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How I Spent my Christmas Vacation
(2003-2004)
This is a mass e-mailing to (i) thank those of you
for your support over the past two days, (ii) to tell my story of woe, and
(iii) to inform anybody who doesn't know (but cares to) that I just spent two
days in the hospital.
The Sunday after finals week I recall spending a lot of time and close
contact with a very sick three year old, my son, Noadiah.
He'd been sick for a few days, so who knows when this story actually begins.
Either Sunday or Monday evening (I don't recall which) I was feverish through
the night, with some kind of lung infection going on for the rest of the
week. The Saturday before Christmas we (my family and I) flew to Arizona for a 10-day
vacation. I was working on about 4-5 hours sleep by the time we taxied away
to Phoenix.
This was about five days after that first feverish night.
Saturday evening I couldn't tell whether I was getting better or getting
worse. My symptoms were less severe than they had been the previous week.
Tellingly, though, I was totally exhausted.
Sunday and then Monday I was getting sicker. Monday evening I got about 1
hour of sleep since my almost constant coughing (clearing my lungs, or at
least trying to) kept me up. My only reprieve was remaining upright, which
also made sleeping difficult. Earlier in the evening, thinking that my
problem was some sort of indoor allergen, I set myself up to sleep outside.
That didn't work at all, but we did have the fun of my putting the air
mattress out on the porch, going inside, saying to my daughter, Talia, "Say, that sounded like
wind," and then checking on the air mattress, only to find that
it was gone. (For those of you who care about these things, yes it was a $100
Therm-a-Rest, two actually, and yes we did manage
to find them, intact, though not on the porch).
Tuesday it was clear that it was time for medical intervention. If you are
keeping track, I would say that at this point this was second if not third
BIG mistake. The in-clinic Albuterol treatment
worked like magic (first time I had ever been treated for an asthma-like
condition), and the portable Albuterol was nice
too. To combat the obvious bronchitis I was prescribed Trimox,
a kind of penicillin.
My bronchitis improved rapidly. Unfortunately, though, by that evening I was
starting to feel itchy. By the next morning I was both very itchy, all over,
and very red. Stupidly, I took my next dose of the Trimox.
I became redder and itchier, though no hives. I thought that maybe I was also
having some lung involvement, thought that is tough to say since I already
was fighting bronchitis. Nevertheless, it was obvious that I was having an
allergic reaction to something.
Back to the doctor. He immediately blamed the Trimox.
"How can I be 42 and not aware that I am allergic to penicillin?" I
asked. The MD just kind of shrugged, then prescribed
Clindamycin.
The rest of the week (from Christmas through New Year's Day) my symptoms
neither worsened nor improved (though I did sleep at least a little better).
What was really difficult to live with were the episodic bouts of redness and
itching (and, yes, I now have scabs all over the place to prove the latter),
coming on about every four hours. Meanwhile, either the Trimox
or the vitamin C I had been dosing myself with before the allergic reaction
gave me diarrhea. That would have only been uncomfortable except that our
plumbing had clogged up our first day in town. It took a week to finally fix
the problem completely, meaning very interesting bathroom arrangements.
Fortunately the diarrhea didn't last long, but being itchy all over and not
being able to bathe really sucked.
We had no idea why I continued to be red and itchy. Was
I allergic to Albuterol, instead of Trimox, and my ongoing dosing with the former making me
itchy (recall that I had never before used the stuff). Was it the pseudo-MSG
in the hot drink that I was downing every hour for the ongoing bronchitis?
Was it the turkey dinner we had (yes, I've been eating a lot of meat lately).
Was it the pure-juice popsicles I was eating left and right to sooth me
throat from the coughing (and which Noadiah, the
three year old, every hour on the hour pulled up a chair to the freezer for,
only to eat half the pop and leave the other half here, there, and everywhere
to melt into carpet and upholstery)? Was it the smoke-flavored Tabasco sauce I had purchased on a whim and left in Arizona a year ago?
Was it the wonderful jalapeno-stuffed green olives my mother in law bought me
for Christmas? Was it all of the soap operas I was watching with her?
No, no, no, no..., no, said the also wonderful Walgreens
pharmacist we talked to. Almost certainly this is/was the Trimox.
"The rash can last up to 30 days." 30 days of ongoing itchy misery?
