Tuesday, February 25, 2014

updates: inpatient in Nairobi, miracles, free Michael, severe malaria, never alone

I'm sitting here in our shared room at the Karen Hospital in Nairoibi, Kenya.  Mike is awake and reading Calvin and Hobbes while sitting in his hospital bed with his feet propped up.  He has large blisters covering his heels so can't put pressure on them.  We are waiting for the doctors to round and then we will take our slow and shuffling walk outside.  The Weaver birds are singing for us; we have a front row seat to their next building and baby feeding.  They enter their nests from the bottom side and the nests are swaying in the breeze.  The birds are bright fluffy yellow bits of energy and life.  Karen is a beautiful part of Nairobi, full of trees and flowering plants.  The staff at the hospital are incredibly kind and often telling us that God is with us and that they are praying for us.  We are thankful to be here for his treatment.

Mike is recovering from complications due to severe malaria.  He first got sick 17 days ago with a fever. We did two rapid malaria tests at home which were both negative so we didn't treat him (which of course, I deeply regret now) until day nine.  That day (Tuesday) found us in the emergency department of Bugando hospital in Mwanza, Tanzania.  He was very ill and his blood smear was positive for malaria with a large parasite count. He was also hypotensive (low blood pressure) and prone to fainting when upright.  He was given IVF right away and when an abdominal ultrasound showed free fluid in his abdomen we made arrangements to be medically evacuated to Nairobi, Kenya.  One day later he was taken to emergency surgery for a ruptured spleen (it was a very large laceration in a spleen that was 4-6 times the size it was supposed to be).  He was transfused with 7 units of blood due to severe abdominal bleeding.

The miracle happened the night before we headed to the Bugando hospital, Monday night, over one week ago.  As we look back now, we realize that Mike's spleen ruptured on the Friday (valentines day), 3 days before that Monday.  On that day, he has sudden acute onset upper left shoulder pain and left upper abdominal pain (which now I know is called Kehr's sign a classic sign of a ruptured spleen).  He also got much worse in terms of his symptoms at home.  But, because every morning he would be fever free and would seem to be a little better, we waited to take him to the hospital (again, something I regret now).  On Monday evening, he seemed worse and at one point I walked into our bedroom to find him collapsed on the floor.  The rest of that night will remain one of the scariest I have walked through with him.

After Mike "came to" after collapsing he was disoriented, covered in sweat, very pale, and extremely weak.  He couldn't sit up without almost passing out again. His blood pressure was low. After some time we were able to get him into the bed.  A doctor came to see him and he was stable in bed, much calmer.  Later that night, Mike got worse again and started to almost faint every time he sat up.  At one point I found him again on the floor and disoriented.  It was late by this time and when I took his vital signs they were unstable.  His blood pressure was 80/40 but as the night wore on it dropped further and at one point I couldn't even find it very well.  His heart rate was up and he was breathing fast.  His color was greyish and he was covered in sweat.  And he was fairly out of it.

Looking back now I can see he was in hypovolemic shock from the rupture of his spleen and the internal bleeding. That night I spent next to him in bed sobbing and begging God to keep him alive.  I knew in my gut that he was very very ill and I was so worried he would die right then and there.  I didn't have "911" to call, so I prayed and prayed.  At about 4 am, all of a sudden his vital signs stabilized, he was still hypotensive (low blood pressure) but I could find the blood pressure and he was conscious and alert, though he still couldn't walk on his own.  That was our miracle.  In talking with our surgeon here, she told us that there is no explanation for why he stabilized like that (and stayed stable until he had surgery on Thursday) but for God.  That for whatever reason, we were shown mercy and his life was spared.  It is still completely overwhelming and brings me to tears even now writing this.

He may not have a spleen today, which complicates our life living in a malaria endemic area, but he has his life and I will be forever grateful for this gift.  When I wrote that poem that I posted here I was sitting in the ICU.  After he had surgery and I was again sitting in the ICU next to him, it hit me that he should have died and what happened.  Sitting there, I read medical articles about splenic rupture in severe malaria and his symptoms and I cried again.

Never have I felt so covered by the mercy and love of God as that moment. Immanuel. We are never alone.

Malaria can be divided into uncomplicated malaria and severe malaria.  Severe malaria can come with high parasite counts, decreased levels of consciousness, weakness to the point of not being able to walk, collapsing, convulsions, difficulty eating, kidney failure, low blood pressure, acute respiratory distress syndrome, jaundice, pulmonary edema, and more.  Mike showed not all of these symptoms, but many of them and now he is improving in every way.

He is now doing much better, though still has a long recovery ahead of him.  He has had two rounds of malaria treatment (specific for severe malaria) but still has scant malaria in his blood. We began the third treatment two days ago and are waiting for the blood results today to make sure all the parasites are gone.  Because has has not spleen right now, he has to get special vaccines and go on permanent (while living in Africa) prophylaxis to prevent malaria.  We hope we will get discharged from the hospital in the next day or two and head to a friends house so that he can do outpatient rehab.  He will need to get vaccines in about 10 days before we travel.  We are grateful to Mike's sister who is flying to TZ now to help watch the kids until we get back in a couple of weeks.

We have been overwhelmed and grateful for all the love, support and prayer sent our way over the last week or two.  Here are some of the many ways we have been supported:  prayer from around the world, friends sitting the the waiting room of the ICU for days to support us, a good friend coming from Bujumbura to support me, someone I had never me bringing my a computer so I could have internet, another friend running errands for us like buying ice and helping me get a phone and internet and shampoo (I packed in a huge hurry!), picking up friends/family from the airport, friends in Mwanza picking up and living at our house and taking care of the girls on a moments notice, encouraging emails, places to go to take a shower and rest, calls and words of encouragement and on and on.  We were stunned by the support we received from Mike's "Malaria free Michael" fund over the last day.  Overall, the biggest blessing has been the support and love of all our friends and family.  Thank you so much.

I'm sure Mike would not appreciate me sharing the "before" photos given how extremely ill (and yellow) he looked with tubes coming out all over his body and multiple IV lines, just know that this photo from yesterday is a gift and a testimony to God's mercy and love.  


Jess said...

Wow. That is pretty much all I can say when I hear about your husband's illness. God must have something pretty fantastic in mind when it comes to your hubby and family in order for him to have come through all that!

Anonymous said...

Thank goodness your husband is okay, that's really scary. Did he get malaria while on anti-malaria meds? That's always my fear (a friend of mine from college's sister got it that way).

My husband was med-evacuated from Gabon years ago - the doctors there didn't know what he had, when he got to a hospital in France, it cleared up because he had impetigo. We laugh about it now, I was not laughing when it happened.

Jules said...

Thank you for taking the time to share the painful details of this ordeal, Holly. God has truly been with you both and your faith has been your guiding light. We thank God for you both, and that you are now on the other side of this.
Much love,