“My head hurts!” I take a look at the area he is rubbing just behind his ear and above the hairline and all I can see is reddening. It is a little swollen and pretty warm to touch. Two or three days later it is still annoying him and now it is becoming painful. I look again and perhaps there is a small bite in the hair, just above the redness, but it is hard to tell.
A few days later Alan is shivering then going hot and cold again. He gives in and goes to bed. We think it is probably a cold, with a sore throat and much sniffling. He is force-fed vitamin C tabs and, although the weather is not cold, it is cool and he soon resorts to violent shivers. He now has to take aspirin to lower this fever as well! I need to explain at this point that he has no spleen, so is highly susceptible to infections and does not have the means to fight them properly, although he seems to exhibit SOME immunity these days.
The next day he is up late (still hot) and the pain in his head is also a pain in the neck! (Not me gov … honest!) I wander off to do the chores. On my return, he is on the step (or what there IS of it as he was rebuilding it! … good timing, that one!). His face is pallid and he is not a happy bunny! He is holding his head and announces, “I think I’m going to be sick!” and promptly complies. I scurry inside for the prerequisite bowl and back for the towel and, hearing a strange sound, turn to see him flumped on the ground … right where the step used to be! I lift him up to see that he fell on his head and his face is bleeding. He is still not conscious but is breathing. The contents of the bowl are strewn around. I have to decide whether to try and lift him UP onto the relatively clean and smooth step or over the rubble onto the ground, when he comes round.
That evening he tries to restore some level of comfort and dignity with a good, old fashioned bath. I then see he has a rash around his shoulders! …. back to the internet! I spend some time quizzing the internet. He has eaten the same as me but for the tablets. It all seems like one thing affecting him over quite a few days. We decide that the most likely thing is rubella. So it will run its course and the rash should disappear in 3-5 days. There is, however, the niggling doubt that it could be Lyme’s Disease, which is contracted from tick bites. We never saw a tick on him so it is easy to dismiss, but ..? Perhaps this is the bull’s-eye rash that is described. He could have had a tick on his scalp. Some ticks inject an anaesthetic with their bite, so you don’t always feel them.
We decide we really need to find out what it is. A blood test will confirm for us. I go to the Centro de Saude and ask. I explain that Alan is at home in case of crossing paths with a pregnant lady, as rubella can cause serious problems for a foetus of someone without immunity to it. She sends us to the hospital as they have no facilities for isolation at the center. We are given a number to call. When I call it, it is a diagnostic and information service and not the number of the hospital!
We give up! Well, almost. The five days of rash should be up and there is no sign of it going anywhere except on Alan! It has spread onto his torso and down his limbs. Not itchy, just blotches; even his palms seem blotchy. The nausea has subsided and the headache too, but they are still there! He still has feverish chills and sweating and no appetite. OK so we really should get this checked. Rubella is now more doubtful and Lyme’s does not have a rash of this kind. Hmmm!
We phone the hospital to find out what we have to do as it just could still be rubella. We arrive to be sent on a merry dance that finally results in Alan being in a busy room with lots of people, including young and some pregnant women. So much for isolation. We keep away as much as possible. I read the signs for Ebola and wince at the thought. Most people would not know if they had it and if suspected, then their procedures are still soooooo ineffectual I think – woe betide the inhabitants of Viseu! Oh … and the rest of us too!
Finally! Alan is seen by the triage nurse at 5:47pm. Well, it is about 2am when we see a doctor to look at the results of the tests. We threatened to leave just before midnight and they kept us there with comments that it was not rubella and unlikely to be Lyme’s.
It seems he has (had? …. I hope!!) Rocky Mountain Fever. This is also passed on by ticks and requires the same treatment as Lyme’s. Antibiotics, but one that is a narrow range one, i.e. used for only a few bacteria. This disease did not appear on my internet search.
The doctor wants to admit Alan but is surprised when we decline. It is my guess that he wanted to keep him under observation as this bug can cause major organ breakdown!!! and can be fatal if untreated – especially for someone with no spleen. However, we thought Alan would be better able to recover at home with Nurse Kathy. The doc rushes to get the first dose into him as time is important, especially having spent nine hours mostly waiting.
Within 24 hours Alan is eating again and seems much more ‘with it’. The rash is just identifiable 36 hours later. He still needs to be checked three days after the start of the antibiotics to ensure his internal organs are not adversely affected, but all is looking good so far! Roll on normality!