A Doctor’s Unexpected Battle with Dengue Fever on Vacation
Insights from Dr. Deborah Heaney
What is Dengue Fever?
Dengue fever is a viral infection transmitted by mosquitoes, particularly in tropical and subtropical regions. Symptoms can range from mild to severe, including fever, joint and muscle pain, rash, and severe fatigue. In some cases, dengue can develop into a rare but life-threatening condition known as dengue hemorrhagic fever.
Dr. Heaney's guest essay "I'm a Doctor. Dengue Fever Took Even Me by Surprise on Vacation" was published in the NY Times as a call to the healthcare community to be prepared to look out for Dengue Fever as the number of cases spread globally. As Dr. Heaney notes in her essay "Overall, Latin America and the Caribbean have had three times the number of cases this year as reported for the same period in 2023". With Americans love to travel, it is critical for people to know the threats and to be prepared.
Learn more about the symptoms and prevention of dengue fever.
Vacation Interrupted by Dengue Fever
Dr. Heaney was enjoying a vacation in Curaçao with her partner, Kyle, and friends when she began to feel unusually weak and fatigued. What started as a peaceful beach holiday quickly took a turn for the worse.
"I was in Curacao… And one day I started getting very weak... I just had no energy, and my friend had to actually pull me until Kyle could come into the water."
Back at their Airbnb, Dr. Heaney’s condition worsened. She experienced intense body pain and a high fever that left her feeling extremely uncomfortable.
"I had total body pain that was excruciating. I started getting hot. Apparently, I was hotter than Kyle could even imagine. He would touch my skin, and it was like on fire."
Diagnosis: How Dengue Fever Caught Even a Doctor by Surprise
Despite being a physician, Dr. Heaney initially believed she had the flu or even COVID. However, after a negative COVID test and worsening symptoms—including severe diarrhea and itching—she began to suspect something else.
"I had a COVID test with me, so I took that, and it was negative... I actually figured it was influenza because what else could make me that sick? And I did a quick little Google search...And I messaged my ex husband, who's a physician assistant and actually has an interest in wilderness medicine, and said, 'Could I have dengue?'"
After urging her doctor to test for dengue, the diagnosis was confirmed.
"I messaged the doctor and said, 'Can you add dengue?' and she said, 'Yes, I’ll add it, but you’ll probably need a whole bunch of other things done too.'...Two days later, the test came back positive."
The Importance of Self-Advocacy in Healthcare
Dr. Heaney’s story is a powerful reminder of the importance of self-advocacy in healthcare. Despite her own medical background, she had to push for the right tests to determine what was wrong.
This experience shows that even healthcare providers may not immediately think of rarer diseases like dengue, especially in areas where it is less common.
Final Thoughts from Dr. Heaney on How to Avoid Dengue Fever
As global cases of dengue fever rise, Dr. Heaney emphasizes the need for awareness and prevention, particularly for travelers visiting regions where the disease is more prevalent. She offers this advice:
- Always protect yourself with insect repellent and mosquito repellent clothing, even in urban settings or areas you think might not have mosquitoes.
- If you start feeling ill after traveling, advocate for yourself—mention your travel history to your doctor and don’t hesitate to ask for tests that might not be on their radar.
Dr. Heaney’s experience highlights the unpredictable nature of dengue fever and the critical need for vigilance. Whether traveling abroad or enjoying a warm climate closer to home, it’s essential to help protect yourself from mosquitos that may carry illnesses like dengue.
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Transcript of the Interview
Mary: Hi, it's Mary from Insect Shield and I am super excited to have Dr. Debbie Haney, a physician from Ann Arbor, Michigan joining me today. Welcome Dr.
Dr. Heaney: Hi, thanks for having me.
Mary: Thank you. And I guess we'll jump right in. The reason we have you here today and inspired us to talk to you and hopefully share some great information is an article that you wrote or essay published in the New York Times back in April of 2024 entitled I'm a doctor.
Dengue fever took even me by surprise on vacation. Can you tell us what happened on vacation?
Dr. Heaney: Yeah. So I was in Curacao, um, with my partner, Kyle and another couple, and we were enjoying the beaches, the beautiful weather. I'd never been to the Caribbean in that area before and things were going fine. We were doing some snorkeling. We were enjoying ourselves. And one day I started getting very. weak feeling, start getting pain in my legs.
