Save a Life, Give blood

A few weeks ago a VSO colleague & I visited the national blood bank in Phnom Penh as part of a general health facility review we have undertaken. So inspired were we that we donated a pint each, right there & then....little did I realise that I probably should have held on to mine.

The need for donated blood in Cambodia increases with a Dengue epidemic, which effects mainly children, such as the one we are just at the tail end of. It seems ironic then that a week after donating blood I came down with Dengue fever - so much for good karma.

It started with me feeling particularly 'ordinary' over Pchum Ben holiday. Whilst in a hotel in Phnom Penh in transit back to Battambang I began to feel really rather 'average' & it took me half the night to realise I was having rigors & chills. Morning brought a sustained fever of 40˚C despite paracetamol & a really bad back ache. Against good advice to stay in Phnom Penh, my homing instinct was so strong I dragged myself to the bus to endured the worst 7 hour journey of my life. Traveling by bus in Cambodia is challenging enough & its hard enough to tolerate very loud karaoke & violent chinese martial arts videos without having Dengue.

Despite thinking I never would, I finally arrive home & went to bed were I stayed for most of the next 10 days with a fever of above 39˚C - it wasn't very nice.

emedicine states the symptoms of Dengue are as follows;

"Many patients experience a prodrome of chills, erythematous mottling of the skin, and facial flushing (a sensitive and specific indicator of dengue fever). The prodrome may last for 2-3 days. Classic dengue fever begins with sudden onset of fever, chills, and severe (termed breakbone) aching of the head, back, and extremities, as well as other symptoms. The fever lasts 2-7 days and may reach 41°C. Fever that lasts longer than 10 days is probably not due to dengue.

Pain and other accompanying symptoms may include any of the following:

Headache
Retro-orbital pain
General body pain (arthralgias, myalgias)
Nausea and vomiting (however, diarrhea is rare)
Rash
Weakness
Altered taste sensation
Anorexia
Sore throat
Mild hemorrhagic manifestations (eg, petechiae, bleeding gums, epistaxis, menorrhagia, hematuria)
Lymphadenopathy
Rash in dengue fever is a maculopapular or macular confluent rash over the face, thorax, and flexor surfaces, with islands of skin sparing. The rash typically begins on day 3 and persists 2-3 days."

Lets just say I ticked all the boxes.

There are several people without whom I would have not survived those uncharacteristically ten long days of fever, cabin fever & the ensuing week plus of post-Dengue weirdness - a post viral exhaustion & mental bluntness best described as 'blah'.

In no particular order I'd like to thank & express my deep heart felt appreciation to

• Soerb who came to my house most days and stayed for hours trying to force feed me bor bor - rice gruel (against my will), mopping my fever brow & giving me bed baths, sweeping my floor, cleaning my house, doing my washing, her 2 children were angels & even put the TV volume down when I asked them to. She didn't once try to coin me or burn me with incense - traditional khmer medicine, for that I am forever grateful. I also had a constant supply of fresh coconuts from her garden.

• Soyeth - my Khmer teacher - who also visited daily & not once tried to teach me khmer. She too force fed me bor bor with dried meat - I was laying in bed with a fever of 41˚C and she was spooning it down me as I was too weak to fight her off. After this I refused all further bor bor feeding attempts. She brought me tinned milk & fresh coconuts. She also gave me bed baths & massaged me when my neck went into spasm but like Soerb resisted coining me although I could see her hand twitching towards the lid of the Tiger balm. When I fainted in the kitchen one night coming back from the bathroom she brought around a chamber pot - she cycled in the dark to do that, as I'm post-dengue & over-emotional this act alone brings tears to my eyes.

• Liong - my amazing VA - who visited me daily & made me fresh orange juice - and disapproved of all the fresh coconuts as they are bad for fever - & when I could eat (day 7!) brought me chinese soup for breakfast with offal (I know that sounds awful but she knows it is my favourite breakfast & obviously bor bor was no longer an option) & when she didn't visit she would text me - above & beyond the call of duty. She also omitted to tell me the whole truth about the follow up of the tachyarrhythmia patient as she knew I'd get agitated. She conveyed get well messages from the mother of the tachyarryhthmia patient - the irony of which was not lost even in my febrile state.

• Rady - qualified nurse - who told me I had a bad cold because adults don't get Dengue but changed his mind after I started bleeding & collapsed in my Kitchen, he took me twice to Laboratories to check my bloods (low white blood cells & platelets - typical of Dengue).  Once on board with the diagnosis he didn't think there was much he could do as I was the doctor & he is just a nurse - physician heal thyself and all that. He did however cook me a meal which Soerb bought over. I was skeptical that he had cooked it as he is, after all, a Cambodian man but Soerb (in khmer) & Panha - his 8 year old daughter - (in english) confirmed it was indeed the truth. I was still at my anorexic, altered taste stage but despite all that the Cambodian male can cook. He told me the other day he is glad I am feeling better now because when I was ill I was "really grumpy"!

• Geordie who brought me take out food once my appetite returned - he knew that mashed potato was what I needed NOT bloody bor bor, took me on the back of his moto - after 10 days in bed and my cabin fever had me at breaking point - for an outing to the Bambu hotel. He also endured 3 days of me in PNH when I couldn't walk far, sit up for too long or generally hold a coherent conversation. He would probably argue that this is no different from normal.

• And last but definitely not least Janice, who insisted on sleeping at my house because the first evening she offered & I declined, I then proceeded to faint in the night - she was really cross about that. She brought me take out food, milk shakes, cakes - when your appetite returns after dengue it really returns. She took me out on little trips to local cafes when I was going crazy with cabin fever. She lent me money, internet credit & bought me bus tickets taking me down to Phnom Penh with her to convalesce once the fever broke. She is a qualified nurse but as I was being assertively nursed by three amazing Cambodian women (whose roles are also my teacher, assistant & friend) Janice did more than just nurse - she was a brilliant friend to me and a complete rock.

The kindness of Cambodians confounds me & Dengue brain is making me a little emotional.

Anyone who knows me will know that I don't like to feel indebted to people but that's tough because I am eternally indebted to these people for all their care & friendship as well as all the friends & family who texted, whatsapped, facebooked, skyped & emailed me. 

emedicine says that occasionally the dengue rash can desquamate - in other words all my skin has now started to peel off & I look like a Zombie.  Pass me the DEET, I don't want this again.........

Feeling all warm & fuzzy  -  thinking it was due to a good deed but not realising it was probably the prodrome to Dengue Fever!

We made light work of the amazing post donation snacks - boiled egg, pasty, cake, 3 bananas & water plus 7up! Oh and can I have my pint of blood back - I am going to need it?