Wednesday, 14 March 2012

Wednesday 14th March 2012 Doctor, doctor...can’t you see I’m gurning, gurning?


In my febrile little mind, I often find myself thinking that I am either cursed or just being toyed with by some higher power with too much time on their hands. The fact that I am 99% atheist doesn’t stop me thinking this. On the contrary, I find myself thinking that this is actually the reason for my continued torment.

Allow me to contextualise this mental aberration...

I have had a bad stomach problem for 10 days. When I say bad, I mean pretty awful. If you’re squeamish at all, I would suggest skipping the next paragraph or two. EDIT: Actually, best skip it all. It's not light reading at all...

It started over a week ago, after another entertaining weekend where I had taken advantage of a two-day weekend to partake in a little boat trip along the Mekong river. It was a good trip, with about eight of us on a wooden double-decker boat and a large cool box of beers. We saw some more of the real Cambodia, including cows being washed in the river by their owner and the wreck (I think it was a wreck) of a wooden fishing boat which had become a playground for local children from a local village. We watched them frolicking around the boat, jumping and somersaulting into the river with an enviable sense of freedom, some of them wearing nothing but broad smiles (I stopped taking pictures when I realised some of them were naked, much to the amusement of my trip colleagues). There were no adults watching over them, and I just couldn’t imagine such a scenario back in the UK.

On the home stretch there were some daft drinking games based on the roll of a die, and then a night of frivolity at Score bar where I won myself a few ESPN goodies by drinking bottles of beer and answering questions about Liverpool Football Club (much to the chagrin of one Scouser who contended vociferously that my correct answer was actually incorrect). When the second Skittle Bomb came out (a cocktail made with Cointreau and Red Bull that actually tastes like skittles sweets) I knew it was time to go home to bed. I'd already drank one, breaking my vow to avoid the stuff that they say gives you wings but can actually give you an arrhythmia.

I’ve had worse hangovers, to be fair. Not many, but there have been worse. My stomach, as expected, wasn’t in great shape on Sunday, but I put it down to the excesses of the day before. I ate a superb roast lamb dinner at the marvellous Green Vespa and generally just chilled for the rest of the day, ordering a sandwich from a sub place I have come to rely on once in a while.

It was on the Monday morning that the real problems began. My guts had been churning all night long, making gurgling sounds that a coffee peculator would be envious of. In the early hours I had to make a dash for the en-suite toilet, and the torrent began. It was violent and nasty and very watery, and there were multiple episodes over the next hour or two. By 7.30am, the time I usually get up to get ready for work, I was worn out and in no fit state to sit in a crowded office, so rang in saying I was unwell and would go to the doctor this time. I instinctively knew that this time wasn’t just run-of-the-mill bad stomach or Phnom Penh Poops. I wondered if it had been the sandwich from the night before. In my mind I saw the warnings I’ve read countless times about salads in this part of the world. They could be washed in anything, really.

I rang my insurance company to get details of the best and nearest clinic to go to, and was told there was one not far away owned by a major international health provider, who just happened to be part of the franchise I was talking to, happily.  I was told I could go along at any time and see a doctor and all billing would be taken care of. So off I trotted (oh dear) to the clinic, filled in the forms, waited for a few minutes, and then got called to see the nurse. She weighed and measured me like some piece of produce, asked a few questions, then led me to another room with a hospital bed to lie on where I was to wait for the doctor.

The doctor examined me, asked questions and took a stool sample. It’s always a delight to have to poo into a little bottle whilst hovering over a toilet and shuffle sheepishly outside to hand the sample to the nurse. The results took an hour to come, and they showed “mixed bacteria”, meaning I could have salmonella, e-coli or any number of bugs. The doctor prescribed antibiotics for a 3 day course and lots of rehydration sachets. I was told to come back in 2 or 3 days should the condition not improve. I took my large bag of meds home with me and took the rest of the day off. By Tuesday morning I felt a bit better and thought I was on the road to recovery. I went to work on Tuesday and Wednesday, and things did improve, but not entirely. I still had occasional episodes of diarrhoea and didn’t feel particularly well, but hoped the pills would do their work eventually. I ate lightly, trying to avoid anything spicy or greasy.

On Wednesday evening I was invited for dinner by the Korean Project Manager and we went to a nearby Swiss/Austrian/German restaurant called Tell. Tempted as I was to order a big plate of sausages, I went for potato soup and chicken, watching enviously as my colleagues tucked into their enormous sharing platter of pork knuckle, smoked bacon and assorted sausages. Still, I thought all was well and recovery was imminent and I went home thinking nice thoughts.

Oh, you fool.

Within an hour or two I felt absolutely rotten. My stomach suddenly got worse again and I seemed to have a fever. What was going on? Had these antibiotics not done their job? What was this illness? The conditions I could think of were typhoid fever and dengue fever. After feeling terrible for an hour, I rang the clinic and asked if I could see a doctor, only to be told it would cost me $125 because they only had an emergency doctor on duty. I rang the UK company and they told me I should go to the clinic, ask for tests for typhoid, dengue and even malaria, and they would take care of everything to do with billing.

The clinic was empty and it took a while for the reception staff to locate the doctor, who was a friendly Cambodian lady. She insisted on a gamut of blood tests and further stool tests. She examined my skin for rashes, finding some curious red pin-prick spots here and there. She said it could be dengue fever and advised me to be careful not to injure myself or take aspirin. It can reduce clotting factors and make people bleed from all kinds of places, even internally. The blood tests came back negative, but the doctor said it might be that the dengue wasn’t showing yet. It can take a few days to show its face in blood tests, apparently. They also didn’t have a result for the typhoid test as it had to go off to a separate lab for culture tests. As it was International Women’s Day on Thursday, the labs were going to be shut, as it had been declared a public holiday in Cambodia (not that our lot would have a day off, of course), and I was unlikely to know anything until the weekend. I was told to return on Saturday afternoon then sent home with paracetemol to control my fever.

