Monthly Archives: December 2011

Next Stop: Milestone

It is four months to the day since we began Next Stop: World with a flight to Tokyo. So far we’ve been to Japan, Australia, New Zealand, Singapore, Malaysia, museums, temples, shrines, caves, fjords, reefs, restaurants, food stalls, food markets, a farm, a mine, a bungy swing, a hospital, a penny farthing race, crappy hotels, nice hotels, comfortable homes, train stations, bus stations, boat docks, taxi stands and plenty of airports.

Next Stop: Kuala Lumpur for New Year’s Eve, and then…?

 

Making the newspapers back home

Our scribbles in a guestbook in New Zealand landed us in some regional Wisconsin newspapers. Small world, huh?

Reporter Mary Bergin found our entry interesting enough to track us down in Borneo, and she featured us in her column, Roads Traveled. Here’s the version of the article on her website, featuring Karen’s gallery-quality drawing of a kiwi bird.

Thanks for contacting us, Mary. It’s always great to make a connection to our peeps back in the Land of Cheese!

Making new friends (of friends of friends)

We have great friends back in the U.S. So many of them offered to make connections with their friends and family members around the world. Singapore offered us the chance not just to stay with one host family, but with two! Hostel and hotel life can get a little dull, so we jumped at the chance to stay with both families.

The Mortonsons of Fox Point connected us with their former neighbors, the Martzels. The Martzels are new to Singapore, having been transferred there by work just a few months prior. Originally from southern France, Bertrand, Juliette and kids Matilde and Antoine were such generous hosts, especially at meal time. We enjoyed delicious food and delightful conversations. I even got to cook a meal. We celebrated when Bertrand and Juliette finished their first-ever marathon. The family gave us a tour of the relatively new Marina Bay Sands complex and we enjoyed watching a Green Bay Packer game on a very early Monday morning.

Getting wet....it rains a lot in Singapore.

Kids in front of Marina Bay Sands

The sore and very happy runners!

Hawker Stall Dinner

A few days later we met up with our second hosts, the Grahams. Thanks to the Gallentines of Minneapolis, we got to meet Jim, Marla and their kids. A job brought this worldly family from Kansas to Singapore over 4 years ago. They were a wealth of information when it came to shopping, good eats and movie theaters (very important, as we had to see the opening of The Muppets). We chatted over delicious New Zealand wine and even folded paper cranes which were being sent to a sick friend in the US.

Enjoying a birthday celebration.

Cheers to new friends!

We are so grateful for these connections around the world. They give us a sense of home, a comfortable place to stay and most importantly, new friends. Thanks friends, old and new!

The natural side of Singapore

Singapore is a small island country, measuring about 26 miles long by 14 miles wide. Most of the country is covered with roads, high-rise apartments, modern buildings and shopping mall after shopping mall. Thankfully, there is some green space too, and in our one week visiting there, we managed to visit two places filled with fun fauna.

First we hiked near MacRitchie Reservoir and did the treetop canopy walk. This rainforest is just a 10 minute walk from our host’s condo, and about 15 minutes into our walk we saw monkeys! Long-tailed macaques are used to people, usually hoping for a bit of food, so we were able to get a close look at them.

Macaque

Crossing our path. Or did we cross his?

A couple days later, we hiked the Sungei Buloh Nature Reserve. Located at the northern tip of Singapore and just across the water from Peninsula Malaysia, this wetland forest and mangrove area is teaming with interesting critters.

Looking north to Peninsular Malaysia

We spotted neon blue Kingfishers, perfectly camoflouged Monitor Lizards, and the amazing Mudskippper. This fish spends more time out of the water than in it!

Water Monitor Lizard

Good cover

Mudskipper

Hello Muddy!

Singapore’s green spaces are the perfect antidote to all the electronics shopping that critters like Ken are wont to do.

