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Parasite wages war in veteran's body

By CAMILLE C. SPENCER
Published February 12, 2007

ADVERTISEMENT [Times photos: Julia Kumari Drapkin] Timothy Carmack gets a haircut from his wife, Shannon, as he rests his swollen feet on a pillow. Their 1-year-old son, Christopher, looks at him. Shannon Carmack uses an industrial-grade sander to prevent "crust" or hardened skin growths from developing on her husband's feet.

HUDSON - Four years ago, yellowish fluid began oozing from the Vietnam vet's legs. It seeped from his pores and pooled in his tennis shoes.

From the knee down, Timothy Carmack's legs swelled to twice their size. They more closely resembled tree trunks than the legs of an agile painter. He feared for his life.

Now 61, he can stand no longer than 10 minutes at a time and can't work. His family, including wife Shannon and their two young children, face eviction. Shannon pawned her wedding ring for groceries. Timothy sold his gun collection to pay other bills.

"My life has basically come to an end," he said. "It causes tensions in the house. It's either look at these walls or go to the doctor. It scares me to death."

And it's all because of a parasite that bit Timothy 38 years ago.

Service in Vietnam, then an odd illness

Timothy entered the U.S. Army in the fall of 1962.

The Plant City man spent five years in a heavy artillery division, a year of that in Vietnam. When he was discharged in 1969, Timothy earned a Bronze Service Star for overseas duty.

Two days after he came home to Plant City, fever took hold. Timothy went into a coma for five days. He lost 40 lbs. Doctors said it was malaria.

He was sent home 24 days later. Timothy had no idea that his body would never fully recover.

For decades, his health waned. About 30 years ago, Timothy started going to see doctors at the James A. Haley VA Medical Center in Tampa, but no one could figure out what was wrong.

First came upper respiratory infections, sometimes twice a year.

Then, pain and swelling in his genitals, a condition called hydrocele. Doctors said he couldn't have children.

Despite his health, Timothy kept busy hunting deer and fishing, and started a painting business.

As a hobby, he sang country-western songs. After a performance at a local bar, he met Shannon.

He married the round-faced nurse and single mother in 2003.

Though doctors said Timothy couldn't have children, Shannon became pregnant. The couple have a 1-year-old named Christopher and 7-year-old Jonathan from Shannon's previous marriage.

Shannon is 29. Her husband is 61.

"I don't care what people say," Shannon said. "My friends were surprised about his age at first, but I told them that once you meet him, you'll love him."

Wedded bliss tested by sheer physical pain

The couple's newlywed bliss in 2003 was short-lived. That same year, Timothy developed throbbing and swelling in his legs.

At 250 pounds, Timothy was already a big guy. But he was carrying an extra 80 pounds of water weight in his legs.

"From the knees down, my legs turned red like a third-degree burn," Timothy said. "They were burning so bad I felt like I could scream."

Doctors still didn't know what was wrong. Some said he was overweight. Others said Hepatitis C. Timothy took aspirin to ease the pain. He feared what would happen if the swelling continued.

He was forced to stop working at his paint company. The couple fell behind on bills.

For years, Timothy wondered if his malaria caused his medical problems. But he had no proof he'd ever had the disease.

Timothy was told that a copy of his diagnosis was lost in a fire that destroyed a building housing military records. In 2004, Shannon wrote letters requesting it. A year later, they were sent a copy of the diagnosis.

Armed with proof that he had malaria, Timothy went to a urologist at the Tampa VA last year to treat his hydrocele .

There, he answered a few of the doctor's questions.

Have you ever been overseas? Ever had malaria?

Timothy nodded. Then, he took a blood test.

The test confirmed that Timothy had lymphatic filariasis, a disease that doctors say he most likely received after being bitten by a parasite in Vietnam.

The disease causes:

-Hardening and thickening of the skin, also called elephantiasis.

-Lymphedema, which causes fluid collection and swelling in the arms and legs, making it hard for the body to fight germs and infections.

-And hydrocele, or swelling of the genitals.

Timothy had all the symptoms.

Doctors say it sometimes takes decades before obvious symptoms surface.

For Timothy, it had been almost 40 years.

VA response is short and contradictory

A Times reporter sent a letter to the VA in December requesting a reason why no one diagnosed Timothy until decades after his symptoms surfaced. The response is short and contradictory.

"The diagnosis has not been confirmed," the letter said.

But medical records show Timothy was diagnosed Jan. 5 with the filariasis.

"It's been diagnosed, and they know what it is," Timothy said. "It's on my record. But they keep denying it. They want another test, then another."

Timothy's next test could prove more telling than them all.

A lymphatic scan ordered by his doctor could put him steps away from resuming a normal life.

In a healthy person, lymphatic fluid, which helps maintain the immune system, is excreted in urine.

But the parasite that bit Timothy caused blockages in his body, so the fluid collected in his legs and made them swollen.

The scan will show doctors where the blockages are. Then, doctors can massage out the excess fluid. Draining the fluid, coupled with antibiotics, should ease some of Timothy's pain.

Even so, it could be a month until the scan comes in.

Until then, Timothy waits. He borrows money from family and friends to pay for groceries. He spends his days sitting on the couch.

He takes morphine and Tylenol with codeine to ease the pain. Cancer, which occurs in a small number of patients, worries him.

Half his age and size, Shannon shoulders the household chores.

She keeps track of the sea of medical records, the endless doctor's appointments. She cooks, helps him to the bathroom.

Timothy is weary from lack of sleep. He has nightmares of war. When he talks of his disease, tears well in his eyes. He fears death.

"I don't want to lose my home and my family," he said. "If they don't get the water out, it can turn cancerous, and that's it."

[Last modified February 11, 2007, 21:26:37]