Why traveling to the Dominican Republic was so problematic
Two years ago the Dominican Republic was a hotbed for the mosquito-borne virus Zika. As you may know, Zika is responsible for causing severe birth defects in babies who are exposed to the virus while in their mother’s womb. When I arrived to the Dominican Republic we knew that we would have to put off trying to get pregnant for at least two months starting from the day we left- and that guideline was only if neither of us showed symptoms. If we did have symptoms, and depending on who had them, that period of waiting could increase to 6 months.
However, when I left the USA I also left the Zika hysteria that had consumed the nation behind. In the USA updates and warnings were featured in the news daily, creating the impression that everyone was at risk all of the time. While the risks were real to those who were exposed, the vast majority of Americans never would be. Conversely, there were ongoing outbreaks all over the DR, but very little was communicated to the local population about their status.
Getting a little too “caught up in the moment”
Arriving to the DR (where hardly anyone talked about Zika) and being thrust into medical emergencies and life and death decisions, Zika’s looming threat lifted as well as the concern for waiting to try. Of course it didn’t help that MH’s family members (who had nothing but the purest intentions) would frequently ask when we would start a family, and that EVERYONE had children around us. But when I would voice my concerns about Zika, I wasn’t met with the same ubiquitous anxiety and concern that I had experienced at home.
So as worries faded and the weight MH and I felt from navigating one crisis after another increased, I gradually loosen my stance. Zika seemed like a faraway concern when we had so many other problems to confront on a daily basis. It was a pressure cooker situation, and rather than the stress crack our marriage, it fused us together. And in a city where you can’t do something as simple as go for a run, the best way to release stress was through intimacy. So MH and I figured, “why not just see what happens?”
My first Zika symptoms
After being in the DR for five weeks I decided to head back to the USA for Father’s Day and my father’s birthday. Two days after arriving, I went to the beach, and when I got back I noticed a slight rash on my face and chest. I have lost count of the number of times I have broken out in a rash of some sort after traveling- especially when sun and salt water in the mix. It wasn’t itchy, but my skin did feel sensitive. I wondered if it could be Zika, but at the time I chalked it up to hives from the stress of the trip. That night I took an antihistamine and went to bed.
The next morning I awoke and the rash was all over my body. I felt tired and a little bit of a mental fog, and at this point I knew it was something more. I took a picture of my rash and sent it to MH, who forwarded it to his family. His aunt, who is a doctor, confirmed that it looked like Zika so I started making the calls.
Trying to get tested for Zika
I searched for Zika test locations in New Jersey, but all I could find was a Zika hotline. When I called, I was told the test was only processed at one lab in the state, so I would need a doctor’s referral. The operator recommended that I call a local hospital, so I did. The hospital stated that the only way to be seen was via the emergency room and to be evaluated by the infectious disease doctor on staff. At this point, I was informed that I may or may not be given the test. Since I had already spent a couple of hours researching the tests and their reliability, I knew that the tests available were notorious for both false positives and negatives. Depending on the test used, they also picked up on whether the patient had Dengue or Chikungunya exposure. I decided against spending thousands of dollars to *maybe* be given a test that *might* be accurate. My concern at this point was knowing if I had something else that could be highly contagious.
An hour later I went to a walk-in clinic and was seen by the doctor there. She evaluated me, and ruled out any other infectious disease. I had no fever, the rash was consistent all over my body, and my eyes were clear of any symptoms. She said the only other thing it looked like was Lyme disease, but the timing of my symptoms didn’t align with when I arrived to the USA. I asked if she could give me a prescription for the Zika test, and it became evident that I knew more than she did about the disease and the resources available. I sat on the exam table for several minutes as she researched Zika on her computer. Her diagnosis: yes, it looks like Zika. But to be sure, I should call an infectious disease specialist on the following business day.
The next day I called the infectious disease specialist referral, and was informed that their first available appointment was in two months. Since testing needs to be performed within the first two weeks of the onset of symptoms, it was pointless to make an appointment. I was in disbelief that despite the amount of national attention that was focused on this disease, our healthcare system was so poorly prepared. Literally no one knew what to do with me.
My Zika symptoms: rash, swelling, and aches
I was fortunate that I didn’t have the more severe Zika symptoms, such as a fever or conjunctivitis. However, by this point my fingers began to swell and my hands looked really cartoonish. Then the following day my feet swelled and my joints began to ache. My rash lasted less than a week, but my feet and knees continued to be alarmingly tender when I would walk first thing in the morning; it felt like the tissue was super inflamed. Thankfully after three weeks I felt normal again.
Officially having to wait
Although the medical professionals that I spoke with were fairly confident that I did contract Zika, I was never officially diagnosed. Therefore, I was treated as if I did have Zika in the sense that I would have to wait at least two months to try to get pregnant. I would also have to follow the same guidelines has non-infected people and have to avoid re-exposure for as long as MH and I were trying. Based on research at the time, it was believed once you were infected you developed immunity; however, there was so much that the medical population didn’t know about the virus: Were there different strains? Was it evolving? Were you really immune?
At the time, I assumed once we passed that two month mark I would be pregnant soon after and we wouldn’t have to worry about Zika for some time. I never would have guessed that two years later Zika would be a reason for why we would have to pursue IVF.
Photo Credit: https://en.wikipedia.org/wiki/User:Muhammad_Mahdi_Karim