$1,400 Worms

I’m standing at the Walgreens pharmacy counter and the clerks says, “You know you have a deductible, correct?”  “Yeah”,  I say while thinking, why’s she asking as I’m sure it’s a hundred or two hundred bucks.  She quips, “Are you sure?,  It is 148 dollars?”.  “$148 no problem”, I reply.  She looks at me incredulously and says, “No, I said $1,483 dollars and 38 cents”.   Is she kidding me?  Pulling my leg?  “Mam, did you say $1,483?”,  “Yup”, she replies, “And that’s after your insurance discount!”.   Hmm, on second thought, “Let me call my doctor before I pick up this prescription”, standing in astonishment at the price she’s just quoted me for 7 pills.

Pop quiz.  What do an itchy bug bite on one’s ankle, a dry cough that comes and goes, and an insanely itchy anus, particular at night, have in common?  Read on and you’ll find out or be grossed out.

It was just over six months after I returned from Namibia and I had a very small bug bite on my left ankle since returning to the accident scene to conquer the dunes which almost took my life 4 years ago.  It itched insanely to the point I clawed it to a bloody mess numerous times.

A month after my return (January 2013) I realized this itchy little red bump wasn’t going away and made my first doctors visit to inquire.  My primary care physician didn’t have a clue what it was and suggested I see a dermatologist.   Note, while in Namibia in addition to this bug bite,  I had developed a cold with a dry cough that had dissipated and thus didn’t think about mentioning it to the doc.

It takes a little over a month to get an appointment with the dermatologist and during this time almost every night I begin waking up due to extreme anal itching.  It feels like something is crawling around on the skin of my bung hole.  Obviously anal itching is not a topic one wants to advertise to ones friends and I’m starting to wonder, is this what happens when one gets to middle age, I’m 42?

Being proactive and not wanting to return to my primary care to get a referral, delaying treatment, I bypass them and setup an appointment with a proctologist, as the anal itching is somewhat disturbing.  Surprisingly, I’m able to get an appointment with them sooner than the dermatologist.

On a side note, proctology, I discover is a dated term.  Colorectal Surgeon is politically correct.  I wonder, am I the only one which somehow missed this transformation in nomenclature in America?  Or are the ones with anal problems the only ones to know the correct doctor practice name?

I’ll spare the gory details, but after surrendering myself to the colorectal surgeon and his “uncomfortable, feeling pressure” He informs me I have a class II hemorrhoid and suggest an ointment to stop the itching.  Would you even think about mentioning to the butt doctor which just got done shoving who knows what in my back-end that I had a bug bite on my ankle which I was going to see a dermatologist about or the fact that I’d been in Africa two months earlier?  Nope, me neither.

Weirded out that I have a hemorrhoid, I make my way a few days later to the dermatologist and discuss my travels and little red bump bite that amazingly in the past week seems to be dissipating.  It was once bright red and now while still itchy, the bump is more flesh-colored and appears to be going away.   Prognosis….not really sure what it is, but since it seems to be going away, give it several more weeks and let’s see if it just goes away.

Dang, what’s going on with me, I’ve got another cold and a darn dry cough.  Geesh, I’ve been immunized for virtually everything in the past, and rarely been sick in my life.  Two colds in a matter of months.  The last one went away, I assume correctly, this one will too, all the while the anal ointment seems to be doing the trick for my back-end nightly itch.  I wonder is this why dog’s drag their butts on the carpet?

Fast forward a couple more months, the bug bite is still present and itches periodically,  my cold/cough has disappeared returned disappeared again, and the anal itch seems to increase and decrease over what I can’t tell frequency as the ointment does it’s job.

It’s been six months and the bug bite still hasn’t gone.  Now I’m beyond frustrated.  I’ve been to two doctors about it, which haven’t a clue.  I know I received the bite while in Namibia and the fact it hasn’t gone away in six months tells me I need to figure out what it is.  Haven’t a clue who I should see, and not feeling confident about the two/three docs I’ve seen I stall doing anything hoping it’ll naturally improve.

I don’t know if it’s fate, fortune, or luck but a friend I’ve known for a decade happens to be an infectious disease doctor.  While we’ve been pals for years, all I ever knew is he works in the ER and diagnoses people with infections.  (dumb me only thinks infections are caused by bacteria, not bugs) One night I bump into him at a local bar and while my ankle starts itching I ask him, “Hey, I got this bug bite last year while in Namibia, a trip he knew about since he was a friend, I’ve seen my primary and a dermatologist and got nowhere.  What kind of doctor/specialist should I go see?”  While we’re drinking beers he looks at the bite and ask me again, “where were you at?”  “Namibia”, I reply.  He pulls out his phone goggles something, looks up and says, “Have you been coughing?”.  Low and behold I’ve been personal friends with the specialist I needed to see all along and I received a preliminary diagnosis at the bar.

Infectious disease doctor appointment here I come. He thinks I may have one of four potential parasitic worms.  Turns out after testing it’s Strongyloides, a microscopic parasitic worm which has an insidious life-cycle within ME the human host.

This microscopic unsightly bugger decided to hitchhike an uninvited ride back to Florida, through somehow burrowing through the skin on my ankle, leaving an itchy small red insect bite like bump.  It burrowed into my blood stream and was circulated to my lungs where it happily laid eggs in my alveoli, causing my cold symptom cough.  The cough while not contagious, spewed eggs into my esophagus which I subsequently swallowed.  The eggs then hatch in my intestines.  Here some of these devious things crawl out my anus at night, creating the extreme anal itch, while others burrow into tissue, and yet others make it back into the blood stream to flow back to my lungs causing a recurrent cough where I continue to auto-infect myself in a vicious never-ending cycle.

Thank goodness for the pharmacy clerks  warning before I blindly swiped my credit card.   I figure if it’s $1400 here, the drug companies must figure if you’re American and can afford to go where you’d catch this darn thing you can afford to be financially raped so they can give them away free where 20 million people a year get infected.  I call the doc before paying and discover there is an alternative medication and have happily extinguished my internal companion for a mere $180 bucks.

While my story may seem gross to many, I consider it part of the experience on my journey to see every country in the world.  I’ve learned a valuable lesson that if I get multiple symptoms, whether I think they’re related or not, even if they’re months apart, need to parlay them to every doc, and that an infectious disease doctor is the mostly likely one I’ll need to consult first if I’ve been in far-flung oddball places of the world.

Namibia almost killed me the first time round, and the second time sent me home telling me to never come back.  I hope it doesn’t keep anyone reading this from staying away.  It was an amazingly diverse incredibly beautiful country which I highly recommend visiting, which my photos and stories from earlier post I hope prove.