Day One Hundred

22 November 2006
I have been out to sea and away from home for 100 days. Wow! It was a very nice day. It is getting cooler out. Highs are in the 80’s now and very tolerable. I had to run my PFA today. The Physical Fitness Assessment consists of sit-and-reach, sit-ups, push-ups, and a mile and a half run. I had to fast over lunch since we ran at 1300 (I did not feel like having a side stitch for the entire run). By that time, the sun was awfully hot; though, the air was not too bad.
I was a bit worried about the run. After going out for a run last Sunday (for all of ten seconds) my knee made me quit because it hurt so bad. This time, I took a Motrin and did fine (except my mouth was so dry because of the heat. I was a bit afraid of swallowing my tongue it was so sticky!). I am currently icing my knees and wondering how sore I am going to be tomorrow because of doing push-ups until my whole body was shaking (which made also me laugh and then I could not stay up any longer and I did a dramatic crash onto the mat). After a quick shower, I then gave my once-a-month cardiovascular health class. I have made all those who have high cholesterol come. The Navy’s new requirement is every sailor must have his or her cholesterol screened every 5 years. We have had to test many cholesterol levels this past year and a lot (perhaps one third) are elevated. Because of that, I implemented this cholesterol lecture (Thanks, Mom!) and then schedule those with really high levels and other cardiac risk factors to see me personally after attending the class. It has worked well. I had no idea that so many people did not have a clue about good and bad fats and cardiac risk factors. Thankfully, I grew up in a house in which a good diet was ingrained into my lifestyle (using butter is still very decadent and reserved for special occasions! Thanks, Mom!) Hopefully a couple of my sailors will think back to that lecture they had to attend and make healthy decisions in the future.

So, I did not include one event in my last entry that occurred during my time in Dubai. I still think and fret a little about it but am getting over it. During the second night at our hotel, I woke up around 0100 with my palms itching. Itchy palms! Yes! I could not believe it. I went to the bathroom, put lotion on my hands and went back to bed. They were still itching and burning a little. As I laid there, I realized that my lips did not feel right either. They also burned like they were really chapped and was made worse then I would rub my tongue across them. Weird, I thought. I must be in some sleepy haze where pain is ultra intensified. I tried to ignore everything until I realized my lips were actually larger than they ought to be. I got up and went to the bathroom again were I discovered Angelina Jolie lips as well as a chin that was solid as a board (it was taunt with fluid). I noticed, too, that I was itching my belly. I took a look and sure enough, I had a bright red rash all over my trunk with a few hives on my flanks. Wow, I thought. I had never had those! So this is how uncomfortable they are! Then, just after I discovered my bright red and itchy belly, my throat started itching. This is not good, I thought. Thankfully, I had Benadryl in my first aid kit that I carry in foreign ports. I took one and then sat on the floor (in my very nice and spacious bathroom) to see what my body was going to do next. Everything still itched including my head, my arms started developing the rash, and my lips grew a little larger. I could not believe that I was experiencing such a major allergic reaction! Over the next hour, I pondered on what the heck I been exposed to. I had never had such a reaction in my life! And if I had been exposed to something, why had it taken 4-5 hours to illicit a reaction (we had been back in the room around 2200)? I could not figure it out. I got up to reassess myself in the mirror. I adjusted my head to the light just so to take a look at my throat. So that is what felt so strange! My uvula (the hangy-down-thing in the back of your throat) had become twice its size. Crap! I thought. How much worse is this going to get? I wish that I had an EpiPen! I thought a little longer about taking another Benadryl (I was surprised the first one did not knock me out cold!) and could not decide…but then I realized that my tongue was beyond my front teeth. That is not where it usually sits in my mouth! Crap! I took the second Benadryl and sat on the floor again. This time I felt my pulse raising as I concentrated on figuring out if my air was going in and out of my lungs like it should. Yep! Except, it seemed a bit labored, but then again, I felt like I was about to start panicking. I did not want to go to the hospital in Dubai! I have plans tomorrow! I am the doctor on the ship. Doctors aren’t the ones who get sick and go to hospitals! I had to talk myself down and then started talking to God. The next hour I prayed and thanked God for my full life (and prayed my tongue would not get any larger). I also realized just how precious life can be and how easily my health and even life can disappear. I thanked God for them and was reminded to not take them for granted. I also learned that my patients who have the same reaction will need frequent reassurance and empathy. That I was now able to give. Such were my thoughts and prayers in my swollen, early morning, Benadryl stupor!




Several hours after it all began, my tongue returned to normal, my itching subsided, my hives were nearly gone, and my lips had not enlarged further. I decided to crawl back in bed. We were waking in a little less than two hours to call the ship to muster. I would check on my progress then. When we woke, I informed the girls of my situation. They did not have to hear much from me. One look at my face and listening to my voice, they knew I had something wrong. Apparently my uvula decided to continue to swell while I slept, so I had a “hot potato” voice. My lips were still rivaling Angelina’s. Thankfully, though, no itchy palms or belly! I kept trying to swallow my uvula and kept gagging on it whenever I talked. Yuck! My Benadryl controlled mind put me back to sleep again. I woke a few hours later and met the girls by the pool. My voice had returned to normal but the lips still were full (but luscious I should say). What an experience! I could not get myself to take another Benadryl because my head was still so cloudy, but I improved as the day went on. By lunch my lips were about normal and by late afternoon, I no longer felt the need to swallow my uvula. That allergic event is one that will haunt me because I will never know what I reacted to. Such a weird experience! But everything turned out fine, and I did not have to experience Dubai’s hospital (of all places I have been abroad, however, Dubai’s American Hospital would have been the one to be at). Now I have a dramatic story to tell and one to obsess a little about. What happened to me that night? I have just recently stopped going to bed thinking about waking with itchy palms; though, I am wary about eating anything that I had that previous day in Dubai. So the lessons I now carry away with me: 1. health is a gift not to forget about and 2. carry epinephrine in your first aid kit.