The horrible and costly dengue

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Sunday, July 20, 2014


JO ANNE NALIPONGUIT-SALAR felt it was the end of her world when her 5-year-old daughter, Jamylia Mystique, contracted dengue for the second time in March this year.

It was horrible and costly.

Jamylia was dying; it cost her family almost P800,000 for her treatment that lasted 26 days where she spent 20 days at the ICU.

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And it started perhaps with just a bite from this tiny creature carrying the dengue virus, the Aedes aegypti.

On the first day of Jamylia’s fever, Jo Anne gave her daughter tawa-tawa drink which is an herb popularly known to help dengue-stricken patients.

In 2010, Jo Anne’s second daughter, Jody, contracted dengue. While Jody was confined in the hospital Jamylia got it too; she was three years old then. Jo Anne let her drink tawa-tawa and she got well without getting to the hospital. Her platelet count rose back quickly.

“I didn’t know that dengue is that worst. It was only when Jamylia got it again that I realized how deadly it is.”

On March 11, Jamylia’s complete blood count test showed her platelet at 258. But, the fever didn’t subside. Jo Anne brought her daughter to Northern Mindanao Medical Center (NMMC) for checkup. She was diagnosed with tonsillitis and her platelet count was at 258. The doctor prescribed her antibiotic.

On March 13, Jamylia’s platelet count was at 158.

On the 4th day of Jamylia’s fever, March 14, it didn’t subside despite the antibiotic. She brought her again to NMMC and this time the platelet count was at 58 and the doctor told her it’s dengue. But, Jo Anne was so uneasy since her daughter got so irritable, restless, her stomach began to bloat and there were rashes too.

Symptoms of dengue had become visible to Jamylia’s; and little did Jo Anne know, her daughter reached the strand or stage 4 of dengue. This is the critical stage where bleeding, shocks and complications happen that could result to death.

“NMMC was so slow. I should’ve brought my daughter to a private hospital right away. At NMMC, her blood pressure was already 80/40 and yet the doctors there didn’t tell me she was critical. I was advised by some friends to transfer to a hospital where there is a dengue specialist. We brought my daughter to Maria Reyna Xavier University Hospital,” Jo Anne said.

“When we got there I felt my daughter could die soon, I told my husband to hurry to the hospital since Jamylia was looking for her. We were still at the ward room because we had to deposit yet P30,000 for the ICU admission. While we produced the money, the doctors ordered the machines to be brought to the ward room so my daughter can be treated right away,” she recalled.

Jamylia was already hallucinating and she kept on telling her mother to send her father and sisters right away. “She was so weak. I thought she’d die already,” Jo Anne told Sun.Star Cagayan de Oro.

As soon as Jamylia’s father arrived, he held her hand; she went flatline. The doctors revived her.

When the money for deposit was available, she was transferred to the ICU. The doctor told Jamylia’s family to provide everything they would be requiring to save her.

“But they also told us Jamylia had ugly prognosis – she was dying and we were told to pray,” Jo Anne said.

Jo Anne prepared herself for the worst but didn’t give up despite the financial difficulties.

Each day at the hospital was a roller-coaster ride. It was uncertain for Jo Anne. But, she held on faith.

“I always cried. I sometimes didn’t understand what the doctors were telling me. I was so scared each time the doctors would speak with us after their conferences on the best possible treatment to apply,” she said.

Complications

As the complications showed up, seven doctors attended to Jamylia’s case.

“The shocks the dengue brought made her situation complicated. The dengue virus hit her heart the most,” Jo Anne said.

The doctors prescribed her the experimental drug for the heart – the Melrinone. It is only available at NMMC, but Jamylia’s family could hardly get it since NMMC won’t sell it to patients not confined in there. They were able to get three though from persistence and help from a politician to just get the third one.

It is sold at more than P2,000. “It is only NMMC which sells it in Mindanao. It is also available in Cebu which I don’t remember where and there are two in Manila, the PGH and St. Luke’s,” Jo Anne said.

“It was so difficult to buy it from NMMC. Good enough, one of my daughter’s doctors has connection at PGH and ordered eight. We had to seek people’s help to buy the medicine from PGH, bring it to the airport in Manila and my sister had to pick them up soon as they reached at Laguindingan airport. We were chasing time,” Jo Anne recalled.

The dengue virus perforated the nerves that drained the water in the blood making Jamylia’s heart to pump harder since the blood had become thicker.

The difficulty to catch up with her heart rate compelled the doctors to intubate her. Then, her kidney failed; so she was put on dialysis for three weeks since she couldn’t pee.

