Izaac's Story

(I wrote this a couple weeks ago. The first draft was about 3 pages longer because I did a bunch of analyzing and rationalizing and justifying and all that stuff that is necessary for me to process but makes for a tedious post to read. I deleted all that. You're welcome. I will probably post portions of the rambling that might have some value but for now, this is just the story. We are back in Uganda now and are, once again, trying to settle in.) 

I know this is over due but, honestly, this is one of those things that needed the perspective of hind site to be even remotely intelligible. If I had tried to write it immediately following the events it would have been little more then emotional raging vomited onto a page and that would have been about as appealing as it sounds. 

  

Anyway, get comfortable and settle in. Here goes…

We’d been in Uganda for about 5 months when Izaac got sick. It started as a high fever. One night in early June we woke up to find our boy burning up. His temp was upwards of 103 and he was pretty miserable. As always, our first thought was malaria and we tested him immediately. To our relief, the test was negative. That being the case, we treated the fever and, in a few days, he was back down to a temperature of around 99. However, now he had developed a consistent, rattling cough.    

The cough didn’t have us overly concerned and we went on with life as usual for a day or so. Next, a morning came when we noticed that His complexion was not right. This is the text I sent my sister that morning:

“Maybe we are just overly sensitive now but Izaac seems pale and his lips are a little dusky. Any thoughts?”

We took him to a doctor in town and had our first experience with the lacking medical system in this country. The doctor we saw said he was allergic to something and gave us cough medicine. We were pretty sure that wasn’t right but he was looking a little better and, between the antibiotic for the fever and the cough medicine, we thought we were ok. Besides the low-grade fever, the cough and the paleness that one morning, there really weren’t any other symptoms. He seemed a little tired and didn’t have the same energy, but otherwise ok.

Here is where the story begins to pick up a bit. On the 17^th of June we had a couple of friends come in for a short visit. They had been in India on business and were spending some time with us on their way back to the States. We spent the next few days with them in and around Jinja, hanging out and having some fun. We spent some time at the orphanage, showed the guys around town, got caught in the rain on a walk and went on a boat ride on the Nile. Through all of this Izaac still seemed tired, he took naps, which is unusual for him, the cough and the low fever remained, but that was it.

When our friends came, they brought in two totes, which they lugged, literally, all over India for a week to get to us. A few of the things that came in these totes were for my sister and so, on Sunday the 19^th we headed to Mbale, to connect with Jennifer and some other friends for lunch and to hand off the supplies. The plan was to go on from there to Sisyiy Falls to camp for the night.

While at lunch we asked my sister to check Izaac out just to get her opinion. She listened to his lungs and didn’t hear much of anything that concerned her. One of the things that the guys brought in was a portable pulse oxameter.  Somewhat on a whim, and because we had a new piece of equipment to try out, we stuck the thing on Izaac’s finger and immediately thought it was broken. We put the meter on a few of us and got normal readings and then put it back on Izaac and that’s when our concern began to grow. That initial reading, during the middle of the day while awake and active, was around 83%. That means that his blood is carrying 83% of the oxygen that it should be carrying (I think?). That, as I’ve learned, is really not good. People are commonly put on oxygen when they fall to 90%.  The medical people around the lunch table grew quite and we knew we were going to need to change our plans. We decided that Izaac should really not be hiking waterfalls and camping, so we decided to go up the mountain so our friends could at least see the place and then come back to Mbale to find a place to spend the night. About 20 minutes after we left the restaurant, we got a call from Jennifer and, having discussed it more with her friends, she decided that we really needed to seek some treatment right away.

Because we are about halfway between Jinja, where we live, and Soroti, where Jennifer is based, we opted to head to Soroti. On the way we began to formulate some kind of plan for our next steps. We would arrive in Soroti about 6pm. There is one place in town where we might be able to get Izaac a chest x-ray and maybe 2 options to get him on oxygen for the night. When we got to town we split up. Jennifer, Christina and Izaac headed off to see what they could get their hands on. After a few hours, they had some answers.

