June
14th 2010
Sick day, the method medicine way.

Posted under: American history, Bodily modification, jobs, students, the body, unhappy endings, weirdness

Not me–it’s Fratguy who’s under the (rather cool and rainy) weather, and another family member is undergoing a surgery today!  It’s going around, apparently.

Fratguy has experienced malaria-like fevers for the past 36 hours or so, which is a little too much Stanislavski-like method medicine and/or method colonial American history for me, but there you go.  He says it’s just a virus, which I think is a ruse designed to get me off his back rather than take him to see a physician.  Back in 1991 when he was in medical school and broke, Fratguy enrolled in a medical experiment for a malaria vaccine funded by the U.S. Army.  It was just like that old OFF commercial:  after getting the vaccine, he had to stick his arm into a tank full of falciparum-infected mosquitoes and get bitten by them!  Well, guess what?  The vaccine didn’t work, so he got malaria.  (And when you’ve had malaria, that’s a lifetime get-out-of-jail-free card for blood donation!)  But, he also got a ski trip to Whistler out of the deal, and I get a great little anecdote to trot out whenever I’m lecturing on the horrors of Jamestown or on the early English settlements in the Chesapeake and Caribbean in general.  Score! 

For those of you who didn’t study infectious disease before 1940 and/or colonial American history, malaria is caused by a plasmodium parasite (either the falciparum, which is deadlier, or the vivax parasite) carried by Anopheles mosquitoes.  The parasite gets into your blood and then settles into your liver and induces a series of very high fevers in the patient, which gradually subside (if they don’t kill you.)  Pregnant women and children are particularly susceptible, but it’s a survivable disease.  Fratguy tells stories about the disease in which he’d have a horrible fever and chills all day long, and then feel well enough to go out at night and attend a party, thinking that he was over it, and then the fever would return again overnight or the next morning.

From what I’ve read on the non-peer reviewed internets, a relapse is not at all likely after 19 years.  But, is it at all possible that he’s been harboring something in his liver all these years, like something out of Alien?  Do let me know if you’ve got any intel on this!  I’ll need to get myself and the kids (if I have any) out of the house.

25 Comments »

25 Responses to “Sick day, the method medicine way.”

  1. Indyanna on 14 Jun 2010 at 9:46 am #

    Mmmph. This is a bummer, but I’d say just go to the hospital and just get it checked out. Will be thinking of youse-all and waiting for the all-clear whistle.

    I’d hate to think of all the control-groups and placebo ingesting cohorts I may have been a member of back in the daze of living on grad. stipend. I got fired from a psychology experiment once for inability to bite down long and well enough on the tongue-depressor thingie that held your head steady while the inquity proceeded. And during the routine follow-up protocols to an asthsma drug study, I once had my eyes quickly looked at by a world-famous opthamologist whose second most prominent patient ever (after me) was said to have been Lord Mountbatten of Burma, or something like that, back during the Big War. It was all a staff accident, and when Dr. Big Investigator found out he had been wrongly steered into the cubie of a famished dissertator, I bet I wasn’t the only one to get terminated that day!

    Hang in there Fratguy, and feel better!

  2. Shane in Utah on 14 Jun 2010 at 10:16 am #

    “For those of you who didn’t study infectious disease before 1940 and/or colonial American history…”

    Or contemporary Africa? Malaria kills more than a million people in Africa every year, according to the WHO…

    My very non-medical expert impression was that once the parasite enters your bloodstream, you’re never fully rid of it and a recurrence is always possible. I’ve personally known people who developed symptoms 5 years or more after the initial infection. But a relapse after 19 uneventful years does seem odd.

  3. squadratomagico on 14 Jun 2010 at 10:20 am #

    I travel in malaria-ridden countries fairly frequently, and I am not terribly vigilant about my anti-malaria medications — mainly because I haven’t traveled in the wet seasons lately, and also because the medications have side-effects (like hair-thinning) that I don’t care for. Perhaps your story will scare me straight, though.

    They never do seem to have developed a vaccine — I always am prescribed oral preventative medications. It used to be a quinine-based derivative, but apparently the virus has become increasingly resistant to it.

  4. Historiann on 14 Jun 2010 at 10:41 am #

    Those malaria drugs sound worse than the disease, quite frankly. I have friends who have delined to take the anti-malaria pills, which have a tendency to bring on psychosis! And I didn’t even know about the hair-thinning. Yikes.

    Fratguy appears to be OK, but sleeps a lot and periodically drains the hot water tank. That reminds me–I should go see if he’s still breathing!

