Tuesday, September 29, 2009


Wow, it has been quite a month. After surviving the swine flu I went back to work for just 4 days before heading to the Southwest for a week. It was awesome--a totally needed change of scenery. We got to chill out, eat good Mexican food, and to see some old friends. It was interesting to catch up with several people that I had met while doing my premed post-bac work. Most of my friends at that point were on the path to medical school or a related healthcare path. Now 5+ years after finishing, I am a resident. One other friend is a 4th year medical student after starting a PhD program and realizing it was not right. Another friend is now a PA. Someone else works in a lab. Two others have done some combination of high school science teaching/travel/other random jobs and are still thinking about going to graduate school, though not medical school. Granted, we are all a pretty non-traditional bunch, but it is pretty interesting to see where everyone ended up in the end.

I got back to work and have been enjoying my elective time. Elective months are nice because they give you time to catch up on everything else that has been lagging. I have been pretty focused on a research project and am wrapping up a manuscript and a couple of abstracts. At the same time it is hard because we are supposed to be learning important material on electives. In a couple of days I go back to my 80-hour weeks on surgicals, so I will definitely miss this time. Time to go to dinner with the family, but I will post some cool vacation pictures later.

Monday, September 14, 2009

The Swine Flu Diaries: Urticaria


Yes, you read that right: urticaria, or hives. No, it is not normally part of the swine flu disease course. But I got to experience it. Lucky me. Here is how it went down.

I awoke feeling a tiny bit better. It appeared the upper GI part of the illness had resolved and it had settled in my lower GI tract. Not that diarrhea is fun, but I'll take it over vomiting. I took my morning dose of Tamiflu, drank some water, and flopped down on the couch feeling fatigued, achy, and out of it. About an hour later I had to make a run for the bathroom. Upon finishing my business there, I happened to glance in the mirror. What the hell? Why is my face so red? Looking more closely I realized that my face was covered with red wheals. I glanced under my pj's and realized they were all over my body.

I woke Mrs. Lone Coyote to tell her I thought I was allergic to Tamiflu. Boy, was she having a rough week with me waking her up with all kinds of problems each morning. We agreed it had to be the Tamiflu since I had not eaten in days. My airway felt fine, but the hives were growing bigger and itchier, so I grabbed my EpiPen just in case.

Eventually, a trip to my HMO was in order and a friend drove me over there to get some antihistamine and to show them my airway was fine. The several hours spent out just wiped me out and I eventually came home, took the antihistamine, and basically spent the rest of the day passed out. All of this meant no more Tamiflu for me. I would have to brave what was to come without the wonder drug.

Wednesday, September 9, 2009

The Swine Flu Diaries: The GI Phase


I awoke on Wednesday morning with a sense of urgency I have not felt in years. It was time to sprint for the bathroom.... now! Unfortunately, I did not quite make it, and Mrs. Lone Coyote was awakened by yours truly vomiting in the kitchen sink. Thus, a new phase of the badness had begun. The fever came down a bit. But now the evil pig virus had taken up residence in my GI tract. I spent much of the day making frequent trips to the bathroom where my body tried to force the little bit of water and Gatorade I was drinking out either side. Yes, you read that right. This wonderful virus features both vomiting and diarrhea as symptoms. Really fun times.

The body aches and headache were still there. I also was beginning to get a really bad sore throat. And I was so weak from all of the activity that it was hard to even sit on the couch for bad television. Remember that thought I'd had the previous day about how slowly could a day pass? This day was sinking to a new low.

And then our prince charming rode in on his white horse to save the day. Well, not really. But our primary care physician did call and suggest we start Tamiflu to provide a quicker resolution to the whole disaster. I was right on the cusp of the 48-hour widow for symptoms, but he thought it was worth a shot. A few hours later we had Tamiflu dropped off at our door by some kind folk who fetched it for us so we would not infect any more people at the pharmacy. We took our first capsules and I instantly felt better. Gotta love that placebo effect, or just a natural lull in my GI misery that happened to coincide with this capsule. Help had arrived.

