Dengue Fever

We have had our first bought with a tropical disease. Unfortunately, Kate is the one that got it. Kate has Dengue Fever, which is a mosquito borne viral infection. Kate started with a fever on Sunday and throughout the week continued to have a fever go up and down. She did not complain of any other symptoms, she simply broke out in a rash the second day. These were similar symptoms she had before when dealing with a viruses in the States, and by the third day she would be better. But by Wednesday, day four, her fever was still coming and going and she began compaling that her legs were hurting, so we decided to go to a doctor. Dr. Elizabeth Perez had been recommended to us, and her office is about two minutes from our house. Dr. Perez's office is in Charamicos, the heart of Dominican Sosua. This is the non-tourist, real-life, day-to-day, Dominican Republic. Dr. Elizabeth has a small office on the main street in Charimicos.






We walked into the office and were greated by a secretary, Nadia De La Cruz. Nadia recognized us from La Iglesia Nueva Vida, the Spanish-speaking church ministry of New Missions. Unfortunately we didn't recognize her. I guess, when you are three of the seven white people that attend the church you stick out a little. (On a side note the town does seem to get smaller the longer we are here. We rarely go somewhere now where we don't see someone we know or someone does not recongize us from the church.) She called the doctor and let us know she would be there in 15 minutes. It seems that most doctor offices are open 24 hours, and the doctor arrives for appointments or is called for walk-ins. She arrived, and we went back to an exam room, for what is called a consulation. The exam room has an exam table as well as a desk and chairs where you can sit and talk with the doctor. She examined Kate, and let us know that she would do some bloodwork to help determine the cause of the fever. She said she was not willing to diagnosis it as Dengue Fever without the bloodwork, but let us know that we would treat her with increased liquids and Tylenol if it were Dengue. She drew blood to get a basic panel, but said that we had to wait until the next day to test for Dengue Fever. She said that it was something that had to be done after five days. She also wanted to rule out a bacterial infection that is often accompanied with leg pain. She sent us home and instructed us to keep using Tylenol to keep the fever down and come back the next morning for more bloodwork. Several hours later she called and said, "You come back now?" Ok, sure...she told us that there was evidence of viral infection and that her platelet count was on the lower end of normal.



We went back the next morning, Thursday. The blooddraw this morning was much more difficult for Kate. I don't think she knew what to expect the first time, but she knew what was going to happen this time. It took much consoling and a lot of effort to get the blood sample today. Dr. Elizabeth said she would have the results in a few hours and she'd call us then. Did I mention that she speaks English very well? THANK YOU LORD. We went home to wait. Dr. Elizabeth called a few hours later and asked us to come to the office. We drove back to her office and she confirmed the diagnosis as Dengue Fever. We were a little confused about the following point, but there were two tests for Dengue Fever, one was negative and the second positive. The gist of what we understood from the difference, is it shows that she had the virus for sometime, and it is not a new infection. How long, and why the symptoms surfaced now we aren't clear about. Regardless, it was good to know what she had and the course of treatment. Dr. Elizabeth gave us the choice of either going to a clinic in Puerto Plata where she'd have to stay until she was better or staying home and having a nurse stay with Kate through the night. She said that she was going to have to give Kate an IV and wanted to make sure there was someone to monitor it through the night. She put the IV in right there in the office, Kate was a trooper, it wasn't easy for her, but she did a good job letting them put the IV in her hand. They taped her hand to a splint to immobilize her wrist. We went home and took an IV pole with us.

Dr. Elizabeth came by the house in the evening to change the IV bag and brought Maribel, the nurse, with her. Kate and Maribel hit it off quickly and even though Maribel doesn't speak a word of English they were doing puzzles and playing games together immediately. She also made mango juice for Kate and got her settled in for the night.

That night Melissa and I slept through the night for the first time in five days. THANK YOU LORD. In the morning Maribel got Kate dressed and ready for the day. She drew blood that morning to check on Kate's platelet level. Dr. Elizabeth had been concerned. Her inital platelet level was 144, and 150-400 is a normal level. Dr. Elizabeth came by that morning to pick up Maribel and check on Kate.

She came back in the afternoon, and said Kate's platelet level was lower. It was in the 90s, but she was confused, since Kate appeared healthier and much more active, so she wanted to do a second blooddraw. We got the results back that evening and her platelet level was down to 89. Dr. Elizabeth said that if it continued to go down that we would have to go to the clinic in Puerto Plata, because the platelets are the component of the blood that assists with clotting, and if Kate were to get a cut it could be dangerous. In a clinic she would be able to get platelets if necessary. For me this really caught me off guard. I was not prepared for Kate to need to recieve blood. I think I would have been as upset in the States, but it was difficult to hear. Dr. Elizabeth said we could wait until the morning, but if the platelet level did not start coming up we couldn't keep treating her at home. Maribel stayed the night with us again. This night, Kate wanted to sleep with us. We slept with the door open so Maribel could come in to check the IV bag and medication. At this point we had run out of the children's Tylenol that melts in your mouth and had to move to liquid medication that Kate did not like and didn't want to take. We had to use a syringe to put it into her mouth. This was a very rough sleepless night. We were very appreciative for the help Maribel gave us. Despite the difficulty with communication. she was very supportive and good with Kate. That next morning Dr. Elizabeth returned for another round of bloodwork. Kate no longer fought and argued about the blood draw and sat there bravely and let Dr. Elizabeth take the blood. One thing that has amazed me is the resiliency and adaptabilty of children. Kate's IV pole quickly became like an appendage and she had no trouble getting around the house and going about her normal routine. We got the results that Kate's platelets were up to 100. Still low, but we could stay home. THANK YOU LORD!!!

Kate was now on the upswing. Saturday night we did not have Maribel, she had to work at a clinic. It was a much better evening. Melissa had been praying about the medication issue and prayed that Kate would be able to take the liquid medication without trouble, as she prayed she was reminded of another spot in the medicine cabinet where she had stored a different kind of children's Tylenol. It is one that Kate had difficulty taking in the past but this time, faced with the alternative, she took it with no problem. THANK YOU LORD!!!

Sunday morning Dr. Elizabeth came back to check her IV and switch the bag. She did one more blood draw and said that if it was up she would stop the IV that afternoon. We asked her if we could take Kate to church. She said as long as we used bug spray on her so that she wouldn't get bit by a mosquito and pass it along to someone else. Dengue Fever is a mosquito borne virus and is passed from an infected person to an unifected person by mosquitos. We sprayed her down and went to church. Kate's first time to leave the house since our Thursday visit to Dr. Elizabeth. Everyone at church was so glad to see her, and she just walked around with her IV pole like nothing was different. We got back home that afternoon, Dr. Elizabeth called and said her platelet count was up to 120, THANK YOU LORD, and while still low we could treat her with juice and water, and she would come take the IV out. She took out the IV, and we took a family trip to Splash, our favorite ice cream shop, to celebrate. We will be going back tomorrow for one more blood panel, and probably a few days later to recheck for Dengue to see if it is out of her system.

This has been a difficult time, but we received such love and support from friends and family through all of this, we never felt alone. People here in the DR came by to visit and pray with us, we received countless e-mails of friends and their children praying. It was wonderful to hear of so many of Kate's friends praying for her, even the ones that didn't know why they were praying for her "plates". The faith of a child. It's Father's Day here in the Dominican Republic, and what a great one for me. We have a wonderful heavenly father that cares about us. He's there for the bumps, and bruises, and tropical diseases.