Summer 2018: The One Where Everything Went Wrong

Hey, friends. Long time no talk.

If you’ve been keeping up with me on Instagram or Facebook, you know we’ve had a pretty rough summer over here. I wanted to catch you up with what’s been going on and to explain why I haven’t been around much for the last 2 months. (TL;DR: the whole family was sick and/or injured nearly all summer.)

After Our Puerto Rico Vacation

As I’ve already shared, we started our summer off with an incredible family trip to Puerto Rico. Sunshine, beaches, adventure, great food…it was pretty near perfect and (we hoped) a sign of good things to come, especially after a really difficult school year. We had a long list of summer plans: road trips, activities, movies, crafts, etc.

But you know the old Yiddish proverb: “Man plans and G-d laughs.”

Shortly after returning from Puerto Rico, the girls set out for their annual week at overnight camp. Vic happened to be traveling for work that same week, so I had 2½ days completely to myself. I enjoy solitude in general. But after circumstances led to me having at least one girl with me 24/7 since April, I was ridiculously excited for the alone time.

Solitude and a SUP Fail

The first day and a half were glorious. I woke up early and made it to the beach in time for sunrise. I read and watched TV and napped. Good times.

On the second morning, I met friends at Anastasia Island State Park to go paddle boarding. There’s a calm little spot that’s perfect for beginners like me. Plus you can see baby sea turtles close up and dolphins in the distance.

Between the 3 of us, we had one full-size paddle board, one child-size paddle board, and a kayak. I was the smallest, so I used the kid’s board. It was really small (both short and narrow) and wasn’t sturdy enough for me to stand on, but I could kneel and paddle on it pretty well.

After a while, we decided to switch boards so that I could have a turn on the full-size board. We made our way over to the shallows and did a little switcheroo. I instantly felt confident on the big paddle board. It was super sturdy, and I stood up on it without hesitation.

Unfortunately…my board’s fin got stuck on some oyster beds over in the shallows. So as I stood and began shifting my body weight forward, my board didn’t go with me. It yanked me backwards, and I slipped off the back…right into the oyster beds.

I caught myself as I fell with my left hand. Luckily I was wearing water shoes, so my feet were spared. And by some miracle I managed to avoid hurting my back or other major injury. But my left hand…oh, boy. Not good.

Urgent Care Visit #1

My entire left hand (wrist to fingertips) was covered in scratches, some of them pretty deep. I was bleeding a lot. I was embarrassed, and so, so disappointed. I’d literally been on the board for less than 30 seconds. My friends helped patch me up, and I drove to urgent care, which thankfully was just a couple of miles away.

I ended up needing 3 stitches, antibiotics, and a tetanus shot. Plus I couldn’t get my hand wet for 10 days, which put a damper on the mini tubing trip that Vic and I had planned for later that week. My hand hurt a lot, so instead of another glorious afternoon of solitude, I spent the rest of the day knocked out on pain meds.

The Calm Before the Storm

The rest of June was pretty uneventful. The girls and I stayed busy with appointments, Bat Mitzvah lessons, karate classes, and the usual errands. We spent a lot of time at the library, Yobe, and Target (a LOT). We went to the water park and the pool. Things seemed to be shaping up nicely.

And…I’m sure you can guess where this is going.

We planned to spend July 4th weekend exploring a couple of Florida State Parks, including Weeki Wachee Springs State Park on the west coast. A couple of days before we left, Amelia started to not feel well. It seemed like a regular cold and cough. Amelia has asthma, so cold and cough almost always go hand in hand for her. At that point we weren’t overly concerned.

Urgent Care Visit #2

But then she started to run a persistent fever. I contacted her pediatrician, who advised us to take her to urgent care since we were out of town. At urgent care, everything checked out: her ears, throat, and chest were all clear. The doctor chalked it up to a random virus and prescribed an antibiotic in case it wasn’t. We came back home in time for the 4th of July, and for the first time in years we celebrated at home instead of watching fireworks at Castillo de San Marcos. We ate hamburgers and watched The Princess Bride and set off fireworks in our driveway. It was still a pretty great day.

After a few days of antibiotics, Amelia wasn’t showing any signs of improvement. I called the pediatrician again, and they had me bring her in. Again, we were told that her ears, throat, and chest looked good. Her cough was getting worse and her fever was not abating, and the doctor (not her regular pediatrician) attributed it to a sinus infection. She was put on a different antibiotic and I was instructed to give her an OTC decongestant.

Back to the Pediatrician

But she just kept getting sicker. She’d had a fever for 10+ days and was getting worse, not better. Something didn’t feel right. Vic and I wondered if she had bronchitis or pneumonia. I checked with some of my mama friends, who all agreed that I needed to get her back in to see the doctor ASAP.

Thankfully, on our third doctor visit, Amelia was able to see her regular pediatrician (a true angel). She picked up right away that this was more serious than a sinus infection: Amelia was having an asthma attack. Her asthma is mild and she’s never had an episode like this before, so we didn’t recognize what was happening.

