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>> All work and no play makes @jonoxer a medical experiment

Sat, Aug 11th 9:27pm 2012: Misc

Recently I’ve pretty much disappeared from every field of endeavour I’m involved in. This post is to give (too much) detail for anyone who wonders what’s been going on with me recently. If you’re not interested in my personal tale of woe, move on! Life is too short. The TL;DR version is that I got a runny nose and felt bad.

For much of this year I’ve been suffering from headaches and a general feeling of pressure in my head. I wasn’t even aware how frequently I'd started taking painkillers until my buddy Marc Alexander pointed out that barely a week would go by that I wouldn’t say something about needing Solprin at some random time. The problem snuck up on me until I was taking painkillers every few days without realising how many I was going through.

A few weeks ago the head pain ramped up a notch and became quite severe, so I took a few intermittent days off work, trying to give myself a chance to recover from whatever was ailing me. It stayed about the same until until Tuesday week ago it got bad enough that I had to leave the office and go see my GP: I was down to a very low level of functionality, so it was time to do something about it.

The doc diagnosed it as sinusitis, so basically just an infection of the sinuses. He prescribed strong painkillers, antibiotics, and anti-inflammatories, and I went home to rest and recover. That night the pain was incredible: I slept a total of maybe 45 minutes, in between periods of holding my head and moaning. Not good.

The next day I was a mess, so the doc made a housecall and ramped it up a notch: prescribed steroids as a general anti-inflammatory, doubled the antibiotic dose, and added a couple of other medications that might help.

The doc was definitely doing the right thing and we were on track with treating it, but we didn’t realise just how bad an infection we were dealing with. The next few days were hell: the slightest pressure change was like being hit in the head with a bat, and I had to sit upright for 5 days straight with almost no sleep. I didn’t get more than 2 hours sleep in any 24 hour period that entire week, mostly less.

So by Saturday morning it was obvious we weren’t making much progress and the situation wasn’t sustainable. I’d been in so much pain (and sleep deprived) for so long that I wasn’t particularly rational anymore. Ann drove me to the Knox Private Hospital ER to see what else could be done.

The physician sent me off for a CT scan, which produced a spectacular result. His comment was “In 30 years I’ve never seen anything like that before”.

Well, at least I knew the problem was real! That was a relief, of sorts.

Yes, the problem is sinusitis, my GP was right. The interesting bit is how it’s manifested itself.

Sinusitis is a general term for inflammations of the paranasal sinuses, but it covers a variety of sub-classifications. For example, it can be classified by location: there are four major sections of the sinus that can be affected, and they’re mirror images on the two sides of your head. The CT scan showed I’m suffering from not just one type, but all four types by location at the same time. But here’s the kicker: it’s only on the left side of my head!

The CT images are amazing. It’s like a composite image from a medical textbook that you would expect to find with a caption something like:

“The left half of the scan shows every possible inflammation type simultaneously (maxillary, frontal, ethmoid, and sphenoid) with 100% occlusion on each. The right half of the scan shows a perfectly healthy result for comparison.”

Sinusitis can also be sub-classified in other ways, such as by origin of inflammation (viral versus bacterial), and other characteristics. Basically, you name it, I’ve got it. But only on one side! Send my right half to work, the left can stay home and recover.

Back to the story. Once the doctor saw the scan I was immediately admitted to hospital, and next thing I knew I had an IV inserted and was being internally washed with a variety of antibiotics. The next 5 days was basically more of the same: trials of different painkillers to find something that would suppress the pain, different antibiotics, etc. Sleep didn’t improve, though, and I think the most sleep I ever had in any 24 hours while in hospital was about 3 hours, not much better than when I was at home.

By last Thursday I was at the end of a 9 day stint starting at home and ending in hospital where I averaged maybe 2 hours sleep per night, and I was mentally turning to mush. The hospital environment was driving me insane, the painkillers that were tried weren’t doing the job, and what I desperately needed more than anything was to get a chance to sleep. The most effective painkillers that were used could only be administered every 6 hours and had an effective duration of about 3 to 4 hours, so each time they were administered I had a short window in which I desperately wanted to get just a few hours sleep. But of course that’s exactly when it would be time to load up the IV with a new antibiotic, then when that was done it had to be flushed, then after being so pumped full of fluid I’d have to go to the toilet which was quite a complicated exercise with the IV, then they’d do obs, by which time the painkillers were wearing off and they’d “leave me in peace to sleep”. Great. So then the last couple of hours of the 6 hour cycle would be spent moaning and sweating again in pain, until the cycle started again.

It wasn’t helped by the constant background hospital noise: dinner carts, rolling beds, loud TVs, shouted conversations, vacuum cleaners. Imagine having the worst headache you could possibly imagine, like being punched in the head continuously, while lying on an uncomfortable plastic bed near the steps of Flinders Street station in rush hour with all the noise around you, and try to sleep. Good luck.

Thankyou so very much, hospital schedule. You suck.

Despite this the antibiotics seemed to be making good progress with the infection so the problem now was really my increasing sleep deprivation, which I’m pretty sure was a major cause of the continuing pain. I’d got to a point where I just couldn’t handle it mentally anymore. By last Wednesday night the only thing keeping me from screaming “SHUT THE HELL UP!” in frustration was that I repeated to myself as a mantra “I’m going to leave tomorrow. I’m going to leave tomorrow. I’m going to leave tomorrow.”

I had no intention of spending another night in that place. I’d rather suffer the pain at home, where at least I’d have a comfortable environment and could be proactive about when things happened instead of being a battery hen in a cage.

So on Thursday morning when the doctor did his rounds I asked him what it would take for me to go home that day. He didn’t like the idea at all, and took a bit of convincing, but in the end we agreed on a compromise: I’d remain as an in-patient at the hospital, but under the “Hospital in the Home” scheme (http://health.vic.gov.au/hith/) where I’d still be under their care but outside their facility. Instead of being in bed 13A in Miller ward, I’d be in bed 1 in Oxer ward. I’d need to continue IV antibiotics, but that could be handled by home visits by a nurse.

Yes, that means any medical staff who need to visit me have to drive all the way to my place to do it. And yes, it costs a bomb, but you’d be surprised: the daily cost of maintaining a fully equipped hospital bed is so high that even when you take into account the home-visit fees, it’s still only about 1/3rd the cost of staying in hospital! It’s awesome. I’m getting special personal free-range hen home service, for far less than the cost of staying in the battery hen cages.

Since getting home my situation has improved significantly. Within the first day I went from the prescribed painkillers being inadequate, to only needing half the prescribed dosage. I had more sleep in the first night than I had in the previous week combined, while taking less painkillers.

Physically I’m still exhausted: a trip to the kitchen and back leaves me feeling like I’ve been on a big run and need a good rest. My body is still fighting a battle, and I’m having daily visits by a nurse to administer IV antibiotics. I’m told the pain could continue for another week, and it may be many weeks before the root cause of the problem is actually dealt with decisively. It’s not likely that I’ll be seen at work in the next week, but after that we’ll just have to see.

But, as this over-long post hopefully attests, my mental acuity is beginning to return to normal. As long as I limit myself to short doses and rest well there’s a lot I can do with just a laptop, a comfortable chair, and some wireless internets.

Finally, a huge thankyou to Ann and the kids! I’d have been stuffed without them looking after me so patiently.



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