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'You're Very Ill' Takes a Sudden Turn to 'You're Very Lucky'
By PHIL HANRAHAN
Published: March 21, 2006
The night before, I felt like a million bucks. I jogged home from work, from Midtown Manhattan to Astoria, Queens, crossing the 59th Street Bridge on a warmish winter evening.
In the morning, my back was stiff. I figured I slept wrong, or maybe pulled something running home. An hour later, I nearly passed out on the subway.
Reeling onto a platform just one stop closer to my destination, I used a pay phone to call a colleague just back from the flu. I described symptoms. Stiff back. Light-headedness. An overall deeply weird feeling. He said, "Yeah, could be what I had."
My doctor agreed it could be the flu when I saw him 10 days later. "It's going around," he said. "Bad bug this year." He'd already seen three or four of my colleagues.
That night I finally invested in a thermometer and took my temperature during one of the nightly fevers that for just a few minutes at the start were a welcome relief from chills that had me shaking under five layers of clothing, ski cap on my head.
105.5. Just as shocking as the number was my perception that this fever was no different ? no more raging ? from the previous half-dozen.
I went back to my doctor. There were also night sweats to report. And excruciating bone and joint pain, migrating arthralgias that felt like fractures.
My doctor prescribed Vioxx.
Two days later, I was back. Small purple blotches covered my body. Also, my feet were starting to swell. And, um, it seemed hair was falling off my shins.
My doctor and a colleague examined me. They speculated the rash could be a reaction to Vioxx. They mentioned Lyme disease, lupus, early arthritis.
Blood work indicated the obvious: inflammation. But was it an autoimmune disease? A mystery infection? How about a kidney abscess? The M.R.I. scan was normal.
My doctor sent me to an infectious disease specialist. After a few minutes of questions ("Have you been to the tropics?"), I hobbled out, no wiser.
Twenty-five days had passed. Fevers had burned 15 pounds off my runner's frame, leaving me emaciated. I still had the rash. At work, I haunted the 10th floor like a ghost.
My mother wanted me to come home. I went home. Within minutes of entering my parents' house in suburban Milwaukee, I lay curled in a fetal position before a living room fire, teeth chattering so hard I could barely speak. My mother took one look at me and said, "We're talking to Bill."
Bill was the doctor next door. He had known me since I was 10. He had been my orthopedic surgeon the summer of my 16th year, when I broke my neck in a diving accident. Bill came over. Bill examined me. Bill said, "You're very ill."
I agreed. Then Bill said, "I think you should see Marcia." Marcia was a general practitioner with the instincts and doggedness of a detective, he explained. She liked hard cases. She would get to the bottom of this.
I saw Marcia that day. She listened for a full half-hour, taking copious notes. She zeroed in on my rash, diagnosing vasculitis, an inflammation of the blood vessels that can be a secondary symptom in certain kinds of serious infections.
Then came the moment, the educated guess: "I think I know what it is. I've never seen it, but I've read about it. Chronic meningococcemia. We need to test your blood."
My blood was tested. An hour after results confirmed her suspicion, I was in a hospital bed, hooked up to an IV, antibiotics destroying the bacteria that had made me sick for nearly a month now. My heart was scanned. Luckily, the infection had done no damage.
Acute meningococcemia can kill you within hours. The chronic variety can be deadly if the sepsis crosses the blood-brain barrier, and the heart can be affected. Most people have immunity. For those who don't, you can catch it from a sneeze.
I spent five days in the hospital, then returned to New York, where I spent the next six weeks with an IV port in my arm, self-dosing before and after work.
A couple weeks after my last IV, the New York City Health Department called. A very serious woman on the other end of the line had some questions. Feeling fantastic by this point, I spoke rather breezily of what had gone on, laughing at the sillier symptoms, conveying an overall attitude of "Hey, what can you do? Life in the big city."
Only two people in all of New York were officially known to have contracted chronic meningococcemia that winter, she told me when I was done chuckling. "Lucky me!" I responded.
Then a question occurred to me. "How's the other person?"
