LW in May 2019

May 2019

It was like we were living inside an episode of House. If you are not familiar with House, it is a medical drama with Hugh Laurie as the lead character named Dr Gregory House. In each episode a patient arrives at the Princeton Plainsboro Hospital presenting symptoms that have perplexed their family physician. As House and his team attempt to diagnosis the patient, many times they really have no idea and are leaping to possible conclusions. These conclusions are most often inaccurate, because of course writers need to fill 60 minutes of tv time. Which as I write that, it brings me to another thought about the show. Those doctors are so often wrong in their diagnoses, it’s a wonder they can hold on to their prestigious positions. Anyway, in the end,it’s usually Dr House who solves the mystery and makes a correct diagnosis to save the patient.

But I digress....

This past week felt like LW was a patient in the care of Dr House and his team. LW went to urgent care on Tuesday midday for a host of complaints falling basically into the “I don’t feel good” category. They discovered his heart rate was elevated and thought he was having a heart attack. EMS was called and he was transported to the ER.

In the ER, LW was hooked up to a heart monitor and an IV. As the drs/nurses tried to determine what was going on, they did blood tests, an EKG, a chest X-ray, a cat scan, and an MRI. Because they were still unsure, he was admitted around dinner time and moved to a room. I imagine all those drs/nurses sitting in a conference room arguing about what they think the next step should be, with some version of House shooting down all their ideas. But in reality they were probably just moving on to the next patient.

Once he arrived in a room on the fourth floor, he was hooked up to a heart monitor, IV, and more blood was drawn. Throughout the night and into Wednesday, he was taken for an ultrasound, another form of scan to check for blood clots, and the next morning underwent a stress test. All of these came back good and his heart was cleared. They were preparing to discharge him when the nurse came in to check his vitals and discovered he had spiked a fever. Sorry....no longer headed for home. Staying another night.

The Dr informed us he had no idea why LW continued to spike fever, have no appetite, and feel so exhausted. From my vantage point, I assumed it was an infection. When the Dr came to that conclusion, he ordered another battery of blood tests and blood cultures. These showed liver enzyme numbers on the rise. However the Dr was not sure why, so he ordered an antibiotic drip. Enter the gastroenterologist .....This Dr mentioned that he thought the infection might be caused by a gall stone stuck in the bile duct leaving the gallbladder. A special type of MRI was ordered to look at the gall bladder, liver, and bile ducts for late Thursday evening and an endoscopy for Friday morning.

After both of those came back clear, we were starting to get frustrated. What was going on? Why couldn’t they figure out the problem? LW was responding to the antibiotic and starting to feel better. Around lunchtime, a doctor we had not yet met or seen from the infectious diseases unit came into the room. With him, he brought a diagnosis. He was our House.
Diagnosis: Cat flea typhus
This is from the California Department of Public Health website: Flea-borne typhus is a disease caused by Rickettsia typhi and possibly Rickettsia felis bacteria that are spread by fleas. Human cases of flea-borne typhus are reported worldwide, but mainly in tropical and coastal areas. In the United States, most cases occur in Texas, California, and Hawaii, with an average of about 300 cases every year. In California, flea-borne typhus is considered endemic (always present) in areas of Los Angeles and Orange counties, but cases sometimes are also reported from other parts of California. A person can get typhus by coming in contact with fleas that are infected with the bacteria that causes typhus. Fleas become infected when they bite small animals like rats, opossums, and stray cats. Fleas can then spread typhus to other animals and humans.

This Dr said LW presented a classic example of cat flea typhus, from the beginning symptoms, all the way to how quickly he responded to the antibiotic. Thinking back he had been bitten by something a week ago. Must have been this so called cat flea.

In the end our version of Dr House saved the day and gave us the freedom we so badly wanted...the freedom to be discharged from the hospital.

June 2019 Update:
LW recovered quickly once the antibiotic began its magic.  He has been back to work and seems to be back to normal.  As he follows up with the infectious disease Dr, we are now finding that the original diagnosis may not be accurate.  Blood work will be done again in July and we will see what secrets it holds.  Until then, at least he feels better.