Made it Home

I'm home now, and rehabilitating. Jonah met me at the airport with a roasted chicken and mashed potatoes. All my friends have been feeding me and taking good care of me. I have a lot to be thankful for and am really happy to be here.

I don't regret the trip (just wouldn't want to re-live the typoid part!), and the experiences I had before getting sick were incredible. How often do you get to have a continuous stream of pregnant patients like that? Being part of the birthing process, learning from the midwives, seeing direct results from a few simple acupuncture points. There were many cases in the acupuncture clinic and in the villages we would never see in our own country. Sometimes it felt like our work was really helpful, and other times the problems seemed beyond our scope. There were definitely some cases where all I could offer was compassion and a referral to a facility they may or may not be able to afford. It makes typhoid look like a walk in the park.

So that's my story. Thanks to everyone who had my back, even from far away.

Love,

Karen

Heading home

Hi again,

I am feeling much better now, still on antibiotics but fully functional and ready to travel. My flight for Malaysia leaves tomorrow and I stay one night there, then home Wednesday. Tonight Sara, Mark and I are at a nice hotel near the airport. They leave a day after I do.

I am happy to be feeling well, and happy to be heading home. Ahhh, home.

Love,

Karen

Typhoid

Turns out it was typhoid, actually, and after 6 days of not holding down food, 5 days of no sleep and unrelenting pain in my head and eyes, and 3 days of continuous vomiting I am back to the land of the living, for real this time. At Sara's insistence and instigation, and with help from Bobby (the local acupuncturist) someone came to my room to draw blood for the test. When the fax w/ results came Mark went online and found staff to interpret (no small feat). He told Frank, who called infectious dz specialist to find out dosage of antibiotics. I couldn't hold the first few down but Sara and Mark took turns reading to me to distract me long enough to absorb a little. I gradually increased the time between puking and broke on through to the other side after a few doses. They think I threw up ballpark 30+ times. (Sara says I looks anorexic but Mark corrected that technically it's more like bulemia.) I've never experienced such prolonged, intense, unrelenting pain, it made the hours crawl by and left me begging for my get-out-of-jail free card. I'm done building my third world cred, I'm never travelling where there is a "dirty" hand. Two clean hands for me please. I might not leave West Seattle, or my yard.

I have no idea what the rest of the team has been doing. My reality was limited to the path between my bed and toilet. Sara and Mark were my lifeline. Last night held down pureed potato, this morning two boiled eggs. Can move my eyes w/o too much pain now. It's going to be ok. Just wanted to let you know since lots of emails not answered.

Karen

Dengue woes

Yep, Frank says Dengue. He and Victor called the local version of the cdc and it turns out there is an outbreak happening. I've turned a corner and am back to the land of the living, after two treatments and some herbs. Apparently the cycle happens this way, you feel better after a few days and a smaller episode hits again around 6 days later. Now the awful pain behind my eyes is mostly gone and the ache is receding. Before the fever broke it was pretty painful (spine, hips, femurs,eyes), but apparently I had a mild case on the spectrum of things. The moral of the story is that you should always travel with your own personal team of acupuncturists!

I probably won't work for a while, so now that I'm not doing anything productive and have nothing to report I have lots of time to report it :)

The rest of the team looks tired to me, all except Dan who still has time to blog and do tech stuff in addition to treating large numbers of patients.

I'll keep you in the loop but just wanted to let you know I'm on the mend.

Happy New Year!

K

Sick

I got really sick last night. I thought maybe malaria since it was painful waves of chill followed by fever. Called Frank but he thought it wasn't, since there is no malaria to speak of in Ubud and I would be feeling fine after the episode was over. Feeling very...not fine, but finally able to get out of bed. We'll get ourselves back to Ubud today and get it sorted out. Sara has a touch of it, whatever it is, but much less severe. It hit us both at exactly the same time--headache, pain behind the eyes. Very achy. I hurled this morning but hoping it's a one-time deal. So hard to self-diagnose in this state. Researching on internet looks more like dengue.

I'll let you know. Thankfully Mark is our support wagon and is taking care of things for us.

K

Layers of chaos

Today was a day off, sort of. We met with the midwives for a few hours this morning so Frank could teach them more about our potential role in the birthing clinic. After a good night's sleep and some down time I have decided that working here is just a matter of sorting through the layers of chaos. There is always a baseline, even when there are no patients there is activity everywhere, scooters idling just outside the clinic, dog running through the treatment room, somebody looking for someone or something. Then you add the patients, who have seemingly endless patience and wait hours for their turn. Add to that the fact that there are very few places to refer patients in need of different care--that they can afford. (The guy with the bone infection sold all his land and his scooter for initial treatment, and has nothing left.) There is a doctor on the staff but he's been out with kidney stones since we've been here. The first I saw of him was yesterday when he came to the acupuncture clinic for treatment. The next layer is my own, being a greenhorn and trying to adapt in all directions.

The communication is also a wildcard. I'm so used to checking in with my patients at home a lot, always making sure everything is ok. It's hard to do here--they wonder why you are asking. Of course they are ok and if they weren't they would tough it out. I can often only go by what I see: muscles relaxing, change in breathing, change in pulse. Maybe that's part of my lesson here. And if I find myself wondering how much good I am doing I have to tell myself that this may be the only care some of the patients ever receive, and if there is even just a small benefit to a few it is something. My teammates are doing an incredible job and teaching me a lot. I still dread pediatrics shift.

Sara, Mark and I are stealing away to the beach for a quick overnighter, 45 min outside of Ubud. Surrendering to being a tourist temporarily. I need to recharge, which doesn't happen if you are anywhere near the clinic.

Love,

K

Day in the clinic snapshot

Since my camera broke on the second day of my trip and I've been blogging so inconsistently, here is Dan Wunderlich's blog, complete with pics and a lot more details, if anyone cares to see more:

http://mytripjournal.com/IntegrativeReliefBali2007

Another long day in clinic today. Saw some really gnarly stuff, still trying to shake it off. I don't know how to read x-rays. I don't know how to read Indonesian. There is no diagnosis from the doctor. Baby screaming. Where is the blood pressure cuff. Two babies are being born right now. There are no blood pressure cuffs to be found. What does this x-ray mean? I could just treat what I see, but what if I miss something critical. Where is a translator? This person's liver is enlarged. We got her blood pressure to drop 20 points. We can't get the bp to drop. This woman's kidneys are failing--the husband with pleading eyes asks if she can please take the herbs instead because the meds aren't helping. He is stressed, worried, exhausted and broke, and just wants to take care of his wife. This woman's feet are black and feel like wood but she says she doesn't have diabetes. This man's leg is infected to the bone and has been for a few years. . .

When Sara and I arrived Dan and Jen warned us that in the clinic you forget to drink water, you forget to go to the bathroom, you work through lunch, there is always something happening. They were right.

That's my latest. Thanks for the notes from home.

Love,

K