Almost became a memory myself this Memorial Day weekend

[Dan]

Some of you know me as the Vandersteen guy or a doctor or Swerd's kid brother. I nearly bought it this weekend. I was fighting a long term sinus infection with Bactrim and prednisone for about a week when Thursday and Friday I started feeling real tired. Saturday one am I woke up to vomit and was itchy all over, thought I had the flu. Couldn't get up until Saturday one PM when I found I couldn't stand. The. I saw the whole body rash and peurpural bleeds starting on my skin. Wife drives me to ED where I was in renal failure shock and a 102 fever. Pulse was 112, oxygenation 91% which is barely acceptable and after four liters of fluid BP 86/43 which isn't enough. I got three large bore IVs and a big central line. I going to the ICU for levophed to raise the BP ( we call it leave em dead) but the fifth and sixth liter get my systolic BP to 90 and my heart is a champ so I dodge the levophed bullet. I need ten liters of fluid to stabilize. But the next morning my platelet count 308,000 last fall) dropped from 71 thousand in the ED to 41 thousand. I'm covered in red spots of blood under my skin. By the next day I have NO platelets left and am at risk to bleed from anywhere just for the hell of it including into my brain. Can't move can't scratch while I itch like hell cant eat anything difficult. Monday and Tuesday I get intravenous gammaglobulin which by various theories rids me of the antibodies I have to my own platelets. Tuesday morning I have six thousand and this morning 25 thou. One needs at least fifty thou not to bleed like stink from minor injury or medical procedure. Transfusions won't work because my body will destroy the platelets. I feel out of the woods finally today but still will be in the hospital getting heavy duty steroids and watching my counts rise till it's safe to go home. Saved by my good heart, really good ED doc, the hematologist and a bunch of on the ball nurses. All a really really bad Bactrim allergy. It's pretty well known in the med world. Thanks for letting me vent.

 

[KEW]

Hey Dan,
Glad to hear you are on the mend! That must have been pretty intense (probably still is unless you compare it to the previous couple of days)!
Sounds like a very, very near miss!

Have you had other allergies to meds in the past or is this a "first time surprise"?

If you don't use a Nettie Pot, you should try it. I used to be plagued by sinus infections (and often wondered if I wasn't harboring the same infection non-stop but it would go dormant under a dose of antibiotics). As a matter of fact, I had a nasty one when you took me to RadioShack to get IEC cables for my Focal Pro Audio speakers. Thanks again, BTW!

I really don't know squat about it, but my experience is the Nettie Pot has reduced my frequency of sinus infection to where I get one every other year.

I have also noticed that infections seem to thrive on sugar consumption much better than my body does. IOW, cutting sugar accelerates my recovery, and binging on sugar (say when I spend the holidays in the wrong house and they have lots of candy/desserts out) seems to prompt infection.

 

[JohnnieB]

Holy Crap! Thought I was having a bad day. This puts things back in perspective.
Glad to hear your recovering. God Bless.

 

[herbu]

Geez!!! Scary!!! Not sure if understanding what's going on would be better or worse. Glad you've turned the corner. Hope everything continues to improve. Wow!

 

[rojo]

Saved by my good heart, really good ED doc, the hematologist and a bunch of on the ball nurses. All a really really bad Bactrim allergy. It's pretty well known in the med world. Thanks for letting me vent.

FWIW, I didn't "like" that you almost died. I just figured after what you went through, you deserve some positive karma. Hope you didn't take that the wrong way.

 

[its phillip]

super scary. glad you are recovering!

 

[Dan]

Thanks for all the wishes. Staying awake through it was scary but I knew what needed to be done was and that helped. There were some screw ups but I used my MD clout to shake things up. Shouldn't have needed to. I will review with administration re the glitches for process improvement. One doc is going to get a piece of my mind. Never thought much of him anyway and this proves it. Platelets are 67 thousand this morning which means final tuning and I can go home. I can electrically shave and floss. No soccer for a bit but I'll be too weak anyway. This was my first drug allergy and I had had Bactrim before with no issues so a surprise. I've been using a Netipot with limits success but the naturopathic ways do have their advantages. I'm in no mood for surgery any time soon.

 

[Dan]

My leg for the not sqeamish:

 

[Irvrobinson]

It's great to hear you're going to make it. Sounds like a very close call.

I'm paranoid about pharmaceuticals, since I'm allergic to so many things, and was reading about reactions like yours when I was prescribed Bactrim DS for a skin infection. And it was a few hours before I convinced myself to swallow the first pill. Luckily, I was able to take the stuff without a reaction. I know people who pop antibiotics like they're aspirin, but I think of them as akin to chemotherapy for bacteria.

 

[rojo]

My leg for the not sqeamish...

You should've put that in a set of [spoiler] tags. I was not prepared for those toes!

 

[GO-NAD!]

