Tag Archive for 'infection'

Wedding Adventure

First, some quick updates.  The infection continues to retreat. You may note a complete absence of it in the wedding photos.  In my trip to the hospital today, the nurse also commented on how well my arm is healing.

While in the hospital, I was expecting some reference to the growing “Obama was born in Mombasa and here’s a fake certificate to prove it” movement, but no one brought it up.

Nairobi was good… very nice to see other volunteers.  I kept commented on what a crazy coincidence it was that we were all there at the same time, but the response I got most often was, “We’re here all the time.”  So I guess it’s just me.

I got back into town Saturday evening and immediately, as planned, visited the groom-to-be to check up on plans for the big day.  The plan was, “Show up at 10.  Or 11.  12 is OK too.”

The next morning, with only a vague notion of what to expect, I had only this plan:

  • Leave the house with the nicely wrapped gift—a tea set.
  • Walk to the nearest Bata and buy some nice sandals because I’ll probably need to take my shoes on and off a lot.
  • Walk to the groom’s house and see what happens.

Things were pretty mellow at the house.  “The house,” it’s worth noting, is more like a small apartment building where the tenants are all related.  I was welcomed graciously, and then I relaxed for most of the morning, sitting on the floor and entertaining the children.

There was definitely a sense that it was an important day, as bottled waters and juices were loaded into a truck outside, but at the same time it was quite mellow.  The groom aside (who had, after all, not yet met his wife-to-be), the general anxiety level was around what you’d expect if you were going to orchestrate a big family trip to the movies.  In a short burst of preparation, everyone (myself included) donned their wedding attire in the last ten minutes or so before we left.  As the Best Man, I was also the second-most-formally-dressed man.  I also smelled quite nice, as many a perfume was applied.  As you can see below, I wasn’t sure whether or not it was appropriate to smile for photos.  My compromise looks more like a sneer.

Groom on the left, me on the right.

The ride in the car was short, and involved much horn-honking.  By design the groom should be the last to arrive, so it was no surprise to see the parking lot packed as we pulled up.  As we stepped out the car, the crowd outside pleaded for the groom’s attention.  We filed quickly through the crowd and past the security barrier into the building.  I found out later that hordes of people often try to crash weddings for the free food.

I left my sandals at the entrance, on top of a gigantic pile.  I wondered how anyone would ever find their footwear again after such an event.  The room was filled with men, not a woman in sight.  All were seated, mostly cross-legged, on the floor, and there was not a free spot visible anywhere.  We stepped around people to get to the front of the room, where there was a raised stage.  The men on the stage reshuffled to make room, and we were seated, side-by-side, with out backs to nearly everyone.  Short greeting were exchanged, and I observed that not only was I dressed quite formally in comparison, but also that a number of men were dressed quite informally.  Shortly thereafter, the man seated facing us began reading from the handwritten Arabic text in his little notebook.  The groom voiced in the affirmative when the man paused.  The room was subdued for this duration, but far from silent.  After these vows were affirmed, newspaper was set on the floor and water, juice, and large plates of Biryani (rice and meat) were set down and shared.  As is customary, I ate with my hands.  Napkins were passed around afterward for cleaning up.  Ten minutes later, the room was clearing out.  More greeting were exchanged, and men came up to the stage and took photos with the groom.

I left with the groom and was led with him (and with another mzungu—a German Peace Corps volunteer)—into a small changing room.  The groom changed into more casual clothes and explained that he was going into the next room to meet the women.  Hundreds of them.  But he also explained that his wife would not be among them.  We were instructed to stay behind, and he walked back outside and then into a neighboring room, which immediately burst out into “ai-yai-yai-ya-yai” screams and music.  After waiting a few minutes, were were given the nod to go into the room ourselves, and we saw that it had the same layout as the previous room, with a raised stage, and the groom was on it, totally covered in henna ink.  The reason for the casual shirt became clear.  The women were dumping it on him and rubbing it into his hair, having a blast.  Others watched in amusement from elsewhere in the room.

