Not for the faint of heart…

WARNING: If you are my mom or dad or sister, I recommend not reading this entry. If you are printing this blog for my grandma, you have the responsibility not to share this entry with her. If you are queasy about diseases or bodily functions of any kind, I recommend going back to the Christmas entry and pretending you never saw this one.

THIS POST IS FOR YOU: If you have an interest in weird diseases, healthcare in Guyana or my general health, you can read this entry. But I warned you.

My first doctor visit was a week or so after I moved into my apartment in October. I actually don’t think I told my mom about that visit because I didn’t want to worry her. Bugs love me. I knew that in Ontario. But mosquitos are different here, besides being the kind that can carry lovely diseases like malaria and dengue fever, my body also reacted differently to them. One bug bite would swell up with a red circle about two inches in diameter – this was not helped by my talent of scratching in my sleep, which would often mean the bite would create a bruise. I won’t go into more details, but the reaction lasted long enough and was painful enough that I thought I should make sure they were mosquito bites and not bed bug bites or something… Wallis’ son was sick at the same time so she sent me with him to her paediatrician. The chairs were really little, but she was very nice and gave me some miracle cream to help the redness go away and extra powerful oral antihistamines. I would like to take a moment and promote Watkins bug repellent, an excellent cream made in Winnipeg. There is a supplier in Bancroft that my mom can put you in touch with – I got a stocking full and when I remember to put it on, no bug bites!

This background information is important to explain why after my family’s visit to Baganara, I wasn’t overly concerned about some bug bites on my feet. Sure they were itchy, but give it a week and they’ll go away. The problem was, they didn’t go away. It was like they were getting itchier. And there seemed to be more than the original three that were in the arch of my foot. And in between my baby toes felt like they were on fire. Upon closer inspection, I scared myself because it looked like there were more bug bites and a path leading from one bite to the next. I decided to ignore it and that it would get better – not the smartest idea I’ve had, but it only lasted one night. I went to Maria the next day for a second opinion who confirmed my suspicion and sent me to the doctor with strict orders to report back.

Time for my second doctor visit. I showed Kala my feet and she gave me the phone number of a doctor specializing in parasites. Dr Validum works at Woodlands Hospital which is a private hospital just one street away from where I work. After some interesting directions, I found his office and as per instructions on the door, knocked and sat until the nurse came to talk to me. I arrived at 11am and was seen by the doctor a little after noon. I went in and he confirmed my diagnosis of worms, more specifically hookworms. My white skin made the track marks appear extra pink so he asked if he could take a picture, because he rarely sees such a textbook case. Lesson to be learned: don’t walk barefoot in the sand. He prescribed albendazole (an oral, anti worm drug – 400mg a day, five days), Fourderm cream (topical antibiotic – apply twice daily) and gravol. I was given instructions to soak my feet in antibiotic soap, followed by epsum salt and apply cream, twice daily. The consultation fee for the doctor’s visit was $2000 (approximately $10CDN) and it was my first experience paying to see a doctor.

I went to the hospital pharmacy where thankfully there wasn’t a line so I didn’t get lost in the system. At one station you drop off your prescription and pick up three copies of your receipt. You take the receipt to the cashier to pay where you get two copies back that have been stamped “PAID” which you take to the delivery counter and pick up your drugs from the pharmacist, leaving one copy there. The total cost was around $500 ($2.50CDN).

That night was the worst firey, burning itch yet. This sensation I now know is caused by the burrowing action. I know they aren’t visible to the eye, but I still contemplated surgery to remove them or amputation of my feet on my bathroom floor. Fortunately the only tool I had was a steak knife, no proper means of cleansing the area and enough sense to know that it was a bad idea. After two doses, the itchy, burning feeling had stopped. I had one day of swelling around the track marks, but then they decreased in size and increased in pink colour. Certain areas looked like blisters which caused me some concern.

I went back to the doctor yesterday. The swelling had been an allergic reaction to the burrowing and dying worms. The bumpy areas were signs of an infection. He explained a little bit more to me about types of worms, but essentially these worms can’t get any further than my feet. If for some reason, I had ingested them, we would have an entirely different set of concerns, but that doesn’t seem to be the case. He prescribed ciprofloxacin to fight infection, more Fourderm and iodine. He sent me over to the outpatient ward to have the infected areas (also known as “bleps” apparently) opened, cleaned and dressed. He stressed the importance of cleansing the area atleast once a day, dressing it and keeping it covered to protect from all the dirt and dust around – meaning wearing socks for the first time in almost a year.

The outpatient room is similar to the pharmacy in that I had to get the price, go to the cashier and then wait in line. The doctor had called over with instructions to go with my note so they were expecting me. It was a first experience for the two younger nurses to see the results of hookworms, or atleast the resulting infection. I don’t know what I was expecting. The nurse had a pair of blunt scissors that I had seen, but never used, in my anatomy kit, gloves and a cloth with soap. I almost think that I could have done it better on my bathroom floor, but she was very thorough though a little rough. She sent me off with the areas covered in antibiotic ointment and slightly nervous because she saw no need to cover the areas.

I am taking my oral antibiotics and nursing my fresh wounds. Also keeping my feet elevated to hopefully minimize pressure on them and increase healing - which gets me a few odd looks when people walk by my office and I'm lounging at my computer with my feet up. I have minimized the details of the physical signs of being infected with hookworms because I know just the thought and some details are enough to gross people out, but if you are so inclined, I do have pictures of my progress and would be more than willing to provide more details.

Lesson learned. You won't catch me with barefeet in the sand again.