Monday, April 6, 2015

The Rabies Shot

Sometimes the most unfortunate events make for the most entertaining stories. 
As Amy and I went for a trail run last Monday morning, enjoying our first true day off of semana santa, we were passing by the farm, and as usual the family and their animals were out.  All of a sudden two dogs turned towards us, barking and growling.  I jumped away from them and kept walking, which is not much in the way of defense, but is always my instinct with mean dogs.  I looked over at the owner who was standing nearby, and thought maybe we were in the clear, but they had focused their attention on Amy instead.   Behind me, I heard her swear and say, “It bit me!  Ow—again!” 

Finally the farmer stepped in, throwing a broom in the direction of the dogs and sending them scattering.  Amy and I took off running up the trail and didn’t stop to check her wounds until we were out of sight. 

The bite on her leg had broken skin, so on the advice of four different people, we went to the ER later in the afternoon to get her checked out. 

Two white girls in a Guatemalan hospital is always going to be an adventure. 

Parking was full at the front of the hospital near Emergency, so we followed the signs to a ramp in the back.  Then, we followed signs to Reception (which was just a tiny desk towards the back of the hospital, and we missed it).  We passed it, realized we had no idea where we were going in the hospital, and were approached by a security person.  She directed us to reception, and that woman gave us instructions on how to get to Emergency.  Of course, we soon screwed up those instructions and found ourselves wandering unmarked hallways.  The security woman must have decided to check on us, and she found us and then escorted us to the Emergency room like the lost little puppies we were. 

From there we were shown to a cubicle and attended to by a nurse and a doctor.  I took over as Amy’s translator when she needed it, and proved that my Spanish skills are good enough—just barely—to get us through an ER visit. 

The doctor cleaned the wounds, then decided to give Amy a rabies vaccine, Tetanus shot, and antibiotics in case any infections had been spread from the dog’s teeth/saliva. 

After the shots, the doctor came back with prescriptions for the antibiotic and the remaining doses of the rabies vaccine.  She explained to me that Amy would need to come back after 3 days and again after 7 and 14 days to get the remaining three doses.  I nodded my understanding—and then divulged that we would be on a trek from Nebaj to Todos Santos and not near any big towns in the next three days.  I asked what we should do about the 3 day dose.  She said any clinic or medical center would be able to help us out.  So I asked,  “Y… si no?”  (Aaaand…if not?)  Her response: “Buena pregunta.”  (Good question). 

On the way out, we once again got lost, but figured it out without needing an escort by following two other women towards the parking lot.  I swear that hospital is a maze… 

After lots of giggles and not too much pain, we made it home, and we figured Amy should be safe from all the potential diseases an outdoor dog could carry.   

About 8:30pm that evening, Amy called me.  Based on multiple opinions, she was freaking out about the possibility of missing the 3 day dose of the rabies vaccine and not sure whether she could even go on the trek anymore.  I think we both shed a tear or two about that possibility.  But we immediately got to work to figure out a solution.

The first step was to call the guides at Quetzaltrekkers, the organization we’d be hiking with, to ask whether it would be possible to go to a clinic and get her the vaccine on the 2nd hiking day of the trek.

The answer was a resounding “no,” unfortunately.  We would be in the middle of nowhere, and the towns we’d be hiking through would probably not even have electricity, much less a medical clinic with rabies vaccines in stock. 

So our second thought was to call the hospital and see if we could take the vaccine with us and administer it ourselves while on the trek.  Thankfully, the answer this time was “yes.”  So Amy hopped in her car and picked me up, and it was off to the hospital once again.

This time, we were on a time crunch, as Amy’s friend was flying in that night in order to trek with us, and Amy needed to pick him up at the airport.  We figured if it was a quick stop to pick up the vaccine, we should be able to make it to the airport on time.

Of course it wasn’t that simple.  At first at the emergency room, they told us they didn’t have the vaccine on hand.  When we complained that we had just called 15 minutes ago and received a different answer, they looked harder and magically found what we needed. 
But the next issue: the vaccine needed to be kept cold.  They wouldn’t give it to us without a cooler or some ice to keep it viable until we got home.  Just as we were about to head to a convenience store to buy something (because of course we hadn’t known about that requirement and hadn’t brought a cooler with us), the receptionist came running up and told us she’d located some ice and could put the vaccine on that. 

We were late to pick up Amy’s friend Alex from the airport, but he’d been waiting patiently, so there was no harm there.  Once we had him in the car, we set out on our next adventure: devising a way to keep the medicine cold while we were hiking for two days. 

We hoped we could find some dry ice, but at 9:30pm on a Monday night in Guatemala City, we had no luck with that.  What we did find was a small cooler which we planned to pack with ice on Tuesday morning, refill on Wednesday morning with new ice in Nebaj (the last town we’d be in before starting to hike), and cross our fingers that if we kept the cooler insulated at the bottom of Alex’s pack and in the shade as much as possible, the vaccine would stay cool until Thursday morning. 

Purchasing ice in Nebaj proved to be more of a challenge than we’d anticipated, but after some searching on Tuesday afternoon, we found a place that sold a few frozen bags of water, and vowed to return Wednesday morning to pick up as many as would fit in the cooler. 

Nebaj, Guatemala 

Our plan worked, and on Thursday morning, we pulled out the cooler to find the ice still frozen and the rabies vaccine quite cool.  With a magnificent sunrise above lofty clouds as the perfect backdrop, we managed to give Amy her second dose of the vaccine and keep her safe from the potential of a deadly disease. 

Opening the cooler

Our inexperience and uncertainty made the whole ordeal pretty comical and entertaining for everyone on the trek (except for Amy).  One of the trekkers was a medical student, so she was deemed the most experience and therefore the one to actually give the shot.  Rachel held her hand, Alex offered moral support, and I captured the whole process in photos.  

How does this work, exactly?

You can tell by her face she's just not comfortable with
the whole process.

Moral support and onlookers.  


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