The henna application was followed by dancing on the stage, with people (myself included) taking turns shuffling back and forth with the groom.  It’s a fun, messy event.  After a few minutes of dancing, we few men left the room, cleaned up, put on our shoes, and not long after, returned to the house.

“But wait, the marriage is over, but where was the bride?”  I asked myself.

I was instructed to go home and change my shirt before dinner, as others went home or into their rooms to do the same.  Dinner at the house was with a smaller group—maybe 20 men and 20 women, eating separately.  The chicken and chapati were delicious, and the gifted tea set was put to use, which made me happy.  After dinner, there was much conversation and mingling, and finally, around ten o’clock, people began packing into vehicles.

I rode in the back of a pickup truck with about twenty-some people as we honked and zigzagged around the island, eventually crossing the Nyali Bridge to the north, and heading into Bamburi.  It was a short drive, and we eventually stopped outside a hoteli (restaurant) with a nice Donald Duck painting outside, and we jumped out and followed the groom as he walked down a narrow hall that led to some rooms behind the storefront.  Things got very loud, and the tradition became clear: the groom knocks on the door, and with the help of everyone, makes a big scene in demanding that the bridesmaids inside open it to allow the two to finally meet.  Eventually the door opens, the music starts, and the cheering gets totally wild.  It was nearly impossible to see inside at first, but I got enough glimpses to see the bridesmaids lined up on the sides of the room, and at the center, the groom seated next to the bride on a couch, from where he presents the ring.  Photos were taken (one with me even, but not with my camera), and the groom and everyone else but the bride’s party filed out and danced in the hallway.  Sodas were handed out, people laughed and danced and got silly, and after a few songs, everyone packed back into the cars and left.

Today—the day after the wedding—the families will spend more time together, and tonight the bride and groom will leave for their honeymoon.  So my glimpse into the wedding process is just that—an outsider’s glimpse, as the process is far from over for the new couple.  I am extremely indebted for the treatment I received during the wedding, and I am lucky to have had the honor of being the Best Man.  I hope my perspective is enjoyable to read, and that I didn’t get too many details wrong.  It was a blast.  Congratulations to the new couple!

4 Responses to “Wedding Adventure”

  • great account of your wonderful day. Another volunteer “paid it forward” so that you could be part of this day. SO, you may be doing the same thing for someone else while you’re in Kenya.

  • I don’t remember saying I was there ALL the time! It was really nice seeing you, hopefully you’ll come to Nairobi again!The wedding sounds great–nice sneer!

  • Wow, this sounds so cool, what an experience! Grandma kept telling me all about it while I was home last weekend 🙂 I’m really glad to hear that your arm is healing– I was worried!! xoxo

  • Think of you occasionally, and finally am attempting to say hello. Not tech saavy as you know. Have looked at your blog and you are having great experiences. Will enjoy seeing you when you get state side. Dustin is officially engaged and Max, Derek’s 15 mo. old son is wonderful.

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.

3 Responses to “Turns out I just have… Strep?”

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…

4 Responses to “Revenge of the Infection”

  • Paul,

    Can you tell us that the names/amounts of the meds they have give you and what you are currently taking. Can you also give us a time-line.

  • Larry (doctor friend of Josh A)

    I am a friend of Josh A. My son is in Peace Corps in Lesotho. Josh called me and seemed concerned about your infection and forwarded your blog link.
    With regards to your infection:
    If you are better great. If not, it would be helpful to know what medications / antibiotics you have been taking (dose strength, pills per day and number of days) and the culture results. If you email me photos of the wound and mouth lesions, I have an infectious disease colleague who may be able to give additional insight.

    • Thanks Larry (and Josh). Timeline and drug info is in my latest post. Self-consciousness dictates that I don’t take pictures to share with you. The doctor in Nairobi is apparently the regional specialist in such things, so hopefully it’ll be OK.

  • FYI. I am worried. And thinking very healing oriented thoughts…. I’m from santa cruz after all…