We could not get the x-ray we were hoping for. The only machine was down (and had been for some time).  Also, the only oxygen option was a barrowed condenser from an orphanage that we were graciously, and honestly, unexpectedly allowed to use for the night.

After friends opened their home and feed us dinner, we settled in for the night at Jennifer’s house. We were able to do some nebulizer treatments, put the oxygen and the pulse-ox on and monitored him for the night. During that night on Jennifer’s couch we began to understand the trouble we were really in. Izaac’s blood oxygen level was falling into the 70’s while he slept and his little heart was racing trying to make up for it. The sickening part: it had probably been like this for at least a few days, maybe longer.

In the morning we packed up early and headed the 4 hours back to Jinja. Upon arrival we promptly went to the best hospital in the area and, again, were sorely disappointed. Without so much as taking his vitals, they said he had pneumonia and put him on IV antibiotics. They would not, however, admit him to be monitored or put on oxygen. We stuck with this course of treatment for a day, returning for the IV meds with no improvements. The next day they decided to try a deferent antibiotic with caused Izaac to break out in a rash all over and we decided to go somewhere else. We then took him to another doctor in town that was recommended to us who saw him and said he needed to be given oxygen a.s.a.p. but he did not have the means to do so. We then spent the next 2 hours or so trying to track down some place in town where we could get this boy some O2

By the time we discovered that we would not be able to make this happen in Jinja it was pushing 8pm. We decided we had no choice but to head for Kampala and one of the big hospitals there. After a harrowing drive through the alternating darkness and blinding headlights of Uganda traffic we made it to the hospital around 11pm, were evaluated and admitted by 2am. Izaac was now on a different IV antibiotic, more nebulizer treatments and constant oxygen. By around 4 am we were all asleep. Izaac and Christina in the bed, Ruddy (my brother-in-law) on the chair and me propped up on the end of the bed against the wall. This lasted all of about 2 hours.

In the morning we saw the pediatrician, ran some tests and waited. Jennifer arrived from Soroti mid morning and promptly began correcting the hospital staff on all of the things that were not being done properly. Despite this, we were glad he was getting care and were hopeful that we were at least headed in the right direction now. So we settled in.

By mid-day of the second day, though, we knew it was time to look for another option. We were seeing no improvement and no one was confident of what the root of the problem was. The pediatrician had some ideas but some things didn’t seem to line up and Izaac wasn’t getting better on the treatment. When we said we thought it was time to head to Kenya, the doc agreed without hesitation. (which is something of a miracle in itself).  

This decision lead to one of the longest, most trying nights I’ve ever had. We carry medevac insurance for situations like this and imagined it wouldn’t be too hard to line up a flight. I called and was promptly told that we would have to have Kenyan Visas in hand before they could set up the flight for us. This seemed ridiculous but despite my continued questions and arguments, the answer was the same: they used to be able to do it but the government has changed the requirements and now there is nothing they could do.

So, we started to try to get visas that would get us into Kenya. We had to apply on line and when we finally managed to get through the whole process, on an internet connection that was slower then rush hour Kampala traffic, we were informed that it would take 2 business days to process the request. By now it was around 9pm on Thursday night.  We began trying everything we could think of. Every contact we thought might have some advice got a call. People from Michigan and Pennsylvania were reaching out to connections they had on our behalf.

By some un-holy hour in the dark of the morning, we resigned our selves to the only real option we had, we needed to get to the Kenyan High Commission and make our appeal there.

8am finally rolled around and we were off. Jennifer had to go retrieve her passport which was at an agency where it had been for a long time waiting for a work permit and I headed to the Kenyan embassy. The lady at the reception was incredibly gracious and sympathetic and said she could get us visas within an hour but she would need a few things so it was now off to find a studio where I could get passport pictures taken and an internet café where I could print some documents. While I was waiting for my pictures to be printed, I decided to call the medevac people again to find out how late in the day I could request a flight and still get out that day. It was a different operator this morning and through the course of our conversation she told me that for a medical emergency they would process the visas in transit and we would have them upon touch down in Nairobi.  Needless to say I was a bit frustrated at that point.

