It’s Just a Tummy Bug, Right?

I’m not quite sure why going to the doctor is such a big deal for me.

Part of it, I guess, is a product of only having one child, and those embarrassing trips to casualty with a mildly snotty infant, and weary doctors uttering the immortal phrase, “Is it your FIRST baby?”

(Yes, of course it’s my first baby! Why the fuck else would I be ringing NHS Direct and bringing him into A&E with a mild cold?)

Part of it, I guess, is ingrained into you when you come from a country where healthcare is free: you don’t waste taxpayer resources on minor ailments that should sort themselves out with over-the-counter medicines like paracetamol.

Anyway, when Zac got sick a couple of days ago – an unusual occurrence for a child with the constitution of an ox — I was definite that I wasn’t going to panic and rush to the doctors.

Doctors? Pah! Doctors are for wusses. And he’s only got a runny bum and a bit of lethargy, anyway. No biggie!

It’s just a tummy bug. Nothing to get hysterical about.

Zac is collapsed on the sofa, looking, it must be said, rather peaky, when I wander over to him and apply a hand to his forehead.

It’s boiling.

I find our thermometer. He’s running a temperature of 39.4° (103°).

Whoops!

Never fear, I think. I’ll give him paracetamol to bring the fever down. And if it goes up to 40, I’ll get him to the doctor, pronto.

Zac takes the paracetamol. The fever breaks.

But he’s still tired and hitting the bathroom every hour or so.

My stoic unwillingness to go to the doctor does not, of course, stop me from going into full hysteria mode when Zac complains of pain in the base of his spine.

Now, I am pretty certain that that’s because I dropped him on his arse while endeavouring to remove him from a wetsuit.

All the same, we are in foreign climes. And foreign climes have strange and terrifying diseases.

So, obviously, Zac has one of them.

The base of the spine is quite near the hips, which is where dengue pain classically appears. He has a fever. There are mosquitoes.

Therefore, he has dengue.

I Google, frantically. Egypt did have some nasty dengue outbreaks during the nineteenth century, which prompts a pleasant diversion into outdated medical reports, but as far as I can tell, there’s no dengue here now.

Avian flu? Last seen in 2009, and anyway, I caught that in Bulgaria and Z escaped unscathed.

Rift Valley Fever? Ooh, that looks promising… I mean, scary! Terrifying, in fact.

But aren’t we a long way from the Rift Valley? And he hasn’t been handling cattle? Do they even HAVE Rift Valley Fever in the Sinai?

Then I Google “spinal pain”.

MENINGITIS!!!! Aaaaarrrgggghhhhh….

It’s TOTALLY meningitis!

“Honey!” I say, putting a hand on Zac’s forehead, now cool. “Why do you have the lights off?”

“Wha’?” he says, rather drowsily.

“Is the light bothering you?” I ask, switching it on.

“I was aslee’,” he says.

There are red marks on his limbs. AAARRRGGGGHHHHH….

I race next door and Google “cup test”. Then “glass test”.

I come back, with a glass. “Do you have a headache?” I ask.

“No,” he says. “I have stomach cramps before I have the diarrhoea, but my head feels fine.”

“What about the light?” I say.

“I’m fine with the light,” he says. “Why do you keep asking me about the light?”

I apply the glass to the red marks on his limbs, which are beginning, even to my fevered mind, to look less like septicaemia and more like a line from sleeping on a folded blanket. They disappear. Or do they?

AAARRGGGHHHH….

I go back next door and talk myself down from meningitis, then set an alarm for 5am to check on Zac, which I proceed to sleep through…

The next day goes better. He’s still largely sleeping and shitting, but I figure that’s the bug working its way out of his system, and he’s well enough to go on the computer, get on Google, and diagnose himself with rotavirus.

And anyone who’s well enough for Google diagnoses is clearly on the mend.

Doctors! I think.

Pah! Who needs doctors?

Plenty of people would have gone rushing to the doctors and it’s only a harmless little rotavirus. Wusses.

Pshaw!

He’s drinking water. He’s eating bread. I mean, sure he’s a bit sorry for himself, but he’s basically on the mend. No fever. No vomiting. Fully lucid. Apparently hydrated. Not in pain. It’s just a tummy bug. Plain, old-fashioned Ramses’ Revenge.

Nothing to get hysterical about.

And, when I feel sufficiently sorry for him to rescind his computer ban, he comes straight to life, gaming on Skype with friends in Latin America.

I can’t help but notice that his bum’s still running, though. Tomorrow morning will be 48 hours. The time at which one would typically call a doctor.

Well, I think. I might try Imodium first…

We are supposed to be leaving Egypt on Sunday, and I doubt they’ll even have samples back from the lab at that point.

And I’m still hoping we can go windsurfing tomorrow.

Zac is back on the sofa the next morning, and still rather peaky. He looks noticeably paler, and, alarmingly, even thinner than usual: he eats as much as plenty of adults but didn’t hit the 30kg mark until he turned 11.

Right! I think.

Let’s give Imodium a go, and if it doesn’t work, we’ll pop round the corner to the doctors…

“I’m not going to have to do a stool sample, am I?” he asks. “I don’t want to poo in a bucket.”

“I don’t know,” I say. “I guess they’ll probably want to do one…”

He drinks some water.

An involuntary lurch, an Exorcist style stream of liquid – pure water, with flecks of bread that somehow hasn’t made it out the other end yet – and the sofa, the T-shirt, the shorts and the carpet bite the dust. Zac slumps back, covered in watery vomit.

Oh shit, I think.

