One for the Books

How many people do you know who have had a spinal tap in Africa?  Probably just one.

Yesterday stared off as a bizarre day and became one that we (at least I) will remember.  We all woke up about 3 hours before our alarms went off due to an especially obnoxious dog barking outside the window for at least a half hour, followed by the Muslim Call to Prayer that last about 57 times longer than usual.  When it was time to actually start the day, we left for the University to continue our lectures, and we learned that the taxis in Niamey had gone on strike, leaving citizens who depend highly upon the taxi system standing around the streets aimlessly wondering what to do next.  While Michelle and I got the lectures started, Dr. Carey and Kristina attended a support group for women and children with cerebral palsy.  However, due to the taxi strike, none of the group members showed up. 

Before I begin with the main story of the day, let me back track and explain why I've been MIA from the previous posts.  Since Day 1 of the trip I've been sick with a fever and neck stiffness, which did not change despite treatment and contant care from the American physicans (Troy and Steve) on the trip.  I've been bedridden most of the week, and in fact I think I've learned more about the shapes of the paint chips on the ceiling and cracks in the walls than I have about Niamey.  Granted, I was able to participate in a couple things each day, and make it through my lecture on Fistula today, but most of the week I've been forced to be a complete party pooper. 

So back to yesterday...  After returning home for lunch, my neck stiffness and headache were much worse, so the American doctors and Susan did an exam, concluding that it is likely that I have meningitis.  They all agreed that I would need an LP to rule out the bacterial form, which is much more severe.  When I heard "LP," I thought they meant some kind of lab procedure, like a blood draw, and there was no way in heck I was letting anyone touch my blood in Africa.  The words "needle" and "Africa" did not belong in the same sentence in my book.  So, when I discovered that LP actually meant lumbar puncture, or spinal tap, you can imagine my enthusiasm (that was sarcasm).  Bigger needle, and not just into my arm, but my spinal column to test my cerebrospinal fluid.  This is necessary to differentiate between viral and bacterial meningitis. 

So I packed my bag (unsure exactly what one should pack to go to an African hospital, but figuring that my Nook e-reader and Dora the Explorer fruit snacks were probably necessary) and we all jumped in the vehicle to head to the best hospital in Niamey.  Every single person in the group sacrificed their afternoon to come with me without even thinking twice.  We got to the hospital (and who knew that Clinique means clinic?  Is that why they wear lab coats at the makeup counters?) and waited in the waiting room drinking sodas from glass bottles (coolest thing about Africa thus far), then it was my turn.  Terrified, I went in with Susan and Troy.  The African doctor did the exam, then wanted to admit me overnight in order to do the spinal tap.  Since I have yet to see an African hospital room, I'm picturing a mix between a military hopsital from WWII with amputee patients side by side and an orphanage.  But since I've never even spent the night in an American hospital before, any orphanage-like room where they only speak French, unless you're reading from the book Madeline, is not my cup of tea.  So on to Plan B...

We left the clinic and drove around to just about every Pharmacie (pharmacy) in town to get all the supplies we needed for Do-It-Yourself lumbar puncture.  After we had everything, we came back to the guest house and the American doctors prepped.  Seven-year-old Lydia gave me an Ariel sticker, my second favorite Disney princess (I already had a Belle sticker from Michelle) for good luck.  Still terrified, but a little more relieved that it would be Troy performing the procedure, I went in the room.  In fetal position, I talked myself into being as brave as Troy's bone marrow transplant patients, who are probably 1/5 my age.  Surpringly, it was not that bad.  And I'm probably the only person I know who has had a spinal tap in Africa.

They started me on an IV as we wait 48 hours for the lab results.  Unfortunately, I will be going home tonight, 2 weeks earlier than planned.  I need to make sure I get the medical attention I need at an American hospital.  Although this week in many ways was miserable and I felt like I wasn't able to contribute as much as I wanted to our learn as much as I had hoped, I did learn a few things through this whole ordeal.  I have so much appreciation for Dr. Carey, Kristina, and Michelle for being there for me every second, and for Troy, Steve, and Susan for taking such good care of me.  I was able to experience African healthcare from a patient's perspective and gain insight into its problems and downfalls.  And by driving to the hospital and then to every pharmacy in town, I was able to see more of Niamey than I probably would have otherwise. 

I wish Dr. Carey, Greg, Michelle, Kristina, and Kate the best of luck on the remainder of their trip!  I will be thinking about them and I hope they have many amazing experiences. 

Au Revoir!

Betsy