Sunday, May 20, 2018

Rock. Bottom

Dear Diary,

I am sitting here in my living room feeling pretty good about the 31-mile week I just had.  31 miles.  Thirty-one.  I used to do that in a day. And this is the most miles I've gotten in the past month, since I started recovering from C. Diff Colitis in April.  It was, without a doubt, the sickest I have have been, and the most pain I have ever experienced for 4-5 days straight.  It was like being in labor.  Waves of pain wrapped around me, usually worsening late in the evenings, carrying on through the night, and abating slightly the next morning.  It is a cautionary tale of what happens when providers don't pay attention, or lack the right training to manage symptoms appropriately.

Part I of II.

In February and March, I had a respiratory thing.  I developed laryngitis from the perpetual coughing, over and above the usual coughing I'd experienced for the past 2 years.  But I had an appointment with an Ear, Nose, and Throat I gutted it out.  It was actually getter when I saw the physician's assistant (not doctor) who examined me.  She me scoped me and said, "you don't have acid reflux."

Thank god, I thought.  Now everyone can shut up about that.

She prescribed a nose spray...and an antibiotic called clindamycin.  I announced it in rounds the next day at the hospital where I work as a social worker.  The doctors sucked air through their teeth when I said the word.  I didn't know why then. But I know now.  And that sharp intake of breath from my colleagues who went to medical school, that was warning #1.  I just didn't know why at the time, and wasn't interested in hearing about it.

Within a few days I was breathing better than I have in years.  I visited my mother-in-law in the hospital who unfortunately had contracted bacterial pneumonia and was also put on broad-spectrum antibiotics.  I visited her in the rehab hospital where she was for about a week, and drove her home from the rehab hospital. She had diarrhea, which they thought she might have from a norovirus.  Mornings, I started practicing hill repeats, and on March 23rd, I took my last dose of clindamycin.

A week later, on Good Friday, I flew to Pennsylvania for a trail marathon.  I was freakishly tired that afternoon and evening.  I ate some fried calamari, but just wasn't hungry for pizza.  (Warning #2)

That was the night that the diarrhea started.  Except it wasn't like the usual stuff.  I mean, at first it looked like your garden variety diarrhea, but then eventually it became clear, amber-colored.  Maybe a tablespoon at a time.  Like jelly.

Fuck this, I thought.  I'm not ditching this marathon.  There was a much longer run going on at the same time, which meant I had 12 hours to finish it.  I would walk it.  It was exhausting.  I drank like crazy, and walked through the woods in the Pennsylvania countryside.

I flew home.  I wasn't hungry.  I turned up my nose at fried chicken.  (Warning #3)

On Monday, April 2 I went back to the ENT.  She asked me about breathing, coughing, etc.  All were good.  I mentioned the diarrhea, and her eyes widened.  "If you still have that in a couple of days, let me know."  Then, she looked in my mouth, and frowned.  "Do you have thrush?"  I laughed.  No, of course not. Probably just stuff from the chronic sinusitis.  But later than night, I thought of that again.  I went to look in the mirror.

Fuck.  I have oral thrush.  I also still had a couple tablespoons of amber jelly coming out of me every couple of hours.
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The next morning, April 4, Day 5 of the diarrhea, I went to Urgent care.  I told them my story, and said, I'm really worried that something bad is happening. The PA patted my hand.  "We're going to test you for diabetes."

What?  No. I don't have diabetes.

She acted as thought I hadn't said anything at all.  "Yeah, we're going to test you for diabetes."

She also tested me for pregnancy, salmonella, cryptosporidium, shigella, ghiardiardia, all were negative. She gave me a script for the thrush.  Then I told her, "I'm having trouble eating.  My stomach is cramping and it's like I can't get food in.  I've been drinking gatorade and Boost."  She responded, "you have to stop that right now.  It will make your diarrhea worse."  She gave me a handout of the BRAT diet, and sent me home.  I made an appointment with my PCP for the following Tuesday, (April 10).

Days 6, 7, 8--April 4, 5, 6th...went by.  Nothing changed except I started having an ache in my middle.  It was worse at night.  I started eating Tylenol and Advil every 4 hours, and getting up at 11 pm and spending the next few hours with a heating pad, going to the bathroom constantly.  Always that same, weird stuff coming out.  I couldn't eat.  My daily calorie intake plummeted to between 400 and 900 most days.  I started googling CLYNDOMYCIN and  DIARRHEA and reading the articles.

I kept seeing Clostridium difficile. It rang a distant bell in my mind.  I think I did a training on this.  Something about gloves, and gowns being required around someone who had it.


I wrote the PA and asked her why she hadn't tested me for it.  No response, except a scripted one from another PA telling me I should go see my PCP.

On Tuesday, April 10, I saw my family practitioner.  She ordered a test for C. Diff, and started me on treatment before the test came back positive.  I had lost 10 lbs.  I called in to work, and they immediately employed a "terminal cleaning" in my office.  I started taking Flagyl.  But it was too late.  The next day, the pain was no longer going away with Tylenol, and I was exhausted and dehydrated.  I had started throwing up.  I was too tired to stand up long enough to comb my hair. My weight had started climbing again back up to normal, but I couldn't sit down for long because of the pain in my middle. I could only lie down.  That evening, Sweet Baboo was working, so I asked Dread Pirate to take me to the emergency room.

The ER dictated to his scribe as he examined me.  He used words like "starving" and said my urine was brown.  My liver enzymes were elevated.  He dictated, "patient is writhing."  He asked me if I wanted morphine.  For the first time in my life, I said yes. I drifted off to sleep. Something during the night Dread Pirate and Sweet Baboo switched places, and I was offered a choice between being admitted and going home.  I chose the latter.  I was sent home about 2 am on the 12th of April with scripts for Oxy and an anti-nausea medication.  I went home, and asked Sweet Baboo to get my some loaded baked potato soup at Kroger.  It's loaded with cream, salt, and potatoes, and I was able to get my calorie count up for the first time in days.

But later that night...the pain started up again, like it did every night.  Oxy didn't make a dent.  The next morning, I asked Sweet Baboo to take me back to the hospital.

And that's the backstory to why, on Friday the 13th in April, I was admitted to the hospital, diagnosed with C.Diff Colitis, on contact precautions, in a single room with intravenous everything (including morphine).

To be continued.

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