Some good news

February 19, 2015 - Okay – so a part of the good news I hinted at in a recent post: The mother and daughter in the confirmed ward both recovered! I am so very, very happy about this. And, in fact, over the past 6 or 7 days, no one has died in the confirmed ward at all (one person came in and died within a few hours, before we could determine what she was sick with; another died, but not of Ebola). And four people have recovered.

This guarantees ABSOLUTELY NOTHING about the future. It could be a complete coincidence. But it sure does help our spirits. And – who knows – maybe we ARE getting some things right.

I think we are, in general, getting more organized about care (really, really difficult in a poorly equipped facility with staff turnover every week and a disease that no one knows the “definitive” treatment for, all while you can only work a maximum of 90 minutes – maybe two hours if you push it – at a stretch). And that we are, most of the time, continuing to get more fluid into sick people, often via two IVs. Also, we’ve started using Imodium for people with non-bloody diarrhea, and it may help. If you are losing tons of body water via diarrhea every day, you can see how slowing down the diarrhea might help you keep hydrated. (On the other hand, if the poop just stays in your body longer, but the liquid in it isn’t actually reabsorbed, it may not.)

So we go on. One thing new that I am learning is how hard the sessions in PPE during the heat of the day can be. In theory, it sounds like you could ensure it wouldn’t be too bad – hydrate really, really well before going in, come out if you feel faint or otherwise on the verge of not functioning. But, in practice – what do you feel like before you stop being able to function? How do you know you’re getting close to the edge? In all likelihood, it won’t be a linear process – it seems much more likely that one moment you’ll be working, and the next you’ll be on the floor. So you monitor your body, and when you begin to feel, in one way or another, more “bad” than you want to, you come out. (Often, there is an anxiety component to it – as you might imagine!) And you hope you notice in time – when there is stuff to do, there is quite a strong incentive to keep doing it, and when you’re working, sometimes you’re not paying close attention to how you’re feeling….

But the two or three hours immediately after one of these sessions do make you wonder what, exactly, you are doing to your body. Generally, I feel a bit light-headed, a bit confused (not centrally, but around the edges), very tired. I drink a lot, of course – sometimes I’ll polish off 1.5 liters in the first few minutes after I’m out. But drinking doesn’t return me to feeling normal. Is it mild electrolyte abnormalities? Is it, literally, my brain has heated up and is not functioning optimally? I don’t know. When the time comes to go in again, it does tend to focus the mind. But I can see myself doing things pretty inefficiently sometimes – going into a room 4 or 5 times to take care of everything, instead of 1 or 2. By the end of the day (or earlier?), I don’t think we are functioning at peak. (That said, if you make a good list of tasks before you go in, you can manage to do most or all of them, which feels good.)