Bagels and Lakhs

They were four little words you definitely do not want to hear while living in India:

You. Might. Need Surgery.

It’s bad enough to be lying in a fetal position after spending your day taking tests. It’s another to contemplate having your body chopped into while living in a foreign country. I was not a happy camper.

It probably started with me boasting that I hadn’t gotten ‘India sick’ yet. I like to say this to people a lot – to be fair, it’s mostly to try and comfort people who are visiting. Such as, “Oh, you won’t get sick from the food. I’ve lived here six months and I haven’t gotten the notorious ‘Bombay Belly’ yet!’ I think I do better than my friend D who just likes to declare that she has a stomach of steel.

But I think there was a little bit of karma involved when I started to feel ill. It was as though the India gods were saying, “ok, you don’t need to get sick from food. We’ll give you a good-old-fashioned-regular-illness instead.”

I felt a bit ill on Friday but I only started to worry in the evening, when I took my temperature and it was above 100. I called my friend A.

“I have a weird question to ask you,” I began. “I have a fever. And Daniel is out of town. If this was America, I wouldn’t be nervous…”
“But it’s India.” she responded, clearly understanding where I was going.
“Right, so maybe you could spend the night over here in case something happens in the middle of the night?”

She, of course, said yes. You see, there’s an interesting thing that happens to all expats who live here: you get paranoid. And it’s justified. You hear too many tales that begin with, “Oh I thought I had a cold. But really it was dysentery” Or malaria. Or dengue. Everyone has horror stories about eating the wrong food or drinking the wrong juice. And these horror stories are much worse than your average food poisoning tales. So even the smallest hiccup or cough suddenly starts your brain ticking. What did I eat yesterday? Did I see a new mosquito bite on my ankle? Did I really wash that apple enough? You could go crazy worrying about getting sick – which is why most people stop obsessing over the small things after they’ve been here awhile. We start brushing our teeth with tap water and accepting ice from places that say they use mineral water. But it always lives in the back of your mind, the fear that India’s many health scares are coming your way.

I thought about all of this as I tossed and turned throughout the night. I couldn’t get comfortable no matter which position I picked. At 2am I looked at WebMd’s symptom checker. Bad idea. Once you say you’ve travelled to a third world country it starts giving you even more ideas. At 4am I wikipedia’ed dengue. That was comforting – apparently I would have had a rash, so it couldn’t be that. At 6am I took my temperature for the 20th time and was nervous to see it had gone up to its highest point so far. By 8am I woke up A.

“I think it’s time to call a doctor.”

My symptoms sounded bad- pain in the abdominal area on the right side of a female usually means appendix or ovaries, neither of which should be left unchecked. So we headed over to a clinic the doctor had recommended in order to get an ultrasound.

As I waited my turn in the plush waiting room I thought to myself, “This isn’t so bad.” It looked nicer than any clinic I’d seen at home. I was able to stretch out on a leather chair while a flat-screen tv showed the day’s cricket match (not my cup of tea, but interesting enough). Even with the nice setting the whole ultrasound only cost 1,200 rupees, or roughly $26. That’s before I even submit it to my insurance. For all the things to complain about the on the potential-diseases-you-could-get spectrum, I also had to be impressed by the low cost of everything. It’s not a low cost relative to the average income in Mumbai (where a large percentage of people only make a few thousand rupees a month), but compared to American health care, it’s a steal.

However my initial optimism soured a bit with the results of my ultrasound. I had “edematous gall ballder walls with sludge’ and ‘enlarged lymph nodes with fatty hila’. How was I to know what that meant? Sludge certainly didn’t sound good. Most annoyingly, they unfortunately they couldn’t get a close enough shot of my appendix to tell if it was bursting. So it was off to a CT (which, just as an FYI, cost around $120).

I’ve never had a CT before, but I can assure you that it is all the more unpleasant when 5 out of 6 techs in the room do not speak your language. They didn’t really understand that I was in a lot of pain, and therefore was having difficulty lying in one position. I couldn’t explain that my elevated fever was giving me the chills, which was also making it hard for me to not shake a bit. Finally a woman came in who spoke English and put a few blankets on me. I thought she might be my savior until she informed me that I would need an IV that would pump warm contrast into my veins as well as a tube going into another area (which I won’t go into depth describing here, since this blog aims to remain family friendly!). Needless to say, by the end of the CT I was feeling worse for wear.

That didn’t compare to my doctor’s visit after it all, where the idea of surgery was finally raised. As I lay curled up, exhausted from tests and fever and an unflinching pain, I listened to what the doctor had to say. You see, my appendix was fine. But that darn gallbladder was indeed inflamed and it would either need to respond to multiple medications or it would have to come out. A surgeon was lined up and at the ready in case I needed him. I suppose that was supposed to be comforting. We would just have to wait and see whether the inflammation and infection could go down before surgery became necessary.

Luckily the combination of the largest antibiotics I’ve ever seen, anti-inflammatories, pain medication, and an anti-nasuea medication normally reserved for chemo patients (the antibiotics apparently can be too strong to handle without some other medication) has made me start to feel like a new person (and all the medications together cost around $5). Within a day my fever went from almost 103 to almost normal. I’m certainly not at my best (those antibiotics are really not making it too easy on me), but at least it’s looking like I can keep my gallbladder.

So what have I taken from my few days of true illness in India? Well, firstly I will never make the silly claim of not having been ‘India sick’ again (although technically, lets be honest, 6 months of no food poisoning is pretty amazing in here. Knock on wood). I’ll also appreciate the cost of medicine here; it’s really something we Americans forget when we have insurance and something we decry when we don’t. If India can do it this cheaply why on earth can’t we even lower our costs a bit? I alternately appreciate being able to see a reliable doctor here and having the means to pay for it. I couldn’t help thinking of all the women I’ve met in Dharavi who clearly can’t afford to even get the kinds of tests I was able to get. It’s scary to think of how much pain I was in and the idea that someone couldn’t get the right diagnosis to lead them to the proper medication. It’s certainly something to be reminded of.

Mostly though, I’ll just appreciate (almost) having my health back. I’ve been lying around thinking of writing and being sad that I have no stories to tell other than the woes of a nauseous person with an enlarged gallbladder. It’s time for me to get better and back to everything I enjoy about living in India. Other than, of course, its predisposition for making us foreigners ill.