What Not to Do When you Get Dengue

Categories Personal Musings, Vietnam

When I sliced my toe on a rusty grate during last year’s Lunar New Year fireworks, I refused to check on what had happened, opting instead to breathe through the burning and the pain, choosing pyrotechnics over inspecting the damage. After the light show ended, I stumbled down to my friend’s apartment to examine the injury. The grate had pierced my toenail and then cut diagonally across the side of my toe, necessitating a tetanus shot and much limping, but thankfully no stitches.

My Vietnamese friends were aghast.  The local beliefs surrounding Tet, Vietnam’s Lunar New Year, include the fact that what happens around midnight on Tet eve predicts and dictates the tone and spirit of your coming year. This is why, as I noted in my long roundup from last Lunar New Year, the person who crosses the threshold into a person’s house at midnight must be compatible with the new year’s astrological sign.

My Vietnamese friends urged me to take care during this Year of the Snake and they predicted that it would be fraught with health issues. After all, it started badly, with an inauspicious blow to my general health (and my toe). Business-wise it could be a success, they insisted, but in terms of personal wellness they were worried.

I laughed it off. It wasn’t out out of condescension that I dismissed their claims — after all, they are similar to my dad’s belief that the shape of our Christmas tree forecasts the mood for the coming year – but because I’m no stranger to foot injuries. When I climbed Agung and Rinjani in Indonesia in 2009, I lost several toenails and much of the skin off the back of my heel. Plus, I’m also fairly clumsy. I’ve been known to walk into walls when not looking, to trip over sidewalks, to have an alarming amount of near-misses over the course of my life.

But my friends were unrelenting. This injury was different. This was a harbinger of a trend for the coming lunar year. I would, they asserted, anxiously await the day that the Year of the Snake was over.

They were right.

Tet fireworks Vietnam

Tet fireworks in Saigon for the year of the snake. Not pictured: bleeding toe.

I have tried to avoid writing about myself other than in the abstract here. I love sharing what I eat, and learn, and the stories of food and people involve me in some way as it is a personal blog. But there is a reason that I only do the state of the union -style posts once a year, or rarely delve into more personal issues: I don’t want this site to be a place where I whine or rant. I want it to be a place where people can learn through food.

So it is for this reason that when I started losing clumps of my hair in late February last year, I never wrote about it, nor shared updates on my Facebook page. And a month later when I stopped being able to bend my hands or knees in the morning without considerable pain, or look at bright light, I didn’t mention that either. I kept up my usual schedule in Vietnam, exploring the Mekong and surrounding regions and walking around town for hours a day.

In May, after flying to England to visit my brother, I could barely walk down the street without feeling exhausted. Alarmingly, when my leg or arm was itchy and I scratched it, I’d develop lines of bruises, colouring the spot where nails had met skin. As the summer went on and my existing obligations and plans were ticked off the list — conferences, meetups, interviews and more — I found myself getting sicker and more tired. My immune system was just not cooperating with anything I did; every cold or virus seemed to latch onto me stubbornly, and most of my days were obfuscated by a cloud of exhaustion.

Doctors were fairly unhelpful. One suggested that I was just stressed. As a former corporate lawyer I was pretty intimate with high stress situations, and I certainly was not stressed. Well, except about the fact that my health was deteriorating. Which, I think, was pretty reasonable on the spectrum of Events to Stress About. In actuality, the pain and hair loss had started at a time when I was the least stressed in decades; I was in Vietnam, loving my exploration of the city and its soups. Another thought I had lupus, and to be fair many of the symptoms lined up, but blood tests gave no indication that I might have it — back to square one.

In August, I took friends up on their offer to housesit during their honeymoon, staying in San Francisco and exploring, and trying to rest. Notwithstanding some up days, my joints were, for the most part, worsening. I kept up my tradition of climbing a mountain for my birthday, but for two weeks after my day in Mount Tamalpais, I had trouble getting out of bed because of the pain. Not knowing what was going on with my body coupled with the consequences of my decision not to share anything here or on social channels converted the chronic pain into a more anxious place; I was actually getting stressed. And I was having trouble explaining to people who wanted to meet up that I couldn’t, because based on my outward-facing social streams, no one would have thought I was having trouble bending my hands in the morning.

