Thursday, June 30, 2011

This is my brain on or off drugs

So I go radio silent on the blog for a few reasons: 1. overwhelming work, 2. enforced time away from my computer, 3. lack of anything interesting to report (ha, yeah right), and 4. gross feelings make me unable to come up with energetic/funny/un-depressing things to write about.  This last week was # 4, followed by #1.  Now that I've reemerged and regained my characteristically sunny perspective, I can find humor in my past misery that will hopefully have entertainment value.

I woke up last Friday feeling like I'd been hit by a truck or something. My muscles ached, which was weird since I'd gone out with some friends the night before instead of playing soccer.  I glumly decided that I was getting too old for even a glass or two of wine as I made my breakfast.  Determined to not let my age interfere with my plans, I met Susmita, BRAC summer interns, to head down to the Parliament house, which I still consider the most beautiful place in Dhaka (I needed inspiration for the writing crunch period).  The CNG driver offers to take us for tk 200.  Too much!  I say, 100 taka!   He says no, and we turn and walk away.  How much should it be? Susmita asks.  "I have no idea.  I just assume that if he says 200, that's too much."  A few blocks later we find a guy to take us for 100.  At least I looked like I knew what I was doing.

Parliament house is beautiful, but I am hurting.  I'm starting to feel feverish and just more and more gross.  What felt like the flu started to turn into food poisoning-like symptoms.  After a month of perfect health, I'm probably overdue for a bout of GI symptoms, but that doesn't make it any more fun.  Particularly since I have a deadline and can't just hide in bed for a few days.  I try not to complain, but evidently it's universal that when you look horrible, people ask, "Are you ok?" in that way that implies that they think you look as horrible as you feel.  Lack of sleep and limited food intake means that I'm pale and a little weak on my feet.  And just less generally obnoxious.  My diet coke intake is also a bit of a joke here, so when I change that up for a massive bottle of water, the people need to know why.  Luckily, since I'm mixing in packets of ORsaline (oral rehydration saline) with the water, soon the explanation becomes pretty obvious.  Huge public health success in Bangladesh: teaching people that you can prevent death from diarrhea, which is caused by dehydration, simply by giving the victim water with specific amounts of salt and sugar.  You can make it, or buy these packets to mix with 500 ml of water for tk 5 (7 cents).  And they are available everywhere.  Based on the number of empty packets I see on the streets (we don't really have a trash system), the use rate is pretty high.

I valiantly try to force myself to eat during this period.  I pack a pb & j on homemade bread (by Bernard, the cook, not me!) for the office and head out the door.  Two blocks later I have a new friend following me to work.  The difference between this friend and my other "friends" is that she doesn't speak Bangla or English.  This street dog walks between 1-10 ft from me, never growling or trying to touch me, but clearly sniffing me out and accompanying me.  I'm not thrilled about this, but she's undeterred by my crossing the main road, hopping the median on the bridge, and even entering another dog's territory (she cowers behind my legs and despite my annoyance with her, I kind of shelter her).  My buddy at the tea stand overlooking the water invites me to sit and have a cup of tea (escalation!) and I can think of few worst ideas for getting over my stomach bug.  "Pore" (later) I promise.

The next day, I don't pack a pb and j because I hate friendship.  Nonetheless, a few blocks farther than where I'd met my friend yesterday a new friend awaits me.  Today I'm not in the mood.  "No!"  I say.  She keeps trotting along behind me.  "Na!" I try.  Same.  I lower my voice a few octaves.  "GO!"  She stares at me.  I walk along ignoring her, and that seems to do the trick.  But what's this about?  I didn't even have food today!  Why are dogs suddenly following me!  Unsolved mysteries of Dhaka.  Luckily this was the day when I started to feel a bit better, at least well enough to consume enough food to lose that lightheaded feeling.  Everything's relative, so that was amazing!

