Two days after finding out her month-long bout with the flu is really West Nile virus, a new Casper resident is already tired of trying to navigate the city's medical system.

Denise Daffer, 40, moved to Casper from Nebraska in August to live with her boyfriend, and had no regular physician when her symptoms got bad enough for her to seek help.

Daffer waited several weeks despite bad symptoms to visit InstaCare and then the emergency room, often the only options for people without a doctor in an emergency. She said she didn't seek care sooner because she isn't the type to ask others for help.

She thought, "It's just the flu, man - cowboy up."

She said she went to the hospital Sept. 10 and was given an IV to help her dehydration. They let her go home, but she felt sick enough to return the next day. She had back spasms and a fever and vomited whenever she tried to eat or drink. She had a spinal tap and was diagnosed with meningitis, a common result of West Nile.

Her boyfriend works occasionally in Houston on oil rigs and couldn't care for her full time, so Daffer's mother, Kay Knapp, volunteered to come up from near Chadron, Neb., to care for her.

Knapp is a medical aide at an assisted living home, and West Nile crossed her mind, although Daffer doesn't know where she might have gotten it. She said she spent some time at Alcova Lake this summer and tends not to wear bug spray.

Daffer returned to the hospital Sunday, when her mother suggested she be tested for the virus.

Monday, she got a call from someone at the Casper-Natrona County Health Department, saying she had a confirmed case of the mosquito-borne virus. Daffer is one of four people so far in Wyoming this year to have West Nile.

Last year, there were just 10 cases, but in 2003 nearly 400 Wyomingites dealt with West Nile, and nine died.

Once she found out she had West Nile, she didn't know what to do. Daffer said she was disappointed none of the doctors who had treated her at the hospital had called, and that the health department didn't seem to have any advice for her.

She made an appointment at the Community Health Center of Central Wyoming for Tuesday, but was too ill to get out of bed and go. Now she has another appointment set for Oct. 4, she said. That seems to be her only option.

"Just to find a doctor is ridiculous," she said.

She said Bob Harrington, director of the health department, called Wednesday to let her know she'd need to have an appointment with a general practice physician before she could be referred to a specialist.

Daffer hoped to see Dr. Mark Dowell, an infectious disease specialist, but she's not sure what he could do for her. The hospital told her you just have to wait out a virus.

"At least," her mother said, "he might be able to tell us what to do to make her feel better."

The Centers for Disease Control say there is no treatment, just good nursing care that could include IV fluids, respiratory support and prevention of secondary infections.

Daffer has lost about 20 pounds and seems pale, thin and weak as she lounges on her bed, cuddling a stuffed animal and watching movies on cable.

She heard it might take "a long time" to recover. Already this week she missed out on helping her daughter shop for a Homecoming dress.

"How long is a long time?" she said.

Reach Barbara Nordby at (307) 266-0633 or at barbara.nordby@casperstartribune.net.