Golden gate bridge

Golden Gate Bridge on an August day.

I confided in my close friends, all of whom were extremely generous with time and hugs, and who stretched their arms wide to pull in connections from their broader networks in the hopes of helping me figure out what was wrong. I was introduced to, and corresponded with, a woman whose many symptoms led her to cut out significant amounts of foods from her diet and completely change the way she lives her life in an attempt to keep her pain under control. I met a gentleman at a conference who had similar health issues while trying to grow a successful startup, leading him to temporarily walk away from his company while he focused on getting better, a terribly tough decision to make. Before doctors had ruled it out, I was connected to a woman had lupus, who shared coping strategies and foods to avoid. And I was given the recommendation of a book that calmed my brain down considerably, Full Catastrophe Living, written for those dealing with the stress and exhaustion of chronic pain and fortuitously updated days before it was suggested to me.

By October when I was heading to India with my mum, I felt like I was hanging on by a thread. I sat in a pile of clothes, packing in tears. I was happy to be taking her to a country she wanted to see, but feeling like I might just stop functioning somewhere between Jaipur and Agra, and fall into a deep, long sleep.

As many of you know, we did have a terrific time in India, exploring the chaos and colour of Rajasthan in a few too-short weeks.  But I did still get sick again and again, and much of the trip is cloudy with pain, too. By the time I flew home to Canada, the airline stewardesses took one look at me as we boarded the plane and then cleared out the back row and insisted I sleep. I was tired and confused and tired of being tired and confused.

And then, I figured it out.

I kept going back to February when it all began. Earlier in the month I was supposed to go to the Mekong, but I woke up feeling so sick and tired that I couldn’t budge. I had a splitting headache and it felt like someone was pressing on my eyeballs; nothing relieved the pain. I thought I had a bad flu and I postponed my visit. My “flu” cleared up a few days later for the most part, though the headache took longer to go away. A few days later, when I was visiting Vung Tau with my friends, I developed a strange rash all over my stomach. It wasn’t itchy — it was just flat red dots that appeared in constellations all over my torso and around my belly button. I remember my friends Christian, Marie-Claude and Andre all staring at my stomach one morning, confused as to what was causing it. We went with heat rash, and quickly forgot it existed. A few days later it was gone.

What could have caused the rash and my flu-like symptoms and then all the tiredness, joint issues and pain?

Dengue.

Interestingly, that’s exactly why Marie-Claude and Andre were in Vietnam — they had gotten dengue in Bangkok and were in recovery on their visa run. I Googled “dengue rash stomach” and saw exactly what was on my stomach in Vung Tau. And then I looked into what happens when you don’t take care of yourself when you have dengue. Those who have experience with it will know that the disease is not really treated per se; treatment involves hospital visits, hydration, and rest, and monitoring white blood cells and platelets, both of which are dangerously low when in the throes of its grasp.

But I learned that when you ignore it as I did, it starts wreaking all sorts of other havoc on your immune system, on your joints and on your general state of being.  I went to a tropical diseases doctor and presented my case, and they confirmed that dengue is almost certainly what had happened, especially given a February infection and my subsequent blood test results, which showed a lower-than-normal white blood cell and platelet count.

There’s little to do at this point other than listen to what my body tells me, resting more, staying out late less, keeping the long haul flights to a minimum. (The time zone changes and effects on your body’s adrenal system were, my doctor said, particularly problematic for long hauls.) I’m back in Saigon now and will be taking one big trip this season, but otherwise staying still. And, you know, avoiding mosquitoes to the extent possible. Damn you, mosquitos.

So, after many months of not saying anything I’m writing this post to reiterate what not to do when you get dengue. Or, put another way, when in dengue-prone areas and having symptoms of the flu, if you then see a rash on your person GET THEE TO A DOCTOR. I wish I had gone to check it out, and could have then taken care of myself properly.

