Monday, October 31, 2011

Still in Hospital? Yep, that's us!

So, after a week at home, during which Sophie's fever reappeared, we checked back into the hospital for another 2 week stay. During the week we were home, Sophie's body went back to normal. Apparently the docs consider a jump in liver function from mid-20s to over 800 to be "slightly elevated." Of course I didn't find this out until I met with them 5 days after being readmitted with no medication starting up.

The newest information is that there are 2 drugs in the regimen for TB that can cause hepatitis. That is why as soon as her liver test came back abnormal, they removed her from all medication. Now we have stopped both of those medications. The problem (of sorts) is that before she was taking 4 drugs in one pill once a day, but two of those drugs were the liver affecting ones. In order to not take those, now she is on an IV drip twice a day and has to take 3 pills 3 times a day. Sophie is taking it all in stride though, and she is happy that these pills are so much smaller and easier to swallow.

Today marks two weeks of being back in the hospital and last Friday was one week into her IV antibiotic treatment. If all goes well, this coming Friday (Nov 4) she will finish the IV, they will test her sputum and blood as well as do a chest x-ray and if her tests come back at a level 0 for infection, we will get to go home on Monday, where she will continue to take pills for the next 4 months. At this point, they want to reintroduce one of the liver affecting pills in a smaller dose to see if she can handle it.

Happily, she has gained 4 kilos back, which was a prerequisite for us going home, so I'm excited about that. Also, her fevers have stopped, so the infection is definitely diminishing, if not gone already. I'll post separately about the amazing time we had at camp with Taw Saeng as well as getting to go to the Yee Pang festival and see thousands of lanterns sent into the sky at once, a la Tangled!

Tuesday, October 11, 2011

Tuberculosis or Wanarot

Disclaimer:  I have been trying to post this for about a month now, but the password software has been not cooperating, so I finally just removed the pictures so I can post it.


Well, the past three weeks have been less than fun. That is an understatement. At times the past three weeks have been downright terrifying. It all started when Sophie had a fever for a week straight. Well, really it all started when I got here and Sophie was having intermittent fevers of over 100 degrees on a regular basis. After her mom passed away, I said that as soon as she moved in, I was taking her to the hospital to get her checked out. Well, she kept having fevers and this terrible cough, but she kept convincing me that it was because of the rain, because of her asthma, because of marching in band all the time. Plus, she was scared to go due to both her parents dying in a hospital, which is understandable. Finally, I bought a thermometer (who knows why it took me so long) and started checking her temperature several times a day. She had a fever of over 100 degrees Fahrenheit every single time I took her temp for a week straight, other than Wednesday morning. She kept claiming she was fine though and she wanted to go to school so I let her.
Finally, Wednesday morning, she had a normal temp, so I felt better about sending her off. Sure enough, an hour later she calls from school saying that she had a fever and had thrown up, so I came to meet her at school and sign her out. I was like "OK, that's it. We are going to the hospital right now." We came to the best hospital in Chiang Mai called Suandok. We had never been here before so we had to fill out a new form. I made Sophie put her real birthday on the form because I knew that if she put the date that was on her school ID, they would send her to the adult ward, and I wanted her checked out in the pediatric department. I don't know why, but for some reason when she registered for school, her mom put that she was born in 1995, making her 16, not 14. Since she has no Thai ID, they would use this for identification purposes, so I made sure that she told them that her school ID was wrong.

Anyway, we finally got sent to the pediatric ward and saw a doctor. Finally, I could speak English and he could understand me and vice versa. I told him about the fevers, the cough, the sinus congestion, that she had been losing weight and had trouble breathing at night while she slept. I told him about the 4 rounds of antibiotics that she had taken over the course of the summer, none of them doing any good. I told him about her parents and the stress that had been on her. He decided to do some blood work and see if they could figure out what was going on.