Monday, September 7, 2009

The Swine Flu Diaries: The Constitutional Phase


It was very early Tuesday morning. After the realization that I was really sick on Monday night, Mrs. Lone Coyote had made me a nice meal and tucked me into bed. But I could not sleep. My lower back was killing me. It was this odd pain, right in the middle of my back, that did not get better with position changes. It felt like a pig was standing on my back, digging its hooves into my vertebrae, and taking revenge for all of the bacon and carnitas I have enjoyed in the past decade. And the fever was out of control. I was burning up, sweating through my pajamas, and shaking with chills. It was awful.

As I dozed in and out of consciousness, I suddenly realized that Mrs. Lone Coyote was up and taking her temperature. Oh no, she now had the flu too, and seemed just as miserable as I was. While I was really sad that I had given her this badness, I was secretly happy that I might have some company staying home.

Misery loved company indeed when we finally got out of bed. Tuesday was spent with both of us flopped on the couch, sweating and groaning, mindlessly staring at DVDs of The L Word all day long. Boy, that show has just gotten terribly melodramatic and tedious in its later seasons. But I digress.

Remember that headache I'd had the previous day? It morphed into a monster that took over my entire head and neck and that Tylenol would not touch at all. Even my eyes hurt. And then there was the nausea that seemed to accompany it at all times. I have never had migraines, thank goodness, but if they are anything like that headache, I can maybe begin imagine the suffering that they cause.

We were in hell on the couch and nothing could was making it any better. Every fiber of my body ached and burned. I tried to stay hydrated and finally emailed my primary care physician inquiring about getting some Tamiflu. Could a day pass any more slowly than this one, I wondered?

Sunday, September 6, 2009

The Swine Flu Diaries: So It Begins


I woke up exhausted but thought nothing of it since I was on call and had worked much of the weekend. It had been hot as hell and hard to sleep in the heat. Grumbling, I threw on my scrubs, grabbed my chai, and raced out the door. It was a signout day for me, so I got in and busied myself getting my cases in order and tracking down missing slides. Even after the chai I had a headache brewing, so grabbed some Tylenol from the communal painkiller bins on my way to signout. "Gonna be one of those weeks, huh," one of my colleagues smirked at me. "Yeah, looks that way," I said. I had no idea what was coming.

It was my last day on surgicals and I was hoping to have a quick signout with not a lot of cases hanging over into my elective month. However, it quickly became clear that many of my cases were not as straightforward as I had hoped. Most of the morning flew by as we were engrossed by cases. I barely noticed that my head still hurt a bit and I was surprised to learn it was lunchtime as I was not that hungry. But I had some very nice tofu and brown rice and it was back to work.

About mid-afternoon things really started to drag. Or at least they seemed to. My headache had gotten worse. It seemed almost like I had not eaten enough for lunch and was hypoglycemic. I felt scattered and exhausted, but chalked it up to the end of a hard month and a rough day. Signout is pathology's equivalent of rounding: presenting patient history, getting pimped a bit, learning about findings. If your head is not in the game, it gets very, very painful.

By the time signout ended in the early evening I was starting to think something was wrong. I was chilled, the headache was even worse, and I was starting to have body aches. Still, I told myself, I would feel better if I could go home, go to bed early,and catch up on sleep. I forced myself to dictate all of my cases, clean out my work space, and move my stuff to prepare for the new rotation starting the next day. Driving home from the hospital I began to sweat, to feel nauseous, and to have rigors. Now I knew there was something really wrong.

The thermometer sealed the deal when I got home. 102.2 degrees F. "Crap," I said to Mrs. Lone Coyote, "I think I have the flu." Time to call my chief resident and collapse into bed. And so the influenza odyssey began.

The Swine Flu Diaries: Prologue

I have spent the last six days completely knocked out by influenza. Based on my symptoms and the infection patterns locally, I was told that I most likely had H1N1. But given that the treatment is the same, no one was going to bother to test me. As the fog slowly dissipates from my brain, I thought I would try to piece together the events of the past week. Hopefully, it will be entertaining and can shed some light on the virus that has recently captivated the public with its with dire pandemic predictions. So fry up some bacon, sit back, relax, and enjoy my swine flu tales of woe.