Update: An American reader living in Manila for many years kindly sent me her story of both dengue and a similar disease called Chikungunya. In her words:

My experience was horrendous. Very, very similar to what you went through. The reason I am emailing you is to let you know it’s very likely you had both dengue and Chikungunya. The mosquito that carries dengue can also carry Chikungunya. If you get bit by a mosquito carrying both, you can be infected by both dengue and Chikungunya at the same time. This is what happened to me.

While both diseases have similar symptons, the main difference is dengue can be fatal, Chikungunya isn’t. However, and this is huge — Chikungunya gives you terrible joint and muscle pains. These pains can last up to TWO years! Eventually you will recover completely though. And it can also leave you exhausted. This is all somewhat new – in fact most of us had never heard of Chikungunya before. There was an outbreak in Manila, and there has also been an increasing number of people getting both dengue and Chikungunya at the same time. Most ridiculously, there is not enough information about this.”

So, something to keep in mind if you’re exhibiting symptoms of the kind I mentioned. The rash for Chikungunya is generally on the stomach area, per what I’ve read, and joint pains ongoing.

* * *

A few days ago when my toe hit my bed frame I heard it crack, a small echo that resonated despite the fact that I was on the curled edges of sleep. Clawing out of morning cobwebs I peered down, noticing quickly that my toe was bent forward at an unnatural angle, the pain radiating into my foot and up my leg.

I didn’t go to a doctor (I know, I know) because everyone and their mother — and even mine too — said that there’s nothing a doctor can do for a broken toe. I examined it, saw that it wasn’t turning grey or losing circulation, and that there was no open fracture or jutted bone. And then I ate a melon popsicle, cut it into pieces and made an awesome DIY splint, resigning myself to another few weeks of limping, of Vietnamese neighbours pointing at my toe and shaking their heads (in sympathy, not disgust) and of doing my food walks a little more slowly than I had initially anticipated.

My friends here were more positive.

This all makes sense!” one of them exclaimed. “You started the year of the Snake so badly, with your toe and dengue. And now you are ending it by hurting the other foot. The snake is eating its head. You have come full circle!”

I listened to what they were saying, and I looked down at my toe. I thought about this year of pain and exhaustion coupled with great press for the site and other business success, and then of new beginnings.

“You know”, I said, musing about the last twelve months, “I am born in the year of the goat. And it’s common for goats to have trouble in snake years, but we’re about to head into the year of the wooden horse, and goats do much better then.”

And my friend looked at me, and then looked down at my toe and giggled.

Jodi, either you are a Vietnamese person under all of that Canadian-ness, or you’ve just been here too long.”

* * *

It’s almost lunar new year again in Saigon, with all of the wonderful chaos and insanity that it brings. Flowers carpet the city’s main parks, and people are transporting them in a frenzy, piled on motorbikes around town.

Tet Vietnam

Tet flower delivery.

A lot of tourists leave for Tet, but I’m looking forward to the relative calm, a break in the motorbike movement and quieter streets. And I look forward to ending the Year of the Snake too, and ushering in the Year of the Horse with open arms.

-Jodi

98 comments to What Not to Do When you Get Dengue

  1. WOW! I have been living in SE Asia for nearly three years and I have thankfully been fine. I will be sure to look out for these symptoms. It’s so easy to let little things like a headache or a simple rash to get swept under the rug. People like us who travel often don’t let these things bother us too much, we have tough skin. But you never know what bigger problem you could face if you don’t care for yourself. I am glad you are better.

  2. On February 3, 2014 at 3:11 am Hannah Pearson said:

    Wow, I didn’t realise you could go so long without being diagnosed with Dengue fever – it’s pretty prevalent here in KL at the moment (ominous sign on the way to work warning how many dengue fever cases there’ve been since the start of January just in my street), so extra paranoid now…

    Take care of yourself!

    • Hey Hannah, I think in the initial infection time I ought to have gone to a doctor but genuinely just thought it was the flu and that was when I would have been diagnosed. Unfortunately the doctors I saw after didn’t put the links together despite knowing I was in a dengue-prone area. So it’s their best guess, and the doctor seemed certain, but it was too long after the initial infection to get a 100% firm diagnosis.

