Drug Induced Hepaptitis

It was this time last year when all the trouble began. The symptoms were subtle and gradual, weakness and muscle fatigue developed, sore eyes, and vision straining. All changes that I easily had written off as stress and anxiety due to the demands of my job, working in retail during the busiest time of the year. I was growing progressively more exhausted but pressed on through my holiday obligations. There was the Christmas shopping for every last human and canine on my list, the entertaining, nursing Pugsley back to health from the surgery he just had after Isaac the beagle attacked him, all the while working overtime at my job.

The pressure was mounting and my energy level was at an all-time low. We were told we had to work mandatory overtime for the week between Christmas and New Years to count inventory. I wasn’t sure how I was going to get through it feeling the way I did but I kept chugging along. By December 27^th, I had been entering inventory numbers into an excel spreadsheet for the last 16 hours when my neck completely stiffened up. During my hour commute home that night the pain was so severe that I broke into tears and cried the whole drive. This was big deal for me because it takes a lot to make me cry but it was like no pain I had ever felt before. That night I made my first trip to the emergency room. After waiting for 3 hours, the Dr. saw me for about 5 minutes and told me I was having muscle spasms in my neck due to the long hours at the spreadsheet work seated in one position. He prescribed a muscle relaxer, vicodin, and told me no work for 2 days. He told me to continue taking the current medications I was already on which included an antibiotic for a minor infection I had, and they sent me home.  I felt really guilty calling my boss to tell him I couldn’t come in for 2 days knowing the rest of my co-workers were having to work overtime through the holidays, but I also knew I couldn’t commute two hours on Vicodin or leave the house in that kind of pain. As it turned out, the drugs did nothing to take the pain away; all they did was make me light-headed and more anxious.

As the days went on, I became sick to my stomach and could not keep any food down. I attempted my favorite thing, vanilla ice cream from Carvel, but even that came back up. I also wasn’t able to sleep very much. I would sleep for an hour or two, then stay awake for 2 hours, and so on. Night sweats also became a familiar routine, I would wake up with my pillow and blankets saturated in my own sweat.  It was disgusting. On the night of December 29th, I woke up around midnight delirious and totally out of it. I don’t remember ever feeling that sick before. I called my mother who lives upstairs from my apartment and she came down, touched my forehead and said I was burning up. She drove me to the ER again and this time they took my temperature, which was 103.9 and whisked me right into a room with warm blankets and they started feeding me Tylenol in large quantities to try to get my fever to come down. After reviewing my blood work, the Dr. came in and told me I had the Flu, to continue all the medications I was currently taking, especially the Tylenol for my high fever, and they sent me home.

I was still in a lot of pain, still uninterested in food, still not sleeping, still having night sweats, still trying to keep my fever down on January 1^st when I got a call from my regular Dr. telling me he had just reviewed my blood test results from the ER and didn’t like something he saw. He said my white blood platelets were not normal and not consistent with the Flu. He said I needed to get down to the emergency room right away for further tests. New Years day at the hospital was a complete nightmare, the waiting room was packed and even though I was sent there by my Dr., I had to wait like everyone else. Finally, I was taken in and given a Chest X-ray. They discussed doing a spinal tap on me but decided at that point they would not put me through that. They took more blood and a Dr. came in with a new diagnosis; this time I was told I had a “Febrile Illness”. I was sent home and told to continue all my meds. This was a Saturday, and I was told to follow-up with my regular Dr. on Monday if I was not better by then.

Meanwhile, I was stressed out about work, I knew by Monday I was supposed to go back in but I was still just as sick, and feeling sicker.  I wasn’t sure how long the “flu” was supposed to last but I remember being very skeptical and not believing I had the flu. I had the flu before and this didn’t feel anything like that. By Monday morning, I was still unable to keep any food down. I had lost about 10 lbs in two weeks, I was so weak that I could not even walk Pugsley outside for 5 minutes, my skin was starting to turn yellow, and my stools were a white clay color. Yes, I knew for a fact this was not the flu.

