Old-fashioned stubbornness can kill you

Future Tense for Nov. 19, 2007

By Steve Welker

I have school-aged sons, so our family usually sees a sampling of whatever illnesses circulate each winter. In fact, one of my boys came home from college this week with an infection that caused a nose bleed lasting hours and he's still suffering from an ear ache. I just hope it's not contagious.

The boys bring home these infections, but I don’t get sick very often and, when I do, the illness rarely lasts more than two or three days. Stubbornly, I usually work right through it.

The last time I got sick I ignored the symptoms as I've done in the past. I didn’t think I had a cold, because I didn’t feel any achiness. We had bought one of those plug-in devices that heats up fragrant oil and gives a nice scent to the house, but after a couple of days of suffering clogged sinuses I thought I might be allergic to it, so we unplugged it.

Day after day I grew increasingly more miserable. My sinuses packed up so badly that I could barely breathe. My nose clogged up, too, with thick mucus. For awhile I totally lost my sense of smell. The sinus pressure created blinding headaches — seemingly pushing the pain right into my face. And I felt constantly tired, but I assumed that was because I was not sleeping well. I thought the dry air might be aggravating my problem, so we bought a room-air humidifier. It helped a little.

I knew my problem wasn’t the flu. I had no fever.

I decided I had a low-grade cold. Drugs don’t kill cold viruses, but they can relieve the symptoms. Soon I was using enough to open a small pharmacy — pseudoephedrine (Sudafed) as a general decongestant; diphenhydramine (Benadryl) as an antihistamine; guaifenesin (Robitussin) to thin the mucus; aspirin, ibuprofen (Advil) and acetaminophen (Tylenol) to relieve the headaches; oxymetazoline (Afrin) as a nasal spray.

Through it all, I kept working, just as I've always done. Big mistake.

Finally, eight days after noticing the first symptoms and after a particularly bad evening when I spent four hours struggling to write a single article, I surrendered my fate to a higher power. I called my doctor’s office and talked to her nurse.

“Oh, we’re seeing a lot of that,” she said. “If I don’t call you back by noon, go to your pharmacy and we’ll have a prescription waiting.”

She called back a little later.

“The doctor wants to see you.”

I’m not sure what prompted the doctor to call me in, but one of her concerns was that I had had the symptoms for so long. As she explained to me, an otherwise healthy person’s body usually can fight off a viral sinus infection in about five days. If the symptoms last longer, the cause probably is a bacterial infection.

Here’s the scary part and what you need to know. Some bacterial infections have become more resistant to your body's defenses. Left untreated, a bacterial sinus infection can spread into your lungs and trigger pneumonia. Pneumonia kills. It is the sixth most common cause of death in the United States. In January, when I was sickest, pneumonia and influenza causes 8 percent of all deaths reported in major U.S. cities.

My doctor gave me 20 pills — an anti-inflammatory medicine for pain relief and a huge dose of guaifenesin to break up the mucus — and told me to stay off work for five days. I stopped at the pharmacy on the way home and mentioned to Tim Matthews, the pharmacist, what I was fighting. That’s when he told me about people in this area who'd died from bacterial sinus infections.

“These should help knock it down,” he said, handing me a 10-day supply of 875-milligram doses of amoxicillin.

A horse would have trouble choking down those pills. I’ve never seen any pills so large, but I was too sick to object.

I spent most of the next four days in bed, usually sleeping. When I was awake, I sipped hot tea and slurped hot soup — the warmth helped relieve the sinus pain — and then went back to bed. I took the pills faithfully.

My doctor said amoxicillin might not clear out the infection. Amoxicillin has been in use since 1972 and some bacteria have learned to resist it, like some other older antibiotics. She preferred to try amoxicilllin first because (a) it’s usually effective against the bacteria causing sinus infections and (b) doctors try to avoid using newer antibiotics to reduce the chances of encouraging more bacteria to develop drug resistance. Every year, it seems, health-care specialists identify yet another disease strain that has developed antibiotic resistance and, in some cases, greater virulence.

I later heard from one of my co-workers that her father, who had the same symptoms as mine, needed a second 10-day course of antibiotics because the first couldn’t halt the illness.

Fortunately, on the ninth day of taking pills — two and a half weeks after noticing the first symptoms — I felt better. Not a great improvement, mind you, but well enough to feel optimistic about recovering. And much, much better than when death almost seemed preferable to living with this infection.

Perhaps you already know what follows, but here’s what I learned from this experience.

First, don’t worry about exotic diseases such bird flu. It’s killed less than 200 people in the whole world. Local infections running through the community may be the bigger threat to your health. Pay attention to what you hear from your kids, co-workers and friends about the diseases at large in your own community.

Second, if you’re sick and the illness doesn’t clear up in five days, call your doctor. Bacterial infections may go away on their own, but why endure unnecessary misery and possibly leave yourself vulnerable to something worse?

Third, a little knowledge may be dangerous to your health. I self-diagnosed myself and treated myself in old-fashioned ways. I was repeatedly wrong. And, incidentally, I would have made things worse if Dr. Chapman hadn’t warned me to stop using a nasal spray after three days.

I'm not disparaging home remedies. Neither am I saying you should call your doctor about every single sneeze or cough. Many people still survive all sorts of infections even without a dose of drugs.

But trust me on this. If you have a lingering illness, more than five days' long, call your doctor. You don’t want to go though what I went through ... in the future.

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Steve Welker is the editor of SurryBusiness.com.

This article, as well as reader comments can be found at stevewelker.net/article/54. Steve Welker is an editor and columnist living in Mount Airy, North Carolina. More of his writings can be found online at stevewelker.net