Wednesday, November 9, 2017
Bad. Ish.
If yesterday was Good. Ish. Today is Bad. Ish.
No, pretty much as bad as could be. Well, no, that’s not true.
‘Choo-choo!!!’
That’s the sound my phone makes when it gets a text message. Like you’re about to be run over by a train. Danae hates it, but it’s the only thing that stands a chance at getting my attention.
The three monsters in my house have been waking up every morning at 5:40 or earlier. This morning was no different. Right after that, the train barreled through my bedroom.
It’s about midnight in DC and Danae lets me know Juniper has a fever of 104 and is vomiting and lethargic. Great. Malaria. Seriously? And Danae had forgotten the quinine suppositories in Bere. She tried to get some in N’Djamena before getting on the plane but had no success. Oh, well. No problem. What are the odds Juniper would get malaria while they were away? Pretty good, apparently.
Danae has some oral medicine, but Juniper would just throw it up. Tylenol syrup stayed down. Danae thinks about giving oral medicine after the Tylenol takes effect.
Danae has an appointment with the neuro-ophthalmologist in the morning. If she takes Juniper to the ER, she will likely miss her appointment.
‘Just take her to the ER. You won’t ever regret it. Even if it all turns out to be fine. They will understand and reschedule your appointment. Nobody will blame you for canceling because you had to take your 12-month-old to the ER with a fever of 104 and malaria and vomiting and lethargy. It’s totally appropriate and what good parents do.’
And then the phone shuts down. Completely. No contact with Danae. No service whatsoever. Can’t iMessage. Can’t text. Can’t email. Can’t Whatsapp. Can’t Messenger. Can’t FaceTime. Oh yeah, can’t even go old school and call. My smoke signals blow away in the wind. My drumbeats don’t carry that far. Phone tower is apparently down. I may as well be in the middle of the Sahel. Oh wait, I am.
I try to put on my strong face and I go to the hospital for worship, but all the while I’m thinking about how Juniper celebrated her one-year birthday on an airplane without her daddy and her siblings, no matter how much the flight attendants spoiled her.
A nurse gets me during worship. He just got a really sick kid and wants to order things, but the computer system is down. I step out. Our server crashed. No, it died. The computer won’t turn on. The charger lights up, but nothing on the computer. I get another charger. Charger lights up. Computer has no lights, nobody home. I try the charger on another computer, no problem. So I grab a screwdriver and pull the hard drive from the server and swap it out with a hard drive from another computer. Now the other computer boots up as the server. Great (genuine). I take it over to the office and set it up as the server. Except now it won’t boot properly. Great (sarcastic). I take out the hard drive again and tear apart another computer. This computer has an old-school pin arrangement on the hard drive, so I can’t swap. I tear apart the original computer again to try and figure out why it’s not getting any juice. I can’t figure it out. I cannibalize a computer from the ER and put the server hard drive into that one. Success! I set it up in the office, turn it on, looks perfect. Except, it doesn’t register itself as the server. Zachri, my guru, is unreachable because the phones are down. Bother. You know what, we’re doing pen and paper today. I have other things to worry about.
The phones come back up. Zachri is a full time college student and has a test to go to. He tries to help me, but needs to run to his test.
I find out Trump won. I didn’t want him. Let’s not get into that. But needless to say I have a hard time explaining that one to my Tchadian colleagues.
I find out Danae is in the ER with Juniper. I am relieved. They are being admitted to the ICU. Juniper will have two IVs after a million pokes. (Not the nurses’ fault.) She will be on a cardiac monitor to make sure the IV quinidine doesn’t prolong her QTc and put her into Torsades (ie, stop her heart). We’d rather have IV quinine or IV Artesunate, but that’s controlled by the CDC in Atlanta and we’d rather not wait for it to be flown up. She is still vomiting and lethargic. But I feel better. Once admitted, she will be getting labs drawn every four hours because she is peeing blood and they want make sure her kidneys don’t shut down and to follow her parasite load to make sure it’s decreasing.
They did a rapid malaria test, which was positive for possible multiple strains of malaria. The lab didn’t believe she had malaria because it’s so rare in America, so they repeated it. Same thing. They are sending it out for a PCR. This is Juniper’s fifth bout of malaria since we got back in July.
I suspect they have her enrolled in some research study. They are at the University of Maryland, which has their own malaria department. We should be charging them to care for her, since it’s kinda hard to find too many pediatric malaria cases in Maryland!
One of my parents will stay with Juniper and one will accompany Danae. Danae sees the neuro-ophthalmologist. She gets her MRI report. Clean. No evidence of multiple sclerosis or optic neuritis or tumor or cancer or aneurysm or stroke. That’s good. As physicians, sometimes you know a little too much of what your diagnosis COULD be. We knew it could be bad. This MRI report is a huge relief. They test her ocular pressure. Normal. They test her visual acuity. Normal. They test her pupils’ reaction to light. Normal. They test her visual fields. Left eye normal. Right eye, well, she clearly can’t see squat to the left of midline. Nothing.
