2020: Can it Get any Weirder? (A glimpse from my journal… Or: “Say hello to my little friend!”)
2020 has been a weird year. We all learned lessons, whether we wanted to or not. I learned that I was taking my good health for granted… and that home is where you make it even if it’s not where you expected it to be.
Hopefully you’ll see what I mean if I share a few entries from my journal:
October 15, 2020
I was just smacking my lips after one of my favourite breakfasts (oatmeal, fruit and yogurt) when I experienced a sudden massive pain in my upper right abdomen. The pain was so bad it laid me out on the floor. Nausea and diarrhea soon followed. Food poisoning? I’ve been there before. I’ll ride it out.
October 16, 2020
After a night of pain, no sleep and many, many visits to the bathroom, I contacted Alberta Health Link. They told me to go to emergency. Dr. Google suggested I was suffering a gall bladder attack (gall stones). The admitting nurse in emergency suspected the same thing and so did the emergency doctor. After some blood tests and an ultrasound, the doctor came back with:
Doc: “Do you have a dog?”
Me: “Yes.”
Doc: “Do you let your dog like your face?”
Me (sheepishly): “Yes.”
Doc: “Well you have a liver cyst.”
Me: “You mean a parasite?”
Doc: “Yes… you have a hydatid cyst in your liver which means you have a tapeworm larva living in the cyst.”
Me: “What?”
Doc: “Tapeworm cysts are extremely rare in North America. I’ve never seen one here. In fact, I’ve not seen a hydatid cyst since I left South Africa.”
Me: “But my dog has always been dewormed and does not eat coyote scat or wild game. How could I have got the parasite?”
Doc: “I’m not sure except that at some point you ingested tapeworm eggs.”
I asked the doctor if I could get tapeworm eggs from handling raw beef organs such as those we use in preparing our Affables’ Snacks pet treats. She said that was highly unlikely since these parasites prefer sheep or goat as secondary hosts (canids being the primary host and humans an accidental secondary host). Also, hydatid cysts of the size I had (6.5cm) take two to three years to develop. We just started making treats in January of this year so that possibility was out. I told the doctor I had worked at the Humane Society for three years and stopped working there two years ago. My job was Animal Care where I received and cared for stray dogs that often were loaded with ticks, fleas and worms. The doctor concluded that I was most likely infected from handling these dogs. Either that or I had a coyote poop eating habit that I was not admitting to.
The procedure for dealing with the infection was to confirm 100% that I had a tapeworm cyst (Echinococcosis granulosum – the dog tapeworm) and then a regime of medication and possibly surgery. The abdominal pain went away by the end of the day. The doctor figured I had passed a gall stone and that finding the tapeworm cyst was just a ‘happy accident’.
I felt bad for the larva that had found its way into my liver rather than the preferred body of its primary host, a dog or coyote, or its secondary host, a sheep or goat. I also felt vaguely insulted. But, I reasoned, the poor thing was just trying to survive in the suboptimal habitat of my body, an ‘accidental’ host, and now it was stunted in its life cycle, unable to live fully. It’s like the Kardashians trying to live with the Trailer Park Boys: things will likely turn out badly for one or both parties.
November 19, 2020
I’ve been seeing an infectious disease specialist and she wants me to go on medication to help kill the tapeworm larva. Unlike in dogs where the tapeworm lives in the intestine and medication is quick and effective (deworming pills) getting meds to work on a larva ensconced in a cyst hidden away from the immune system is problematic. The most effective medicine is Albendazole which is an anti-worm medication for humans but that medicine needs to be taken for months to be effective and some people have side effects such as headaches, nausea, dizziness, confusion, sweats and chills, fatigue and reduced liver function. My specialist wants me on the meds so when they biopsy the cyst to confirm the presence of the tapeworm, if any of the parasite escapes the cyst, the meds will reduce the possibility of the parasite establishing elsewhere in my body (spleen, brain or lungs). I’m game for the pills. The last thing I need is even less brain function!
I distinctly remember my parasitology instructor at the University of Alberta suggesting a sure cure for a tapeworm infection was copious consumption of alcohol. I was tempted to buy a bottle of scotch and medicate myself. Afterall, the side effects are essentially the same as I would have with Albendazole but with a lot more fun on the way.
November 24, 2020
I had a liver biopsy today which confirmed Echinococcosis granulosum in my cyst. As well a second smaller (1.5cm) cyst has been discovered. Not sure if it is a second parasite or a benign cyst.
Either way, Samantha no longer wants me to lick her face.
November 27, 2020
I emailed my longtime friends, photographers Mark and Leslie Degner about my stowaway. Mark is a biologist and often teased me in grad school about how much I ate. “Geez!” he’d exclaim. “You must have a tapeworm. How can you eat so much?” How prophetic.
After sending them the ultrasound of my cyst they wrote back: “So cute! We can see the resemblance.”
(Strangely, just this summer we moved to within an hour of where they’ve lived for the last thirty odd years…and just a couple weeks later they moved to another province. Hmm. Coincidence?)
December 4, 2020
Back in emergency. I’ve been suffering severe headaches, sweats and chills, extreme fatigue and general malaise for days (and it was not from self-medication with scotch!). After blood tests, CT scans and observation it was determined that my liver was severely stressed. Either the parasite had leaked into my body and I was having a reaction, or I was suffering from side effects of the Albendazole. Recommendation was to stop medication to see if symptoms disappeared.
December 16, 2020
My liver function is returning to normal, so it seems the medication has strong side effects for me. I discussed possible procedures with a surgeon about dealing with the cyst. One procedure, percutaneous aspiration, involves piercing the cyst and injecting concentrated saline solution to kill the larva but this must be followed with months of medication to reduce the risk of reoccurrence. The other option is to cut me open, lay my liver lobes on my abdomen and surgically remove the cyst which is more effective but has much more risk. Even surgical removal should be followed by medication. So, I may have to challenge my body with the medication for several more months. At least I will have a valid excuse not to do house chores.
December 29, 2020
I am feeling closer to normal than ever since being off the medication. I am supposed to get a liver aspiration sometime in January and then go back on meds. So the health journey continues.
For me one of the biggest lessons of 2020 is not to take your good health for granted but to be kind to your body; eat well, rest, exercise and appreciate the wonders of a healthy body. Good health can disappear fast.
The second lesson I learned is one I have in common with my tapeworm friend. It may not live in its definitive host, but it seems to be doing fine. It’s made itself a comfy little hibernaculum in my liver and is happily going about its daily business. The same happened for us. Sam and I ended up living in an old mobile home in the aspens fringing a shallow lake in central Alberta. Not our definitive habitat but it works for us. We are comfy and happy in our little hibernaculum. Unfortunately, there’s not room in my hibernaculum for me and the tapeworm larva. My love of nature only goes so far.
