Monday, January 27, 2014

Courting Mortality and Other Unintended Consequences

As usual, the fall and early winter months are extremely busy for me at work. That is why I historically post very little during this period. 

This year offered a new twist - a five day stay in Intensive Care battling a severe infection with fever that no one can figure out how I got or where it came from. Needless to say it was not the average January for me.

I am out of the hospital now and recovering slowly at home, but the memories and impressions of those days compel me to log them here, both as a means of getting it out of my system, but also as a way of telling people what happened without me having to repeat the story another forty-seven times. I think we'll all be happier in the long run.

The official diagnosis is "Cellulitis of the face, with Sepsis." It actually started January 6 as a severe rash in my right groin that literally seemed to spring up over night. Unfortunately, the 6th was my first day back at work after the holiday break, so taking the day off seemed ill-advised.

While I was coping with that issue, Tina came down with a high fever and infections in both ears, leaving her essentially deaf for most of that week and the next (she is only at about 40% hearing even now). The sore throat I had also developed seemed minor compared to her problems, so I pressed on. In retrospect that was a big mistake.

By Tuesday the 14th the sore throat was gone, but the rash was weeping. When I got a low fever that night I decided to call in sick the next day. I also got a small swelling in my neck. I was due to see the doctor anyway on Friday, so I decided to wait. That was mistake number two.

The next day the swelling in my neck was much larger. I decided to see our Chiropractor for the pain in my arm that I had since early December. It turns out I had the radius of my right arm out of place. He put it back in place and then proceeded to work my abdominal, chest and face muscles. He is a pressure-point Chiro, not a bone-cracker Chiro. While that was all well and good, it was mistake number three as I was going to need those muscles in short order and now they were bruised and sore. It was turning into the perfect storm.

Thursday I woke up and had difficulty swallowing. I forced plenty of fluids that day, but my fever kept rising. It hit 105 that evening and we soaked my feet in ice water, which brought the temp down to about 102. That night it hit 105 again and another cold soak followed.

Friday morning I could barely swallow. We staggered to the doctor's office, not sure of what I had or if it was contagious. The Doc took one look at me and said I was going to the hospital right away. Fortunately Providence St. Joseph is right across the street. I was admitted and in a room within an hour.

The initial evaluation did not go well. The floor nurses had to bring in an ICU nurse to install the IV. Further scrutiny by the staff followed and I was brought to ICU as fast as they could push me there.

By then I knew I was in terrible condition and resigned myself to whatever was to come. Oddly enough I wasn't scared. Concerned, yes, the cold, hard reality that I might not survive was present in my brain, along with the fact that the next few days would be long and miserable. But I wasn't scared. In fact, I was more fascinated by the technology and the teamwork displayed by the docs, nurses and technical staff than anything else. That helped calm me in the long run.

My doc is an Internist. He quickly called in reinforcements. Soon I had an Ear/Nose/Throat doc, an Infectious Diseases doc, a Cardio doc and a Pulmonary doc. I have a natural irregular heartbeat that I call palpitations. That scared the boo out of them. Unfortunately I also developed a stress arrhythmia, so I started a drip for that.

By this time they had installed a central Venus catheter for dispensing IV fluids into my body more efficiently, as well as a Foley catheter for removing fluids from my bladder. They also installed various pads on my torso and legs for EKG readings and the like. I was pretty well wired up. Tina said a one point I had five or six bags dripping into my body, plus oxygen via a thin flexible tube attached to my nose.

My temp was climbing again and hit 105. I was quickly covered in damp towels with ice cubes liberally sprinkled across them and had a fan blowing on me all night. I did not feel cold at all.

The big status board soon became my focal point and refuge. I could monitor my vitals and see how the battle was progressing. The first night was just holding my own.

One of the things that did go right was my CPAP machine. As most of you may know I have sleep apnea. I just got a new machine in early December, with the pressure set twice as high as my old machine. The first three weeks were horrible as I tried to adjust to the new full-face mask, machine and pressure. At times I didn't think I would, but fortunately I did. That new machine would save me as I was able to get real sleep during this whole ordeal. 

The first night in the ICU produced a bizarre set of dreams. I visualized data streams, but not like the binary code of the Matrix. No, mine was, as befitting a historian, files, folders and sub-folders. They streamed past me and I could dip into any one of them and see the data converted to visual imagery. Most of it was fanciful, and I knew that, but it was an interesting way to dream. It seemed very logical.

The morning brought more tests as the fever continued to rage. They did an ultrasound of my heart and I could watch it beating in real time. A day later they would ultrasound my throat looking for clots, and that was fascinating to watch as well.

The team of docs continued to winnow down the possible diagnoses until they came up with Cellulitis. They ruled out the mumps, mono, an abscessed gland, and other probabilities, but never could figure out how I had gotten this infection on my neck. They even did a swab of my groin and found it full of Staph infection, but still no method of transmission. My primary doc started calling me the "mystery man."