I got home at around 2am, feeling worried about what I could potentially have. I brushed my teeth as gently as I could, checking my skin every half an hour or so for signs of more blood spots. I slept fitfully, feeling my temperature rising and falling every few hours. I found myself, the agnostic insomniac, praying. I bargained and begged, reasoned and rationalised. Why is this happening to me? Why does it always happen to me? What have I done to deserve this? Please let me get better!

Thursday and Friday were spent feeling pretty crappy. I watched a lot of movies on HBO and Fox Movies. I watched a few more than once, including that cheery little number “The Road” where a man and boy cross a dead and catastrophe-devastated America trying to find food and avoid cannibals. The book and film are both superb, but really, really depressing.

I wasn’t improving by Saturday. If anything, I was feeling worse again. The watery stuff was once again shooting from my sphincter like a jet of foul-smelling, algae-filled water, I felt nauseous and there was a sharp stabbing pain right in the middle of my lower abdomen. Something was seriously wrong in there. At least I was losing some weight, eh? I mixed and drank sachet after sachet of Royal D rehydration therapy – it’s quite tasty, but looks like fluorescent piss in all honesty.

I rolled up to the clinic as arranged and got a different doctor this time. He was from Ecuador and seemed to be quite a decent, funny guy. The typhoid cultures were not back and he insisted on yet MORE blood and stool tests and also had the nurse give me a couple of bottles of rehydration liquid through a drip. I laid there looking up at yet another clinic/hospital ceiling, wondering what it must be like to be fucking healthy. I had an ultrasound scan of my abdomen, asking what the sex was, which made the operator laugh (probably out of politeness), and then the results of today’s test came back.  The doctor told me the results wearing a surgical mask, which he hadn’t had on before. Should I have been worried?  There was no dengue, which was good, but there were still signs of bacteria. Which kind was anyone’s bloody guess. Oh, come on!

Dr Ecuador prescribed some different antibiotics and also a strong anti-parasite drug. It is usually a single-dose treatment to kill things like giardia, which is a common parasite in the developing world, but for whatever reason I would take 3 doses over 3 days. 4 tablets a time, after lunch. He said he hoped it would be the last he saw me. Charmed, I’m sure, but I hoped I wasn’t going back to the clinic for this thing either.

When I got back to my apartment I received a call from the London branch. They noted all the results and the treatments prescribed and said they hoped it would work. If there was no improvement, they said, they would consider sending me to a clinic in Bangkok or somewhere else with better facilities for diagnosing what gives one the shits. I can see that the doctors here are of a decent standard, but ain’t so sure about the facilities. The fact that testing is such rigmarole tells its own story.

After a light lunch I took my 4 anti-parasite tablets and the one big antibiotic. I tasted blood after a few minutes, but it didn’t last, so I didn’t panic. About 4 hours later I was again on the throne, and it was really bad. I guessed that the drugs were having some effect, even if it meant turning me inside out.

Sunday was a bit calmer. The symptoms abated a little bit. I didn’t venture out at all and was starting to get bored. The diarheea once again hit a few hours after the tablets, but wasn’t anywhere near as bad as Saturday. Hope was showing her face again. I prayed to God, Allah, Buddha, Shiva and Paul Daniels that night. But not a lot. 

Monday seemed to signal a breakthrough. There were still cramps and pains and one or two little episodes of green liquid, but there was light at the end of the tunnel. I was completely shattered, however, and any thought of returning to work was dismissed. I had been advised not to go back by doctors anyway, since I could quite easily spread whatever I had in the office, given the lack of personal space and the completely unsanitary toilet facilities (no soap or hot water). By Monday night the torrent had stopped.

So yesterday I returned to work. I was still tired and there was still tenderness in my abdomen, but felt I had to show my face. There’s another “big meeting” this week, and although I’ve managed to do a little bit of work here and there from the apartment, I’ve had to rely on a colleague in Hanoi to cover a few things. Last night I went out for dinner for the first time in ages, taking in a lovely shepherd’s pie at the Vespa. It was huge and came with a pile of chips and Heinz beans, but I finished it all up. I’m not touching booze though. I’m waiting until my stomach feels like it can take it. After dinner I went to a supermarket and bought some alcohol hand gel to use in the office (oh and some chocolate...giving Australian Cadbury’s a shot). I will do my utmost to avoid contagion from now on. This will mean being much more choosy about what I eat as well, I would say. Can I avoid any further illness in these last two weeks before I return to home sweet home? Anyone want to offer odds on that one?

Today I was in work again. I was still tired, but then I have been having trouble sleeping. The various noisy things in my apartment are doing my head in. A cricket or cicada seems to have taken residence above my head, the AC unit is rattling a lot, the window blinds are rustling all the time and some unspeakable creature (bird/lizard/monkey) sits round the side of the building making the weirdest call I’ve ever heard, like a duck that’s swallowed a foghorn and is trying to cough it back up. I hope I don’t meet it on a dark night. I laid there until well after 1am last night, unable to sleep and cursing the curse on my head. I may be on the mend (fingers crossed) physically, but I am sometimes convinced that someone somewhere is watching me through a camera, pressing buttons to make noises that they know will annoy me, or even give me another illness to deal with. I’m in my own, twisted version of the Truman Show where the aim seems to be to get me to go completely bonkers.

Well, you’re probably too late, mate. Probably too late...

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