What on earth was I to do? "Benadryl," she replied. And so, I
became a Benadryl addict, taking a maximum dosage every four hours. I even
set my watch stopwatch to keep track of when those four hours were up and I
could take my next dose. Having no experience with Benadryl, I ended up more
or less sleeping for a day and half (one of the side effects is drowsiness).
Worse, we didn't actually buy Benadryl, but "Wal-dryl,"
which comes in a handy package that looks just like that of Benadryl, but is
impossible to open, particularly at three in morning and when itchy all over.
The real Benadryl, I also should add, didn't make me as sleepy as the
pretender.
Of course, we still had to fly back to Ohio,
which we did on New Year's eve. We made an appointment to see my in-town
doctor for Friday. At this point we were quite adept at making long-distance
calls to make doctor appointments or, especially, to be pre-approved for
out-of-town urgent care, particularly since somewhere in the middle of this
trip Cameron, my wife, and Talia both came down
with what we suspect was Strep throat (both diagnosed presumptively), for
which each responded wonderfully to their prescribed antibiotic. Thank
goodness both Noadiah and Anne, my mother in law as
yet remain healthy despite the whorl wind of infectious diseases surrounding
them.
New year's evening I think I forget to take my daily dose of Clindamycin (by that point I was exhausted, though
dutifully getting ready for the upcoming quarter, to start the coming
Monday). Could this have been my next BIG mistake? The next day I had my
doctor's appointment, but woke up so late that I barely made the appointment,
much less remembered to take the Clindamycin.
Surprisingly, at the appointment my rash was much less severe and my
bronchitis quite improved. Still, the doctor switched my antibiotic to Levaquin, and prescribed Prednisone for the rash. The Levaquin also was to be taken once a day, and with meals,
so I figured my habitual skipping of lunch probably made the evening a better
time for dosing. Unfortunately, that may have meant that I had went 48 hours without an antibiotic dose. Also, since my
rash was improving (though not by any means gone), I decided to avoid taking
the Prednisone, especially after reading the scary insert that came with it.
Cameron considered the latter concern kind of silly since I had been dosed in
Arizona
intravenously with steroids for the allergic reaction. Still, I didn't take
that prescription, perhaps my next BIG mistake.
Saturday was a long day at work, again getting ready for the upcoming
quarter. I took the Levaquin the night before,
dutifully avoiding antacids, as instructed by the pharmacist. This time not
reading the insert, though, I thought nothing of taking my multi-vitamin and
mineral supplement along with the antibiotic. I did this both Friday and
Saturday evening. "Don't take Levaquin with
minerals," the insert said. So was I now three days without an adequate
dosage of antibiotics? And just how effective was either antiobiotic
anyway?
By Saturday afternoon/evening I had gotten a lot done, but could barely walk
because my blood oxygen levels were so low. Though I could breath
only with difficulty, I was able to breath in a significant volume. When I
got home I set to work on declogging my lungs, in
the manner that I had worked out over the previous week: (i)
breath in steam, (ii) breath in steam dosed with eucalyptus oil, (iii) take a
dose (two actually) of Albuterol (perhaps a little
ibuprofen as well), and then (iv) get down on my knees, with my face low to
floor, and hack out as much mucous as possible from my lungs. All Sunday I
went through that routine as I continued to get ready for the first day of
the quarter. Unfortunately, the treatments would last only about two hours,
and I was loath (yes, my next BIG mistake) to increase the frequency of my Albuterol intake beyond that prescribed. By about 5:30 in
the afternoon I was so unable to breath that I knew it was time to go to the
hospital. I could barely bring in any air into my lungs, and it was all I
could do to put my socks on. Naturally, I was still Prednisone free, afraid
as I was getting worse and worse in my lungs to introduce yet additional
variables into my diagnosis.
Off we went to MedCentral, our local hospital. It
took no more than 15-20 minutes to get there. Along with way I decided that
if this was my time to die, then though that certainly would be a bummer, at
least perhaps I had accomplished and done enough to look back, in my last
gasps, at a life well lived. Fortunately, we didn't come to that, though
parking 100 yards from the emergency room entrance just about killed me. I stopped
at least four time to catch my breath. Stupid of me
not to have accepted the invitation to be dropped off at the door.
And then we were inside, and the emergency room, 6:00 pm Sunday evening, was
very crowded. But we were triaged quickly, all the while my symptoms
improving. Perhaps an hour or an hour in a half later I was inside, though a
slew of more pressing emergencies delayed things even further. Still, the
staff was great. Thank you, Jerry, a student of mine who, as I write this, I
haven't actually had in class (since I haven't actually, yet, been to class).