Ken in the techno mall

How Ken Survived a Malaysian Hospital (and why Karen is up for Doctor of the Year)

The blog has been a little quiet for a couple weeks, and that’s because I’ve been in the hospital. In Malaysia. No, I wouldn’t recommend adding it to your holiday itinerary.

It’s a long, drawn-out tale, and one I wanted to get into the record books. I’m breaking it into three posts, so start with Sipidan if you want to experience the entire narrative sweep. Seeking Help in Sandakan takes me to private labs and clinics in town, and then I finally check into Duchess of Kent Hospital, where the real fun begins.

If you’d rather stick with our usual jovial posts, we’re happy to oblige: before Malaysia, we were in Singapore, and we have a couple fun posts coming with oddball critters and happy humans to spare.

How did I survive a Malaysian hospital? By taking charge of my healthcare, with the backing of my wonderful wife. Rest assured, as I type this, I feel fine, and we’re getting ready to move onto new cities and new adventures soon!

 

Duchess of Kent Hospital (HKSAMH part 3)

DAY FIVE OF ILLNESS.

After a night of constant fluid ingestion (and expulsion, for that matter), we returned to the hospital for a blood test. I got poked at 8:30am, then we sat around with anime cartoons blaring at us on TV until the results arrived at 10:30.

The Emergency doc from yesterday interprets the results for us. My platelets are about the same, around 74K. Dengue fever is rampant in this area, so in the absence of certainty, we have to assume I have dengue and treat it accordingly. The doctor explains that I am entering the “critical phase” of the disease (days five through seven), during which my fever should break, the platelet level should bottom out and then start rising, while my fever may rise temporarily before subsiding altogether.

Dengue Fever "critical phase" parameters - got it?

During this process, any sudden bleeding or change in blood pressure must be caught quickly. Supervision and monitoring are key during this period, and he says that the opportunity to go back to the hotel at night is no longer available- I need to be admitted to the Men’s Ward, which, he says, has about 11 beds and the necessary staff to come by frequently and change IV bags and administer blood tests.

I wanted to avoid staying at this hospital, and Karen and I tried to scheme a way out of it. We thought of flying to a private hospital in Kuching or Kota Kimbalu. The problem is that if I have dengue fever, my capillaries may be fragile and the pressure changes of flying are out of the question. Take a bus? The bus ride here was very rough on me, and I can’t reasonably spend any part of the “critical phase” unsupervised on a bumpy bus anyway. They have me by the IV tube.

Modern British hospital design, circa 1950

We exit the Emergency entrance, cross the driveway, and enter the large concrete building across the way. Any optimism I had about the condition of this building fades. I begin to feel that I am being marched to my prison cell after receiving my sentence for a particularly heinous crime.

The front, um, “lobby” is dark and dingy. We begin climbing steps (no lift?) in a poorly-lit staircase. One flight up, we head down a hallway. As I march past smaller enclaves of people, every head turns, every eye follows the new inmate. Finally, we enter the Men’s Ward, a high-ceilinged room with roughly 11 beds in. They are all occupied, so we keep walking into the OTHER room on the Men’s Ward, the one with 25 beds. Every bed along the wall is occupied; there are a few temporary beds in the middle, and I am led to one (just like prison overcrowding!). Home Sweet Home.

My eyes scan the room. No central air. Just a bank of windows- all of them open with no screens- and ceiling fans spinning.

My view of the Men's Ward of Doom

All the doctors and nurses wear surgical masks; none of the patients do. You can guess who we’re going to side with here. We ask for masks, are given a whole box, and are never without one on our faces.

The reason I’m here is for close supervision. The irony is not lost on us when it takes, literally, hours for them to start me on an IV drip. When they find that it is very slow, they realize that they used the wrong size needle (pediatric size). I don’t have many obvious veins popping out of my arms, so I’m glad when they relatively painlessly get the correct needle situated in my right hand.

I am supposed to receive 117 ml/hr, and after an hour we can see that I haven’t received nearly that much. Karen officially makes her transition to Dr. Karen. She will now monitor my IV and adjust the drip rate as needed. I’m finally getting 117 ml/hr thanks to her.