Monday morning came and after arguing with the receptionist who was trying to tell me she had no openings, I was finally able to get in to see my regular Dr. He took one look at me and told me I was jaundiced and dehydrated and that I definitely had something other than the flu. He made me give a urine sample which I remember was a dark brown color. He sent me back to the hospital for an ultrasound of my organs and sent me home saying he could not admit me to the hospital with just jaundice and dehydration. I waited until 3:00 the next afternoon for results of my ultrasound test but he never called. Finally I called and his nurse told me the test showed that I have Gall Stones and that I needed to make an appointment with the surgeon. I was a little surprised to hear this considering I was not at all a candidate for Gall stones. I did not have any bad eating habits, I was not overweight, and I was still fairly young for gall stones to develop.

On January 6^th I showed up at the surgeon’s office looking and feeling like death. I was ready to drop at any minute because I had virtually no food in my stomach for 2 weeks, every muscle in my body ached, and I was a very dull shade of yellow. The Surgeon took one look at me and my test results sent over from the other Dr. and he said, “You don’t have gall stones!” I was ready to collapse. There was a snow storm outside and he said, “I’m going to admit you to the hospital now for Jaundice and Dehydration.”  Wait a minute I thought, isn’t this what the other Dr. told me he “couldn’t” admit me for? It didn’t matter at that point, this was actually the first bit of news I heard in a while that gave me any hope. Hope that once I was in the hospital they would find out what exactly was wrong with me. By the time I got to admissions, I had to wait for the four people ahead of me to check in. When it was finally my turn, I used my last ounce of energy to walk into the admissions office when I collapsed. Next thing I knew, I was in a wheelchair being brought to the 3^rd floor.

Whatever my illness was, I had developed a keen sense of smell and aversion to food. The thought, smell, or sight of any food made me nauseous. This was unfortunate because I do LOVE food. I started to worry if my taste for food would ever come back. The first room they had me in was with a 90 year old woman who smelled so bad that I began to dry heave. I explained to the nurse that if they ever expected me to eat again, they had better put me in a different room, and they did. 

The next day, January 7^th was my birthday. The Priest came and gave me the Holy Sacrament, the Annointing of the Sick. I spent one week in the hospital and while I was there I developed a bladder infection, a spastic colon, and I had my first ever enema and CAT scan. I spent the night with Nurse Ratchet on Thursday who would not give me pain medication I requested for 11 hours. By the time I was released, I was told I had Hepatitis even though my blood tested negative for Hepatitis A, B, C, and D, all the kinds you get from virus, from bad food or water, or from sharing needles. Nonetheless, they were sure that’s what I had because my liver was inflamed and not working right. The bile in my body was entering my bloodstream instead of being filtered through the liver like it was supposed to; this also caused a great deal of itching for me. For the next 2 months, I had to continue going for blood work and tests until I was finally given the news I had suspected all along. I had Drug Induced Hepatitis from the antibiotic Bactrim that I had been taking for that minor infection.

As soon as I was discharged from the hospital, I started feeling terrible pain in my lower back, and I continued to get low-grade fevers. I went back to work for a couple weeks until the pain became so unbearable again that I couldn’t drive and worse, it traveled back up into my neck, where this all started. After a whole new slew of tests including a bone scan, MRI, more cat scans, more X-rays, more ultrasounds, they “surmised” (because sometimes that’s all Dr.’s can do) that the reaction to the medication had traveled into my spine causing the pain. In addition, I had been on bed rest for so long that my sacroiliac had completely shifted out of joint. I spent the next 4 months undergoing intense physical therapy to rehabilitate the muscles and joints in my back and neck.

It is now a year later since this all began and I am left with some residual pain in my lower back and neck. If I keep up with my exercises I learned in therapy, it feels better but it always hurts when it’s damp or raining outside. From time to time I still get low-grade fevers and my energy levels have never returned to where they once were. My vision at night is also really bad although I’m not sure if that can be attributed to the Drug Induced Hepatitis. What I learned from this experience is that I am allergic to Sulfa drugs, something I never would have known. I also advise people now who are on any type of new medication that is known to cause liver or kidney reactions that they should request from their Dr. to have their blood levels monitored to check how the medicine is reacting in their system. Of course what I really learned is that a good Dr. would suggest this prior to putting you on any new medications, unfortunately mine did not. Otherwise, my liver enzymes would have been detected as seriously out of whack before it got as bad as it did. I was misdiagnosed 4 different times before being admitted to the hospital and even then it took a full month to determine exactly what caused my illness. Then it took 3 more months to straighten out the damage done to my body by grueling physical therapy 3 and 4 times a week. My advice is to always question the Dr.’s and go with your instincts. In the end, I am just thankful this year to be alive and healthy.