He works in the ER and wants to be an MD. Go for it, Jerry. Eventually the
respiratory therapist arrived. Yes, take the Prednisome,
a double dosage. Once again I took one of those great in-clinic Albuterol treatments. Then another. And about an hour
later, another yet. The physician, the respiratory therapist MD, explained
that his philosophy was that if I still wasn't breathing well after the third
dosage, then it made no sense to send me home, since I likely would just end
up back in the hospital in four hours.
That night I slept in the emergency room, since the rest of the hospital was
more or less out of beds. Fortunately, this was in a private room in the
emergency room, with a real door that really closed and almost sort of kept
the sound out. There even was a TV! I was given an IV dose of Zithromax (sp?), another antibiotic, as prescribed by my hospitalist, the physician who did the actual admittance
to the hospital. I was also given an Albuterol
treatment every four hours. "It's time to wake up and try to breath again!" The reality, though, is that I didn't
sleep much that night. Perhaps it was the Prednisone keeping me up, yet
another reason why I initially had avoided it.
The next day consisted of Benadryl through a catheter, and yet another Prednisome equivalent, also through the arm. I recall
spending the day in a haze alternating between more IV drips, needing
desperately to get up to urinate, watching the sci-fi channel, and a great
seemingly six hour documentary on WWII on the history channel, totally zoned
out, waking up from time to time for that great hospital food (which I
appreciated greatly), still in my street clothes (since this was the ER, not
the hospital proper), cold despite my vest (and not able or willing to put a
coat on over the catheter), wishing I had access to a toothbrush, and
generally totally enjoying myself (as I avoided attending what should have
been my longest lecturing day of the year). Somehow, within all of that, I
managed to coordinate the handing out of assignments to students who, again
as I write this, I haven't even met yet. More important, I spent the day
coughing up phlegm, slowly clearing my lungs. At one point I recall watching
the sci-fi channel, dripping in sweat from the exertion of all of this
coughing which, just as I couldn't cough up anything more, another Albuterol treatment would prime the pump for many
additional hours of enjoyable (ya right) hacking.
At some point I was moved to the hospital proper, and put back on Levaquin, though taken through the arm rather than
orally. The new place had a better bed, but no door! The curtain was not
enough to keep out the sound and the light just outside of my
"room", especially since I was right next to nurse's desk. That
night (last night as I write this) I watched Jaws II on TV and read from
Churchill's "The Gathering Storm" (which Cameron had brought in at
my request--gotta love WWII literature). The next
day, today actually, was spent dozing, watching TV, eating more of that yummy
hospital food (including lots and lost of popsicles), though with ongoing
concerns about making sure that I was given a lactose-free meal, since I am
lactose intolerant (and really don't need more diarrhea to add to all of the
above). So, bleary-eyed, in the middle of the night I asked this question: If
live-culture yogurt has residual lactose and that lactose is digested by the
yogurt-present bacteria as you digest the yogurt, do the antibiotics
saturating my body kill the bacteria before they can digest the lactose? And
does that even matter, since if the bacterial enzyme is secreted, or the
antibiotic lyses the bacteria thereby releasing perhaps even more enzyme, the
lactose may be digested even without the culture living? My nurse got a
chuckle out of that one.
We also sort of came up with a shorter version of what went wrong: Bronchitis
complicated by an allergic reaction to penicillin (which may very well have
affected and continued to affect the lungs) complicated by a tendency towards
asthma ("So how do you normally treat your asthma?" one medical
personnel after another asked me. "I have asthma?" was always my
reply.) which was further complicated by travelling, perhaps missing antibiotics doses, and
generally completely (and probably stupidly) wearing myself out in
preparation for the upcoming quarter of teaching. OK, maybe that wasn't so
short.
So now I have so many medications I've had to sort them into labelled ziplock bags (home to
take twice a day, home to take once a day, home to take only once the
prescription for the better stuff runs out, always carry with me, etc.). But
I am home, and I suppose I should call it a night. I do have a big day of
teaching ahead of me tomorrow, my first since I've already missed two, and
two big classrooms of students whom, I am told, are even more apprehensive
about taking biology with me than usual. Don't worry people, I don't bite
(though watch out if I should cough on you).
Steve Abedon
January 6, 2004
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