Dr. Karen

She also helps me drag my IV bag with me to the grim bathroom, a trip I make often because I am keeping myself so well hydrated. It always stinks in the bathrooms, the toilets work intermittently, and the walls are dirty. The bathroom can also be used as a shower, so the floors are always wet… sometimes the floor is completely covered in a puddle. Hmm, let’s see, take a bunch of sick, elderly, balance-challenged patients and have them walk through water to use the can. Brilliant.

Grim bathroom

The nurses-in-training travel in flocks. The simplest operation (i.e. sticking a thermometer under your arm) requires at least two of them. More complex operations will garner you a gaggle.

A gaggle of nurses

I didn’t find much to smile about in my situation or that of the other patients. But the nurses could always find something to giggle about. Asking me to pee in a cup for a urine test ended in giggles. Any language difficulties were worthy of a giggle. And then there was the time they gave me an EKG. They drag a cord across my face- giggle. They drop part of the expensive unit on the floor- giggle.

EKG hilarity

At dinner time, the ward is jam-packed with family members visiting patients. Being in the middle of the room, my bed is jostled by people trying to squeeze by. One older man has dozens of visitors- his daughter strikes up a conversation with us. By the end, she is asking if there’s anything I need her to buy me: fruit? beverages? We are touched by her generosity.

As night falls, Karen and I are torn. We realize that I need more monitoring than Dr. Karen can provide (i.e. blood pressure readings), yet we are observing unhealthy practices around me. Concerned about lax standards in a roomful of sick people, we announce that we were going back to the hotel for the night. One doctor comes by to try and talk us out of it; she relents and says we can leave, as long as we sign a form that it was at our own risk. Minutes later, she returns to say that the head doctor can’t let us go and will stop by to talk to us soon. It isn’t soon, but eventually he shows up and gives us a big speech about how I need supervision. We hit him with our observations: my blood was taken at noon and we’re still waiting for results at 10pm, nurses are not checking on my IV drip, the woman teaching the student nurses is not wearing a mask and is coughing on people. “This is a government hospital,” he says with resignation.

We ask if we could pay to move to a better room. Miraculously, mention is made of a “first class” room, a private room with air conditioning. That’s where I want to go. The doctor unspools another speech about how I need to stay in the big room, where the staff is moving around me all night, noticing anything that is going wrong. Karen has stern words with him over the quality of observation I am receiving from the staff. Finally, an agreement is reached. The doctor will take blood for a test early tomorrow morning, so it gets into the lab early, before the daily backlog. If the blood test is trending positively, I can move into the first class room. Tonight I will sleep in the big room.

I hunker down, as if digging into a bunker to wait out an aerial bombardment. Karen tells me she doesn’t want to leave me overnight. “I don’t trust these people to take care of you,” she says, tears welling up in her eyes. It is touching, and I couldn’t ask for a better advocate than her in our conversations (arguments) with the staff. But there’s nowhere for her to be comfortable, and there’s no point in her getting sick, too.

The best a loyal family member can do is try to sleep nearby in a lawn chair. One woman spreads out a cardboard box and spends the night underneath her sick husband’s bed.

Quality time with a loved one

The U.S. is waking up at this time of day/night, so we decide Karen will go back to the hotel and call our health insurance company’s nurse helpline for advice. We say farewell.

Despite all the talk of careful observation, I know that my health is 100% my responsibility this night. I tighten my mask and settle into bed- of course my feet stick off the end because it’s too short.

Gecko

Geckos on the ceiling of a hospital ward? Doesn’t seem like a good thing, until you watch one eat a bug that otherwise might have come down and bitten you. Go, gecko, go!

