Painful Swelling on a Pacific Island

After acquiring a severe infection on a remote Pacific island, Nadia Aly had to be medically evacuated to Queensland, Australia.

Since 2012 I have spent more than nine months each year diving and snorkeling around the world, rarely spending much time in one place. In May 2018 I had an incident that precipitated my first call to DAN®, and I hope it will be my only experience requiring a medical evacuation.

After snorkeling in harbor waters that weren't very clean due to runoff from the island (although that's not the definitive cause of what happened to me, I have my suspicions), I woke up the next morning with a large, swollen bump behind my ear. Not thinking much of it at first, I eventually went to the pharmacy because the local doctor wouldn't be arriving until late June (it was a small, remote island). Thinking it might be an ear infection, the pharmacist gave me an antibiotic, but over the course of the day my energy quickly dropped and I developed a high fever. Around midnight, I woke up with an intense, throbbing pain where the jaw meets the ear — the worst pain I have ever felt in my life.

The pain became unbearable, so I quickly searched my still-packed suitcases for any type of pain reliever. I took two ibuprofen, crying with pain until the medicine started to kick in. A dose every four hours like clockwork was all that held the pain at bay. At this point I called DAN because I didn't think an ear infection could be so painful. The medic advised me to go to the hospital, but I knew that doctors there wouldn't have much to offer in terms of diagnosis or solutions other than an IV drip.

After waiting it out for two days as friends watched over me, I woke to an even larger face. It was apparent that something was really wrong. I had used the entire travel-size bottle of ibuprofen and needed to see a doctor. My fever broke after three nights, but the pain and swelling were getting worse.

I finally went to the local hospital as the DAN medic had suggested, but I feared they would have no way to properly diagnose me. The doctor confirmed that I didn't have an ear infection. My throat was starting to hurt, and inhaling was painful, so I called DAN from the hospital. With no way to diagnose me locally and after seeing the photographs I was sending of the increased swelling along the back of my neck and front side of my throat, DAN decided to evacuate me to the Gold Coast in Australia for an ultrasound and CT scans. They were concerned that the potential infection could close my airway or spread quickly.

Twenty-four hours later I met the medevac plane at the airport, where a doctor and nurse from the Gold Coast quickly assessed me and helped me board. I showed them pictures of my face and explained the amount of pain I was experiencing. They immediately gave me some steroids, which drastically reduced the swelling, as well as some morphine for the pain during the plane ride.

Aly was diagnosed with bacterial parotitis, which required hospitalization and
four days of IV antibiotics.
Upon landing, they took me to John Flynn Private Hospital in Tugun, Queensland, where a doctor who understood the situation examined me. The staff took blood samples, CT scans and an ultrasound, along with some very uncomfortable swabs down my throat and up my nose.

It was clear from the ultrasound that one of my parotid (salivary) glands was extremely swollen with fluids, and the doctors diagnosed me with bacterial parotitis. I spent three nights and four days in the hospital on drip antibiotics and fluids.

Without DAN I would have had to get myself out of this grueling situation, and there is nothing worse than being alone on the road, sick and vulnerable. DAN took care of things from the minute I first called them. They contacted me every day, and I updated them on my situation through texts and photos. They continued to call me daily and acted quickly when I needed evacuation.

It's a no-brainer to be a DAN member. I use their annual trip insurance since I travel most days of the year, and the DAN Guardian dive accident insurance is a small price to pay for peace of mind in the face of unknown events on a dive or snorkel trip. You never know what life will throw your way, but DAN is there when you need help dealing with the unknown, especially in remote areas of the world.

I am very thankful for DAN and the doctors who helped me during this very painful situation.
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© Alert Diver — Q3 Summer 2018