Knocking on death's door: Zika, Dengue Fever, and the fight to survive. From CHSC Missionary Nurse, Elizabeth Martin.
Zika … it’s all over local news channels, in the news papers, and is a common topic of discussion. In the months of preparation for my arrival first in Guatemala and in Honduras, many people have asked me, “But aren’t you scared of getting Zika?” I can honestly say that I am not because I am not getting pregnant and most people who get zika don’t have symptoms or think that they have a mild flu. Zika generally is of no concern for a non-pregnant person. There are mosquito spread virus here in central American that are much more severe than Zika to the point that they can even be deadly. Dengue Fever is one of those mosquito spread viruses. When bitten by a mosquito carrying Dengue Fever, a person will develop a sudden onset of a high fever, severe joint pain, a rash, and mild bleeding. In some cases, like in that of 12 year old Juana (name has been changed), dengue can have deadly consequences.
It started last week when Juana arrived in our 3 bed emergency room in severe pain and just not feeling well. She was admitted to our in-patient ward where she moaned and cried in pain for two days and was not really getting better, in fact, she kept getting worse. Her respiratory status was slowly deteriorating. Instead of breathing at the normal 10-12 breaths a minute, she was breathing almost 50 times a minute and was requiring low amounts of oxygen. By Thursday morning, she was quite delirious, screaming and flailing in her bed in pain and fear, as her family and I tried to convince her to wear a non-rebreather face mask for a higher amount of oxygen. Poor Juana screamed all morning in between her short naps of sheer exhaustion. She did not want to wear the oxygen that she so desperately need and did not want anyone to touch or get near her.
By noon, it was clear that we needed to act fast or she was not going to make it. Putting someone on a ventilator at a mission hospital is no easy task. In the chaos of the doctors trying to put in a breathing tube, several other of the staff and I were scurrying around trying to determine “Does the ventilator work?” By golly it does. “Do we have sedation medication?” Only Propofol for short term sedation such as surgeries but we’ll use it. “Does the IV pump work to give the medication?” We’re working on that. “Do we have enough oxygen?” Enough to get through a few days before we will need to get more. “Oh no… the bed isn’t working correctly!” We move her into a different bed. After having to find working monitors, suction, and struggling with the ventilator settings, we finally had her set up.
For the past week, our little mission hospital has done what we can with what we have. We have provided the best care that our Juana could receive all the while, praying for the miracle that this little girl so desperately needs. She has remained on the ventilator with a nurse and doctor at her bedside 24/7 for almost 9 days now. It seems like every day she takes a step forward and two steps back but we have not given up on our girl. We continue to fight for her through the exhaustion. We continue to up with creative ways to make up for our lack of resources and lack of experience taking care of ventilator dependent patients.
We have hope for her as for the first time in a week, her fever broke and her respiratory rate has dropped from 50-60 breaths a minute to 30 bpm (which is still high but very much improved!) In spite of the improvement, she is still very sick. Her lungs may take weeks to heal on the ventilator but we push on.
God is good! Our girl is still fighting and we have hope!
Zika … it’s all over local news channels, in the news papers, and is a common topic of discussion. In the months of preparation for my arrival first in Guatemala and in Honduras, many people have asked me, “But aren’t you scared of getting Zika?” I can honestly say that I am not because I am not getting pregnant and most people who get zika don’t have symptoms or think that they have a mild flu. Zika generally is of no concern for a non-pregnant person. There are mosquito spread virus here in central American that are much more severe than Zika to the point that they can even be deadly. Dengue Fever is one of those mosquito spread viruses. When bitten by a mosquito carrying Dengue Fever, a person will develop a sudden onset of a high fever, severe joint pain, a rash, and mild bleeding. In some cases, like in that of 12 year old Juana (name has been changed), dengue can have deadly consequences.
It started last week when Juana arrived in our 3 bed emergency room in severe pain and just not feeling well. She was admitted to our in-patient ward where she moaned and cried in pain for two days and was not really getting better, in fact, she kept getting worse. Her respiratory status was slowly deteriorating. Instead of breathing at the normal 10-12 breaths a minute, she was breathing almost 50 times a minute and was requiring low amounts of oxygen. By Thursday morning, she was quite delirious, screaming and flailing in her bed in pain and fear, as her family and I tried to convince her to wear a non-rebreather face mask for a higher amount of oxygen. Poor Juana screamed all morning in between her short naps of sheer exhaustion. She did not want to wear the oxygen that she so desperately need and did not want anyone to touch or get near her.
By noon, it was clear that we needed to act fast or she was not going to make it. Putting someone on a ventilator at a mission hospital is no easy task. In the chaos of the doctors trying to put in a breathing tube, several other of the staff and I were scurrying around trying to determine “Does the ventilator work?” By golly it does. “Do we have sedation medication?” Only Propofol for short term sedation such as surgeries but we’ll use it. “Does the IV pump work to give the medication?” We’re working on that. “Do we have enough oxygen?” Enough to get through a few days before we will need to get more. “Oh no… the bed isn’t working correctly!” We move her into a different bed. After having to find working monitors, suction, and struggling with the ventilator settings, we finally had her set up.
For the past week, our little mission hospital has done what we can with what we have. We have provided the best care that our Juana could receive all the while, praying for the miracle that this little girl so desperately needs. She has remained on the ventilator with a nurse and doctor at her bedside 24/7 for almost 9 days now. It seems like every day she takes a step forward and two steps back but we have not given up on our girl. We continue to fight for her through the exhaustion. We continue to up with creative ways to make up for our lack of resources and lack of experience taking care of ventilator dependent patients.
We have hope for her as for the first time in a week, her fever broke and her respiratory rate has dropped from 50-60 breaths a minute to 30 bpm (which is still high but very much improved!) In spite of the improvement, she is still very sick. Her lungs may take weeks to heal on the ventilator but we push on.
God is good! Our girl is still fighting and we have hope!