The night passes interminably. I feel every minute. I listen to podcasts for a while, then they give me a headache. Every twenty or thirty minutes I need to pee, so I clamp off my IV bag and carry it to the dreary bathroom, do some acrobatic one-handed urination, and then return to bed. One time, I also extract a roll and some jam from my food bag before unclamping the bag; the IV drip doesn’t start back up, probably because the “inlet” in my hand had time to heal up slightly and close the hole. It’s pretty quiet… none of those attentive staff members pass by… I try to clear the blockage myself, as I’ve seen the nurses do… and finally someone passes by. I tell her my drip has stopped, and she walks away. She returns after a while and gets it started again. I’ve lost maybe half an hour of hydration. I think they took my blood pressure once- that’s the sum total of staff attention overnight.

DAY SIX OF ILLNESS.

They kept up their end of the bargain on the blood test- they drew blood nice and early, like 5:30am.

Karen returns around 7:00am, and I can finally rest a little bit easier. I survived the night, my advocate is back, and we have some test results to look forward to. My temperature is down to 98.6- whew!

They probably never have the chance to clear out this ward and give it a deep clean, so Super Backpack Vacuum Man comes through spot-vacuuming, followed by someone mopping.

Super Backpack Vacuum Man

Of course hours go by with no news. At 10:00, the doctors come by on their rounds. We ask about switching to a first class room, and once again get the “you need closer monitoring” argument. “But my indicators are all headed in the right direction,” I plead. “Actually, your platelets are down to 60K,” counters the doctor. We realize that my morning test results came back and no one told us about it. We let them have it. Dr. Karen asserts that we are not getting the information we need from them. And at this point in the “critical phase” my platelets are supposed to bottom out and then start climbing. And she learned from her call to the U.S. nurse that a truly dangerous platelet level is 15K, so I am nowhere near that.

They agree to transfer us to a first class room.

Heaven on earth: the first class room

The first class room is heaven. It is a private room with a bed, a chair with cushions, two tables, a closet and an air-conditioning unit. The bathroom is shared with the room next door. In the U.S. this would be the most basic room on offer- and patients would complain because it doesn’t have a TV.

The choir of angelic voices is interrupted only by the woman next door, hacking up a lung. Her coughing and sputtering is almost continuous, and our shared bathroom is often in use. I decide to pee in a bedpan to reduce our need for the bathroom.

Meals are delivered on plastic trays, and Dr. Karen picks through them, removing, for example, the many bones in the fish they served.

Dinner with my ever-present tether

Despite the apocalyptic predictions that I would feel abandoned here, nurses pop in occasionally to take my blood pressure and temperature and change my IV bag. They never get the drip anywhere near the specified rate, so Dr. Karen always makes her adjustments after they leave.

I continue to drink ungodly amounts of water, fruit juice and 100 Plus. I’m not going to let them throw another “but your _____ parameters are low” comment at me. Victory through hydration!

At 6:00pm, a doctor draws blood for a test. Miraculously, he is back in 45 minutes with the results. My platelet level is now… 91K! We nearly raise the roof with a cheer. But there always seems to be some bad news lying in wait: the doctor reports that my hemocrit numbers are showing that my blood is a little too thick.

The solution? A faster flow of IV fluids. Isn’t that ironic (since I’d be getting even less if we weren’t secretly goosing the juice)? They later decide to stick with 117 ml/hr. How does that address the issue?

With a decent chair available, I can finally vacate the bed and let Dr. Karen take a much-deserved nap. Even when she got back to the hotel for a night, she spent some of her time on the phone and gathering supplies and clothes, so she hasn’t had a good night’s sleep in a while. When bedtime does roll around, she cobbles together the chair cushions and various blankets to create her own bed, of sorts.

Karen's corner

DAY SEVEN OF ILLNESS.

Bright and early, at 5:30am, they take my blood for a test. By 7:45am, we have the results (I’m liking this submit-the-test-early-for-early-results scheme). The news is not good: my platelets have fallen to 80K, and my hemocrit is still abnormal. I’m dehydrated. The problem is that last night… I slept. Delicious, blissful sleep. I regret nothing. Today I will return to “Victory through hydration” and lick this. But boy did I need that sleep.