Um, and in fact, unfortunately, that was the same day that my snorkel decided to not work and was stuck. And so I had to float all the way back from where I was on my back, and I'm not a great swimmer, and I just couldn't do it. I mean, I know I'm not a good swimmer, but I was just had no energy, no fatigue.
I mean, a lot of fatigue. And my friend had to actually pull me until Kyle could come into the water. It wasn't too deep and carry me out. So I didn't really know that I was sick yet. I had had some aching. But when we got back from that, I just started having we got back to the Airbnb and I was having severe pain.
Um, I had in part of that. ordeal. I had tried to hold on to some rocks and had flipped under and against them. And so I thought I'd broken ribs. I had him checking everywhere. Um, and then I just went and got in bed and I had total body pain that was excruciating. And, um, I started getting hot. Um, apparently I was like hotter that Kyle couldn't even imagine.
Um, Couldn't believe how hot I was. He would touch my skin and it was like on fire. And for the rest of that evening, um, into the next day, I was just sort of writhing, um, taking Tylenol probably more often than I should have. Um, and that was the start of it.
Mary: So you're on vacation and so are you, you're towards the end of the vacation? What's happening now?
Dr. Heaney: Yeah, we were, well, we did leave the next day. Um, I was worried if I was going to be able or not. I did have a COVID test with me. So I took that and it was negative, but I didn't know what was wrong. I actually figured it was influenza because what else could make me that sick? And I did a quick little Google search.
Like I had. I thought I maybe the day before had a couple little bites, but they were smaller than mosquito bites should be. And I messaged my ex husband, who's a physician assistant and actually has an interest in wilderness medicine, and said, could I have dengue? And he said, no. Well, that doesn't fit the incubation period because that was just the day before.
Plus, you know, when you hear hoofbeats, think horses, not zebras. We figured it was much more likely that I had influenza. So I wore a mask and then traveled home. You know, there were delays, there were lines at customs and I mean, had to stand. I wasn't having severe pain anymore. It was, um, And I was just a little bit warm.
I was having some aching, but just, just wiped out. But I did make it back to Michigan.
Mary: So you get back to Michigan and you go visit the doctor because you're still not, not feeling well. What's, what are the next
Dr. Heaney: Well, I got back and, um, I was too weak to work. Um, I was working virtually anyway, but there was just no way. So then I started to get this profuse diarrhea. Um, actually, nausea and vomiting are more common with dengue, but I'm whatever reason I did have a lot of nausea, but I had profuse diarrhea for like 36 hours nonstop.
And
Mary: So you're weak and then have nothing inside you.
Dr. Heaney: And, um, I just got sicker and sicker and I called Kyle and said, you've got to take me to the ER. Um, I need to go to the ER. And he said, can you drive yourself? And I said, no way. Um, um, And I, I also had developed itching all over my body, like couldn't sleep itching. Um,
Mary: it's like every symptom you can think of. You can think of, okay, I've got itching, I've got diarrhea, I'm exhausted, I'm feverish.
Dr. Heaney: I know. And then
Mary: Yeah.
Dr. Heaney: fluids, please. And they evaluated me, um, gave me IV fluids cause I, Oh, the other thing is I like, hadn't urinated. And like a really long time. So I was like, I clearly need to get some fluids, but nothing made sense to us on the blood work.
I didn't even look dehydrated. I'd low sodium, low potassium, low magnesium, low calcium. Um, but what was most worrisome is my white blood cell count was like 1. 6, which is 4
Mary: what would be, we have, what's normal?
Dr. Heaney: to 10.
Mary: Okay. Wow. Wow.
Dr. Heaney: five to 10. Um, you know, we were worried about cancer at that point, like leukemia or something. Um, you know, the physician assistant didn't want to alarm me, but wanted immediate followup and my liver enzymes were all elevated. So she thought that I'd been taking too much Tylenol and that had caused my liver enzymes to be elevated.
Um, um, Stop taking Tylenol, start taking Advil, which is actually contraindicated in Degay, and um, go see your doctor, and do hepatitis labs, and you know, various things. And, I went back home, the itching was severe, I started getting these patches, this rash, it causes like these blood under the skin patches.
on my backside, up my back. It was just like every day it was something new. I tried to walk, you know, the sobriety test. We call it tandem walking, walking in a straight line. I couldn't do it. This is like, I have foggy brain. I'm like, this is the weirdest thing.