Her blood oxygen level was 94. After two in-office nebulizer treatments, it actually went down to 93. At that point, the doctor told me that I needed to get Amelia to the ER.

ER Visit #1

I was given the option of transporting her privately to the hospital right down the road or by ambulance to the children’s hospital downtown. They allowed me to drive her to the ER (only about a mile away) as long as I agreed to get her there immediately without any stops. It was all pretty scary (but I figured that transporting her in my car would be way less scary for her than riding in an ambulance).

At the ER, they were able to get Amelia’s asthma under control pretty quickly. Once her breathing and blood oxygen were more stable, they were able to do a chest x-ray, where they found the underlying cause of her asthma attack – she had pneumonia.

She was discharged from the ER with prescriptions for Prednisone and an antibiotic (her third). And within 24 hours, she was feeling so much better. It was a lousy way for her to spend her 10th birthday (ironically, she was in the same hospital where she was born), but we tried to make the best of it.

Pneumonia vs. Wilhelms, Round 2

Within 24 hours of starting the proper treatment, Amelia started to feel better. But to the great surprise of no one, as soon as that happened, the rest of us started getting sick. Luckily, Sophia’s illness turned out to just be allergies. Vic, however, was probably the sickest I’ve ever seen him (not counting stomach bugs). He had a persistent low-grade fever, a bad cough, and he was absolutely exhausted for days. While he was never officially diagnosed, I’m pretty sure he had pneumonia.

I was officially diagnosed with pneumonia, but like with Amelia, it took a while for me to receive the proper treatment. Also like Amelia, I have asthma. It’s typically mild and only presents when I have other respiratory issues. Whenever I have a cold or allergy issues, it very quickly turns into a tightness in my chest. So it was no big deal when I started to feel a little tightness on July 15, because we’d spent the previous day at the home of friends who have cats (I’m allergic).

Urgent Care Visit #3

After a couple of days, the tightness turned into a cough. I decided to be proactive and went to urgent care on the 17th. I didn’t have a primary care doctor because my PCP switched to a medical concierge practice, and I hadn’t found a new one yet. Plus, my insurance co-pay at urgent care is only $5 more than my co-pay for my primary doctor.

Anyway, not surprisingly, the urgent care doctor was fairly dismissive. She gave me a 7-day taper pack of Prednisone and a prescription for Zithromycin, with instructions to only take the antibiotic if I wasn’t feeling better after completing the full 7 days on Prednisone.

The Prednisone helped, and I began to feel better. My cough didn’t really improve, but my fever was gone. On the 21st, I even felt well enough to brave the crowds at Target to take the girls school shopping. Things started out fine (or as fine as they can possibly be while back-to-school shopping). I don’t know if I overdid it, but about mid-way through our shopping trip, I started to feel terrible again.

My fever was back, and my cough was worse than ever. My cough was dry, unproductive, and extremely painful. Every time I coughed I got a stabbing pain in my lower left abdomen. I started to wonder if I’d given myself a hernia. The steroids were no longer helping (nothing was), and I hadn’t started the antibiotics yet (per doctor’s instructions).

Urgent Care Visit #4

I returned to urgent care on the 24th, and since I’d had a fever and cough for so long, they decided to do a chest x-ray. And – you guessed it – I had pneumonia too. I was given another course of Prednisone and a different antibiotic, which I was to begin right away. My fever was really high that day, and my cough was worse (and more painful) than ever. I was told by the doctor that if I started to feel worse, I shouldn’t return to urgent care, as there was nothing more they could do for me at that level of care. Rather, I needed to go to the ER.

The Prednisone helped again, and once again I started to feel a bit better. My fever didn’t come back, but I was still coughing almost constantly. That’s when I began to notice bruising on my lower abdomen/pelvis, right in the spots where my cough was most painful. I also started to have pain in my lower right abdomen, as well as near my ribs and across my upper back. I wasn’t getting worse, but I still wasn’t getting better. I’d been really sick for over two weeks at this point.

I tried to make an appointment with a new primary care doctor (who I saw for several years before switching to my more recent PCP), but they couldn’t see me as a new patient for 2+ weeks. They advised me to go to urgent care. But urgent care told me not to go back there either. So after much deliberation, I drove myself to the ER on July 31st.

ER Visit #2 (or “Why Are You Here?”)

At the ER, things got a little…weird. It was quite apparent that the medical staff didn’t think my symptoms warranted an ER visit, despite the x-ray report from urgent care stating that 1) I had pneumonia, and 2) I should go to the ER if further treatment was required.

I totally get that the ER doesn’t want to waste valuable resources on people who can be treated at a lower level of care. And they especially gave me the side-eye when I explained that I didn’t have a primary care physician. But I honestly didn’t know where else to go at that point.

The ER nurse literally asked me, “What made you wake up today and think, ‘I need to go to the ER?'” I don’t think she intended to be unkind, but she clearly didn’t think I needed to be there – which I assume is why I wasn’t even given a room and instead spent hours parked on a bed in the hallway.