Another doctor stops by to tell us that my dengue antigen test came back negative. He thinks that I most likely have a viral fever, not dengue fever. However, they are not able to run the conclusive dengue test, since they do not have the necessary test kit. I should be able to leave the hospital tomorrow.

Mimi, the front desk manager from our hotel, stops by with a fruit basket and kind words.

Yet another new doctor arrives, introducing himself as a specialist. He says that my parameters are headed in the right direction but that I remain in the “critical phase”. “We would like you to stay one more night, so we can make sure nothing changes,” he says with pleading eyes. “I was told that you want to leave early.”

“I don’t want to leave early. I want to maintain a standard of care,” I tell him. We had already decided to stay (a much easier decision to make in the first class room), so it was no problem to oblige.

4:00pm test results put my platelets at 94K, with hemocrit improving. By 8pm, platelets are 102K. Victory through hydration! The fluids keep flowing, in drip and drink form, and we even listen to the some music and an episode of This American Life. There’s a light at the end of the tunnel.

DAY EIGHT OF ILLNESS.

As Departure Day dawns, my early-morning blood test shows platelets at 104K and hemocrit looking good.

Feeling better at breakfast

No more need for an IV drip, ready to be discharged. So of course we sit around for hours more. I’d have no problem packing up and marching toward the front door, but I’ve still got that leash stuck in my right hand.

We finally get a nurse to remove it (ahhh), and Karen leaves to settle up the payment for the first class room. I pack up and stand by the door. Then by the window. Then I sit. This is taking a long time. It turns out the hospital only takes cash… and doesn’t have an ATM. Unbeknownst to me, Karen is taking a taxi into town, extracting a wad of cash from a machine, and returning to make the payment. The total cost comes to RM 620 (US $195).

Released from my sentence, we gather our bags and walk through the crowded ward toward freedom. We have had plenty of time to wonder about the people crammed into these beds, in this dingy, stuffy room. Do they accept these conditions because their own homes are worse? That’s probably the case for some, but it can’t be for everyone. I guess if you grow up seeing this as the standard of care, you get used to it. But that doesn’t make it a good place to recover from illness. We did not see evidence of patients demanding better- ask for a mask, people, and if the nurse is coughing on you, tell her to knock it off!

The doctors and nurses (excluding the coughing one) here are doing their best. Karen read that Malaysian doctors are required to serve a couple years in a government hospital before they can accept more lucrative postings. That probably explains why so many of my doctors were very young. They all seem to genuinely care about their patients, but they simply don’t have the resources to achieve what we would consider an acceptable level of care.

The great escape

Blinking in the bright sun, we load our bags into a taxi. As we start down the hill, I catch one last glimpse of the buildings of the Duchess of Kent hospital. And then it is gone… from my life, at least.

Goodbye, Duchess

 

 

Seeking Help in Sandakan (HKSAMH part 2)

DAY ONE OF ILLNESS. I had just gone from this…

A-OK

… to this…

Sick on Sipidan

… in no time flat. My face felt hot and my energy was drained. I was having a great time chatting with my fellow divers from around the world (Canada, U.S., Spain, Sweden, Slovakia and of course the obligatory German), until I ultimately lost the ability and/or inclination to speak, eat, or sit upright. They had a lovely lunch that I couldn’t stomach.

Lunch on Sipidan

I bowed out of the third dive, then the fourth, then I just wanted to get back to Mabul Island and lie down. Of course, that meant a half-hour roller coaster ride through choppy waves. Arriving at Mabul Island, the dive master asked if I’d like to get my luggage and go all the way back to mainland Semporna, closer to supplies and doctors. Good idea. Drat, another half-hour ride (thankfully, not as choppy).

I spent the night at the rundown hostel where my Sipidan adventures had begun. I finally managed to connect with Karen via email and then Skype, and we made plans to meet up the next day. I sprang for a private room with air-conditioning. Although the bed was as hard as a rock, sleep came quickly.

