An early morning and hookworm

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Yesterday wasn't a very nice day, and started much earlier than normal. I will let my diary of the early morning expain...

Early Morning Bowel Movements
17/12/05
Immediately after diarrhoea shivering. The 5/10 minutes later hot flush and sweating.
Wake up feeling thirsty and abdominal cramp.
First bowel movement - small amound of faeces produced.
Second bowel movement (shivering) - very small amount of faeces produced.
Third bowel movement - Medium / small amount of faeces produced -some collected and frozen
Time after third bowel movement 01:20
Treated with salt rehydration solution - 1 glass before bowel movements - 1 glass sipped during gaps finished off after third bowel movement.

Drugs in previous 24hrs
- Deoxycline (note mispelling, I was not at my best) 100mg taken with breakfast
- Ciproflaxin 2 x 500mg in afternoon
- Multivitamin pills - 1 in afternoon - 1 in evening
3 litres salt rehydration solution during and following previous diarrhoeal episode (in addition to solution taken during current episode)

01:40 2 x loperamide (also known as imodium) taken with third glass oral rehydration salt solution

Food in previous 24hrs
-Tea -spaghetti/noodles (plain)
-Lunch -rice and beans (small serving)
-Breakfast - bread and egg (I think)
Appetite poor - little desire to eat

Patterns in diarrhoea
-typically in morning after breakfast - not always
-often three movements
-recently causes significant dehydration problems - three problematic dehydration episodes in past 48hrs (Ed note - including present one)

Red blotches on skin - due to heat?
Nausea during early rehydration
salt therapy

2:15 1 litre salt solution taken (Ed note first litre finished)
Sleep attempted
2:25 sleep attempt fails due to further bowel discomfort
2:30 fourth bowel movement small/medium quantity faeces
further nausea 02:37
continuing nausea and feelings of bowel discomfort 02:45
feelings of dehydration
Further litre salt solution made up 02:58
vomiting episode 3:10

After this I woke Bishop Douglas to tell him, and he watched me for a while. After this I asked to be taken to hospital, and I packed my bag with all my medical equipment and notes as well as the above diary. I went to the Marie Stopes hospital. The gates were bolted, and we had to wait for someone to open them. The hospital seemed very quiet, and I wondered if I was the only patient there, although later in the morning there were several patients. After a consultation with the doctor, I was led upstairs to my bed. I was hooked up to a bag of IV fluids to rehydrate me. I was also given an injection into my bum for the nausea. The stool sample was taken for analysis. After one bag (500ml) was run into me fairly fast, I had two more bags run into me more far more slowly. By around 8-9 am the stool test had been done and I was told I had hookworm. I was discharged at around 1pm and given the drug albendazole as well as being told to keep taking the ciproflaxin. I will take the drugs for three days.

When I got back I had small lunch of rice, beef and tomato (well brunch at lunchtime - no breakfast) and took the albendazole, as well as the normal deoxycycline and a multivitamin pill. Afterwards I felt pretty sick and rested for the remainder of the day.

The albendazole is quite horrible and made me feel pretty ill. This is because it works by blocking the hookworms from taking up glucose but this has the side effect of stopping me from taking up glucose. For the first fews hours I felt very ill, although by tea time I was well enough to have a little tea - some chips and tomato.

Hookworms are a type of intestinal worm, they cause unexpected tiredness or lack of energy - thus explaining why I have felt so tired. My book says that they are caused by walking barefoot, which I have only ever done around the house (which has clean lino floors) and once on the beach. From what the doctor, nurse and other people have said to me they can also be caught through food. From the treatment I have given I think have the more severe type - Stronglyloides - which my book credits with "more severe symptoms". I think it is causing the diarrhoea, given that it lives in the intestines, any bacteria would also be killed off by the dual antibiotics of ciproflaxin and deoxycycline.

Before I went to bed I had a perfectly normal faeces. Bwana asifiwe!

I also slept through the night normally.

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