  3. I can’t imagine traveling as much as you still managed to do in your condition. Thanks for sharing your story. Maybe it will help someone who would have otherwise avoided seeking a doctor.

  4. Jodi, Your narration/photos are awesome, and keep up the good work! I do understand your decision to not write it on a blog. IMO, you may not be paranoid enough when it comes to things like this where the consequences are not immediate/apparent(unlike physical safety). Take care, and again your website is really awesome!

    • Hey Rich, I did look into it, of course — but was misdiagnosed (or told it wasn’t anything to worry about). I was plenty aware of consequences and quite frustrated about not getting answers. I think the post is clear on that front. The only thing I was not doing was writing about it publicly, but it was hard to do so with no real path of what was causing the symptoms. Glad you like the site.

  5. I hope you’re feeling a lot better, no accidents or diseases during Tet, I hope. Dengue is a serious disease from where I come from (Manila, Philippines). It would suck if I developed dengue in the middle of traveling.

  6. Hi, Jodi! I can only imagine what you have been through… I come from a city in the middle of Amazon rain forest, so dengue is a pretty common disease, often mistaken by a heavy flu – the difference usually lies on how much exausted and how long this situation lasts: dengue is always worse. People with dengue can’t make it from the bedroom to the bathroom without being helped by someone else, so I must ssay, you’re a really strong girl. But, as far as I am concerned, dengue can only be fatal if you get it a second time (or third, forth…). That’s what we call hemorrhagic dengue. So stay safe :)

    • There are 4 types of dengue. if you get infected again it will be much worse and your chances of developing hamorrhagic fever increases. With dengue alone I spent several days in the hospital and it took me months to recover. My son was very ill and caught every cold for about a year. Asthma symptoms and allergies also get pretty bad. Be vigilant with he insect repellent, you need to avoid catching it again.

  7. Wow, how utterly petrifying! My partner and I are moving to South Korea next year and will be traveling SE Asia for a lot of the time, I am so glad I came across this as I hadn’t even considered something like this being an issue!

  8. Wow, what a story! I just found your blog from a post in Buzzfeed, so glad I did. Love your writing. Be well :)

  9. Just found your blog – What a scary story! Glad you have found the cause and on the mend!

  10. That’s quite a scary tale Jodi. I’ve had dengue twice, and I know what you’ve gone through. You must have a very strong constitution to be able to power through the way you did. Both times I had dengue, I was very ill and there was no going anywhere. On my last RTW I contracted dengue in SE Asia, and made it as far as New Zealand before I crashed. I didn’t know what I had, but the doc thought dengue or malaria. The test came back dengue, and the doc also said: “BTW, did you know that you’ve had it before?” Looking back, I now know that I had dengue hemorrhagic fever that I caught in Belize. I spent a week in the hospital, and believe it or not, the doctors never diagnosed what I had. So your advice to “Get thee to a doctor” is good, but I would also advise if you’ve been to a dengue area, let the doctor know. Next week, I’m off to Mexico for a week, and since I’ve had two of the four types of dengue, you can bet that I’ll be hosing down with mozzie spray. ~James

  11. Oh gosh … yes Dengue can really be a pain in the ass. My friend got it last year in Thailand, and she was like you just too stubborn to go to the hospital. She spent almost a whole week in bed before she was to weak to go to the bathroom and I finaly could persuade her to go and see the doctor. So really, be reasonable the next time… :D

  12. Thanks for sharing your story! I hope you are slowly recovering

  13. I hope you get back to 100%. I would be very similar to what you did and just ignore it unless I was completely incapacitated. Luckily I never got seriously ill. I knew somebody who got dengue and it sounded like one of the worst things you could get. I keep this story in mind in future

  14. On February 28, 2014 at 2:12 am cynthia brownsmith said:

    Starting over in Saigon for the new Lunar New Year will definitely bring relief. It sounds awful. Why on earth do women just power through misery while showing up with a smile and carrying on. I hope you will find your great energy again. I love your blog.