Mary: And at this point, how many days are you back?
Dr. Heaney: I think about three or maybe four. By the time I went to my primary care provider's office, I saw someone else there. She was baffled. I went back and looked at all the chart notes today and not one single note mentioned I'd been in Curaçao.
Mary: Yeah, I was going to ask, so no one asked if you had been out of the country traveling
Dr. Heaney: No, because the history was, just as far as the timeline of my illness, I was on vacation in Curaçao and I started to get sick, so they knew that, but apparently it wasn't part of the consideration. Um, and so, you know, the primary care provider, did all these tests. She was worried, thought, well, we might have to send you to infectious disease or to rheumatology or to hematology because she just didn't know what was going on.
And I went home after that. And by the next day, I was feeling a little bit better, like Lex foggy brain. And I started looking things up online again. Dengue kind of popped into my head again since I'd seen it before, but it's not even like I knew what dengue was. It was more of a Googling what could happen if you travel here and looked at the list of things and was thinking, Hmm.
And then Ray, my ex I was talking about with the, uh, uh, wilderness medicine experience, he and I had been texting and he asked me. was. And then he said, how's your liver? And I said, as a matter of fact, not good. The enzymes were up. He said, I think it's dengue. So at that point I was like, okay, he thinks that, you know, this is just too bizarre.
So I messaged the doctor and said, can you add dengue? And she said, yes, I'll add it, but you'll probably need a whole bunch of other things done too. And then A little less than two days later, the test came back positive.
Mary: Wow. So if you hadn't thought of it and asked for it, you could still be on a journey of being sick for a long time. Or does dengue, would you have recovered just on your own?
Dr. Heaney: I would have. Um, I had what's considered mild illness because severe, severe, I know, right? Severe illness is life threatening, hemorrhagic fever, um, need supportive care or you could die kind of thing. And.
Mary: Um,
Dr. Heaney: and my doctor, they were both relieved at that point because I was already better.
So they thought I was past the critical phase where I could have gotten very, very ill. So I would have recovered. But there's a couple of things I wouldn't have known. One is that the second time you get dengue, you have a much higher chance of getting the severe life threatening disease because of an immune stimulation that's already occurred.
So that's
Mary: Yeah. I was going to ask about that because I noticed you were in your article you meant or your essay that there is a vaccine, but they don't want to give it to people because you could get more sick. So how does that work?
Dr. Heaney: So, there are four strains of dengue. So, if you happen to get the second
Mary: Okay. I didn't interrupt quickly. Did you know this before? Did you know there were four strains before? Okay. Yeah. So,
Dr. Heaney: No,
Mary: okay. Yeah.
Dr. Heaney: Yeah, no. Um, doesn't everyone know that? So, if you happen to get sick with the same strain, and of course you don't know what strain you had, You have some immunity to that, at least for a while. I don't know for how long.
If you get sick with a different strain, you have sort of just enough immunity for your body to recognize it and build, um, a response where your immune system kind of goes out of control and you can get very, very ill if you get one of the different strains. So. If you give the vaccine, which is, I forget which strains, I think the vaccines may each, and there's several they've looked at, have two strains in them or such, and you get a different, the vaccine has a different strain from the one you've gotten, it can precipitate that severe illness.
Now, when the public health department called me, um, it's a reportable condition, um,
Mary: Okay.
Dr. Heaney: He pretty much has said, Well, I guess, you know, you have dengue. And so I said, Yeah. And I asked a couple questions. Um, he really the only information he gave me was the good thing is there's a vaccine and now you're eligible for it since you've had dengue because I had asked, Isn't it more of a risk to get it the second time?
Um, and so he told me that. And then he said, Yeah, When I inquired, um, I have no idea where you can get it. We don't give it. So the truth is that the only vaccine approved in the United States is only available to those under 16 years old, not to adults. So those under 16 who already have, um, serum confirmed dengue.
So I'm not eligible for any kind of vaccine. And
Mary: Okay. That's probably another conversation. Is that just because of the age and the way the body responds because to have vaccines under 16, is that
Dr. Heaney: You know, I'm trying to remember. I've read about it. Um, a lot of times vaccines are only approved for certain age group because that's where they've studied it. I think I think some of it's a risk benefit if I recall, because if you get it and you're younger, they may think that there's such a high risk of they're much higher risk of getting very ill.