Even as a child of two or three he’d routinely make it to the bathroom when he puked, and, apart from one memorable bus journey, this has been the case while we travel.

He lurches again, a full-body retch that’s painful to watch. The rest of the water comes back up. His forehead’s damp with sweat, but still no fever.

“Right,” I say, fetching him a change of clothes. “We’re going to the doctors. Now.”

It takes him a while to get his clothes on, but, fine upstanding chap of 11 that he is, he’s resistant to help.

I think he’s probably tired, what with getting up through the night for bathroom breaks for two nights running.

We make it across our ridiculously enormous garden and out of our ridiculously enormous gate before he sits down suddenly in the street.

“What’s the matter?” I say. “Cramps again?”

“No,” he says. “I just feel really weak.”

“OK,” I say, now genuinely alarmed. “I’ll carry you. Don’t worry. It’s only round the corner.”

“This is how people die of diarrhoea, isn’t it?” he says, waving away my offer to serve as porter. “Their bodies can’t absorb either food or water and they die of dehydration and malnutrition.”

“You’re not dying,” I say, bracingly.

But, I realise, he has a point.

If he were smaller, I’d have had him at the doctors sooner. Because he’s eleven, my gut instinct is to treat him as an adult.

But he’s not an adult. He’s a 30 kilo child with no fat reserves to burn.

There’s someone seeing the doctor when we arrive, so we sit in the waiting room, Zac pale and floppy with his head in my lap.

“We’ll be five minutes,” says Doctor Sadek. “Just five minutes.”

In my lap, Zac undergoes the magical transformation from “poorly” child to “potentially very sick” child, and seems to shrink, becoming younger, smaller, more and more vulnerable by the second.

An entire family emerge from the surgery, their teen daughter complete with brand new bandage on her elbow, expressions of relief all round.

Zac lies on the couch, and one doctor examines him while I explain to the lovely, fatherly Doctor Sadek the sequence of events.

“Diarrhoea, vomiting and fever?” he says.

“Yeah,” I say. “Only one day of fever, though. It cleared with paracetamol.”

“He has gastroenteritis,” he says. (Or, as we lay people call it, a tummy bug.)

An exchange of Arabic with the lady who’s been examining Zac.

“She says he has starvation on his breath, the smell of starvation,” he says. “We’ll need to put him on intravenous fluids.”

“Right,” I say, processing this.

A drip? Fuck! He’s really ill!

He hasn’t digested anything for 48 hours. Of course he’s ill! D’oh!

I am irresistibly reminded of a time when I was about Zac’s age, and had what we in my family term “a bit of a nasty cough”. My mother sent me off to walk to the doctor’s, in the snow, only to be summoned to the surgery to collect me on the grounds that I had acute bronchitis, a 40 degree temperature and shouldn’t be walking anywhere at all.

This, I think, is where I get my bracing attitude to doctors…

Zac, who’s normally very brave about needles, is extremely anxious about the IV – close to tears, in fact.

He looks very, very pale, very, very thin and very, very sick as he lies on the couch by the IV rig.

“All they’re doing is rehydrating you,” I say. “The first one’s a sugar solution, to get some fluids and calories into you, with a medicine in it against the vomiting and cramps. Then they’ll put another one into you, which is salt, to balance your salts out again and get you even more hydrated, and antibiotics, to get to work on the bug that’s causing all this.”

“Don’t worry,” says lovely Doctor Sadek. “It won’t hurt. Don’t look. It’s just a little plastic tube.”

Zac whimpers a little bit as the needle goes into his arm. I stroke his leg.

Drip, drip, drip goes the fluid.

Lifegiving fluid.

“You do this all the time, right?” I say to Doctor Sadek.

“Yes,” he says. “Every single day.”

And, I would imagine, he does it every single day with kids much, much younger and much, much sicker than Zac, kids out of the desert in pickup trucks after the herb tea didn’t work its magic, kids from families who don’t go to the doctor not because they’re being macho but because they can’t afford it…

The IV works little short of a miracle. Within twenty minutes, the ghastly pallor has gone, and there’s almost colour in his cheeks.

“Mum?” he says, out of nowhere. “You know about euthanasia?”

“Yeah,” I say. “What about euthanasia?”

“And the pro-life people who won’t let euthanasia happen?”

“Yeah,” I say.

“Well, when Old Granny died she wanted to die, she felt her time was up, so they didn’t give her treatment. So if she can choose to do that, why couldn’t she just ask a doctor to kill her?”

“Well,” I say, breathing a sigh of deep relief. “It’s the doctrine of double intention. Which you might think is a piece of Catholic double think. But it goes like this…”

He’s better, I think. Any time now, he’ll be talking about MineCraft.

“Look,” says Doctor Sadek. “His colour’s come back.”

150ml into the first IV, and Zac begins talking, not about Minecraft, but about something called Team Fortress 2.

We leave equipped with an eyewatering selection of medicines. An anti-vomiting medicine for before meals.

Something called Streptoquin, with a bunch of antibiotics in it plus something to clear the muscle spasms and work against cramping, for after meals.

And Flagyl, a hardcore antibiotic typically prescribed for amoebic dysentery and other nasties, also after meals.

I guess that’s what they do here. Rather than wait for samples to get back from the lab, they just treat for amoebic dysentery anyway.

“Do you think we should have gone to the doctor sooner?” I ask Zac.

“Yes,” he says. “I think we should have gone yesterday.”

And, I think, he’s right.

Because, while gastroenteritis is “just a tummy bug”, so is amoebic dysentery. And, while it may not have the Google glamour of Rift Valley Fever, that kills kids here, and elsewhere. I will try to avoid Googling it this evening.