DAY TWO OF ILLNESS.

I awoke in the crummy hostel feeling crummy and hot, possibly feverish.

Scuba Junkies, emphasis on the "junky"

I asked at the dive shop for a local clinic (or in Malay, klinik). There was one just down the block. Listening to my description, the doctor suggested that it could be a viral infection, a bacterial infection, or possibly dengue fever. He didn’t think it was dengue fever because I didn’t have diarrhea, a strong indicator. He gave me Tylenol for the fever and suggested I take an antibiotic just in case. Cost for his time and two prescriptions: RM70 (US$24).

Prescription in a bag

Prescriptions here come in a cute little bag with simple instructions on the front. Very convenient for keeping track of pills, although U.S. lawyers (and well-informed patients) would balk at the lack of 17 pages of warnings and disclaimers.

I forced myself to eat lunch and took my pills. Completely drained of energy, I flopped back onto my rock-hard bed and was surprised when Karen appeared a few minutes later- oh, wait, it was actually a few hours later. My level of care certainly improved, as she bought me beverages and light foods.

She also had a thermometer and confirmed my 102 degree fever. I had chills, sweats and body aches. I would much rather have been doing a third day of scuba diving near Mabul, as planned!

All I could do was try to get some sleep and stay hydrated.

DAY THREE OF ILLNESS.

Tiny Semporna was looking like a dead end. We couldn’t take the rock-hard bed any longer, so we decided to continue as originally planned to Sandakan, where Karen had booked us five nights at a resort. It was meant to be a break from traveling where we could just relax as a couple. Sounded like a good place to recuperate.

I was starting to have diarrhea now, calling into question the doc’s diagnosis. I can go to a clinic in Sandakan for a second opinion, just gotta get there… by bus.

Our chariot awaits

A 5-hour bus ride sounded daunting to me. At least there was a bathroom on the bus, so I could continue to drink fluids. And the driver did not take hairpin turns at breakneck speed like they do in Peru, although he made some pretty daring passing maneuvers. We unexpectedly had to switch buses halfway, which delayed our arrival an hour. I just tried to hold on, hold on. Late at night, we walked into the Sabah Hotel, the most Christmassy place we’ve seen in this predominantly Muslim country.

Christmas cheer

A nice room, nice bathroom, nice pillows and blankets. Fever of 102, chills, diarrhea. I collapsed into bed for the night. Hard as a rock. Oh well.

DAY FOUR OF ILLNESS.

I woke up with a temperature of 100.2 and bad chills. I’ve always thought that was an unkind twist of nature- your body is way too hot, so you get chills and want to throw blankets over yourself. Karen also noted a slight rash on my back (she knows best what “normal” looks like back there).

Breakfast was included in the room price. Despite a lack of appetite, I forced myself to eat some potatoes, a sausage, some fruit, and of course I drank fluids.

Turns out there are kliniks all over Sandakan’s small downtown area. Through a recommendation from the hotel, we wound up at Klinik Thian. As we stepped into the roomful of locals, the power went out- the lights, fans and the overworked air-conditioning unit all fell lifeless. Activity continued: nurses scribbling notes, weighing people, etc. The Malaysian system for record-keeping is to handwrite everything on 3×5 cards and staple them together. There are hundreds of cards everywhere: on the counters, on desks, and in bags.

Malaysian medical records storage technology

In a few minutes, the power was back on and the temperature back to bearable. I was called pretty quickly- was I given preferential treatment, or were most of those locals waiting on the pharmacy at the next window? Who knows.

Ken at the Klinik

The doctor poked and prodded a bit. He suspected viral infection, dengue fever or malaria. One thing he didn’t buy into was a bacterial infection- and he posited that the antibiotic I was on was probably causing my diarrhea, D’oh! Previous medical care is now skewing my current medical care by introducing extraneous symptoms! Needless to say I stopped taking the antibiotics immediately. The doctor sent me to the Gribbles lab around the corner for a blood test.