So sometimes they just approve it for those reasons. Um, And also for people who need to go to endemic areas for whatever reason, visiting family or I don't know. But, but the number two thing that I wouldn't have known is that, well, and you're probably going to ask about this, these local spreads that can occur in, in areas.
Yeah. So what can happen is the way there's traveler cases in the United States, and that's the vast majority. of those who present with dengue in the U in the continental U. S.
Mary: Yes.
Dr. Heaney: Um, there are small pockets, especially in the southern U. S. of locally transmitted infection, which means the person got bitten by an infected mosquito there.
Mary: Right. And that's where me like the Florida cases like the really the Southern, we have, there's some cases. So, but then you, you could have been, or you were a carrier then and could have created a local outbreak in a sense.
Dr. Heaney: when I, when I asked him about that, he said, well, there aren't mosquitoes, that type of mosquitoes up here. And it, It's early March and by the time we have mosquitoes, your vital titer will be too low to spread it. So I had asked about that though. He hadn't even brought it up. He didn't know that I wasn't going to Miami the next week to visit family.
I mean, it should have been some, it's something very important to let people know. And when you've had dengue during that period when you can be a carrier and what happens is the mosquito. That type of mosquito, the atheist mosquito, bites you, gets infected from you, replicates, virus replicates, and that same mosquito, you know, bites someone else.
So, that is how it's spread, and people who have dengue need to know to protect themselves. to wear insect repellent, though, if they just had dengue to wear protective clothing and insect repellent to prevent, to protect the public. So,
Mary: Yeah, I don't think is, yeah, that's a whole nother thought of it that people I don't, I didn't even really think about as much when I was reading. I saw that it's on the local side, but I think with insect borne disease, people aren't thinking like, Oh, I'm going to, I'm going to become almost a carrier and I can then spread it where we're thinking of all of our other, you know, with COVID and everything else everyone's been dealing with spreading it and thinking so if a mosquito bites me and then bites someone else and, um, You could create your own outbreak, which is, yeah, that's frightening.
Um, and I know you mentioned, so continental U S is typically, you know, the traveler, someone coming from outside, but I know we're seeing more. I mean, Puerto Rico, I understand they had a large outbreak and that was a, I assume a kind of, you know, it was spreading amongst itself. It wasn't a traveler based.
Dr. Heaney: yeah, they had a dengue emergency this year. Um, and that's actually where the CDC dengue branch is located. Um, they had, You know, hospitals were getting full of people who were seriously ill. I can't think of the number. I don't know the number of cases there, but it was it was huge. And, you know, so one in four people who gets dengue who gets infected with dengue get symptomatic at all.
So you've got when you look at the numbers, you only see people who are who got tested, and you wouldn't get tested unless you were symptomatic. So, the number infected is far greater than the numbers you see. And, 1 in 20 gets the severe illness. And, if you've got, you know, a million people with the illness, 1 in 20 are a lot of really, really sick people.
So,
Mary: because it's. Yeah. It sounds like a debilitating. I mean, it's, and you're, it's seeming and you look like you're, you're in good health and obviously you're out on vacation, you're scuba diving or active person, but probably just like any of these other illnesses, if people are immunocompromised or maybe not in the best shape and health that they're that much worse off,
Dr. Heaney: Yeah, um, and snorkeling, not scuba diving. I'm way too scared. I'm way way too wimpy to do that. Um, don't want someone to watch this and say she was claiming she's a scuba diver. Um, yes, and you know when you get this serious illness, it If you get supportive care, so, um, there's no specific treatment, but you need fluids, you need, you know, your blood pressure might be dropping, you need, um, meds for that, whatever it may be.
If you get hospitalized and get good care, you're not going to die, most likely. Those who don't get supportive care, and therefore those who maybe weren't diagnosed, are the ones who die and it's not a high percentage of them. So, yeah, if you already have underlying weaknesses in your immune system and that sort of thing, but I don't think that's really a necessary component of it.
It's just the infection.
Mary: Yeah, I mean, that's, yeah, you've got, like, to hear your symptoms and how ill you were. I mean, it's, it's pretty astounding to, that'd be so scary.
Dr. Heaney: The scariest thing was thinking I spending, you know, three days, four days thinking I might have. blood borne cancer. And I had told the whole story to colleagues who were also physicians and they were really worried. Um, you know, it didn't strike them either. I work with a bunch of pulmonologists and, you know, it wasn't something that sounded familiar to them.