Surprise, You’re Staying

My vitals were stable, and my chest x-ray looked pretty clear. I was fully expecting to be sent home with an identical treatment plan to the ones I’d been given at urgent care (steroids and antibiotics). But then, a twist: the ER doctor decided that since I’d “failed outpatient treatment,” he wanted to keep me overnight to stabilize my asthma and rule out other diagnoses.

I wasn’t thrilled about staying, but I also had about zero confidence that the 3rd time would be a charm for outpatient treatment. I’ve never been hospitalized for asthma before; in fact, I was only diagnosed about 6-7 years ago. Outpatient care has always worked for me. So I genuinely had no clue how to manage this type of exacerbation, especially on top of pneumonia. So it seemed like a good idea to be admitted and to get things under control.

Of course, my ER experience turned right around. I was moved out of the hallway and into a room posthaste. (It probably also helped that it was shift change and I got a new nurse, who presumably wasn’t sick of seeing my face in the hallway.) The nurse placed an IV, drew blood for labs, and took me for a CT scan of my chest to rule out a pulmonary embolism (blood clot) in my lungs (my scan was clear).

I should also mention that I showed the bruises on my abdomens to at least 3 doctors/nurses, and not one of them had ever seen anything like them.

Not the Ritz

Vic and the girls brought me dinner and some things from home, and soon after that I was admitted to a room on the 7th floor. I’m sure I’ve already bored you with enough details here, so I’ll spare you from having to read even more. I’ll just sum it up by saying that for the next 2 days/nights, I was monitored closely. I underwent various tests, had multiple labs drawn, did breathing treatments every 4 hours, and was pumped full of steroids and antibiotics.

My treatment team determined that my pneumonia had mostly cleared up, so the focus was on my asthma. My blood oxygen was decent (94-97ish) but I remained tachycardic (new word I learned = resting heart over 100 bpm). It would shoot up to the 120’s with even the slightest physical exertion. At one point, a group of nurses rushed to my room – my heart rate was in the 140’s and they thought I was in distress. When they walked in, they found me standing next to my bed, stretching my quads. I was literally standing still. It was funny, but also a little alarming.

I showed my abdominal bruising to the doctor and nurses on my floor, and like in the ER, no one could recall ever seeing it on another patient. I guess it’s more common to get bruises and coughing related injuries near your ribs, but not in your abdomen. The only incident noted occurred in someone who was on blood thinners, which I am not. But an ultrasound of my abdomen and labs to test my blood coagulation were normal. I wonder if this has anything to do with the structure of my post-op spine – perhaps I’m somehow coughing differently than I would if I had flexibility in my lumbar spine? Any thoughts on this?

Anyway, after my second night in the hospital, my back was a wreck from sleeping in a hospital bed, and it was getting hard on my family to accommodate for my absence. The doctor was on the fence about sending me home, and honestly I think one more night in the hospital would’ve been helpful, but I asked to be discharged and she agreed.

My discharge plan included more Prednisone, another round of antibiotics, and Symbicort (a maintenance med for asthma). I’m scheduled to meet with my new primary care doctor on August 18.

Back to Normalish

It’s now been a few days since I’ve been back home, and things are slowly getting back to normal. My heart rate is mostly normal, other than a few random spikes here and there. My abdomen is healing and only occasionally hurts when I cough. I do still have pain across the back of my chest, although it’s hard to determine if it’s breathing pain or regular back pain or unhealed coughing pain.

My cough is much less frequent, and my breathing is pretty normal when I’m at rest. I do still get a little short of breath with mild exertion, but I’m doing my best to rest as much as possible.

So that’s what I did on my summer vacation. Four urgent care visits, two ER visits, one inpatient hospital stay, and countless trips to the pharmacy. I need a vacation from my summer break. It’s been a tough summer all around, and the girls have had to fend for themselves WAY more than normal. But they’ve been troopers, and Vic has done a phenomenal job at making it all work.

The Takeaway (or What I Learned on my Summer Vacation)

1. I need to do a better job at asthma maintenance for both Amelia and myself. This experience goes to show that even mild asthma can result in serious episodes especially when it isn’t being properly managed.

2. I should listen to my instincts. I knew that Amelia wasn’t being properly diagnosed. I knew she had pneumonia. I knew I had it too. Sometimes medical professionals can be dismissive, especially when symptoms are mild to moderate (i.e., when you’re not waving a bloody, cut-up hand in their face). It’s all part of the triage process, and it’s necessary. But sometimes you just know that something isn’t right. And those are the times when you have to keep pushing until someone listens.

3. I first learned this trick from my friend Jan (@10jan30) on Instagram, but I also heard it from at least half a dozen people in the hospital too: while coughing, hug a pillow firmly against your chest to reduce pain.

4. Hospital beds + fused spines are a bad combination.

Whether you’ve read this far or skimmed through the highlights or scrolled down to the bottom of my post, I thank you from the bottom of my heart for your support and love. They mean the world to me. My birthday is coming soon, and so is the 5 year anniversary of this blog, so some good things have to be in store, right??