Thanks for all the wishes. Staying awake through it was scary but I knew what needed to be done was and that helped. There were some screw ups but I used my MD clout to shake things up. Shouldn't have needed to. I will review with administration re the glitches for process improvement. One doc is going to get a piece of my mind. Never thought much of him anyway and this proves it. Platelets are 67 thousand this morning which means final tuning and I can go home. I can electrically shave and floss. No soccer for a bit but I'll be too weak anyway. This was my first drug allergy and I had had Bactrim before with no issues so a surprise. I've been using a Netipot with limits success but the naturopathic ways do have their advantages. I'm in no mood for surgery any time soon.

Glad you're on the mend. I realize that we are in two different countries, with two different medical systems, but I think there is one universal rule of thumb for anyone admitted to hospital - you need somebody not affiliated with the hospital to be your advocate. Maybe slightly different in your case, as you are an MD and also physically/mentally able to be your own voice.

A few years ago, my sister was admitted for a Staph infection in her bloodstream. She was going downhill fast and they put her in the ICU in an induced coma. I have no complaints about her treatment in the ICU. It was absolutely top notch. It was touch and go for several days, but due to the very competent care she received, and because of her younger age (mid-thirties) and fitness (she was a regular runner), she pulled through. It was in the step-down ward where things started going off the rails. Shift turnover led to missed information between staff and, although she was now conscious, she was too weak and confused to do anything for herself. We had family members with her whenever it was permitted. We were the ones ensuring information was passed from shift to shift (this wasn't a continuous problem - don't get me wrong - but, there were a couple of instances). We had to make sure she was getting fed, as staff would leave her meals without acknowledging the fact that she couldn't feed herself. That kinda thing.

In other words, if you have a loved one in hospital, don't assume that everything is being done in their best interest. They need somebody to be on top of things and speak up if something doesn't look right.

Again, glad to see you came through OK!

 

[GO-NAD!]

You should've put that in a set of spoiler tags. I was not prepared for those toes!

Why? P'Dawg looooves surprises - especially any photo showing toes.

 

[Alex2507]

You should've put that in a set of spoiler tags. I was not prepared for those toes!

I read this while listening to Jewel croon out "Who will say-eyay-ve your tooooooeee-ooh-oes?"

Somebody needs to PM that pic to Greg.

Dan, glad you made it. I had no idea stuff like this could happen.

Congrat's on being AH's first horror classic.

Take good care.

 

[STRONGBADF1]

Get well soon! And pm those toes to Greg!

Sent from my SM-G920V using Tapatalk

 

[Midwesthonky]

Whew! When things go wrong, things go wrong!

I know a bit about medical mistakes. I was in the hospital next to DisneyWorld in Orlando for infection that dropped me at the hotel. Nursing was short staffed so I ended up watching and learning how to handle the IV alarms myself. I didn't appreciate when the saline drip ran out while being mixed with potassium (If my memory is right). Needless to say, the burn sensation sucked! The nurses reacted pretty damn quick when I called then and they realized they had screwed up badly.

Communication wit the docs was poor too. Could have been out a day earlier had the doc bothered to explain they needed a stool sample to test before they would release me. Ugh...

 

[Dan]

I think some things in medicine are getting better in terms of awareness of the need for formalized communication handoffs and there are now US standards that certain things always be done for certain common conditions so dumb stuff doesn't happen as much. We have a very high awareness for error with many redundant checks.

At the same time knowledge and technology races ahead mine, radiology, changes the fastest of all. The other docs can't kepnupmwithnour changes yet not all will use us as a consultant to get the right imaging done just want it done STAT then bitch about garbage in garbage out when its they who can't ask a coherent question. The advent of the hospitalist is a plague IMO. It's nice they are always around but they are the weakest docs in general I've ever known. Beware of them. Know little do nothing. I always have to tell them exactly what to do and I haven't done that stuff since the late eighties. I'm lucky in in the system and can advocate and choose wisely when I am not stubborn. Patients have it rough but always have.

I have always tried to explain things to patients in plain English. No fancier word than ultrasound. Works well 98% of the time

 

[j_garcia]

Glad you are OK.

 

[Midwesthonky]

I have always tried to explain things to patients in plain English. No fancier word than ultrasound. Works well 98% of the time

I would be too tempted to say "We're gonna drill a hole in yer head and root around in there with a stick and see if we can find that there dang problem..."

 

[Swerd]

Dan – It's great to see you talking on AH about your week from hell. I just got home in the last hour and haven't had time to look here today until now. Love the photo, and so will the resident AH foot-fetishist Paradigmdawg . You may want to snap a few more for him.

Keep making those platelets! Is there a betting pool for tomorrow's count? Put me down for 109.

What is a Netipot?

Here is one more person who deserves a shout out – your wife! She often gives people the incorrect impression that she is shy & timid. But she came through last Saturday with flying colors.

I know you love your signature line (from some movie the title of which I can't remember) "Who cares if you can't afford the speakers! When you die you can be buried in them!", but I wonder if it might seem a bit like tempting fate. Just a thought .

 

[Swerd]

Found it, Judge Rheinhold in Ruthless People