  15. Jodi,

    Look into blood ozone therapy. It will kill pretty much any pathogen in your system. I have been battling chronic fatigue and this has helped me somewhat. Good luck!

  16. Sounds like yo had one heck of a year! Jeez talk about bad ju-ju! I really hope things are better for you now.

  17. Such a pity you didn’t see a doctor while you were in Asia initially, as most would have diagnosed dengue fever quite quickly whereas a western doctor is largely unlikely to look for that. That way at least you would have known you needed to take care of yourself. :)

    I’ve lived in Bangkok for 12 years and traveled all over SE Asia. I’ve never had dengue, or any other illness for that matter, but I have two Thai friends that caught dengue in the middle of Bangkok (yes, those darned mosquitoes can give it to you right in the middle of a city as well).

    Luckily, dengue is rarely fatal, but for anyone planning on visiting Thailand they should be aware it does exist everywhere here and tourists do get it. This year we’ve had some of the highest number of cases in decades, so if anyone feels the first signs of any symptoms, take some time off, sleep, eat and relax and take care of yourself (there’s not much a doctor can do actually, unless you are internally bleeding and then it’s blood transfusions).

    Fascinating blog, btw.

  18. Wow!! Glad you are okay! It’s always in the back of my head when traveling…

  19. You need to be careful around dengue fever. There are 3 types of dengue and chances are less that you will get another one of same type but if you ever get then it can be more fatal than the first one. Mosquitoes don’t survive harsh winters or full summers, they are mostly around in Spring and Autumn or temperatures ranging 15C to 30C. So, if you are traveling to regions with known dengue outbreaks and temperatures are mild then it would make sense to carry a mosquito repellent with you – however, with that being said.. I don’t think you can hide from a mosquito.
    Above is from my experience after living Pakistani side of Punjab, outbreak is same at Indian side of Punjab as well. So, best to visit here in either high summers or full winters.

  20. This sounds HORRIBLE. I am glad you are okay, and I LOL’ed at the post’s URL, but I am off to check out vaccination options for Dengue for our trip in the fall. I can’t imagine going through this!

  21. I heard that you can stay for a long time with the symptoms without knowing that you have dangue fever.

  22. Hey Jodi, So sorry to learn that you’ve been sick – and I completely understand the (often bizarre) situation of carrying on with work in social media while masking the big things going on in life. Strange business – you’ve handled it with great grace!

  23. Hi Jodi,

    Thanks for the informative AND interesting post.

    I am a Canadian living in Vung Tau and with all the insects, rodents and sharp, rusty pieces of metal around combined with my regular attire of T-shirt, shorts and flip flops [not to get into other cultural and environmental hazards] I am often considering my general well being.

    Although there are ways to decrease exposure to dengue the instances of one hearing about anyone coming into contact are rare so I don’t usually bother due to laziness and the unwillingness to compromise my overall comfort. Somewhat risky and absurd, I know.

    More importantly, though, was the question of how does one know they have it and what does one do if they suspect they do? For some reason I never proactively researched it assuming, I suppose, I’d leave it until circumstances necessitated it. Absurd, I know.

    This is just a long way of saying thank you for taking the time to present it as such; I hope the remainder of 2014 proves to be significantly healthier.

    Yuri

    *Found my way here via the T-shirt article on Saigoneer

    • Hey Yuri, welcome to the site. It was nice of Saigoneer to post the t-shirt – glad they liked it!

      I’ve got several friends here in Saigon who have contracted dengue in town. Blood tests are a good way of finding out, though one friend had to go to two separate doctors are the first said he didnt have it and the second said he most definitely did.

      Be safe in Vung Tau and eat some Banh Khot for me!
      -Jodi

  24. That’s a very scary experience, I do hope you’re better now.

    I caught dengue during the end of March. All of a sudden I found myself with this extremely high fever & chills. So off to the doc I went. My GP said to keep an eye out if the fever persists as he would need to do a blood test to check for dengue.

