Round 3...

OK, I know it's been awhile since my last blog entry, but I have a pretty good excuse. Originally scheduled to follow-up with the doctor on Wednesday the 7th, after finishing my antibiotic course, I trekked into the city and returned to him on Monday the 5th instead, as my left leg was not getting any better and the stiffness & ache were persistent, despite elevation, hot compresses, and Cipro coming out of my ears. The good doctor ordered an x-ray, to rule out bone infection. Back down to the diagnostic imaging clinic I went, where I just was the week before for my doppler ultrasound (which I'll remind everyone showed no evidence of DVT). The x-ray was completely normal, and I trudged back up to the doctor, who then referred me to a general surgeon at Nairobi Hospital for a second opinion. Make my way over to the doctors' plaza there, and after taking my complete history and symptoms, tells me we have to rule out a clot indefinitely, as I have the classic symptoms and a doppler is not 100% accurate (a fact I did not know). He orders a venogram, makes a call to the radiologist, and gets me in the same day. Now, what I have related thus far probably sounds like it went very smoothly and progressed at a fairly quick pace. In reality, my Monday started at 9am and I found myself sitting in radiology around 4:30-5ish. My emotions at this point have been a roller coaster, and all the waiting has not helped slow down my brain that's moving at a million miles an hour. Just imagine, I have been assured twice now that I have no clot in my leg, relieved of my original suspicions, and now I am faced again with the possibility of having one. As I lay on the table, with the contrast dye being injected into my foot, the radiologist surveys the screen as the dye spreads up the veins in my left leg. I crane my neck to see what he's seeing. I can't quite explain in words my thoughts when the radiologist says to the tech operating the scan, "Stop it right there, I can see the thrombus." I can't stop the tears at this point, barely able to see the white strip in my distal femoral vein that appears about 2-3 inches in length, as I realize what this means--I have a DVT, deep vein thrombosis, that I've been walking all over Nairobi with for the past 2 weeks...the feeling of waste at being down and out for 2 weeks when I'm here to volunteer, how this is a black mark on my medical history forever--worse than getting an F on a school paper, but probably the most severe thoughts going through my head are the what if's, and that scares me more than anything--thinking of what could have happened. Everything is a blur until the general surgeon appears in front of me, saying things like "admission" "anticoagulation treatment" and "observation", as I am led to the admission desk, then up to the short stay or overflow ward, since the hospital is completely full. This place is a Hilton compared to the other hospital I was at...I'm told later that all the diplomats and VIP's are brought here for treatment--glad I have that travel insurance to cover this bill. One of the other volunteers has been great and has been with me through this whole process, contacting our in-country coordinator and getting a list of things I'd like to have brought back to have in the hospital. I am placed on strict bedrest, but bargain to have bathroom privileges (I refuse to use a bedpan!)...we compromise on a bedside commode. I am started on subcutaneous clexane (heparin) injections and oral warfarin. As the buzz of being admitted dies down and I'm left alone, I dissolve completely--yep, full BD (breakdown), finally letting all the frustration, anxiety, anger, being scared, unsure, out of my system. Relief starts to settle in after about an hour, just having a diagnosis and receiving the correct treatment. Prayer has been a constant the whole day, and I find myself thanking God that I didn't throw a clot...lose a leg...just to be alive! Three of the volunteers at the house stop by later to visit and bring me my stuff, along with some goodies. It's a good feeling to have a "family" being so far from home, something I come to appreciate even more as the week goes on--the volunteers are so good about coming to visit me, organizing shifts and bringing in contraband with each visit...I swear I'm going to weigh 100 pounds more eating all of it and being on bedrest--good thing they let me share with them. I'm given a sleep aid that first night (and every night after), as if I need it I'm so exhausted (later find out the sleep aid is none other than Rohypnol, or more commonly known as Rufies...). Tuesday morning the general surgeon gives my case over to a cardiologist, who then reviews my history and symptoms with me, then goes over the treatment plan. Late Tuesday I'm transferred to the MCF ward, with a private room to my surprise, making sure I still get to have a commode. Amazing how the things we do everyday without thinking become such an ordeal when you're on bedrest. Realize the irony of how I left my job working at a hospital to come volunteer, and now that I'm here to volunteer, I'm stuck in a hospital...getting a whole new appreciation what it's like to be a patient. Wednesday and Thursday pass by pretty much the same, except Thursday I get to go for an abdominal ultrasound to make sure a tumor wasn't the cause for the clot, with my history, which comes back completely normal. The cardiologist rounds every morning to review my INR from each morning's wake up call blood draw, and then again in the late afternoon to make sure I'm doing ok, assuring me from the very beginning that Friday is the latest he'll keep. But by Friday, the excitement of getting out of there is drowned out by 1) going out of my mind with boredom being on bedrest the whole week and 2) my discharge being held up by insurance issues. Finally get things straightened out, and as I WALK out of the hospital--have never felt better! Walking into the volunteer house and getting hugs all around, taking a shower, and sleeping in a familiar bed that night are just wonderful! So I have a few more bruises now since I'm on warfarin daily (for the next 6 months to a year), I get to wear these very sexy compression stockings during the day (not so comfortable in 80-degree temperatures), and I have a follow-up with the blood lab and the cardiologist on Wednesday the 14th, which will probably be a weekly occurence, then monthly until he's assured my blood levels are stabilized since this was a spontaneous clot. Also have to look into getting a self-test INR machine (sort of like diabetics have to do with their blood sugar) so that I can check my own levels once a month after I leave Kenya. Not the best thing to have to deal with from now on, especially with all the travelling I have ahead of me, but my leg finally feels better, and I can get on with what I came here to do. Today, Saturday the 10th, I went with some other volunteers to visit the orphanage, and just to have those kids that I haven't seen for 2 weeks and have only spent 1 week with so far yelling out my name and running up to me as I walked through the gate was the best medicine ever! Now I sit here in the internet cafe, with my leg elevated of course or constantly moving to keep the blood flowing, updating all of you back home. Thank you from the bottom of my heart for all the love and support--to be so lifted up by so many prayers through this whole ordeal has truly made all the difference.