BACK IN THE USA

In October a fellow volunteer and I were walking to a luncheon meeting when I suddenly experienced chest pain and nausea.  It was a hot day and I assumed I had failed to remain well hydrated.  When we reached our destination I sat down, drank several glasses of water and within moments felt great.  I resolved to be more careful about hydration.

 

 Fast forward to February

It is 3:00 AM on a Monday; I am laying in the bed sweating and praying for even the slightest breeze.  Suddenly, chest pains.  I ask myself, “How much water did you drink on Sunday?”  I don’t answer.  Not because I don’t talk to myself, but because I have no idea how much I drank. 

At approximately 3:00 AM on the following Tuesday I am lying in bed and sweating.  Chest pains.  “How much water did you drink on Monday?”  This time I answer, “Three liters.”  Now I am worried. 

 

  

Fortunately, I was already scheduled to go to Kampala to have dental work done.  Prior to seeing the dentist I reported to the Chief Medical Officer (CMO) at Peace Corps and informed him of my symptoms.  The CMO ordered an ECG for later that afternoon and a blood test to check for heart muscle damage.  The next morning a consulting cardiologist read the ECG and I was admitted to the ICU at Nakasero Hospital in Kampala. 

Meanwhile the Peace Corps chartered an air ambulance to take me to a hospital with more advanced equipment.  In addition to a two person flight crew the ambulance was staffed by a British intensive care physician and an emergency room nurse practitioner.  By 7 AM the medical team was at the hospital to transport me to Pretoria, South Africa.  They had flown from Nairobi, Kenya to Entebbe, Uganda where they hired an ambulance to pick me up at the hospital. From Entebbe I was flown to Pretoria, South Africa and admitted into the ICU at Wilgers Hospital.  A day later they had a diagnosis and treatment began.   

I can do nothing but applaud the way the Peace Corps responded to my situation.  The response was sure, swift, and very professional.  I could not have asked for more.   

After discharge from the hospital I remained in Pretoria for several weeks, to ensure I was stable, and then sent back to the States.  Right now I am with my brother and his wife in Texas. I have been medically separated from the Peace Corps and therefore am no longer a volunteer.  However, I was told that if I reduce my risk factors for cardiovascular disease, if there is no recurrence of acute episodes over ~90 days, and my cardiologist in the US is supportive then I can ask to be reinstated to active service.  My request would need approval from the country director and both local and Washington based Peace Corps medical staff. 

I am committed to returning to Peace Corps service as soon as possible and I have reasons to be optimistic for a favorable outcome.  I fully expect to achieve the reduction in risk factors.  My blood pressure is already in the normal range (multiple confirmed and consecutive measurements with diastolic below 80 and systolic below 120).  With my recent weight loss I already have a good Body Mass Index (BMI) but now I am intentionally losing weight in pursuit of an even lower BMI.  My cholesterol is already low but I am now on meds to increase the level of ‘good fat’.  Since returning to the States I have embarked on a fitness program.  I walk 11 to 13 miles every other day and created a strength training program to build lean mass.  My original plan was to enroll in a health club but upon reflection I have decided to only do programs I can duplicate in Uganda.  So I have two knapsacks that I have loaded with bricks and cinder blocks and I use those for many of my exercises.  All other equipment I use is readily available in Uganda.

The clinical literature reports that my type of spasm is controllable with drug therapy over 90% of the time. Thus I am optimistic regarding recurrence of acute episodes.

On Monday I saw a US cardiologist.  He has ordered additional tests and I have to meet with an additional specialist but based on his feedback I am encouraged that a compelling case can be made to the Peace Corps as why I can safely be reinstated to volunteer status and return to Uganda.  My next appointments are on April 23 and 25.  Test results should be available soon thereafter.  I will report more at that time.  

Due to the way I departed Uganda my US cellphone remains in Uganda.  If you wish to reach me then send an email and I will call you or if you wish to call then call my Mobal number which is 01144 7738 803168, from the US or Canada.