I rushed back to the hospital, informed the staff that we would be leaving and needed to be discharged, set up the ambulance that would take us to the airport and began to prepare for a 3pm medevac flight to Kenya. It was decided that Jennifer would accompany Christina and Izaac on the flight as our medical liaison while I held back to take care of things at the hospital, then to Jinja to get Ellie and settle things there. I’d follow as soon as I could.

The ambulance arrived at the hospital at about 2 and, upon being told that flight was scheduled for three, the driver said, “well, then we’re running late”, loaded Izaac and the ladies up, and took off. From what I’m told, that trip through Kampala traffic was about the quickest, and most terrifying 45 minutes in recorded history. It included stints of driving on sidewalks and directly at on-coming traffic and was punctuated by blaring horn and siren the whole time. Aaand… Izaac slept through the entire thing.

The ambulance took them right onto the runway where Izaac was transferred to the waiting medical plane. The plane took off and flew much lower then a commercial flight offering stunning views as they passed over lake Victoria and the plains of Kenya into Nairobi. Aaand… Izaac slept through almost the whole thing.

From there it was on to the pediatric hospital via a less aggressive, if not less nerve-wracking, ambulance ride through Nairobi traffic.  They all got settled in, got some much better care and waited for morning to see the doctor and the pulmonologist. Right away we knew we were getting better care here and felt more confident.

At this point Christina, Izaac and Jennifer were in Kenya but Ellie and I were still in Uganda, 12 hours and an international boarder away. I had to get Ellie, deal with some money stuff and take care of work permit stuff.  I tossed around a few ideas on how we would get to Nairobi but in the end the best option was to catch a morning flight over. On Sunday afternoon we once again packed up and made the trip to Entebbe. That night we stayed with a friend and jumped on a Kenya Airways flight to put us in Nairobi mid-morning.       

We arrived at Jomo Kenyatta International and got a ride to the hospital where we found Izaac hooked up to a monitor and breathing through a mask but in good spirits and looking better. He was getting nebulizer treatments every few hours and was on some new antibiotics and steroids. He was also getting physiotherapy treatments, which he really didn’t appreciate at all. It wasn’t too long, after the test results came back, that we got a diagnoses of a-typical pneumonia. The right-center lobe of his lung had gotten plugged and ceased to function.

We spent 7 days in Kenya. By the time we left Izaac was doing really well. His O2 levels were maintaining around 95%. He had much better energy and his color was almost normal again. A few days before we left, Izaac was doing well enough to be off the oxygen and able to get out of his room and explore the hospital. He loved the playground in the courtyard but his favorite place of all was the vending machine in the reception.

On something of a side note: while we were in Kenya, only one person could stay at the hospital with Izaac so we needed a place to stay for Jennifer, Ellie, and either Christina or I. Jennifer connected with a place called Amani Gardens, which used to be called the Mennonite Guest house, which I last stayed at when I was 7 years old. It is strange to return to a place after 23 years. Things change, but not all things and usually not completely. This place was enough the same that it brought back a lot of memories. Anyway, it was quiet and spacious and we could rest a little there and Ellie loved it. It is, quite literally, a peaceful oasis in the heart of a chaotic city.

In an effort to wrap this up in the next few pages here is where we’re at now. We returned home (to Uganda) and began to re-settle. We struggled with what to do next. Izaac was better but we didn’t have a real answer as to why or if it would happen again. We were torn because we didn’t really want to fly back to the States but we also needed to do what was best for Izaac. In the end, after a lot of praying and seeking wise council we decided to return.

We are home in Michigan now for a while. Izaac is doing really well. He’s been checked out and the doctor is quite confident that a series of contributing factors, including the anti-malarial he was on, resulted in this illness and Izaac is not more susceptible and it is unlikely to happen again. We are resting and recovering now. Were spending time with friends and family and wrestling with all of the emotions that arise as we look back and look forward.