  5. squadratomagico on 14 Jun 2010 at 10:58 am #

    Yes, there is one newer anti-malaria drug that brings on serious psychosis in a fairly high percentage of people. SweetCliffie tried it once and had a rather bad afternoon curled up in the fetal position; other people I know who have used it suffered from horrible, violent nightmares until they stopped. I forget what it’s called, but luckily there are other alternatives on the market as well.

  6. ladysquires on 14 Jun 2010 at 11:14 am #

    I wonder if malaria is sort of like the Epstein-Barr or chicken pox virus (even though it’s technically not a virus). Though you develop an immunity to the diseases caused by the pathogen, said pathogen remains dormant in your system, particularly in your nerve endings, which are not affected by your immune system. After a couple of decades, your immune system can forget how to keep that particular pathogen at bay and it can come back with a vengeance.

    I got to hear that delightful bit of information this weekend because my Mom has shingles in the area around her main facial nerve. Fun stuff. I know that the whole dormancy thing is sort of common knowledge, but the residing in your nerve endings thing kind of freaked me out.

  7. The History Enthusiast on 14 Jun 2010 at 12:55 pm #

    If malaria is the same as ague (which I believe it is), then it can reoccur many years after the initial infection. Some of the letters I read for my research (from the 19th century) continue to describe bouts with ague for long time spans.

    I hope he feels better soon!

  8. Sisyphus on 14 Jun 2010 at 1:40 pm #

    I seem to remember from my undergrad microbio class that the malaria bacterium (or is it a virus? that I don’t remember) has a three-day life-cycle, so one of the ways malaria presents is in three-day cycles of chills/fever and then feeling better. This helps with the spread of drug resistance, too, as people falsely assume they are better and leave the area without completing treatment.

    I thought that there was a cure, though, because I went and read up a lot on recent anti-malaria campaigns after reading _The Poisonwood Bible_. The nets they are passing out seem to be working and the incidence level of malaria has dropped a lot recently, although it’s going to be major work to get it to drop any more by the UN goal date.

    And it’s a novel, so who knows how accurate it is, but in _The Poisonwood Bible_ Leah keeps relapsing every few years when she is especially stressed or her food intake has gone down a lot.

  9. jlg on 14 Jun 2010 at 3:56 pm #

    http://www.nlm.nih.gov/medlineplus/malaria.html
    check this website…paid for by your tax dollars and damn good!

  10. Historiann on 14 Jun 2010 at 4:42 pm #

    jlg–thanks for the link, but there’s apparently a new and improved website. I found the FAQ humorous, especially the answer to “why is there no vaccine?” (According to the website, “There is currently no malaria vaccine approved for human use. The malaria parasite is a complex organism with a complicated life cycle. Its antigens are constantly changing and developing a vaccine against these varying antigens is very difficult. In addition, scientists do not yet totally understand the complex immune responses that protect humans against malaria. However, many scientists all over the world are working on developing an effective vaccine. Clinical trials with possible vaccines are currently happening.”)

    The Army was on the case 20+ years ago, before probably before the fall of the Wall, so presumably it was a disease they thought they might need to fight because of the Cold War (possibly in Africa or Central and South America.) I wonder who’s bankrolling the research now–probably still the military, I’d guess.

    Interestingly, in his residency my husband treated a large number of patients with sickle-cell disease. (The sickl-cell mutation apparently protects against malaria–but sadly, now it’s just a very, very painful pediatric disease.)

  11. Comrade PhysioProf on 14 Jun 2010 at 5:49 pm #

    I think you’re supposed to drink a fuckton of gin-and-tonics to cure malaria.

  12. Matt L on 14 Jun 2010 at 5:59 pm #

    yes… more gin and tonics…

  13. Historiann on 14 Jun 2010 at 6:58 pm #

    Thanks for all of your concern. I saw Fratguy for dinner, and he says that he too thought about malaria, but then remembered the disease manifesting itself quite differently. For one, the fevers came and abated on an almost precise 24-hr. schedule, and a splitting headache. This time it just felt different. But, I can say that this must be the very first time he missed a day of work in the entire time I’ve known him. (He agreed with so little struggle that it concerned me that he gave up so easily.)

    He also says that CPP and Matt L. are welcome to visit any time. (With a metric fuckton of G&Ts.)

  14. Indyanna on 14 Jun 2010 at 7:00 pm #

    The bad news is… You don’t need the gin, only the tonic. But you’d need to drink a flatbed-trailer’s worth of Schwepes’s Best Stuff to even make a dent in the symptoms. So it’s probably best to go with those old Peace Corps pills that you may (or may not) have on stock. The G&T “cure” at least plays to an edgier version of the tropicalism trope, sort of a more hipsterish version of Margaritaville.