Pressures

As the family was feeling the pressure of Jamylia’s situation inside the ICU, the hospital pressured them to pay the ICU each time the bill registered high. “Every now and then, the cashier would call us to pay half of the incurred bills. And there was medicine to buy each day. The dialysis cost us around P20,000 to 40,000 a day in three weeks,” she said.

As Jamylia got out of the hospital, the bill reached P451,000 including the professional fees of the doctors. They spent P350,000 for the medicines.

“The hospital’s lawyer called us and we were asked to find possible means to checkout from office. The lawyer asked us if there was something we could give as a collateral. My husband’s family has a land title in Surigao and so we gave it to the hospital so we can check out,” she said.

“Each day, I was facing the worst to happen. It really felt like it was the end of the world. Yes, I am only receiving around P3,000 from my salary for the next three years since I got a loan of P430,000, but it is worth it since my daughter is alive.”

Paranoia

Since Jamylia got out of the hospital, she has become sensitive to anything that would weaken her.

A month after she left the hospital, she got typhoid. She also gets bronchitis from time to time. Jamylia has to wear mask.

“I am so paranoid whenever Jamylia gets sick. It’s just so difficult,” she said.

To protect the children from mosquitoes, Jo Anne makes sure that they use mosquito net at night. The electric fan is on all the time.

She would dab citronella to her children before going to school.

Encephalitis

For Regina Palmes, coming back home was the immediate decision after she was informed her daughter, Susane Lorette, 8, contracted dengue.

She booked a flight from North Carolina to Cagayan de Oro right away.

“I told Nanay (Susan Palmes) I have to go home. I couldn’t forgive myself that if something happens to my daughter I won’t be there,” Regina said.

When she arrived on July 18, she was surprised to see her daughter at the ICU. Her family didn’t inform her. She thought Susane is experiencing the same condition with her nephew, Christian, who got dengue in December 2013.

Her nephew was admitted to the hospital but didn’t go through any complication.

The family didn’t want Regina to be tensed and worried while traveling and so they kept the ICU information from her.

During her travel, Regina had delayed flights from New York to Shanghai and Manila that compelled her to book another ticket since she already missed her Cagayan de Oro flight.

“After I heard what she went through. I realized it was the reason I was so restless in my flights. I could feel how my daughter felt,” she told Sun.Star Cagayan de Oro in an interview at the hospital Saturday afternoon, July 19.

Upon the onset of Susane’s fever, Honey Mejorada, Regina’s sister, gave her tawa-tawa drink, papaya and durian. But, Susane’s fever didn’t subside which prompted Honey to bring Susane to the hospital on July 13.

Her platelet count dropped to 16. She was immediately brought in to the ICU and had six bags of blood for transfusion.

Then, on July 17, Susane had seizure. Her complication hit her brain. She has encephalitis.

As of July 18, the hospital bill is at P44,000 excluding the doctors’ fees and medicines bought outside the hospital.

At press time, Susane’s platelet count has gone up to 80. And the family requests for more prayers to completely heal her.

Campaigns

A city health officer admitted that dengue virus couldn’t be eradicated until everyone will do its share to ensure the surroundings are clean and apply the ways to do it. The community is urged to know the symptoms and don’t take fever for granted.

Dengue according to the Department of Health has become an all-season disease and it worsens during rainy days.

Adults are also warned to be vigilant on getting fever since dengue doesn’t exempt one. There had been adult fatalities already due to dengue.

Vaccine

Health Secretary Enrique Ona said the dengue vaccine developed by a pharmaceutical firm is already being eyed for release in July 2015.

"This is of great public health importance due to the high incidence of dengue and its disruptive effect on the country's health system," Ona said in a press conference last week.

The health chief said the first Asian dengue vaccine efficacy trial for more than two years now showed a promising overall efficacy of 56.5 percent, which means that more than half of the subjects did not get dengue.

He also noted that the study showed that after three doses, the vaccine reduced the possibility of developing dengue hemorrhagic fever by 88.5 percent.

Ona also said that during the observation period, a 67 percent reduction in the risk of hospitalization due to dengue was observed.

The study on the dengue vaccine efficacy was performed in a total of five Asian countries, namely Indonesia, Malaysia, Thailand, Vietnam, and the Philippines, involving a total of 10,275 children, whose ages ranged from 2-14 years old.

In the Philippines, there were 3,500 children coming from Cebu and San Pablo involved in the study.

Because of this, the health chief expressed confidence that dengue will no longer be a public health threat as early as next year.

Published in the Sun.Star Cagayan de Oro newspaper on July 20, 2014.

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