Anaphylaxis in the mountains of Nepal

Just another day in Nepal. Doing house fellowships and hiking a mountain or two to get there. I deliver the message I’ve prepared. They feed us with delicious chicken, rice, lentils and mango juice boxes. We part ways. We stop to pray for a man with left-sided paralysis. He’s not immediately healed. We advise him to have the faith to believe he will actually be healed because without faith, the Lord usually won’t heal. We hike down some more and stop at a tailor’s sewing school. Here is where I consumed my 4th mango juice box. 4 in one day, totally normal, right? We pause to enjoy the magnificent views of the mountains/ valley and altogether gorgeous Nepali landscape. My teammate Marge befriends a dog, who is licking her face like it’s going out of style.

We go down to see the soon-to-be-ready clinic right next door. We now note that Marge is breaking out in a rash all over that is worsening and she’s feeling lightheaded. We rush inside to see if they have actual medicines and my other teammate Christa (who’s conveniently a nurse) and I (a Physician Assistant) frantically apply every cream we can find in the kit on the table.  The creams are labeled in Nepali so we don’t know what we’re lathering all over poor Marge. At this point, Marge is essentially a canvas for all sorts of white creams. None seem to help and there’s no actual oral or injectable medications. Marge is getting worse, with more lightheadedness, burning itchy rash, and throat/ chest tightness. So, we decide to leave the makeshift clinic and get to an actual hospital as she clearly needs more medical attention and IV/ IM meds.

So I ask our host where’s the nearest hospital and he says we can get a moped and they’ll take her to the hospital. I ask how far away the moped is and he says, “Near.” I’ve learned by now that whenever he says a length of time or distance, you always multiply by 2 or 10 or some factor. So, I just pray that it’s actually near since Marge is fading fast. We then proceed to descale the mountain, running down rocky, uneven terrain. Marge cuts her toe and it’s bleeding but she just keeps going. No time to stop. The locals we pass by just stare at Marge as her rash is very red and diffuse all over. Our teammate Christa offers multiple times to physically carry Marge the rest of the way because Marge is starting to get tunnel vision and become weaker. But Marge refuses. We get to the main unpaved road and our host asks a random person with a moped if she can ride with him down the mountain since she needs medical treatment and he denies us.

So we continue trekking and I’m amazed at Marge’s willpower and strength. We’re all trying to be positive and I’m honestly glad we didn’t know initially how far we had to go down the mountain, because we just held onto the hope that it was only a little farther the whole time. Finally, after what seems like a lifetime, we make it down the mountain probably 30-45 minutes later. Marge isn’t doing too hot and lies down on the cement floor by the church/ our temporary home and I hastily grab the first aid kit and find the Benadryl. She takes the Benadryl tablets and I get our teammate Kelly’s epi pens, just in case, as Marge says it’s getting harder to breathe and we still have to get to the hospital. We finally determine that the Pastor can take her and I will squeeze on the back of the moped since she shouldn’t go alone as she’s liable to pass out, especially with Benadryl in her system now. The Pastor is wary because it’s illegal to have more than two on a moped (for good reason: it’s a tiny seat with no good place to rest your feet) but I convince him that she can’t go alone.

We get on the moped and go about 30 minutes down the mountain entirely too fast but he was hurrying, which we appreciated. I struggled to stay on and gripped onto her and to the bike with all my strength. The curves and muddy, rocky terrain was pretty harrowing but Marge and I talked the whole way so she’d stay awake and somehow she did. She’s a fighter for sure. Seriously, amazing willpower when her body was basically giving out on her. We arrive to the “hospital” and walk in and they take her vitals and shortly later, have her walk up the stairs (we went up to the 3rd floor and had to come back down one flight) in her extremely lightheaded, weak state to see the doctor finally. He talks to her for all of 5 minutes, writes out the treatment plan with meds/ prescriptions and we are dismissed. We go down the stairs, the nurse pulls the meds from their pharmacy, and she sits down on a bed finally. All the beds have bloodstains and the nurse injects the medicine into her vein directly without any IV and gives her a pill to take. Then they watch her for 30-40 minutes and she does improve with the Benadryl and steroids in her system. Poor thing finally can lay down, contact her parents and rest a bit.

They check back on her and say she can leave since she’s improved and give her 4 prescriptions.  I pay for her ($10 USD total) and we wait for the Pastor (who’s also our translator) to return. He just stepped away to his house for a sec because, why not? And we finally leave on the moped, stop to get one of the prescriptions and sodas, and then go back up the mountain. It’s even scarier this time because I really feel like I’ll fall off so I cling to Marge and Pastor and to the bike with all the inner thigh muscles I still have working. I get off at one point and walk and they wait for me ahead so that I can walk by the police station so we don’t get caught with 3 on the moto. We arrive back at the church at last and poor Marge can finally rest and sleep.  Pastor rushes back to the city where we just came from since he’s late for a house fellowship that was planned. What a day!

I am so relieved Marge is doing better and her rash is almost completely gone and her symptoms have improved and that she can finally rest like she deserves. That was a close call! I’m grateful she was able to hike down the steep, rocky  mountain in her borderline anaphylactic state and maintain consciousness on the hike down and the moto ride to the hospital. I’m so relieved she improved quickly with the meds and that she didn’t have to stay overnight in that scary excuse for a hospital. Everything in my PA being was appalled at the hospital conditions and I lost my cool at one point in frustration with the staff and care. It would’ve been a nightmare if she’d had to be admitted and could’ve progressed even more if we didn’t have those two Benadryl tablets in the first aid kit. Honestly, it was an awful scenario but the Lord preserved her life and our sanity throughout the whole ordeal. Definitely a day to remember!

So, thank you Lord for your faithfulness and healing in a life-threatening situation! And Marge, my sweet friend, here’s to you for being such a trooper throughout the whole thing. You never complained once and you pressed on when your body was shutting down on you and you were facing a million stares by confused locals on the hike down. You’re an overcomer, my friend, and you’re freakin AMAZING and inspiring. And it was truly an honor to walk through that awful experience with you. But let’s not do it again, okay?!

Hope I didn’t scare any of you with this story. Just wanted to be real. We are fine and the Lord is good. We will press on for our work here is not done yet. So, watch out Satan, because we are a force to be reckoned with. My Marge is a fighter. ??  And I’m so glad I get to be on her team!