So, um, That's what I was most scared about was that there was something seriously wrong or the onset of some sort of, um, autoimmune condition, which was the other most likely thing with the labs like they were and I, that would be something that would probably be lifelong. So yeah, I wasn't too, too excited
Mary: that had to do. Yeah,
Dr. Heaney: about that either.
Mary: very difficult and I'm sure emotionally and obviously physically just so challenging. One, I was thinking of the. When you're about the kind of local or when someone gets it and carrying it on, there was an article, they were worried about the Olympics that actually there could be a small Dengue outbreak in Paris because people were coming from everywhere.
So I mean, I feel like Dengue is getting some more attention outside of Thailand and Vietnam and Asia. Um, have you seen that as well now that you're probably paying a bit more attention to the Dengue media?
Dr. Heaney: Yeah, they they made a really big deal about the Olympics, about it being a super spreader event. Um, I don't know. I just didn't see that happening. I mean, yes, there have been some cases in France, but not a huge number of them. And I just think that what? Well, I heard I read many interviews and watched many interviews on it.
Um, what they were concerned about was millions of people coming together. But it's not like COVID where trans, you know, normal transmission gets people sick. So it didn't end up being the case. And the good thing about it was that dengue in general was getting press.
Mary: Yeah.
Dr. Heaney: So I was happy about it. I didn't really think it would happen.
Um, though I liked that people were thinking about it and I just liked in general the press it was getting. Awareness is so important.
Mary: Yeah, that's it. Cause it reminds me so much of our work kind of in, in the tick borne disease. It's the knowing it's like, okay, saying I was in nature and you may not have known that you were even bitten by the mosquito or it's the same thing with ticks, people don't realize they're like, Oh, I never saw a tick and it's like, yeah, you may, you may not have seen a tick.
Um, and just saying to the doctor, Hey, I do. Walk outside, you know, and, and potentially I was around one. So the awareness and that's what our goal is just getting the word out. So people, someone like you was like, wait, I was in a country and I Googled it and it said, Oh, they do have dengue and coming back and being able to say the doctor, should we add that to the blood list?
You know, that seems like.
Dr. Heaney: Well, what happened and so after the essay was published, a lot of people, of course, read it and reached out to me. But I read some of, and it was shared on their, um, you know, their YouTube page and their X site and all that. And I read some of the comments. And you know, a lot of them were very positive. I kind of stopped reading just because there were so many.
But several people said I'm surprised with her background that she didn't think of this. It's textbook, you know, all the symptoms. But I, I don't know that I had a concept, any concept or understanding of this before. I was really sick. And just felt awful and I couldn't really even think straight like I thought about dengue Briefly, I was looking my texts today.
Mary: Yeah, no, you said that you messaged to your, to your,
Dr. Heaney: Yeah, I I messaged
Mary: could this
Dr. Heaney: you think it's dengue and almost as a joke Because you know, oh i'm one of those people googling things, you know, like who's even ever heard of it, right? um I completely forgot about it. I mean, I was just so ill. Um, and you just can't really think straight when, when you're like that.
It was only when I started to clear that I thought about it. So, you know, it's, it's tough.
Mary: I think, yeah, and honestly, sometimes the comments, people, if they were in the same position, we see how they act. So yeah, it's good that you, your brain did clear and you could ask and, and now kind of help advocate, you know, to educate. So what, yeah, so I was, I was going to ask like, so the response, so I would assume people were like, this is great.
Let's, we need to get the word out. So, and in New York Times, obviously a publication that has a large, um, readership. Um, cause I was even, I mean, I think in just some facts, like from your article, I mean, Latin American Caribbean have had three times the number of cases this year as reported last year. So, I mean, that's that's a huge increase, three times.
Dr. Heaney: Well, yeah. And it was, um, Year to date. I think I'm I know that, um, like Michigan, for example, already had, as of like a month ago, twice the number of cases in all of last year. So what was You know, remarkable at the time the article was published is that the cases were already higher than the prior year and it wasn't mosquito time yet.
Mary: Right? Yeah, that was, yeah, it was August. I mean, April the 3rd.
Dr. Heaney: Yeah. So, you know, if you look at maps from prior years, you know, it's going to be low and then it peaks in, you know, the summer when there's typically more mosquitoes and this was very unusual. And in fact, when I was in Curacao, I mean, I wasn't smart. I brought insect repellent. I even brought, as I told you earlier, some insect shield pants.
