I hit the ground running. I had errands to run in town and flew around on my bike trying to get it all done. I picked up dinner on the way home and entered the house at dark. I had a bus to catch to Bangkok at 8am the next morning and a bag to pack.
It was 2am before I finished all the things I needed to get done. Not only was my bag packed with a carefully planned selection of medical necessities, the laundry was done and folded, the kitchen was cleaned, the garbage was taken out, all the shutters were closed and locked and another million tiny household tasks required before leaving for a long time were done.
In the morning, I caught a motorcycle taxi out to the bus station and bought the last seat on the 8am bus to Bangkok. Eight hot, sweaty hours later, I arrived in the city.After a day of shopping for last minute necessities, we headed to the airport. Everything was fine until just after we checked in. We were grabbing lunch before heading through immigration when it hit me. Suddenly my body felt like it had been hit by a ton of bricks. My back, in particular, all of a sudden developed a terrible ache, not a good portent for the beginning of a trip which involves hiking through mountains for weeks on end with a pack on your back.
I had resolved early on to minimize my complaining on the trip. However tired and sore I might be while hiking, I decided, I would try to keep it to myself as much as possible. Never the less, when we finished eating, I suggested we go to our gate right away. All I wanted to do was lie down.
By the time we got to our gate, I was shivering, but I told myself it was just the overly airconditioned environment in the airport. I lay down across several chairs while we waited for our flight to be called and closed my eyes.
Once on the plane I called for a blanket and paracetamol immediately and spent most of the flight cuddled under the blankets asleep. The paracetamol did its job because by the end of the flight I had managed to convince myself that I was just under the weather, but that I would be fine.
Off the plane, it became quickly apparent that I would not be fine. We waited more than half an hour in the queue for our visa-on-arrival. When I could no longer stand up, I sat on the marble floor, using every ounce of my willpower to stay sitting and not lie down like my body wanted me to.
By the time our time came to get a visa, the situation had deteriorated even further. Forced to stand, I became nauseous and had to focus my attention on not throwing up all over the visa officials. They must have noticed.
“You aren't well, are you?” they asked, peering at me intently and moving back a little from the counter.
I was not well, indeed, but I managed to stay on my feet long enough to collect my bags, change money and get into a taxi.
I remember that the sun was setting as we entered Kathmandu and that the city seemed much less crazy than I had imagined it. We were taken to a hotel in the tourist area beyond our price range and ended up making the rest of our journey on foot. I remember the first street where we started out from, but beyond that, the tangled maze of Thamel, the tourist district, remains murky to me. Jay did all the work in scouting a place to stay, I merely plodded behind him, concentrating on putting one foot in front of the other and staying upright.
At one point, someone was walking next to me, asking me if I wanted some marajuana or hash, then he was replaced with a speeding motorcycle which almost clipped me. I knew we had to stop and soon, so we followed a tout down a dark street, up a set of dark stairs and into a dark room.
It wasn't a bad place to stay, really. It had a bathroom three steps from my bed, which was about all the steps I could take for a couple of days and it was clean and reasonably priced. It was also dark and dingy and the water was often shut off and the electricity was often cut. It was all I saw of Kathmandu for the next week.
The thermometer in my first aid kit measured my temperature over the next few days ranging from 38.5 degrees to almost 40. My blood sugars rose to help my body combat the infection and we battled to bring them down. I quickly developed keytones, a sign that the blood in my body was becoming acidic. Except when people woke me up, I slept almos constantly and when I wasn't sleeping, I was in pain. My body ached pretty much everywhere pretty badly. My head and back and legs were the worst. I took paracetamol every two hours. It kept the fever from getting over 40, I suppose, but it did little to alleviate the pain.
There is no treatment for dengue fever. It is important to keep patients hydrated, as dehydration is often the cause of death for those with the illness. In 5% of cases, people develop hemorragic dengue, a more serious version of dengue in which platlet levels in the blood drop to dangerously low levels and can lead to death.
Our guidebook said that there were hospitals in Kathmandu but they should be avoided at all costs. As a diabetic patient, I have a fear of hopitals in developing countries. Even in Bangkok, there are very few young people with type one diabetes. I went to Mae Sot hospital once to get insulin and had to convince the doctor there that it was for me and that I knew how to use it myself. I can see myself being admitted for something simple, like dengue fever, and ended up seriously ill, because of missed insulin shots. But after several days of dengue, a friend told us of a clinic. I was getting better by then, but the tests confirmed that I had dengue fever, that my platlets and white blood cell counts were low and that I was mildly dehydrated.
It was only after the visit to the clinic, when I thought I was getting better, that I got the tell-tale symptom of dengue fever: the “rash.”
The “rash” is actually exploded blood vessels. For some reason, dengue can cause small hemmorages which you can see on your skin. I first noticed it on my ankles, then on my hands, but it spread up from my ankles to cover my legs, all the way up to my thighs. I couldn't look at my skin without shuddering.
The dengue fever took a week from our five week vacation and had a pretty serious impact on our plans. My Mum and Dad arrived in Kathmandu the day after our flight landed. This is the first time I have not travelled alone, and what a good thing. I would not have been able to meet my parents at our arranged location if I had been alone, but Jay left me for a few hours and brought them back to the hotel. I have vague memories of our time together, snippets of our conversations in between bouts of sleep.
We had planned for the four of us to hike together on the Annapurna Circuit, a trail which takes at least 17 days to complete. My parents had a much shorter vacation planned and each day they spent in Kathmandu waiting for me to get better was one day less they could hike in the mountains. Finally, they had a choice to make and they left Kathmandu after I visited the clinic when I was awake and walking a little and getting better. I was still a long way from shouldering the pack and hiking in the mountains, so they shouldered their own packs and headed out to a shorter trek in the mountains on their own.
When I got better and made it out to those mountains I couldn't help regretting that the incredibly bad timing of the illness. I have been living in a dengue zone for four years without getting sick. Jay has been sick with it three times, as has my neighbour. Of course, being sick in Kathmandu is definitely preferably to being sick somewhere days away from medical attention in the cold mountains, but I missed the opportunity to spend so much time with my family and share such a great experience with the both of them.
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