    That’s pretty funny about before the Wall fell. The land version of WWIII would likelier have been fought in Eastern Europe. Now with these asymmetrical wars, who knows? Hope this link works. How’s Fratguy doing, BTW, to stay on-thread?

    http://www.straightdope.com/…/will-the-quinine-in-tonic-water-prevent-malaria

  15. Historiann on 14 Jun 2010 at 7:20 pm #

    Thanks, Indyanna–you’re welcome too!

    He’s feeling much better. He hasn’t had the shakes and fever since late last night, so we’re hoping that this is the end.

  16. Susan on 14 Jun 2010 at 8:35 pm #

    I’m so sorry that life has landed you in the world of early modern/tropical health. I certainly do know that malaria stays dormant, so it wouldn’t be beyond belief, but it sounds like it was in fact just a nasty virus. Since everyone else has told you everything useful and correct already, I’ll just hope you can bring Fratguy a G & T, which sounds so much better than grapes. (And much much better than tonic on its own. I’m not sure that it actually has any quinine anymore, but the thought is nice.)

  17. Hotshot Harry on 14 Jun 2010 at 9:20 pm #

    Tell Fratguy to check his Yankee at the door and go see a doctor. Unless he’s enrolled in another “study” that will reward him with a special trip and he isn’t telling you about it…in which case I prescribe a nice single malt, neat with a drop of water.

  18. Yusifu on 15 Jun 2010 at 3:45 am #

    In my experience, malaria can pop up in lots of different ways, and it’s definitely possible to get a recurrence after several decades. It’s also nothing to fool around with–one of my professors from grad school nearly died of cerebral malaria, and that was after visiting his native country.

    Lariam’s the prophylaxis that causes psychosis. Fansadar can make all your skin fall off. But malorone is pretty easy to tolerate, and they’ve now approved doxycycline as prophylaxis as well. I don’t know if those two get used as treatment, though.

  19. Knitting Clio on 15 Jun 2010 at 5:57 am #

    Since I study history of medicine, I’d just like to second what others have said about malaria being an ongoing problem in many areas of the world — and with global warming, the mosquito that carries the disease is spreading northward.

    The Cold War is only part of the story (and keep in mind that the struggle between the capitalism/communism was largely fought through proxy wars and economic aid to various parts of the global south). Prior to the Cold War, concerns about how to control malaria were a central issue for the British Empire and other imperialist endeavors by various European powers (of which the American colonies were one).

    I don’t see anything “hilarious” about the CDC’s explanation about why there is no vaccine. It’s similar to the reason why we need a new vaccine for influenza every year. Every microorganism adapts to changes in its environment and malaria and influenza are especially malleable. Current studies are sponsored by the World Health Organization, not the U.S. military.

    There are other environmental issues as well. Prior to the 1970s, prevention involved using massive amounts of DDT to kill the mosquito. This caused all sorts of environmental problems and human diseases (i.e. cancer), while also causing the mosquito to develop resistance to the pesticide.

    In short, malaria has proved to be a more intractable problem than can be solved by a simple “magic bullet”.

  20. Historiann on 15 Jun 2010 at 7:16 am #

    Uh. . . I said the absence of a vaccine was “hilarious” because Fratguy’s malaria happened in testing (another failed!) vaccine 19 years ago.

    Further, this post was not meant to belittle the problem of malaria worldwide. When I said “For those of you who didn’t study infectious disease before 1940 and/or colonial American history. . .” I didn’t mean to suggest that those were the only ways one might encounter malaria in the modern world. Those are just the disciplinary trainings of me and Fratguy.

  21. Z on 15 Jun 2010 at 10:31 am #

    But many vaccines and inventions take a long time to get right, and it is worth being aware of more than one’s own narrow discipline.

    Anyway, I guess it’s not malaria if he says not, he should know, and I’m glad he’s better!

    But yes, malaria is forever. The longer it’s been since you got infected the less likely recurrence is, but it does happen.

  22. Tenured Radical on 15 Jun 2010 at 10:37 am #

    Suggestion: send the children (you may or may not have) for an overnight, and play African Queen!

  23. Historiann on 15 Jun 2010 at 11:01 am #

    Heh. I don’t have the hat collection for that (yet.) A few more years and a few more wrinkles, and I will.

  24. Fratguy on 15 Jun 2010 at 2:39 pm #

    Mrs Fratguy’s spiffy nurse’s outfit seems to be at the cleaner’s. Damn. I guess I’ll settle for CPP’s suggestion of consuming ample G and T’s. Thanks for the well wishing, seem to be on the mend today

  25. Bing on 15 Jun 2010 at 4:25 pm #

    Thanks to Fratguy for putting his butt on the line for others!

    HJ

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