Saturday, 27 September 2008

A Nut of Excitement

Many of you have asked how I have been fairing with allergy...well now I've got a story for you.

I have been extremely diligent about managing the allergy in this environment. I compare it to eating in the dining hall at my university where you are served buffet style and the food is arranged in cases based on theme. Common sense dictates avoiding the islands that could be hazardous: Tai, Asian, desserts, stir fry, etc. It's much the same here. I have a sandwich or salad for lunch and for dinner sliced meat, rice and a vegetable. Plain and simple. I also each as much packaged food as possible since labeling is always a plus.  The major drawback here is not being able to pick up the phone and call 911 although there are emergency ambulance numbers and I live a 5 min walk from a 24 emergency clinic.

Well last week, Friday I believe it was, I found that my neck was irritated throughout my shift. I wouldn't say they were hives exactly but my skin was itchy and rash-like and I found myself holding the phone away from my ear so as not to chafe my neck.  I wasn't particularly concerned because with all the dust and weirdness out here, scratchy is not abnormal.  

By the end of the shift my left eye was starting to give me issues. It felt irritated and begged to be itched. I made it back to my CHU and climbed in bed to read and accidentally rubbed it. We went down hill from there. Although I washed my hands, washed out my eye and took a dose of Benadryl, the next day my left eye was completely swollen shut.  With another does of Benadryl, it was back to normal by the end of my shift but unnerving none the less. I have no explanation for the cause other than I came into contact with something my body didn't like.

Well having that encounter with a minor reaction dictated last night's course of events.  My teammate Kris went out to grab us dinner and came back around 12:30am with burgers and fries, a relatively common Friday night splurge for us. Around 1:30am I noticed that my throat felt constricted. It didn't itch, it didn't hurt, I had no hives anywhere, and I was breathing freely without wheezing. Despite my surprising lack of other symptoms the first thing that comes to mind with that sensation is a reaction. 

I went ahead and took a does of Benadryl but it made no impression. After pacing about the office for another half an hour trying to talk myself out of the fact that this could be a reaction, I decided to quit fighting and go the the "ER". Epi-pen in hand I told my concerned teammate that I just wanted to be there in case the reaction decided to go full blown on me. I jumped in the Explorer and was there in just a few minutes. 

So here was my first experience with deployed health care in a war zone. I pull up to the clinic and there's a solider outside using a laptop to project his unit's mascot onto a T-wall where he was painting over the digital image. Twilight zone. He asked me if I was alright and then pointed me through the right door. Inside I found the place deserted. I was in what appeared to be an intake room, but the lights had been dimmed and the desk was empty.

Thinking that I would shortly be dying I forged on into the area that said Restricted, Do Not Enter.  "Hello?" I called. "Is someone here"? At once I found myself surrounded by three uniformed soldiers that seemed absolutely baffled to see a young, blonde woman while at the same time noting that my face was swollen and that I was clearly trying to keep my voice steady. I rapidly explained about my history with anaphylaxis and that while I could not explain my lack of other symptoms, I did not like the way my throat felt. I could tell that they were as confused as I was by the way the medical condition was playing out, but I did my best to tell them that I was VERY familiar with Epi-pens and ICUs and suffocating to death from a reaction and after a few minutes I think I had them fully convinced.

They went and woke up the doctor, a Major, whose combat trauma services, I was told, were sought by injured servicemembers at all the FOBs. I soon learned that I was surrounded by combat medics who were used to mortars and rockets and IED injuries and not this more unique, temperamental condition. I was subjected to my first battlefield triage experience when the combat medic started the IV. He stuck that sucker into me like I had the constitution of Rambo and he the finesse drunken sailor.

The doctor ordered me a round of steroids, told me they'd monitor me for the next four hours and that I was not be left only. This last point caused a dilemma when I went through my first IV bag and had to pee like a racehorse. I told my dear attentive staff sergeant that I needed to use the ladies room and he nodded, unhooked my IV bag, handed the bag to me and said "the latrine is outside on your left, don't trip on the IV tube" Errrr okay?  So I walked myself back out into the dusty desert night and went over to the coed latrine where once inside I hooked my IV bag on a nail that had been hammered into the plastic stalls.  I can't say it lacked for the character. I wanted the real thing, I got it. Twice more I made that trip after 2 IV bags. 

Over the course of the next few hours my throat did not improve which resulted in a new round of steroids around 4:30am and my increased frustration with my throat. Was this even a reaction? Why did I feel like I had a noose around my neck but with no other symptoms? I sat with the medics who regaled me with grizzly stories about their deployments, about casualties and rocket injuries. They are currently still treating rocket injuries on a weekly basis from people who have been hit on base which was a disconcerting thought and they advised that when Ramadan ends on the 3, be ready. Alrighty then.

About this time I began to panic about the car situation. I had driven our only car to the TMC and the next teammate needed the car to drive to work. I managed to convince my new combat friends to not only drive the car back to my pad, but to walk the keys up to my teammate's door. This created a new flourish of activity which included my poor bleary eyed teammate announcing herself in my room 15 min later to ensure that I was still alive. After convincing her that things were under control, she agreed to go over and fill in our team leader and that I should be out of there by 6:30am.

By 5:30am my throat had loosened enough and the doctor gave me the green light. The disconcerting ending to this story is that we still have no explanation from my throat tightening. It is common enough for me to have mild reactions, but not one so internal that involves the constriction of my throat. The good news is that now, almost 24 hours later I feel fine apart from a steroid headache and my bruised and blood-blistered IV arm. I'm heading back over tonight to thank the medics and give them some Starbucks and one of our challenge coins.  Although it isn't exactly an experience I look forward to repeating, it's one more tale I can bring back from my time in Iraq. 

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