Since I arrived in Bali a year and a half ago, my body has been beset by illness. From Bali Belly where your insides turn to liquid to weird rashes to discovering I have an allergic reaction when bit by many red ants.
I was racked with appendicitis, salmonella and a UTI two Octobers ago and spent four days in hospital.
Last October, I was diagnosed with an amoeba. In November, amoebas and typhoid. The amoebas proved resistant to the first round of treatment, so it took almost a month of antibiotics to purge them from my body
Returning to Bali in January, I come down with hives and a sinus infection. Two weeks later, belly cramps and achiness set in around lunch. I spend the night in bed and head to the hospital the next morning. “It’s nice to see you again,” I say to Dr. William.
“Not so nice for you, I think,” he responds with a laugh. “You’re sick again?”
“Yes, I think it’s typhoid. I feel achy like I did in November.”
A nurse comes in to take my blood. She is young, Indonesian, pretty. She puts on her latex gloves and then realizes she has forgotten the vials in back, so she opens the door, retrieves them, and returns to draw my blood, all while wearing the same gloves. I watch her dirty, latexed-hands insert the needle in my vein.
As tests are run, a couple emerges from another exam room and sit to my right. He wears orange robes with a long bushy beard, probably in his 60s, and has his arm wrapped in a cloth sling. His wife is in her 50s, wears yoga clothes. She explains to their Balinese tour guide, “We just need to chant mandala. We don’t like to DO many things. We just like to BE. If we can just chant mandala and meditate, his arm will heal.” You’d be surprised how often this happens in Bali: people in the emergency room calling to consult with their spiritual advisors in California while their partner is being examined. “My spiritual guide says it’s in his lungs” Or asking the doctor about a patient in the ICU, “Can he continue his juice fast?”
Dr. William explains that I have amoebas. I test positive for typhoid, but it was a weak positive (level 4), so I don’t need to be treated. I will take Flagyl for the amoebas and then prednisone, Levoquin, Sudafed and Loratadine for my sinusitis.
I cannot sleep the next two nights, my heart and mind race. I ask my friend Lindsay, an amazing nurse from the States, what the deal is the next day when she comes over. “Let’s look at your medicines. God, do you have pneumonia?”
“Then why did he give you this? Stop taking this,” she says throwing it on the table. “Are you taking this one before bed?”
“No wonder you can’t sleep. It basically has speed in it. Stop taking it! And this… predesone is given for rashes and other… stop taking this, too. Just stick with the Flagyl for your amoeba. Here instead of making a clear diagnosis, doctors just prescribe a little bit of everything. Medical practices in Asia will be the death of antibiotics. They’ve already found a antibiotic-resistant strain of TB in the slums of India…”
I am finally able to sleep, but Sunday night, I still don’t feel better. My whole body aches: the darts from one part of my body to another joint. I call Lindsay, and she offers to go with me to the doctor to help navigate the medical system and language gap.
It is a different doctor, a rotund Indonesian woman who wears colored contacts and a warm smile. “So what seems to be the problem?”
“I was in on Wed and diagnosed with an amoeba, which I am taking flagyl for, but I really think I have typhoid, too. Everything hurts.”
She opens my records and looks at the notes from my last visit. “Yes, you have typhoid and you were given medicine for it.”
“No I wasn’t.”
“What?” she asks, looking down. “The Levaquin was for the typhoid.”
“No, the doctor told me that since the typhoid was only a level 4, I didn’t need anything for the typhoid. The Levaquin was for my sinuses.”
“No, it was for the typhoid. What medicines are you taking?” Out of my backpack, I pull the Flagyl, Paromomycin, and the Panadol (like Tylenol) that I have been knocking back every 3 or 4 hours to try to get rid of the pain.
“Where are the other medicines?”
“I decided to stop taking them, they were making it hard to sleep.”
“You should not be taking both of these,” she says, motioning between the flagyl and paromomycin. Chose one. They do basically the same thing.”
“But doesn’t the Flagyl kill the amoebas floating in your intestines while this one works on the amoeba that have burrowed into the lining?” Lindsay asks.
“They do the same thing. She needs to choose one.”
She has me get on the examination table. Unlike the last doctor who just checked my blood pressure and temperature, she listens to my belly, checks my abdomen. She calls the nurse in to take blood and I cringe, realizing it is the same dirty-gloved nurse as last time who left a huge bruise on my arm.
I want to ask for another nurse, but I feel like a jerk, so I hold my tongue. The first part is smooth and without glove contamination, but then she takes the vial of blood off the needle, and instead of taking the needle out of my arm and then applying pressure, she applies pressure first, jamming the needle deeper and deeper into my vein. “Oww!”
“It hurts?” she asks, surprised.
“Yes!” When she removes the needle, the bleeding refuses to stop for a few mintues. Hours later, my arm still throbs. I remove the band-aid and see this:
They run tests for dengue (a dip in white blood cell counts is a customary indicator) and typhoid again. My typhoid levels are up, as expected since it has gone untreated for 5 days, but my white blood cell count looks good. Lindsay delicately broaches the medication issue again, “In America, I know we tend to be more aggressive in our treatment, but the American standard is that both these medicines are administered at once. Since she was already resistant to Flagyl once, she had to do two, 10-day doses in November, isn’t it a good idea for her to do both?”
“I have read about that. Yes, since she is American, maybe that is a good idea. Indonesians can often get rid of the amoeba on their own, so if they need medicine, Flagyl is enough. But she has an American belly…” the doctor nods her ascent.
Five days later, I am still in bed, achy and unable to work. I call Lindsay, and she invites me to another hospital at 8am to see a doctor she respects. “He’s like my grandfather, smiley and gentle. And he is a really good doctor. He thinks critically about things, reads medical journals. You’ll be in good hands.”
I take a cab to the hospital. A trailer truck has tipped over, and there are no tow trucks in Bali, so traffic is basically stopped. We inch along, painfully slowly.
When I arrive, Lindsay comes to meet me in the lobby, which is also a mall (nothing like being able to shop for groceries or buy a new camera in the basement of your hospital). “May I borrow your identity?” the nurse asks when I check in.
Lindsay, Dr Benny, the nurse and I sit in his examination room. He asks smart questions. He wants to know my last test results, but I do not have them, and Lindsay somehow remembers all the information—white cell count, typhoid levels…
He examines me and explains he is going to check my blood and stool to run tests on my white blood cell count, typhoid, liver, and for chikungunya (similar to dengue and malaria). I cuddle up and wait four hours for the results, watching shows on my laptop.
The results all appear normal; it is still the typhoid ravaging my system. I just need to rest, be patient.
I have often pondered how sickly I was as a baby and whether or not I would have survived in this climate had fate found me birthed here. Or maybe I would be stronger now, had I survived through the delicate stages of infancy and childhood, my body already resistant to the things that arriving in my 30s are tearing me down.