Fever of unknown origin

Fever of unknown origin! For those of you who are medical you have an idea of what I am talking about. For the rest of you, this simply means a fever without an obvious source. For example a child with a fever, who has no obvious pneumonia, ear infection, sinus infection, or infected throat. In the United States we generally assume this is some sort of viral syndrome and the child will most likely improve over the course of 5-7 days with minimal treatment. In Africa, fever of unknown origin (FUO), especially in kids is much more daunting. With illnesses such as malaria, meningitis, and tuberculosis much more prevalent, and many parasitic infections present that are uncommon to us the differential diagnosis is much more challenging. Add to that, the fact that many children remain unvaccinated this creates quite a melting pot of infectious disease possibilities.
For this reason, one of my biggest fears when deciding to travel with small kids to Africa was the fever of unknown origin. Shea and I both knew this was a very real possibility, but still hoped this was a bridge we would not have to cross.
Unfortunately this last week we experienced FUO x2. First Gracie then Beau became ill with unexplained high fevers. After ruling out the most common things we decided (with the help of Todd Stephens who luckily was here) that they both should be treated for malaria. We have since treated them with 3 day courses of coartem, and after several sleepless nights they are both recovering well, and doing fine.
It was not an easy time, as you can imagine. I asked myself many times while holding Gracie why we were here. I thought to myself on more then one occasion about going home while praying that Beau would stop shaking and crying with fever. Looking into Shea's tearful eyes and not having any good answers was a terribly helpless feeling. It was quite a challenge, but I could feel the Lords presence as family back home kept us in close prayers, and our friends Paul and April were a constant encouragement and comfort to us on those wakeful nights. In the midst of it all it seemed very difficult. In reality many of you are going through, or have gone through many more difficult things. Even now as you are reading this many of you are struggling with loss of loved ones, abuse, broken relationships, job loss, financial crisis, poor health, and much more.
Fever of unknown origin in African is much like suffering that occurs in life. We do not usually know why it happens, or even how to make it stop. In the midst of the pain there are rarely answers or solutions to the problems at hand. All we can really do is keep going(or in medicine treating, often with multiple medications), and pray a lot. It is this dependence on God that makes the experience worth it. In the end the pain is always worth the growth (easy to say when your not in the midst!!). James says in James 1:2-4 “Consider it pure joy my brothers, when you face trials of many kinds, because you know the testing of your faith develops perseverance. Perseverance must finish its work so that you may be mature and complete, not lacking anything.” Or in 1 Peter 1:6-7, Peter says “though now for a little while you may have had to suffer grief in all kinds of trials. These have come so that your faith-of greater worth then gold, which perishes even though refined by fire-may be proved genuine and may result in praise, glory and honor when Jesus Christ is revealed.”
The good news is trials/suffering like FUO usually resolve. Whether it takes 4-5 days( like it did with our kids), or many years (like the struggles I know some of you are facing today). In the end your pain is well worth the faith you gain through your perseverance. And your months or years worth of suffering will seem like a mere drop in the bucket compared to the inexpressible joy you will have for eternity with our Creator. Anyway, just another valuable lesson I've learned from our time here in Zimbabwe!
Well to change gears, aside from our little battle with illness things are continuing to go well here in Zimbabwe. We just had a visit from Dr Leu, and Dr Stephens. They were here for about 4 days, but added so much in there brief time here(actually....they literally brought a lot of stuff....most importantly a kiddy pool for the kids). But no, we really enjoyed rounding, clinic, and even operating with them. They were just very encouraging, and helped a lot with some of the work load.
We also made our first trip back to Harare to reload on groceries. It was really nice to get a break from the hospital, and mainly just driving in a car for a change(its amazing how much you miss the freedom to drive when you haven't done it for a while). Paul and I got to take turns driving a 1990s Toyota Land Rover through the bush in Zimbabwe and in Harare. It was awesome just to have the freedom and it was just a ton of fun to drive(especially the dirt roads). Don't worry April and Shea kept a close eye on us making sure we kept in the left lane(yeah.....they drive backwards here), and watched with great care as we made our very strange wide right turns. The whole driving on the wrong side of the road (well, I guess it depends who you ask), takes some getting used to, but by the end of the weekend I think we had it figured out. It was a lot of fun, and we do have an interesting driving in Zimbabwe story, but I think it will be more fun if we tell it in person.
The medicine here continues to be both challenging and fascinating. I know Paul has shared with you recently one of our sad C-section stories. (By the way if you haven't checked out Paul and Aprils blog, you should do so at mcquilleninternational.blogspot.com . Paul is a gifted writer, much more eloquent then I, and he gives much better play by play as he usually updates his blog twice weekly.....oh yeah and did I mention he also takes great pictures). Sorry for the commercial interruption...back to my thought. Anyway, we have had several very tough C-sections as moms often labor for 2-3 days at home, before they finally get to us. This makes the procedure very difficult since often the babies head is deep within the pelvis, and the babies are often near dead by the time they arrive. On the flipside, we have also had some really great outcomes were babies that should not have survived lived, and this has been very encouraging. We had one little 28 week baby deliver vaginally through a placenta previa (this is when the placenta covers some or all of the cervix...so not something you want to deliver through.) Anyway the mother went into preterm labor and we were giving her steroids to help mature the babies lung before Csection. Unfortunately she delivered precipitously before a Csection could be done. Amazingly the baby has done wonderful. Usually babies less then 34 weeks do not survive here, but obviously God is in control, and we are all excited to see this little one still kicking and crying.
Well I think I've gone well over my 1000 word limit(sorry not hard to do when I get rambling). I have so many more stories to share, but I'll have to save them for another time. Anyway all 4 of us our doing great. I think Gracie will be crawling soon. Beau is starting to talk a lot more and he is just a blast to be around(if we could just get him potty trained we'd really be ecstatic). He will be turning 2 in about a week, and I think he is already pumped for his cake and ice cream. Shea is doing a great job balancing home and work.....she really loves getting a chance to work in the hospital and is doing a great job.
We miss everyone a lot, and love getting all of your emails. So please keep them coming.(and pictures are great as well). We hope to hear from you all soon.
To His Glory
John, Shea, Beau and Gracie