The doctor examines her retina. Normal. She calls in a retinal specialist to examine her retina. Normal. Nothing abnormal they can find in her lens, vitreous humor (which isn’t as funny as it sounds) or retina. No cataracts. No posterior vitreous detachment. No retinal detachment.
I breathe easier knowing I’m not the worst doctor. I was gonna feel bad if I had seen a normal retinal exam and then they found an abnormality.
Then my chest tightens again remembering I still don’t know what’s wrong with my wife.
No explanation for why she’s half blind in one eye. They have no evidence for it, but they still think it’s the retina, despite both of them finding it normal on exam. So they ask Danae to go see another retinal specialist for some fancier testing on Friday, two days away.
I guess the day ends a lot better than it started. No multiple sclerosis or stroke or cancer or any reason to have a surgery.
(And to top it off, Adrian helps me figure out how to set up the new computer to function as the server and our electronic medical record is back up by 9pm.)
But in the sickest of ways, I’m almost disappointed. Here I had spent the last three days researching all of Wikipedia and all my medical and emergency textbooks reading everything I could on ophthalmology and neurology. I had kinda made peace with the idea that Danae was gonna have some horrific incurable disease and I had resolved in my heart I was going to be the best, most loyal husband ever. I’d start working out so I could life her onto and off of the toilet. We’d start eating healthy. I’d clean house and cook. I’d go to work and make money. When she had good spells, we’d travel the world and go hiking and enjoy ourselves and our family. I was really gonna be awesome at this. And to think that Danae would go and be healthy and steal this opportunity from me. You know, sometimes that girl can be so dang selfish.
Then I remembered that much better spouses than I have gone down this road before and failed.
Yeah, maybe I’ll just thank God Danae seems to be marginally healthy at the moment.
Juniper is in the ICU. Danae has no evidence of life-threatening illness. I suppose today wasn’t horrible. It started out just about as bad as could be, but we finally caught the break we needed. I can still call it Bad. Ish.
Bad. Ish.
If yesterday was Good. Ish. Today is Bad. Ish.
No, pretty much as bad as could be. Well, no, that’s not true.
‘Choo-choo!!!’
That’s the sound my phone makes when it gets a text message. Like you’re about to be run over by a train. Danae hates it, but it’s the only thing that stands a chance at getting my attention.
The three monsters in my house have been waking up every morning at 5:40 or earlier. This morning was no different. Right after that, the train barreled through my bedroom.
It’s about midnight in DC and Danae lets me know Juniper has a fever of 104 and is vomiting and lethargic. Great. Malaria. Seriously? And Danae had forgotten the quinine suppositories in Bere. She tried to get some in N’Djamena before getting on the plane but had no success. Oh, well. No problem. What are the odds Juniper would get malaria while they were away? Pretty good, apparently.
Danae has some oral medicine, but Juniper would just throw it up. Tylenol syrup stayed down. Danae thinks about giving oral medicine after the Tylenol takes effect.
Danae has an appointment with the neuro-ophthalmologist in the morning. If she takes Juniper to the ER, she will likely miss her appointment.
‘Just take her to the ER. You won’t ever regret it. Even if it all turns out to be fine. They will understand and reschedule your appointment. Nobody will blame you for canceling because you had to take your 12-month-old to the ER with a fever of 104 and malaria and vomiting and lethargy. It’s totally appropriate and what good parents do.’
And then the phone shuts down. Completely. No contact with Danae. No service whatsoever. Can’t iMessage. Can’t text. Can’t email. Can’t Whatsapp. Can’t Messenger. Can’t FaceTime. Oh yeah, can’t even go old school and call. My smoke signals blow away in the wind. My drumbeats don’t carry that far. Phone tower is apparently down. I may as well be in the middle of the Sahel. Oh wait, I am.
I try to put on my strong face and I go to the hospital for worship, but all the while I’m thinking about how Juniper celebrated her one-year birthday on an airplane without her daddy and her siblings, no matter how much the flight attendants spoiled her.
A nurse gets me during worship. He just got a really sick kid and wants to order things, but the computer system is down. I step out. Our server crashed. No, it died. The computer won’t turn on. The charger lights up, but nothing on the computer. I get another charger. Charger lights up. Computer has no lights, nobody home. I try the charger on another computer, no problem. So I grab a screwdriver and pull the hard drive from the server and swap it out with a hard drive from another computer. Now the other computer boots up as the server. Great (genuine). I take it over to the office and set it up as the server. Except now it won’t boot properly. Great (sarcastic). I take out the hard drive again and tear apart another computer. This computer has an old-school pin arrangement on the hard drive, so I can’t swap. I tear apart the original computer again to try and figure out why it’s not getting any juice. I can’t figure it out. I cannibalize a computer from the ER and put the server hard drive into that one. Success! I set it up in the office, turn it on, looks perfect. Except, it doesn’t register itself as the server. Zachri, my guru, is unreachable because the phones are down. Bother. You know what, we’re doing pen and paper today. I have other things to worry about.
