Saturday, November 8, 2008

It's enough to give me an ulcer....

It had to happen sooner or later- I have been so lucky so far, but this week, I got sick.
It started by waking me up at 2am on the morning of the election. My stomach was aching and I had overwhelming nausea. I couldn’t even eat the pancakes that Kristin and Andrew made me. For those of you who know my eating habits intimately, you would know that this was a clear signal that things weren’t right- pancakes are one of my favourite foods.
Anyway, for the rest of the day I couldn’t eat. My abdomen ached in a way that I have never experienced before. It was a deep boring pain and associated with shocking nausea. Anytime I attempted to eat food or drink liquid, I would be rolling around in agony about an hour later. So I stopped eating and I stopped drinking. All I could do was lie in bed- but only in one position because if my stomach came into contact with the back of my abdominal wall, I was in agony.
Chris came over and examined me. My abdomen was distended like a balloon and when Chris palpated my abdomen I nearly jumped off the bed. We both came to the conclusion that I may have a stomach/duodenal ulcer. She went in search of a drug called omeprazole and by some miracle, she was able to put her hands on some. It was difficult keeping the drug down but I managed to get a decent dose in. I woke up the next morning feeling a little better and I foolishly went in and did my ward round. By the end of it, I could barely stand. I was in agony. Chris and I started to worry a little bit and we made contingency plans of what to do if things got serious. I was adamant, that despite the fact I had developed some very mild malaena (suggesting that I was bleeding in the stomach), I did not want a blood transfusion even if I was really unwell. I am not morally opposed to blood transfusions- I simply don’t trust the blood here to be free from HIV. We would not stop for help in Swaziland but simply go straight to South Africa. Thankfully, we did not have to enact these plans, because regular doses of the omeprazole seemed to work over the next two days. I stayed in bed, remained nil by mouth and slowly improved. Chris checked on me regularly. Last night, she was absolutely gorgeous. She made me a clear soup and I was able to tolerate a few mouthfuls. It was delicious, very simple and very much needed because I was dehydrated and weak. It was this simple, random act of kindness that helped improve me dramatically. I’ve been able to have more and more of this soup and I now feel much better. I still have a constant, dull ache in my stomach but I’m able to get out of bed, I’m able to tolerate fluids and I feel much better within myself. I think I may have dodged a bullet….
I am very well aware that this presumed ulcer is probably due to stress, otherwise it could be a big parasite growing in my stomach…..
I’m not sure what to do about the stress. I certainly have tremendous support from my friends here. Courtney emails me everyday and I get a great deal of comfort from her predictable contact. I just think that what I witness here is stressful. For instance, I often have people join me for my ward rounds. Kristin and Susan (both nurses) have joined me and both have been incredibly distressed at what they witnessed. I have a young Swazi girl who has completed a Bachelor of Science and has applied to do medicine. She asked to join me on my rounds so that she could get a taste of what medicine is like. I have tried to be an enthusiastic role model for her, but she has often been reduced to tears at what she sees. Other people have vomited on ward rounds and earlier this week, I had a young girl from the Netherlands faint whilst we were seeing patients. I think these reactions are normal for what we are seeing here. It is distressing, it’s almost surreal and the reaction we have to the suffering is visceral.
Also contributing to my stress is the ever present fear of snakes. A huge Black Mamba was found in the female ward earlier this week. Thank God I was not there to witness the chaos and hysteria that ensued.
Last night, one of the security guards knocked on my door and he warned me that a huge snake was found behind my house yesterday. He warned me that I need to keep all my doors and windows closed and make a lot of noise as I exit my flat.
If that isn’t enough reason to develop an ulcer, I don’t know what it.