By yesterday, I am a new woman.  I got up early to get some work done before my morning meeting, so by the time Tim, my host, came downstairs, I was on my third cup of coffee and WIRED.  He had gotten accustomed to this ghost of a Maria over the past few days and looked at me quizzically when I started spouting off about some theory I had about global health acronyms or something similarly strange.  Upon learning I felt better, he began to list out different causes of my symptoms.  Doctors are funny like that; they need an answer, whereas I was just happy to feel better.  While we eat breakfast, he asks some specific questions about my symptoms (why would that interfere with one's appetite), and he arrives at a diagnosis: giardiasis.  A common parasite.  "You should take metronidazole."  I point out that I"m already feeling better, so no need to involve medication.  But evidently it is recurrent; it comes back cyclically.  Which explains why I've been getting sick on a monthly basis for about three months now.  Now I'm listening.  I grab my little BRAC notebook and write down, in purple pen, "M-e-t-r-o-n-i-d-a-z-o-l-e.   500 mg.  2g over 4 doses.  every 12 hours."  Tear half the sheet out of my book (no reason to waste the whole thing) and put it in my pocket.  Tim recommends a few pharmacies that he thinks have good quality medications, and I decide to go there later that afternoon.  "There are some pretty serious side effects of the treatment though,"  he says.  Now this makes me reconsider taking medications; I've got less than a week to complete my book and I really am feeling better.  "You can't drink while you take this medication."  That is hardly a problem.  "And you might have a metallic taste in your mouth."  "No problem, I used to chew on bullets before my boxing matches to get in the mood."  Blank silence and staring.   Joke fail.  I blame the parasite for feeding on my humor.

I decide to make like a bullet and leave for work.  The day ends up being insanely hectic and going all sorts of interesting ways.  I spend a lot of time running up and down the stairs, so it's a good thing that I'm back to my normal energetic self.  When I get ready to leave around 7PM, Zahed bhai says, Maria, it's raining.  I'm carrying several books for my advisor, so can't shrug it off like I normally do.  I decide to head downstairs and talk to the guards until the rain stops.  Well, that's the thing about monsoons.  It just doesn't work that way.  You'll be waiting all summer.  Luckily my boss comes downstairs before too long and offers to drop me off, since I'm on the way.  Once here, I drop off my books, and ask the cook if he knows where an umbrella is.  He says, with the faintest hint of a smile (which is more than I usually get), "I have never seen an umbrella in this house."  That's strange, I think, but I grab my bright green raincoat and head out the door.  There are a number of puddles to hop in and around and cars to avoid (I'm very glad that my coat is super bright but wish that hoods had peripheral vision), but I make it to the pharmacy without too much difficulty.  I present my "prescription" that I wrote and the guy reads it all back to me.  "So how many pills to you need?"  2g of 500 mg pills.  Someone help me out here.  "Four" I say.  Although my confidence at this point is rather low.  He only has 400mg.  Luckily 2g can also be divided evenly by 400 mg.  For about 25 cents, I've got my treatment course.  No instructions.  Just the pills in the foil/plastic wrap.  No box. No instructions about taking it with food, avoiding alcohol, contraindications.  Free market pharma.  It's a little scary for me.  I am used to checking the little box on the electronic thing at CVS that "No, I don't want to speak to a pharmacist."  I have to say, I have a lot more appreciation for regulation and quality standards now that I live in a place where they are largely absent.

To be on the safe side, I decided to take my first dose with food.  So I went to a coffee shop called Bittersweet with a friend and got a carrot cupcake with sour cream icing and a lemon meringue tart.  Both were up to the mark!  And they played the kind of 1990s hits that you'd expect in that kind of kitschy upscale coffee shop.

11 hours later, I'm still waiting for the metallic taste!  I  did sleep the whole night through without waking up even once--and since we have a busted circuit, I have no power in my room, so that was sans fan, sans AC.  It was like being back in Boston in August.  This is why I "trained" at sleeping in the heat!  Now I'm clearly a champion at it ::)

Off to North End for a cinnamon roll to accompany dose 2.  Ohh, and I left out the best detail about giardiasis.  It's common among hikers and in places with monsoons (go figure), ponds, etc. and also known as "beaver fever."  Sorry typhoid, you are no longer the coolest illness I've ever had.

1 comment:

Ramblin' Man said...

Oh, I think typhoid is much cooler. "Typhoid Maria" is much scarier than "Giardia Girl". By the way, I got your card! Thank you. - UP