I'd feel better if you could at least afford a nicer sign at the entrance

I paid my money and got poked. I was careful to observe the instruments the woman used to administer the test: they were all properly-wrapped, single use and sterile. That’s something I’ll need to keep an eye on here.

Proudly poked by Gribbles

The results came back negative for malaria, but my white blood cells and platelets were low, which could be dengue or a viral infection. Hydration and rest would be critical. The doctor suggested I go to the local hospital, where they could perhaps put me in a “day care” ward with an IV drip, and then send me home at night.

Arriving at the hospital

We arrived by taxi (or in Malay, teksi- I love languages you can sound out!) at the Emergency entrance of Duchess of Kent Hospital and handed over my note from the klinik. Several people gathered around and read it like a document unearthed from a pharaoh’s tomb, turning it over and asking others for help interpreting it. I explained that I needed to be admitted for rehydration. They took my passport and signed me in as Kenneth James (well, that is what it says on the first line of the first page), so that shall be my name for the duration of the coming ordeal. They charged me an RM50 (US$17) admission fee. As Karen was waiting for the receipt, they put me on a gurney and wheeled me into the hospital. Heads turned as the white guy made his grand entrance.

They slotted me in next to two other patients. Soon a nurse was asking me questions, then a doctor was asking the same questions: fever? (yes) diarrhea? (not since I stopped taking those antibiotics) abdominal pain? (no) rash? I think I have a slight rash on my back, but Karen is the one who knows what my back is supposed to look like. I asked to have my wife come back. The doctor continued as if I hadn’t said a word.

They needed to move one of the patients near me but couldn’t quite fit his bed through the gap, so one of the nurses pushed my bed aside, slamming it against the concrete wall with a jolt. Enough room now.

Several more people stop and ask me all the usual questions about my condition. When they ask about my rash, I tell each of them that my wife knows more about that and we should have her join us. My polite request is ignored as if it had never left my lips. Finally, I stop answering any questions until my wife is present, and before long Karen has appeared.

Ken gets a drip

They set me up in a ward of 6 beds, a fairly clean environment which has the only central air we’ve seen in Malaysia. As they put me on an IV drip, I remind Karen that she and I both need to pay attention to the supplies they use, making sure sterile items are unwrapped in front of us and handled properly. When I ask to use the toilet, the staff appears confused, as if this need has never appeared in a rehydrating patient. Eventually, Karen and I work out a system whereby she helps wheel my IV stand to the bathroom and stands outside while I pee. The bathroom is a wreck- the floor is wet because it’s also a shower (like on a scuba diving boat), and the toilet doesn’t flush properly. I trundle back to bed.

Ken settles in

The doctor is concerned about malaria, which doesn’t seem right to us, since we’re taking an anti-malarial pill every day. He explains that there are four types of malaria in this area; our chosen pill only protects against the most life-threatening cerebral variety (don’t get me wrong, I like being protected from that one). He runs two blood tests for malaria, and both come back negative. Dengue fever is another concern, but the test is expensive, so the hospital only runs it once a week. He does a primitive tourniquet test for dengue fever on my arm, and the results are negative. What we do know is that my platelet levels are still low.

The doctor is making noises about me staying the night. This prospect didn’t excite me. I announced that I would be leaving and spending the night at the hotel and that I’m willing to methodically hydrate to his specifications overnight. He said I should drink a total of 3 liters of water overnight. That meant drinking about 250 ml of liquid every hour (the math is so easy with the metric system- I love it).

He gave us prescriptions for more Tylenol and a rehydration powder to add electrolytes to water. They also have a carbonated isotonic drink here called 100 Plus, so we stocked up on that.

100 Plus

I had an alarm wake me every 1 to 2 hours- I would drink 250 to 500 ml, go to the bathroom, and go back to sleep. It made for a long night, but I never felt dry and I knew I was working toward getting better.

Continues in: Duchess of Kent Hospital