Saturday night was shaping up to be another rough one. It was nearly worse. Because my CPAP does not have the capability of attaching an oxygen line they wanted me to use one of their CPAPs that could. This was the most disappointing piece of equipment I had seen at St. Jo's. The machine was on its own cart, like a hot dog vendor, and sounded like a Stanley Steamer when they fired it up. Moreover, the vent on the hose sounded like a blow-hole. The mask fit horribly and leaked. After an hour I objected and rejected their machine. They asked how I was going to get oxygen into my mask and I said I would figure out a way. It turned out to be relatively simple: I just strapped my mask over the small oxygen tube and it sealed fine. I was able to sleep in quiet and without leaks.

They tried a new tactic that night. Along with the cold towels and fan, they started a cold infusion drip, essentially cooling me from the inside. I like to think of it as running ice water in my veins, but that's a bit simplistic I suppose.

Around midnight I had a strange sensation. As I looked up I could see colored particles floating in the air in the shape of my upper body and head. The particles descended and mingled with my body. Another, differently colored set of particles then formed and descended as well. After about five or six of these waves my body started to tingle.

I was afraid I might be having an allergic reaction to something. They had started an anti-fungal drip along with all the antibiotics I was already getting. I checked the status board and everything looked normal, aside from the temp which was holding steady at about 102.4. 

I continued to watch the board and then noticed the temp go down a notch. And then I felt sweat. The fever had broken at last.

Once I knew that had happened I went back to sleep. My data dreams were replaced by purely visual data streams, sort of like looking at a double stripe of photos on a Coolris presentation. I could dip into and out of any image and would find myself in the most vibrant and colorful dreams I can ever remember having. I've not had anything that brilliant for decades! Unfortunately, I haven't repeated that since.

My temp in the morning was holding at 99.9. I knew there would be at least one more night of fever as the monster within would try to come back, so I settled down for another long day, this time sweating like a pig. 

They started me on respiratory therapy as well, including inhaling atomized particles of Xanthine (I think that's what the therapist said). Regardless, it was like smoking the world's biggest hookah or peace pipe with little puffs of this mist coming out. You could sort of taste it after awhile.

That led to probably the most fanciful of dream sequences that night. I began to imagine a series of Victorian-style black and white line art moving pictures depicting the adventures/misadventures of a plucky hero against the evil professor Xanthine and his menacing dust. For instance our hero's quaint airship would have its tail fins set ablaze by the evil professor and spiral down to impact in the Amazonian jungle in a cloud of smoke, debris and Xanthine dust. Or the steering wheel of his car would mysteriously come off and our hero would spin around in a cloud of Xanthine dust. Well, you get the picture.

The rest of the stay in ICU was to stabilize my vitals. I was still on medication for my arrhythmia, plus my blood pressure was too low, so they had to boost that. Eventually, on Tuesday the 21st, I was moved to the general floor. I would eventually come home Thursday, but not before there was concern that my blood pressure was too high.

Recovery is slow. I'm on home IV treatment until at least the 29th. I have a lot of fluid retention as they pumped me so full I looked like the Micheline Man. That is slowly going down with the help of a diuretic.

In short, I'm still a mess, but a much better mess than I was last Friday. I am actually fortunate to be around. 

In retrospect I should have seen the doctor a lot earlier than I did. The harsh reality is that listening to your body is a lot easier said than done. People get busy, have obligations not just to themselves but to co-workers, employers, customers and family. It is so easy to delude yourself into thinking you are not as bad as you really are. The next thing you know you are caught up in a crisis and stuck in ICU with your life in the balance. 

I hope I will learn from this. I certainly don't want to repeat the experience if I can help it. Perhaps this narrative will help some of you as well. I can only hope some good comes out of it.

I will return to historical articles in the very near future. Thanks for reading.


  1. Sheesh! Is there anything I can help with?

  2. Wow, Tony, I'm so glad you're on the mend. What a frightening ordeal. Thank goodness for modern medicine, and good doctors. If you ever get a theory about where the infection came from, do let us know. You're in my thoughts for the rest of the month - sending you good vibes for fast healing and returning strength. Hugs to you and Tina. xoxo

  3. Thank you for sharing Tony, #1 it's a great life lesson and reminder that we are not super humans as we hope and to listen to our bodies. #2 you have fascinating dreams and retention. I am so glad you are OK and hopefully Tina is 100% now. Love you guys....

  4. Good God, Tony!! So glad you are home and on the mend. Sending healing cyber waves to you and Tina! xoxoxox

  5. A terrific blog about a horrific experience. For both you and Tina to be laid low at the same time is inconceivable. I am grateful to your medical specialists for pulling you through, and thankful you are sharing your hard-won life lessons with us. I hope you have Netflix to help pass the time!

  6. Christie told us you were in the ICU and we were surprised since you had been fine when we saw you over Christmas break. Good to hear that both of you are healing. We will keep you in our prayers!

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