Friday, June 05, 2009

Code Brown - Rota Virus

Just like my bout with diarrhea before Christmas, I am back in the hospital again. On Monday afternoon, I started feeling very hot and sweaty though I had not exerted myself much and had no fever. We barbecued some bratwurst but before eating I lost my appetite and felt nauseous. A short time later, I had my first run to the bathroom with diarrhea. After about 8 more episodes, the later ones with vomiting, I was getting severely dehydrated. I lost 10 lbs since the morning even though I had a good breakfast and lunch. During the night I tried to drink more water, but by morning I could not sit on the edge of the bed because I was too light-headed. I even dropped a cup of water, breaking it on the floor.

My wife called the BMT clinic and then 911. The paramedics came and took me to the hospital emergency room while giving me an IV on the way. All I had on was my disposable diaper, but at least I was still warm. After a brief stay in the emergency room, they got me up to the intensive care unit (ICU) where they put me on more IVs. To increase the flow they inserted a central line (with 3 lumens) into my jugular vein and at one point were pumping 2 liters of fluid per hour into me. I still had 2 other IVs inserted by the paramedics and ER staff. In the space of one day, my weight fluctuated from 208 lbs down to 198 lbs and up to 223 lbs, just due to losing or adding fluid. Back in December, my weight had been up to 235 lbs before we brought it down to around 198 through paracentesis plus diuretics.

A big complication of the dehydration was that my blood pressure dropped severely and my kidney function was decreased. My BP was down in the 60s/40s where normally it is the 120s/70s. Of course, my kidneys did not really have much fluid to remove, but Drs were concerned that the creatinine level was elevated. In addition, they discovered a heart problem called PAC, (premature atrial contractions) though not life threatening and not related to this situation. My white cell count was elevated indicating an infection while my platelets dropped. I skipped my phlebotomy yesterday if for no other reason they have withdrawn enough with blood samples over the past four days. All of my blood counts are now back to normal.

Anyway, one of the tests showed the Rotavirus, which is the leading single cause of severe diarrhea among infants and young children. I am now on a couple of medications to fight the virus and supply lost minerals plus a full liquid, lactose-free diet. They allowed me a regular diet yesterday until the diarrhea came back last night. Now I just heard they are taking me off everything by mouth except for medicines and ice chips. They want my gut to rest and heal.

For a while I felt like I was tied to the bed. I had 5 leads for EKG monitoring wrapped around my chest with IVs in both arms and the central line in my neck, all getting tangled together. One line was tied to a special instrument that monitored my central venous pressure. That was mounted on the wall so I could not walk with it to the bathroom. I had to use the commode by the bed. At least now I am down to just the central line in my neck which is used for one IV and blood tests. I can get up and walk around the room and take my "coat rack" (IV stand) with me to the bathroom. I still get poked 4 times a day for insulin shots though.

They don't let me out of the room and any hospital staff that comes in wear disposable gowns, masks and gloves. They are very cautious about spreading this contagious virus to others who have compromised immune systems in this ward. My wife also had a minor bout of diarrhea on Tuesday after me. She also learned yesterday that a student at the grade school where she teaches has the Swine flu. Luckily, it was not one of her students, but we have to be extra cautious if she gets any symptoms.

I probably will not be home until Sunday at the earliest if I can make it a day without the diarrhea.

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