Antibiotics, Bed Rest and Friends – Standard for Recovery in Central Africa

In early August I was found collapsed on the floor of my office at the Hotel Club du Lac.  So far, I’ve been given three versions of ‘what happened’ – and then there is a fourth version (mine).Taken to the hospital by kind staff at the hotel, I was put on IVs as well as administered massive doses of Benzylpenicillin every few hours by IV  (aka penicillin G potassium or sodium).

Penn G not only is an extremely potent antibiotic, it can also quite painful when administered:    Extreme pain up the arm in which the IV is located, strong and unpleasant taste of the drug in one’s mouth, etc.  This is a drug that I’ve used on occasion for horses (here) having a serious infection – and now I understand why it was necessary to peel them off the ceiling on occasion, following injection.

Here are major maladies that can be treated with Pen G:

CLINICAL INDICATION	DOSAGE
Serious infections due to susceptible strains of streptococci (including S. pneumoniae) -septicemia, empyema, pneumonia, pericarditis, endocarditis and meningitis	12 to 24 million units/day depending on the infection and its severity administered in equally divided doses every 4-6 hours.
Serious infections due to susceptible strains of staphylococci – septicemia, empyema, pneumonia, pericarditis, endocarditis and meningitis	5 to 24 million units/day depending on the infection and its severity administered in equally divided doses every 4-6 hours.
Anthrax	Minimum of 8 million units/day in divided doses every 6 hours. Higher doses may be required depending on susceptibility of organism.
Actinomycosis Cervicofacial disease Thoracic and abdominal disease	1 to 6 million units/day(*) 10 to 20 million units/day(*)
Clostridial infections Botulism (adjunctive therapy to antitoxin) Gas gangrene (debridement and/or surgery as indicated) Tetanus (adjunctive therapy to human tetanus immune globulin)	20 million units/day(*)
Diphtheria (adjunctive therapy to antitoxin and for the prevention of the carrier state)	2 to 3 million units/day in divided doses for 10-12 days(*)
Erysipelothrix endocarditis	12 to 20 million units/day for 4-6 weeks(*)
Fusospirochetosis (severe infections of the oropharynx [Vincent’s], lower respiratory tract and genital area)	5 to 10 million units/day(*)
Listeria infections Meningitis Endocarditis	15 to 20 million units/day for 2 weeks(*) 15 to 20 million units/day for 4 weeks(*)
Pasteurella infections including bacteremia and meningitis	4 to 6 million units/day for 2 weeks(*)
Haverhill fever; Rat-bite fever	12 to 20 million units/day for 3-4 weeks(*)
Disseminated gonococcal infections, such as meningitis endocarditis, arthritis, etc., caused by penicillin – susceptible organisms	10 million units/day(*); duration depends on the type of infection
Syphilis (neurosyphilis)	12 to 24 million units/day, as 2-4 MU every 4 hours for 10-14 days; many experts recommend additional therapy with Benzathine PCN G 2.4 MU IM weekly for 3 doses after completion of IV therapy
Meningococcal meningitis and/or septicemia

Source: http://www.globalrph.com/penicillin_dilution.htm

After several painful weeks of this IV solution, I was administered 500 mg of Amoxicllin-Acide Clavulanique 2x daily for several weeks, promptly vomiting after each until the dose was administered throughout the day.

Little islands of consciousness occasionally appeared in a black sea.  Strange visions, apparently constructed out of both the unconscious together with happenings during occasional bouts of consciousness, are primarily what remain of that time.  For example, I have a distinct memory of being introduced to the head of the clinic-hospital, who – I was informed – was actually a leading veterinarian up north.  At the time, this made perfect sense to me…

A variety of friends and well-wishers came to visit – often bringing a meal to eat in my room, knowing that I couldn’t eat – but would enjoy their company.  This is standard in Burundi, and once my photos are liberated, I’ll  put some in a blog.

But such great happiness to learn that Evelyn Early, who just before my illness had been visiting me (and who is now in DC), rounded up old friends and colleagues known in Egypt in the ‘old days’ – and all have helped immeasurably in getting me back on my feet!  Much more about this wonderful adventure, too, as strength returns.

Following about three months in the hospital, that included excellent physiotherapy towards the end,  I was taken  home to ‘enjoy’ another month of bed rest.  And really, quite too weak to perform even the simplest tasks until last week.

Somehow I had seriously injured my left knee cap – it was shattered – and surgery was performed on several times.  Now I can walk on it.  But will I be able to ride again?

Dorinda, whom I brought from Kenya to the Cercle Hippique, which is located in Burundi – shown here with friends who are all finding their boxes. Irakozi.