Sophie freaked out when she saw the needle. I mean FREAKED out, crying and holding her arms away and begging me not to let them take her blood. I literally had to hold her down to let them stick her; it was traumatizing for both of us. We had to wait an hour for the labs to come back, so we went down and got some lunch. Then, the most surreal thing happened. We could hear music from where we were sitting and when we went back toward the hospital, Sophie said "P'Heather, music!" We looked over and there was a nurse, in full nursing uniform, and a police officer in full uniform (including sunglasses and baton) singing and playing away in front of a crowd of patients waiting for the doctors to come back from their lunch break. Not only singing, but singing Patsy Cline of all things! It was crazy. We sat down and listened for the rest of the show and lunch break. They didn't sing any more English, but the nurse had a really good singing voice and the cop also played the harmonica! It sounded like any acoustic indie band in the States and I kept expecting to just understand the songs.

So, surreal lunch over, back upstairs we went to await our fate. The tests came back fine for her liver and kidney function but they did detect a bacterial infection in her blood. We saw a new doctor, a woman this time, and she said there are several tropical fevers that present with just a fever and no other symptoms, so she was prescribing a strong antibiotic that should drop the fever in 24 hours. We were supposed to take her temp every 4 hours and come back on Friday to tell them how she was.

Well, that night, no fever, the next morning no fever. Yay! Or so we thought. Sophie came to Taw Saeng after school with a fever, but said she felt great. She was the most upbeat and energetic I'd seen her in weeks, so I thought it was all ok. By the time we got home, she had spiked a fever of nearly 104, so I knew it was something worse. Much worse, I feared.

That night, I hardly slept at all, plagued by dreams of worst case scenarios.
I took her temp during the night in her sleep and in the morning. Her fever never broke. We went to the hospital for our appointment and waited for 2 hours to be seen. Finally, the nice lady doctor from the other day saw us. The tests came back negative and because she still had such a high fever (38.3 or 100.26F) the doctor wanted to admit her for more tests. I was like “What do mean ADMIT her? When?” The doctor says “now.” I start flipping out. I’m like “What do you mean NOW? Can’t you just take more blood? Can’t it wait?” She’s like, “Uh, no.” So she sent us for a chest x-ray because of the suspicious cough. I was glad for that because I have been wanting her to have a chest x-ray for ages. But, I was still freaking out. The last time I had seen this combination of symptoms was in college when my friend Kathryn was diagnosed with Hodgkin’s disease.
I called my friend Mon (who is a nurse and works at Suandok a lot) while Sophie was getting her x-ray and sort of freaked out and she talked me down saying she was sure it was just an infection and they would give her some IV antibiotics. So, we go up to the children’s ward to get admitted and wait for the x-ray. While we are waiting, they say, “OK has she had other symptoms? Weight loss?” and I’m like “Yeah, she’s lost 7 kilos in 2 months.” The x-ray comes back and her lungs are white. Not black like they are supposed to be, but really cloudy. So, they say, OK she has a chronic infection. We think it’s tuberculosis. At which point I think, “Ha, I was right! I hate being right about horrible things.” About a month ago, I had thought, “What if it’s TB?” but then she never coughed up blood, so I thought, how could it be TB? But at least TB is not cancer, right? It’s treatable, she will be fine.
After a decade of waiting, they finally decided to put her in an isolation room on the children’s ward. No TV and it looks like it’s a storage room, but at least we have our own room and no big rooms with 25 babies in cribs like all the other rooms on this floor. I had called Ning when they were going to admit her, so she came to the hospital and of course arrived just as things were starting to happen. They were taking blood so I had to go with Sophie cause she was freaking out again and I handed the phone off to a doctor to give her directions. The head doctor wanted to talk to me after they took Sophie’s blood and I was like “OK, great, I would love to know what is going on.” I asked her to wait for Ning to get there so we could hear at the same time. She was kind enough to speak in both English and Thai so we could both understand everything. She asked if she had thrown up at all lately, and I told her all the days I could remember that she had in the past month. I felt guilty that I hadn’t brought her sooner but every time she had thrown up, either I didn’t know about it til a day later or so or it was just before school and she said it was because the food from the day before was bad. Always it was just once, never throwing up like flu symptoms.
She said again they thought she had TB and she would have to be admitted for 2 weeks! What?! Where is that money going to come from? Plus, I have to get tested and Maiko and maybe everyone at TS. Then, the bombshell that was not even on my radar, not even in my brain, not even the slightest concern: “We also think she has HIV.” HIV? What? What do you mean HIV? How would she have even gotten HIV? Then I remembered. The blod transfusion when she was 7 and in the hospital. That has to be it. Things started to fall into place. Her weak immune system, Abby saying that as long as she has know Sophie (5 years) she has been sick and had a weak immune system and had this cough. Plus, her parents had “suspect medical history” so maybe she contracted it that way. Although, I feel like if she was born with it, they would have caught it much earlier and she would not be as healthy as she is now. Basically, the doctor needed our permission to test her for it, so of course I gave it. She was like “Don’t worry, now there are good drugs. She’ll lead a normal life. Life expectancy is very long.” Yeah, but that means that every day for the rest of her existence she has to take a handful of drugs, expensive drugs, drugs we have to pay for from where? Her whole life will be altered. Altered, but not ended. At that point, I was like “Um, can I have cancer back? I understand cancer. Cancer is beatable. HIV is not.”
Ning and I decided not to tell anyone yet until the test comes back in the morning. I headed home to get some stuff and on the way back, called Mon again to tell her. She was like “Uh. Yeah, I was trying to figure out how to tell you that you should have them test her for that. Her parents died from suspect reasons and from what you have told me about her history in the past 6 months, I was thinking that.” She told me to talk to a social worker and explain the situation and that we serve an awesome God. I had my little meltdown on the phone with her as she was talking and saying that God definitely put me in her life for a reason and this is it. That I am a tough cookie and really strong and not everyone could handle this and not to freak out.

