I’ve recounted this series of events dozens of times in the past 3 weeks. In fact, I’m relieved to commit it to ‘paper’ and direct all future inquiries to this website! WARNING: This post contains an obnoxious level of detail.
- I started to cough sometime in the middle of August. It was a tiny cough, 3 – 4 times a day. I remember it so clearly because coughing isn’t my usual M.O. when I do get sick. It was mid-month because I thought to myself, “this is okay, if I am getting sick, I will have plenty of time to recover before vacation.”
- Towards the end of the month, I was feeling worse. I had missed at least 1 day in the office due to a general ‘blah, I’m coming down with something’ feeling. I had a low-grade fever, no other symptoms – except that tiny cough. Then, a day or two later, the fever was gone, I figured whatever it was had passed, and I packed to go on vacation.
September 1 – 6, 2011
- Vacation! I flew into Las Vegas International on September 1. The approach was rough, and though that wouldn’t normally bother me, I felt positively awful by the time I was off the jetway. “Perhaps I’m not over that bug,” I thought. But, dammit, I was on vacation. I WOULD feel good!
- My next hour was spent trudging to baggage claim (boy was that a long, tiring walk), waiting to buy a shuttle ticket, and seeking out an ATM. I also had to stop in the middle of it all to sit, tear up, and catch my breath. “I really don’t think I’ve gained so much weight,” I thought.
- I struggled during our active vacation and blamed my fatigue and breathlessness on 1) my excess weight and 2) the high elevation. I didn’t say anything to Seth, but he certainly noticed when I couldn’t keep pace at the Grand Canyon.
- At this point, I intermittently had trouble taking a satisfying, deep breath when at rest. And when I couldn’t, I secretly panicked. Wash, rinse, repeat.
- Once home from vacation, I fell back into the low-grade fever funk, missed another day or two in the office, and started coughing more frequently. I had a few of these days earlier in the summer too (pre-cough), and my family and I started to think we should rule out an autoimmune disease.
- By the third week of September, the cough was productive.
October 4, 2011
- I went to a CVS Minute Clinic to get some antibiotics. They had helped me with bronchitis a few years ago; but as I would learn, Minute Clinic won’t treat a cough 3 weeks or longer in duration. They took my vitals, listened to my lungs, and told me to see my primary care doctor for a full work-up.
October 5, 2011
- I chose a primary doctor on convenience and availability. There was a new, networked, satellite office in the same complex where I work, and one of the primary care doctors could see me the same day. Perfect!
- I presented the doctor with as much detail as possible and focused on my two symptoms: low-grade fever funk days and productive cough. He ordered A LOT of blood work – 7 full tubes. When I asked about the cough, he smiled, shook his head, and said, “just an allergy cough.” I replied, “I don’t have allergies.”
October 12ish, 2011
- I received a return phone call from the doctor. The blood work “looked fine,” and he referred me to a rheumatologist to further investigate. That doctor couldn’t see me until the end of November, so I got a name elsewhere and setup the first available appointment.
October 31, 2011
- By the time I got to the rheumatologist, I was coughing a lot, and I started coughing up blood in the morning. I was still missing time in the office, approximately one day per week. I had to figure out what was wrong with me and pronto.
- The rheumatologist took a very thorough history and reviewed my blood work. He remarked that a couple levels were slightly elevated. After the exam, he concluded I didn’t have any signs of an autoimmune disease, but that I may have a condition known as fibromyalgia. I know this condition is controversial, but decided I would research it.
November 4, 2011
- The cough was unbearable by the start of November (to the point where I was coughing up blood consistently and sometimes vomiting), so I made another appointment with the primary care doctor. By now I had also made a return visit to the CVS Minute Clinic (evidently the fever made me forget their 3 week cough policy), and they had politely turned me away again. This time, though, the nurse said, “tell your doctor you need a chest x-ray.”
- At the doctor’s office, I gave the report from the rheumatologist and specifically requested a chest x-ray. His response: “I don’t need you to tell me. I was going to do that anyway.”
- He listened to my lungs (“The good news is that you don’t have pneumonia.”), completed his exam and concluded, “I really think these are allergies.” He provided me samples of Singulair, a script for a z-pack, and orders for a chest x-ray. I was to try Singulair for 2 days before starting the antibiotic. I have no history of allergies or asthma, but I followed the instructions.
November 5, 2011
- Knowing that something was definitely wrong with this horrible, bloody cough, I scheduled the x-ray for the following day, Saturday. After developing the films, the tech asked, “have you had an x-ray for this before?” I responded that I hadn’t, and she had me wait. I’ve never had to wait after an x-ray. My brain went into the “if I only have a year to live…” mode.
- Twenty minutes later a hospital employee handed me a phone with my primary care doctor at the other end. The films showed multi-focal point pneumonia in my right lung. He was going to phone in a stronger antibiotic, and I should follow-up with him in one week.
November 7, 2011
- It was 3:30am, and I was in a state of mild distress. I drove myself to the emergency room, x-ray report in hand. They started me on fluids (I was certainly dehydrated) and gave me an anti-inflammatory and the prescribed antibiotic via IV. After running blood and urine tests, they ordered a CT to rule out a blood clot. At that point, they gave me a choice: admit me to be on the IV antibiotics for a couple of days or go home and see if I improved over the next 24 hours. I chose option B and went home.
November 8, 2011
- That morning I called my primary care doctor and told him of my emergency room visit. I asked him if I should be feeling any better yet. He said, “you are on day 4 of a 14 day antibiotic.” I thought to myself, ‘thanks, I could have figured that out.’ I pressed on and asked him if I should go back to the hospital. His response: “If you feel shortness of breath, go to the emergency room.” His response was mechanical – like the narrator on a TV ad listing the side effects of a medication. I had a very serious case of pneumonia and my primary care doctor was reading off cue cards.
- I wasn’t experiencing ‘shortness of breath,’ but I did feel awful. I returned to the ER where they promptly agreed to admit me.
November 10, 2011
- After meeting with infectious diseases and pulmonology the day before, I was having a bronchoscopy. This involves a flexible tube going up your nose, down your trachea, and into the bronchi. While there, they viewed the areas for signs of disease and collected three types of specimens for biopsy. The procedure went smoothly, but my recovery from it did not.
November 13, 2011
- A new CT showed almost no reduction of the infection/inflammation.
November 14, 2011
- I had been in the hospital for 6 days. On antibiotics and steroids for 6 days. Having blood work done daily for 6 days. And I wasn’t feeling consistently better. I would feel okay in the late afternoon but awful some mornings and nights.
- Every single day I received a quality visit from three departments: hospitalists, infectious disease, and pulmonology. They didn’t know what was going on, but they weren’t going to stop until they figured it out. Tests started getting more exotic (maybe I picked up an odd fungus at the Grand Canyon?).
- It was around 2pm when the pulmonologist visited me. “There’s no way to sugarcoat this, and it makes no sense at all, but you have lung cancer.”