SitRep 26 AUG 03

I have been ill.

Really ill.

Stuck in the hospital ill.

It turns out I was life-threateningly ill, though the situation never
got to a real crisis, merely some desperate hours.

I, it seems, am allergic to sulfa drugs, and a sulfa drug is what we
were using to treat my arthtritis.

It started with a lack of appetite, moved on to feeling like a summer
cold. A week ago Sunday I decided I wasn't sick enough to deal with the
ER to get drugs to deal with the symptoms, esp. as I had to be up at
0700 Monday.

So I planned to get up, get ready, visit the Clinic, get some meds,
collect my orders to Ft. Lewis (since my tests earlier in the week said
my system was handling the treatment just fine) and just maybe be in LA
for some leave by the weekend.

That's not quite the way it happened.

For starters my sense of fever was higher than it had been when I
spent Sunday in bed. I was shaking to beat the band in formation. I
decided to warm up in the shower before I headed to the Main Hospital.
In the shower I was ill. When I was done I was too weak to go, so I
placed a wake-up and slept for a couple of hours.

Got to the clinic and signed in. When they took my vitals they
discovered I was dehydrated, and started pumping fluids. As I got more
liquids my fever rose from 99.6 to 101.4. In the course of the day I
got six liters of fluids, and spiked at least one temp 0f 104F.

At this point I was not happy. One of the doctors looking at me asked
if I had a rash, I said no, and when my shirt was pulled up, lo! and
behold, it looked as if I were speckled with measles.

They had not been there, so far as I could recall, when I was in the
shower.

It's now about 1600, I get moved to the ER, new docs, repeat of
questions. I am wired for light and sound. My blood oxygen is around
92 percent, My pressure is a bit low, and they are worrying about all
sorts of strange things. Will I agree to a spinal tap.

Now being a patient is not the most powerful of feelings, having a
pair of doctors ask if one is willing to let them stab one in the back,
with a slew of minor risks (and the rare complication of real injury)
leaves one at a mental disadvantage. These are the guys who are
supposed to know.

I do have to say that the doctors being officers, and me not, didn't
really enter into the equation.

It was uncomfortable. They tell me I have thick, strong and fibrous
ligaments in my spine. On the other hand, being so slim meant they
didn't have to go in more than an inch or so to get the fluid, which was
clear as glass.

One worry down.

A bed was found for me and I installed in it. Single room, private
bath. Fluids through the night. At this point I've not eaten since
Sunday evening.

Tuesdsay came, and with it the doctors. My attending, my intern (who
has been a treat, attentive, supportive, informative. When he stops
looking like a puppy dog he is going to be a pretty good physician (no
offense to him, but he doesn't look much more than 23, and still has
some diffidence in presenting his opinions), Rheumatology (I called to
let them know things weren't going so well) Infectious Disease,
Dermatology.

I saw no less than nine doctors on Tuesday, and we came to the
conclusion Maia leapt to when I told her I had a rash (I'd called her
from the ER), sulfa reaction.

Now I become the victim of the best medicine money can buy. If this
is a sulfa problem, all we need to do is through some steroids at it and
it will fade away.

If it is, however, caused by a pathogen, I could get very much worse.
So more tests, more fluids, more spiking fevers. I am still on Oxy.
Pulmonary comes in to consult. They want a sputum sample, but I can't
cough one up. Next question, will I submit to a Bronchoscopy (you know,
that procedure where they run a fiber-optic able up the nose, and down
the throat to look into folk's lungs).

The choice is simple, yes, and I get the steroids sooner, no and I
wait. This is Weds., I've not managed to eaet more than a couple of
bites since Sunday and I have terrible diahhrea. There is no question
as to my answer.

Turns out I've been drinking too much water, and aspiration is to
great a risk, so it will have to wait until Thurs. afternoon, and from
midnight on I can only take the merest sips of water to go with my
pills.

And every time I spike a fever, more blood comes out of my arms and
down to the lab.

The rash has gotten unbelievable. I am red from head to foot, and the
palms of my hands and soles of my feet are starting to get red spots.
Dermatology is worrying about something called Steven's-Johnsons, so
they take some biopsies from my ankle.

I'm just worrying about making it to morning.

The bronchoscopy. What a treat. To numb the throat one inhales a
vaporised topical. Then they pour some in the nose, and the
instructions are to sniff and swallow. I gag, choke, and cough. Then a
gel is placed on swabs and placed in the nose.

Thankfully the next step is some IV drug and the rest is a miserable
blur. I was on my side, pressure in my nose, and then gagging and
choking, while they flushed some fluid in, so they could suck it out.
Hacking and spitting (well, drooling is a better word) that was done.
Then the questions, "does that hurt?"

"No."

And they took the first biopsy.

"Does that hurt?"

I am a little more gone, and don't really register the question.

"Sergeant Karney, does that hurt?"

"Uh.. no, it tugs a little."

And they got the second biopsy.

In the Post Anasthesia the gave my my first steriods. By the time I
got back to my room I was feeling more human. My fever was broken.

My supper was at the side of my bed. For the first time in five days
I was not disgusted at the sight of food.

In fact I was ravenous. I wanted to wolf it down. I forced myself
not to. Five days of not eating. The last thing I wanted was to throw
it all back up.

It took me about an hour and a half to finish it.

Friday had all the people coming by to see me. Asking how I was,
telling me I looked better. It also had me walking to the Cafeteria and
eating huge quantties of food. Dermatology came by and told me they
were still worried about Steven's Johnson Syndrome.

Seems my rash was bad enough that it might start to cause my skin to
slough. In effect I would become a burn patient. So I'm to look for
blisters, peeling, flaking, cracking of my skin.

Today I am doing all right. I still have an IV in my arm. My head is
ringing from the steroids (though I am on a smaller dose, of a gentler
steroid, and no longer have to get my blood-sugar checked twice a day)
and my guts are (touch wood) started to get themselves back in order
after more than a week of drastic upheaveal.

My Dermatologist is happy with my skin (and glad that the bed in the
burn ward he had set aside, and the people on call to treat me went
unsused) and lots of people say I look better.

It is the lots of people which brought it all home to me. I seem to
have been quite known to the staff. People I can't recall are telling
me how much better I look.

I am a giant strawberry birthmark, and I will be here for at least
another week or two (Rheumatology and I have to figure out were to go
from here). I want some leave. In the worst way.

This has been a very hard week for me, and probably harder for the few
back home who knew what I was able to relate to them. But I made it.

Terry