William has only been in Dushanbe for less than six months, but he decided that this week would be his time to monopolize the med unit here at post.
Diarrhea is a constant here in Dushanbe, so when William started having issues, I wasn't very worried. After all, it's so much easier to deal with an infant's diarrhea than a toddler's diarrhea. Potty training does have its occasional downsides. But when he started vomiting, I began to pay attention.
On day seven of the diarrhea and day four of the vomiting, I decided that I probably wouldn't be overreacting if I brought him in to see the doctor. Seven month old babies don't have a very wide margin of error and when you live in a place where serious medical attention is several time zones and a couple of plane rides away, waiting isn't the best idea.
Pretty quick we agreed that IV fluids were going to be helpful, but it turns out that dehydrated infants have very difficult veins to put IVs in, especially when the nurse is used to working on adults and not babies. So instead we tried oral rehydration, but it didn't go very well and three or four hours later William got to have another attempt at the IV. It's amazing how tiny baby veins are and how much they don't stick out when they're incased in layers of baby fat.
For awhile after the second attempt, William seemed to be doing better, but he took a turn for the worse in the late afternoon. The wonderful doctor, who was only filling in because ours has left with no replacement, spent most of the afternoon on the phone consulting on the best way to get fluids into a rapidly declining baby.
There was some discussion of an intraosseous infusion, but the nurse, doctor, and four medics available had never done one on an infant. In the end, we packed up an IV kit from the embassy and headed to a local hospital. The doctor managed to get an IV in his head, after attempting one on his foot, wrist, and vein. Once the needle was finally in, the rest was easy and William slept peacefully in my very (very) tired arms while he got juiced up with 225 mL of IV solution. We made it home by 8, twelve hours after William and I had left the house that morning.
Saturday was better than Friday, but by 2 this morning, William was in a bad state again. Brandon, who had been awake and trying to feed William the entire time, got to take him in to the embassy where he got another IV infusion through the same vein that had worked so well Friday night.
After a lot of discussion and test ruling out other possibilities, the doctor decided that William had probably come down with a rotavirus. He has been vaccinated, but only once (he was supposed to get his second dose this week, but that didn't happen), and it turns out that vaccination doesn't necessarily prevent infections, just makes them less severe. Rotavirus vaccination are pretty recent, only being just over a decade old, and have cut down on hospitalizations for infants tremendously. I remember getting the fact sheet about rotavirus when Sophia was getting vaccinated (Kathleen didn't get vaccinated for rotavirus) and wondering why she needed that particular vaccination.
Now I know why babies get vaccinated. If we had been in the US, William would have been in the hospital. If we had been living in a remote village in Tajikistan, William would have been in the ground.
Instead, it was somewhere in the middle with some very sleepless nights and a lot of good work done by the medical staff here at the embassy. Once again, I am grateful for the blessing of modern medicine.
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