And. I thought maybe there were little things around. I never saw a mosquito and I, we were talking casually to the host of the Airbnb and I said, Oh, I might put out some of this mosquito thing she had. And she said, Oh, there's no mosquitoes now. This isn't mosquito season. You don't have to worry about it now.
There are no mosquitoes now. So I just kind of. Figured there were no mosquitoes. And
Mary: ticks and people think it's, Oh, it's winter and there are no ticks around. And I think one thing too, and your article brings up is with things warming and our mosquito seasons are going to be longer and longer. I mean, I'm in North Carolina. I don't think, I think it's almost all year, you know, there's time said we've got mosquitoes now.
So.
Dr. Heaney: yeah, definitely. I mean that the, um, 80th mosquitoes, which are, you know, the ones we're talking about here are moving higher up. Um, they were just, you know, very Southern and now we're getting, they're getting into the Southern United States, but they've actually even found them in mosquito surveillance higher.
I read an article. A few months ago that in Grand Rapids, Michigan, they had found a couple in the pool of mosquito surveillance that they do there. So, and they live longer and the virus replicates faster when it's hotter. So, yeah, it's hard to know what's going to happen. I mean, I know the CDC right now isn't worried about some huge, you know, um, epidemic in the U.
- of outbreaks, but, um, Certainly in the southern part of the U. S. It's a concern. There's just been a couple cases that people got in Orlando, but people are traveling, especially post covid. People are traveling all over and for individuals. Certainly it's really important for providers to be aware of it and for travelers to be aware.
In fact, I was, uh, looking back again today. So I think I'm a savvy traveler. I always look at the State Department alerts before I travel. So there had been some political turmoil in this area, and that's what I was following. That's what I was following. A health alert for Curacao was put out of a dengue outbreak on February 20th.
We left for Curacao on the 23rd. Well, by that time I had stopped my obsessive looking at the, you know, so it was just a little too late or I would have been paranoid enough. And I guess it's not paranoid if it's true, but I would have protected myself
Mary: Or you're a bit more cautious, right? And maybe, and you, when you started feeling ill, right away said, Oh, not, could this be dengue as a joke, but as a serious, like, this could be dengue.
Dr. Heaney: for sure.
Mary: Um, well, I mean, I'm sorry you went through this, um, but it's wonderful that you've been able to spread the message, um, and kind of just get people educated, you know, for healthcare, for just people, you know, owning it and saying, wait, I was just somewhere potentially that dengue was, or also thinking, I'm, I don't necessarily have to be somewhere where there was an outbreak, you know, it can be, it's spreading, it's around.
So to be alert. So. To, you know, finish up, if you, what's your, when people ask you now, cause you've become a de facto dengue expert. What do you say? What do you say? Like, they're like, okay, what's one thing I need to know or should do? That's two things. Um, what do you say to them?
Dr. Heaney: Well, the most important thing is protecting yourself. Insect repellent, um, insect, um, resistant, protective clothing, and trying to avoid perhaps traveling in peak seasons. I mean, even though there's mosquitoes all year round, you know, going when there's more of them, um, trying to keep windows closed, go places where there's screens, there was.
There were no screens. Doors were just wide open, and these were nice places. There was no air conditioning in the main areas. It's just not practical. And trying to, you know, the people think about, Oh, I'm going out in the woods. I'm going hiking. That's not where dengue lives. Dengue is more common in urban areas.
And so, not to think, which is what I was thinking. Oh, sitting on the porch in my B and B, I'm going to be fine. But to protect yourself in all those places because that's not a safe place either. And the second thing is to advocate for yourself. If you get ill to keep it in your mind, because I think I was the 10th case in the whole state this year when I got sick.
maybe the first in my county. I mean, it just now, since then, like you said, there's been more news, more awareness. We've gotten things from the, um, Michigan Department of Health and all these things. But the odds of a provider having that on their radar if there's so few cases coming back from traveling.
So to emphasize your travel history so that your provider pays attention to that.
Mary: Okay, that's excellent advice. Well, thank you so much for sharing your story and, um, hopefully it, uh, people have learned some things about dengue and we can help, uh, reduce, um, anyone else having to go through what you did. So
Dr. Heaney: Thank you. Thanks for having me and thanks for what you do.
Mary: Absolutely. Thanks.