    2 days later (usually I don’t get fevers that last longer than a day), the fever was there, but lower. Me being me, did not realise it. I also went off to work that day.

    Got home, was so tired, and slept for a while, and off to the clinic I went. Again. Blood test done; results come in that night: negative (platelet count was 170,000, which is still normal).

    I was getting more upset as I was miserable & tired and nothing made sense.

    The weekend came, my fever was there, though I was walking about but sleeping frequently and not eating/drinking properly.

    Monday morning comes. Doc insists again on another blood test. 3 hours later I get a call confirming it’s dengue & to get myself to the hospital ASAP. Platelet count was 90,000.

    Spent 4 days in hospital, hooked to an IV. Fever in and out, I didn’t feel like eating, but forced myself to eat small bites. Slept so much it felt unnatural. Blood was drawn every day 2-3 times to monitor platelets. This time my platelets had dropped to 45,000 from 90,000.

    When I was discharged my platelets had risen to 92,000 but I felt so tired and crappy. I was working on my thesis and was so upset at myself because I didn’t have the energy to concentrate.

    It’s been 3.5 weeks & despite my blood test showing a normal platelet count, I still get tired faster than usual. I have been advised to extend my candidature as time is so so scarce.

    I felt like crying when it hit me that I might have to extend my period of study because it’s such a mess and I am so behind. But if I’m being realistic, it’s probably the best thing to do. I hate using sickness or personal tragedies as excuses, but I probably don’t have a choice.

    I just wish this fatigue would go away so I can go back to do doing things normally. I used to workout 4-5 times a week, intensely. Right now? It’s been almost a month and the thought of those hard workouts make me tired & I find myself curling up under the covers, sleeping it off.

    It’s so unpleasant, this annoying dengue. Ugh.

    • Hi, thanks for sharing some of your story as well. From those I’ve spoken to with dengue, many have felt exhausted for months afterwords, even though their platelet and WBC are back to normal. Best of luck with your thesis and I hope you find rest and respite shortly. -J.

  25. Hi Jodi
    I’ve just come across your site on bloglovin’, and how interesting that the second post I read is this! I suffered a similar effect following a mosquito bite, known in Australia as Ross River Fever. For the first time in many years, I’d caught the common cold, and with my immune system down, the mosquito’s timing was perfect. I developed every classic symptom. As a full-time rep on the road, my first indication was feeling a searing pain in my upper thoracic spine whilst driving (oh, it’s all the driving I’ve been lately, I thought). That same afternoon, the glands in my groins and armpits were like golfballs – ok, that’s strange. That evening, a full blown rash had painted my skin. The following morning, my ankle joints and wrists were awfully stiff and quite painful (not to mention weak as water). Touching anything stung. 48hrs after that initial stabbing pain in my upper back, I struggled to move. Picking up the kettle was a two handed job. Driving? Forget it. A blood test revealed Ross River Fever. An interesting point to note is that it is common in Queensland and Western Australia, but no so in Victoria. Clearly these carriers travel far. The symptoms seemed to disappear for about a month after this initial bout, but then all of a sudden, they returned. Whatever was going on in my ankles had just decided to tell me again. Getting out of bed and putting weight on my feet was a monumental effort and excruciating. Sometimes it would take ten minutes, crawling to get to the bathroom (not ideal first thing in the morning!) I don’t think I’ve suffered as much as some, and am grateful that I am young and fit (couldn’t imagine an elderly person dealing with it), but it took around nine months for my joints to really get back to normal, and for the extreme tiredness to clear up. Even now, two years on, my fingers can be suspect. The best advice is to protect yourself from mosquitoes and ensure you seek treatment for any cuts asap! Great site by the way, and congrats on your many years as a digital nomad. Looking forward to reading more of you posts :) Cheers, Anna

    • Off to Google this mosquito borne illness — wow, that sounds awful. I’m glad you’re doing better but after a year + on my end I’m still having join trouble so I can imagine your frustration with the same. Be well and let’s hope to both avoid mozzies in the future.

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