"The other person," she said after a brief silence, "did not do as well."
By PHIL HANRAHAN
Published: March 21, 2006
The night before, I felt like a million bucks. I jogged home from work, from Midtown Manhattan to Astoria, Queens, crossing the 59th Street Bridge on a warmish winter evening.
In the morning, my back was stiff. I figured I slept wrong, or maybe pulled something running home. An hour later, I nearly passed out on the subway.
Reeling onto a platform just one stop closer to my destination, I used a pay phone to call a colleague just back from the flu. I described symptoms. Stiff back. Light-headedness. An overall deeply weird feeling. He said, "Yeah, could be what I had."
My doctor agreed it could be the flu when I saw him 10 days later. "It's going around," he said. "Bad bug this year." He'd already seen three or four of my colleagues.
That night I finally invested in a thermometer and took my temperature during one of the nightly fevers that for just a few minutes at the start were a welcome relief from chills that had me shaking under five layers of clothing, ski cap on my head.
105.5. Just as shocking as the number was my perception that this fever was no different ? no more raging ? from the previous half-dozen.
I went back to my doctor. There were also night sweats to report. And excruciating bone and joint pain, migrating arthralgias that felt like fractures.
My doctor prescribed Vioxx.
Two days later, I was back. Small purple blotches covered my body. Also, my feet were starting to swell. And, um, it seemed hair was falling off my shins.
My doctor and a colleague examined me. They speculated the rash could be a reaction to Vioxx. They mentioned Lyme disease, lupus, early arthritis.
Blood work indicated the obvious: inflammation. But was it an autoimmune disease? A mystery infection? How about a kidney abscess? The M.R.I. scan was normal.
My doctor sent me to an infectious disease specialist. After a few minutes of questions ("Have you been to the tropics?"), I hobbled out, no wiser.
Twenty-five days had passed. Fevers had burned 15 pounds off my runner's frame, leaving me emaciated. I still had the rash. At work, I haunted the 10th floor like a ghost.
My mother wanted me to come home. I went home. Within minutes of entering my parents' house in suburban Milwaukee, I lay curled in a fetal position before a living room fire, teeth chattering so hard I could barely speak. My mother took one look at me and said, "We're talking to Bill."
Bill was the doctor next door. He had known me since I was 10. He had been my orthopedic surgeon the summer of my 16th year, when I broke my neck in a diving accident. Bill came over. Bill examined me. Bill said, "You're very ill."
I agreed. Then Bill said, "I think you should see Marcia." Marcia was a general practitioner with the instincts and doggedness of a detective, he explained. She liked hard cases. She would get to the bottom of this.
I saw Marcia that day. She listened for a full half-hour, taking copious notes. She zeroed in on my rash, diagnosing vasculitis, an inflammation of the blood vessels that can be a secondary symptom in certain kinds of serious infections.
Then came the moment, the educated guess: "I think I know what it is. I've never seen it, but I've read about it. Chronic meningococcemia. We need to test your blood."
My blood was tested. An hour after results confirmed her suspicion, I was in a hospital bed, hooked up to an IV, antibiotics destroying the bacteria that had made me sick for nearly a month now. My heart was scanned. Luckily, the infection had done no damage.
Acute meningococcemia can kill you within hours. The chronic variety can be deadly if the sepsis crosses the blood-brain barrier, and the heart can be affected. Most people have immunity. For those who don't, you can catch it from a sneeze.
I spent five days in the hospital, then returned to New York, where I spent the next six weeks with an IV port in my arm, self-dosing before and after work.
A couple weeks after my last IV, the New York City Health Department called. A very serious woman on the other end of the line had some questions. Feeling fantastic by this point, I spoke rather breezily of what had gone on, laughing at the sillier symptoms, conveying an overall attitude of "Hey, what can you do? Life in the big city."
Only two people in all of New York were officially known to have contracted chronic meningococcemia that winter, she told me when I was done chuckling. "Lucky me!" I responded.
Then a question occurred to me. "How's the other person?"
"The other person," she said after a brief silence, "did not do as well."
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