The phones come back up. Zachri is a full time college student and has a test to go to. He tries to help me, but needs to run to his test.
I find out Trump won. I didn’t want him. Let’s not get into that. But needless to say I have a hard time explaining that one to my Tchadian colleagues.
I find out Danae is in the ER with Juniper. I am relieved. They are being admitted to the ICU. Juniper will have two IVs after a million pokes. (Not the nurses’ fault.) She will be on a cardiac monitor to make sure the IV quinidine doesn’t prolong her QTc and put her into Torsades (ie, stop her heart). We’d rather have IV quinine or IV Artesunate, but that’s controlled by the CDC in Atlanta and we’d rather not wait for it to be flown up. She is still vomiting and lethargic. But I feel better. Once admitted, she will be getting labs drawn every four hours because she is peeing blood and they want make sure her kidneys don’t shut down and to follow her parasite load to make sure it’s decreasing.
They did a rapid malaria test, which was positive for possible multiple strains of malaria. The lab didn’t believe she had malaria because it’s so rare in America, so they repeated it. Same thing. They are sending it out for a PCR. This is Juniper’s fifth bout of malaria since we got back in July.
I suspect they have her enrolled in some research study. They are at the University of Maryland, which has their own malaria department. We should be charging them to care for her, since it’s kinda hard to find too many pediatric malaria cases in Maryland!
One of my parents will stay with Juniper and one will accompany Danae. Danae sees the neuro-ophthalmologist. She gets her MRI report. Clean. No evidence of multiple sclerosis or optic neuritis or tumor or cancer or aneurysm or stroke. That’s good. As physicians, sometimes you know a little too much of what your diagnosis COULD be. We knew it could be bad. This MRI report is a huge relief. They test her ocular pressure. Normal. They test her visual acuity. Normal. They test her pupils’ reaction to light. Normal. They test her visual fields. Left eye normal. Right eye, well, she clearly can’t see squat to the left of midline. Nothing.
The doctor examines her retina. Normal. She calls in a retinal specialist to examine her retina. Normal. Nothing abnormal they can find in her lens, vitreous humor (which isn’t as funny as it sounds) or retina. No cataracts. No posterior vitreous detachment. No retinal detachment.
I breathe easier knowing I’m not the worst doctor. I was gonna feel bad if I had seen a normal retinal exam and then they found an abnormality.
Then my chest tightens again remembering I still don’t know what’s wrong with my wife.
No explanation for why she’s half blind in one eye. They have no evidence for it, but they still think it’s the retina, despite both of them finding it normal on exam. So they ask Danae to go see another retinal specialist for some fancier testing on Friday, two days away.
I guess the day ends a lot better than it started. No multiple sclerosis or stroke or cancer or any reason to have a surgery.
(And to top it off, Adrian helps me figure out how to set up the new computer to function as the server and our electronic medical record is back up by 9pm.)
But in the sickest of ways, I’m almost disappointed. Here I had spent the last three days researching all of Wikipedia and all my medical and emergency textbooks reading everything I could on ophthalmology and neurology. I had kinda made peace with the idea that Danae was gonna have some horrific incurable disease and I had resolved in my heart I was going to be the best, most loyal husband ever. I’d start working out so I could life her onto and off of the toilet. We’d start eating healthy. I’d clean house and cook. I’d go to work and make money. When she had good spells, we’d travel the world and go hiking and enjoy ourselves and our family. I was really gonna be awesome at this. And to think that Danae would go and be healthy and steal this opportunity from me. You know, sometimes that girl can be so dang selfish.
Then I remembered that much better spouses than I have gone down this road before and failed.
Yeah, maybe I’ll just thank God Danae seems to be marginally healthy at the moment.
Juniper is in the ICU. Danae has no evidence of life-threatening illness. I suppose today wasn’t horrible. It started out just about as bad as could be, but we finally caught the break we needed. I can still call it Bad. Ish.
Mr. German, you've inspired me to start writing again.
ReplyDeletePraying for you guys.
Oh I love how you can create these words for us to get a tiny peek into the window of your lives. I cannot imagine the tension and angst over all this but thank you for sharing so we can pray for you and with you from all parts of the world.
ReplyDeleteThinking of you, praying for you, and always appreciating your blog posts.
ReplyDelete