August 20, 2007

The dreaded thing                

The dreaded “thing” happened. John got a slight fever Thursday evening after a long day painting the church next door, his four day in a row doing that. He went to bed early. His night was a bit fitful, but Paula wasn’t aware of it until 5:30 a.m. She touched John and realized that he had quite a fever. So she got up, got two ibuprofen and water and coaxed John into sitting up and taking the medicine. Then “nurse” Paula went into action with the rectal thermometer and was a little aghast when it read 102.5. But, a year ago a similar occurrence with 104 gave Paula a little relief.

We were to go to Sincelejo, about a four-hour drive from Barranquilla at 1:00 p.m. that day with our boss, German, and the accompaniers for August. John ate a small breakfast and figured he would improve. So we took the “transport taxi” van with German and the accompaniers. John, who figured shorts were fine for him, wrapped himself one half hour into the trip with Paula’s scarf and an accompanier’s jacket and slept most of the way. When we got to our hotel in Sincelejo, John went straight for the bed and slept through dinner and into the night. In the middle of the night Paula awoke and touched John to check on him. His pajama top was wet with perspiration. It looked like his fever had broken, so he put on a dry shirt and both slept until 6:00 a.m. John felt a little better but the fever developed again, and he lay down to rest and slept through breakfast.

By now Paula and John were both worried and decided to see a doctor. About 9:00 a.m. German took them to a clinic and hospital a couple blocks away—via taxi, since John was quite weak. The staff was very professional, in a setting that took us back a few decades. The doctor ordered blood and urine tests and had an IV connected. We waited about three hours for the lab work to arrive.

The doctor arrived and told Paula that John had “dengue clasico.” That meant he had to be hospitalized for up to a week because of possible blood complications. Paula then called their medical provider in the States and talked to a doctor about the treatment and handling of this situation. The doctor said that “dengue” is a parasite transmitted by a mosquito, which causes a low white blood cell count and a low blood platelet count. The worry was more with the platelet reading and the possible necessity of receiving a transfusion of blood platelets. We needed to make sure it was a good hospital – clean and thorough and careful about their blood sources. The clinic hospital checked out all right, and John was admitted about 5:00 p.m. It was a small, 19-bed private hospital, and John had a single room. Since there was a long couch in John’s room, Paula spent the night. True to fashion, the nurses paraded in and out of the room all night to take vitals, change the IV solution, and administer medicine. John had to frequently empty all the IV solution that collected in his bladder. “Hospitals are not for wimps.”

Next morning the doctor came around 8:00 and said that the blood test results were good and bad. The bad ones caused a delay in discharge and it would be necessary to stay three more days. Because German and the accompaniers were leaving that day, we asked if it would be possible to go back home and go to a clinic there for the continuation of his care. The doctor agreed. So we took the “transport taxi” van home to Barranquilla. John went directly to bed and slept well, since his sleep the night before had been interrupted so much.

On Monday morning John seemed very confused, so we went to the clinic at 7:00 a.m. We went directly to the emergency entrance, talked with the doctor and had blood and urine tests taken again. German arrived with Gloria, the executive secretary of the Presbyterian Church of Colombia. They translated for us and said that the tests showed it wasn’t dengue but a similar type of parasite. John’s white blood cell count is very low (the platelet count is now normal), and they want to admit him for observation until the white count is out of danger. John had two meals and watched the change of staff and patients come and go for 15 hours before being admitted to the hospital. Fortunately, he slept much of the time. Paula wasn’t as calm and began to “stew.”

Gloria again came to see if she could help, and we were grateful for her help. At first there were no beds available and she tried to call other hospitals. She talked to some of the “higher-ups” and the doctors—to no avail. After a couple hours, an administrator offered a room in the “suites,”  and finally, at 10:00 p.m., John was taken to his “penthouse” room on the eighth floor. What a floor! Large suites, a bed for Paula, quiet, very clean, individual care. But first, Paula and Gloria went home to get pajamas, towels, soap, tooth care items and a blanket  Hospitals in Colombia don’t supply any of those items.

The night went a little better until 4:30 a.m. when John had to pee. Forgetting he had the IV attached, he pulled his arm and walked to the toilet. Paula awoke and saw John in the bathroom with drops of blood all over the floor, bed, and John. We haven’t tied him to the bed, yet, but Paula is not taking her eyes off him.

Around 4:00 p.m. the internist and hematologist came to the room. John’s white blood cell count had fallen more and they wanted to do a bone marrow biopsy on Wednesday. They have ruled out malaria and dengue, but don’t know what kind of virus is affecting John. This sounds like the right thing to do, since we have had daily contact with the doctor in the United States. He talked to the internist today and agreed with the plan of action.

Finally, the white cell count began to rise, and the fever hadn’t come back, so the doctors said that John could go home on Friday. The blood marrow biopsy was normal, and that was really good news. Even though there wasn’t a firm diagnosis, we know that it wasn’t leukemia or a more serious tropical disease. Our prayers and the prayers of many of you who knew about this have been answered. We truly appreciate family and friends at times like this. It has been very reassuring to have the contact with the doctor in the States, and it also changes our concepts about the quality of medicine outside the United States. We both feel that the doctors, staff, and technicians have been very professional, have treated us with concern, and have stayed on top of the situation. Thank God for the medical profession!

John and Paula

The 2007 Mission Yearbook for Prayer & Study, p. 46