Be Anxious for Nothing – except when on Larium

Hello blogosphere, I write to you from an empty dining room in an Entebbe guesthouse.

I would like to say, that I am no longer taking Larium. 

At first, it seemed that the side effects were not, in fact, affecting me. I have always had nutty dreams, most notably, my dreams have a bad habit of picking up where my day left me off. This is cause for some genuine confusion come morning time. Some of my coworkers who are prone to depression stay away from it, as it can make you more depressed. However, I have not felt more depressed than the expected dose of depression when living in an isolated, impoverished, conflict-ridden village in the dead center of Africa. 

I did notice, however, on my last R&R, there was little of both. I could not fall asleep without my passport, money, Swiss Army Knife and headlamp on the pillow beside me. That way, if anything happened, I would know where the important things were and I could run quickly. 

Now, before you think I sound out of my mind, please, bear in mind my daily life style and the places I have been for recent R&Rs… are they in your mind? Alright then. 

  

So, with that in mind, you may understand that my heightened sense of paranoia is not necessarily unhealthy, but a mere necessity of environmental adaptation. I have assumed thus,blaming all my anxiety on Ango. The thing is, this enlightened level of anxiety 

has been instrumental in getting me through
my day to days at the Ango base. 

Yes, I love my job… but it might be out to kill me. And if not my job, then Ango in and of itself. 

Take last week alone: 6 foot viper in my generator, giant spider watching a movie with me by my head on the wall, giant spider bites all over my legs that are still bleeding 6 days later, 5 days in a row of 14 hour work days, mosquito and fly bites that make me wonder if I have leprosy, lightning strikes, bumpy airplanes, dodgy roads, over exuberant military… I could go on, but I am getting more stressed out just typing this. 

Either way, you get the point. 

So, needless to say, my daily needs of adrenaline, anxiety and paranoia have been perfectly on par with my level of activity. However, like I said, my last R&R I was really struggling with feeling very unbalanced and uneasy. My levels of these usually much required pheromones (Are those pheromones? I don’t think so, but it sounded good.) did not drop as my level of activity and responsibility did. So, I had made it up in my mind that if I could not calm down in Europe this September, it was time for a change in my malaria prophylaxis. 

The other day, though, when I got to Bunia, one of my coworkers was talking about how calm she was after going off of Larium, then another chimed in on how it was making her crazy and another how she was still paranoid even as she was staying at her cousin’s house (an ambassador, who lives in one of the most fortified places you can find in these parts)… So, yeah, that to say, I have quit cold turkey. Now, fellow hostel stayers do not have to endure my talking in my sleep and I do not have to endure waking up to hitting walls with my fist thinking I am defending myself from a carjacker in Nairobi. I guess it is a win-win situation. 

However, with the switch always comes a bit of exposure risk. In my cosmetic bag for my Europe R&R (where I hope to soak in as many Rs as possible), I have a thermometer, two rapid result malaria tests and malaria treatment, just in case. So, yeah, if needed, I will be giving myself a blood test… because I don’t already do enough ridiculous things in my life. 

I am not a Guava

Colby the Colobus - Part Two

That night Colby cuddled in my arms and fell asleep. I gave him tree climbing lessons, walked him around, fed him various fruits and generally spent too much time thinking about how awesome this was.

He would turn when I called his name, run to me when I knelt down and climb on me when I held out my hands.

I loved him.

So, Monday we met and Tuesday I was feeding Colby a guava when it fell out of my hand and he bit the next available thing... me. I immediately put him on his tree stump and started squeezing the space between my thumb and pointer finger. At first, it did not seem he had broken the skin. I had this perfect little arch of purple pressure marks and as I washed with soap and water, two of the little marks began to bleed.

Dang it.

I kept squeezing it, hoping to purge anything that might be trying to invade my blood stream. I went to our medical office, which was sparsely populated with medical staff, but one of our supervisors was there to administer iodine. I had already raided one of my co-worker's rooms for an alcohol wipe from her first aid kit, but I was feeling ultra paranoid. Monkey bites are nothing to mess with.

As iodine was administered to my now barely bleeding hand, I was told not to worry, that anything that could be carried by the monkey could not be helped with any medication. AIDS, Ebola, etc.

Clearly, I needed a second opinion.

So, I emailed our 24/7 on call doctors at InterHealth. Dr. Claire got back to me so quickly and with fantastic advice. All of the first aid intuition I had administered was right on, including squeezing the bajeepers out of my hand. So, yay me. I also needed strong antibiotics and antivirals and post exposure rabies vaccinations... all as soon as possible. Antibiotics we had, but the rest would require a logistical miracle. So, I started making some radio calls, and when they did not work, it was time to bust out the SATphone.

The earliest I could get the vaccinations and myself in the same place was Friday.
That was later than the 48 hours recommended, but that's what I get for living in Ango.

I could wait.

Wednesday morning I woke up to a dying Colby. 

                                By 11:30am he was dead.

I could not wait.

By 2:20pm I was on a MAF plane that was chartered just for me, on my way to Bunia. By Thursday afternoon I was in Kampala at The Surgery getting my post exposure vaccs and various other preventative tablets.

Hour 47 of the 48 hour window. Thank God for an amazing team and good health insurance.

The doctor requested I stay in Kampala for at least a week, to be sure I do not come down with a fever or any other worrying symptoms. So, here I have remained. Pretty bored, missing Ango and really feeling like I have not worked much in the last month.

Though I have had no fever, I have felt sick all week and so lethargic. I am told by wikipedia that this is rather common when taking 34 pills a day of heavy-wide-spectrum antibiotics and antivirals. It has been hard to focus on working from here, even though I had high hopes. I just feel like vomiting and laying down all the time.

Hopefully these side effects will subside now that I am only on one of them. I want to go back to work, I want to fix some recent mistakes I have made there. I want to never have a pet monkey without a local vet.

It was fun while it lasted. It makes for a very dramatic story, though at no time did it actually feel dramatic.

In the end, I made it into our country program's monthly Situation Report that gets sent to HQ:

"Courtney Brandt was bitten by a monkey on 19^th July and medivaced to Kampala for preventative treatment. She arrived at the Surgery in Kampala 47 hours after the accident."


And onto InterHealth's website for World Rabies Day:

"At InterHealth we often come across weird and wonderful cases of infections, and rabies is no different... An aid worker in rural Democratic Republic of Congo had been vaccinated against rabies. She encountered a cute baby colobus monkey half way through her project. Unfortunately, the baby monkey playfully nipped her. She wasn't close to medical facilities and required a semi-urgent medevac to complete the post-exposure treatment."

                                                                                                                      So, that's something.

Ango Awesome