Dengue

Kids,

After two full years in India we did an amazing job of staying away from illness, food borne or otherwise. Of course we saw common colds and flu’s come home from school, but we didn’t have any area specific illnesses like malaria or dengue…until now. The story begins two days before my birthday.

In August I headed to Delhi for a conference as we started the push to expand our international business. The conference was two days and although I wasn’t thrilled it was over my birthday, I was looking forward to it.

The last day of the conference was the day it all began. I’ve found monitoring my waking heart rate to be a great indicator of whether I’m starting to come down with something. My normal waking heart rate is 42 beats per minute (bpm), consistently within 1 or 2 beats from normal, and when I see it elevate I start taking vitamin C to get ahead of whatever I might have. Normally when it’s elevated it reached the upper 50’s or lower 60 bpm. On that day I woke up and my waking heart rate was 76bpm so I knew something different was up.

As the morning progressed I started to feel tired and got a mild headache. Around mid morning I had to make arrangements to get back to Mumbai instead of waiting for the scheduled evening flight, which would get me into Mumbai at 11pm. The trip back was a blur, but I made it the entire way, reaching home by 6pm and heading straight to my room.

I spent the next 36hrs in bed. I didn’t sleep straight through but for the first time in my life I didn’t want to be on the couch watching movies when I was sick. I wanted to sleep. When I was awake I had no issue walking around the apartment to get water and prove that I was alive.

On Sunday I was still tired, and even though the headache had subsided I decided to visit the doctor to see what was going on. The Out Patient services were shut down on Sunday’s so I had to visit the Emergency Room.

After 10 minutes with the doctor he sent me for labs to see if I had a bacterial or viral infection. The tests came back viral, which you can’t do anything about, so he sent me home with pain killers and directions to come back on Monday to see a general physician.

When I met the doctor on Monday morning she had me go back to the lab with a longer list of tests. Two were for Dengue. The results wouldn’t be ready until later that evening and since I had another appointment the following morning to review the results with the doctor I didn’t pick them up until the following day.

The next morning I left with high hopes for a quick release, and even told Johnathon who was also home sick, that I’d be back in a couple of hours. When I picked up my results my heart sunk, positive for Dengue. After confirmation on Tuesday the doctor admitted me for observation.

Once I was confirmed to have Dengue we immediately took Johnathon into the doctor to get his opinion on a similar bug that we thought he brought home from school. Originally I thought I also had that run of the mill virus that was going around, but wishful thinking.

The doctor agreed that we should get him tested and we’re happy to report that it came back negative, with his platelets close to 200,000, mine were 86,000 when I was admitted. The doctor told us that kids generally don’t get the same symptoms even if they are confirmed to have dengue. So given that Johnathon followed behind me on every transition, like fever and rash, we suspect he did have it but the test was a false negative.

The hospital that we go to is really good, although I always have to figure out how to communicate with the doctors. It’s not a language barrier, but cultural norms for conversation and information gathering. My doctor this time was good, but she didn’t divulge anything about the plan without being asked. Over the next four days I learned to be more up front with my questions and when I did she gladly explained the answer.

By the time I was admitted to the hospital I was at the tail end of the fever which officially broke on Wednesday morning. Outside of the fever I didn’t have headaches or muscle aches I just felt tired.

At this point I learned what Dengue really does, it kills your platelets and blood work, which is why I was admitted to the hospital for observation. Over the course of four days my platelets dropped from a Sunday value of 105,000 to 56,000 at its lowest, which was Wednesday/Thursday.

During the stay I continued to be tired, but that was about the extend of it. This caused major issues for me mentally because I figured I’d be getting discharged in the middle of the week. When I found out it was more likely to be the weekend it destroyed me. Luckily your mother was there with me when the doctor broke the news about how long I’d be under observation.

Small detour…when I was 12 my grandpa, your great-grandfather, died of a heart condition. I still remember going to see him for the last time in the hospital, communicating with him through pen and paper, and then waiting in the hallway of that hospital for everyone else to say their goodbyes.

When it was all over I overheard that he had symptoms for some time but refused to go get it checked out by the doctor. I loved my grandfather so much, and still think about what he’d do in my situation, but I told myself then that I would not ignore symptoms no matter how bad the results could be. This is why I go get a full annual checkup every year even though the doctors have told me that it’s not required at my age.

I thought of this a lot during my four days in the hospital and kept reminding my self that I just had an all day health check in July that came back with gold stars. Ok, not gold stars but still good overall. Unfortunately that report wasn’t going to get me out of the hospital any faster. This was a waiting game and I was stuck.

I also realized that I hold on to my independence more than I originally thought. I truly hated being the one in the bed with everyone waiting on me. That’s my job. When you guys would come and see me I was so excited, but also felt bad. I know now how crazy that is, but for as long as I can remember I’ve prided myself on my self sufficiency, and during the days in the hospital that was all gone.

After letting go of my original discharge expectations, and getting behind my new target of the weekend discharge, things got much better. The days went by rather quickly and my blood results followed the doctors outline perfectly. On Thursday my clotting metric started to rebound, then on Friday my platelet count was on its way back up, and by Saturday my white blood cell count was turning the corner too.

To my delight I was discharged on Saturday with all the metrics heading in the right direction. I couldn’t wait to get out of there. I normally don’t joke around with Ajay, because he doesn’t get my humor, but today when he asked me to wait 10 minutes for him to pick me up, which he always does, I told him no. Of course I was kidding, but I really wanted to get home.

The service was good and I never felt I was not being taken care of, but like most hospitals the food was awful. Luckily by day three I was able to get just plain chicken breast with bread, which held me over until my discharge.

Upon discharge I was told to schedule an appointment on Tuesday, with Monday being a holiday, to redo my labs and see the doctor. By Tuesday I was already feeling better although still experiencing the rash that the doctor told me about. My labs came back that night with my platelets at 242,000, right in the acceptable range.

Overall I have to say that I didn’t react nearly as bad as some when it comes to Dengue. I didn’t have severe headaches, joint pain, etcetera. Mine was more like a solid flu. Although I don’t recommend trying it on purpose.

Love,

Dad