Well, long story short, after 3 days, not one, we finally found out that she is HIV-negative. Hooray! No more sleepless nights. Ha ha, yeah right, anyone who has slept at a hospital knows that you never get a full night's rest. So, here we are, one week into isolation, praying that her tests will come back improved on Friday so that we can go home on Monday. Unfortunately, we still have two months of house quarantine to deal with, but at least people can come visit. Luckily, I was able to speak to Sophie's teachers and they will come to the house to give her finals tests and help her stay up with her homework for the two months she will be out of school. Thank the Lord for gracious teachers, which are rare in Thailand! 

Also, I am thankful for the head doctor on her case, who is also a Christian! She was talking to us about how happy she was that the HIV came back negative and that she truly believed we were all here because God put us all together at this moment in time and God has a plan for us. It was kind of awesome actually, and made me feel so much better knowing that our doctor is a Christian. 

Now we are in isolation, hopefully with only one more week to go before we go home for a two month quarantine stay and 6 months of medication.  

Well, I guess I'll update before posting this. We have now been here for almost 3 weeks and are going home on Monday for  just one week while Sophie doesn't have to take medicine. The doctor thinks the dosage is too high because it is giving her jaundice and headaches and stomachaches. She wants to let her system flush the meds for a bit and then we have to get readmitted and figure out the correct dosage. When we were admitted, her TB level was 3+, now it is down to 1+ but we can't go home and stay home until it is at 0. 

In other news, our house flooded with waist deep dirty river water from all the flooding happening in the north. Fun times. So, between working, taking Thai lessons and staying at the hospital trying to keep Sophie from losing her mind with boredom, I now have to take my motorbike to the shop, and go home every spare hour I have to try to clean everything with bleach before we go home on Monday so that it's sanitary for Sophie. Not trying to say pity me, but just wanting people to know why it's been a whole month without a post. :)