, at the hospital.”  They would look confused as to why that wasn’t in my file, and then send me back to the waiting room.  Eventually I was taken back to the same room where the doctor “forgot” to take the culture sample.  Upon removing the gauze, it became quite clear that the infection was gaining ground again, as —SKIP TO THE NEXT PARAGRAPH IF YOU’RE SQUEAMISH— SERIOUSLY — okay really, move along if you don’t like gross stuff… dark red blood and puss immediately began oozing out of two separate places and dripping onto the bed where I was sitting.  The nurse moved to clean it, and I stopped him and asserted, “TAKE A CULTURE SAMPLE NOW.”

After he took the culture sample, another nurse came in and asked me if it was a bug bite.  They suggested making a larger incision, and they were surprised that the first doctor hadn’t.  I refused to let them touch me any more until they found all my files, because as long as I’m still getting questions about whether it’s a bite, no one’s doing anything.

Eventually all was found, a doctor I liked was brought in, and they made the larger incision.  The test results on the culture will take two more days, so in the meantime I’m in the same situation—bloody gauze on my elbow, soaked through onto my shirt, and best-guess antibiotics in my stomach.

This whole experience hasn’t been good for my moral, and it’s even worse now that the infection is apparently attacking tiny little shaving cuts on my face.  So, much like my last bout of Giardia, this whole thing has been accompanied by a lot of movie-watching in my house.  Transformers 2 was terrible, by the way, in case you haven’t heard.

I’m supposed to attend a local wedding on Sunday, so I really hope things clear up by then, so I don’t need to show up with a Phantom of the Opera mask.  I’ll have a better idea on Wednesday when the results come back.  Stay tuned…