Hello people
Sometimes your mind gets too overwhelmed , so you decide to write things down so that it feels lighter.
As emergency physician , I have honestly not gone into the causes of fever beyond certain point. Probably, its almighty way of teaching me fever evaluation through highway.
Its been almost a year , that fever has been a frequent visitor. In the pandemic that we're in , it has freaked me out n number of time . The thoughts that would crawl into my head are did I bring COVID home by any chance. The day or two would be horrible till I would get my covid report. The negative report would be a sign of relief , but the fear of false negative would keep me away from friends and family.
The disappointment of being struck at home just thinking and taking care of yourself when the country has hit the rockbottom during the pandemic is huge.Kills everyday.
This works out if it is once or twice , I got tested for COVID 19 eight times, tested positive once . Now, if its not COVID, then what? This time again tested twice for covid, tested negative.
As much as we know its abnormal for a 27 year old to fall sick so often . Its highly sickening to get evaluated and comeout with unusual bacterial /viral infection. Later on the investigations began to show no infection. Now shit began to seem worse. Why that fever? What's going on with my body?
On a sarcastic note my temperament and temperature both got hotter and hotter day by day.
Inferiority complex :
The point where you feel like a weakling in the room not sure if you're healthy enough to pull the next shift effectively was very depressing. In a pandemic, where each doctors efforts matter. Being a frontliner with skills I knew mine mattered the most. Watching your skills getting wasted like that was frustrating...
Overtime some personal factors added up and my mental health went on a downslide so did my academics. The faster I would try climbing up , the harder I would hit the rock bottom
I could see all this reflect on my behavior. I was landing in a proper burn out situation. I took a break from work to nurture my health. I worked very very hard on myself. Sounds cliche. But yes , this was the first time in my life , I was consciously taking care of myself. Like you would take care of someone you love...
1/4/21
Doctor shopping
I join work back and my frequent visitor is here.(FEVER). 2 weeks later . This time it didn't seem to leave me or let me feel better. I got back home .
My struggle to find a right Physician began so did my tests. One suggested it was inflammatory fever while other suggested it was undifferentiated arthritis. One planned to start me on steroids the other on HCQs.
While all this went on I grew weaker and weaker. Lay on bed all day. Upset with my body . The same one which has fought so many battels with me. It was mean of me not to take my own side. But thats how us humans are... We tend to blame first rather than support.
27/4/21
Losing weight and battles
I lost yet another Kilo weight just like that adding it upto 4.5kgs. I would have been jumping had it been any normal day. I quietly weep as the struggle to get the cause of fever continues.
With all blood test coming inconclusive. I underwent PET scan after lot of anticipation.
28/4/21
Another fall
I woke up with cold and sorethroat. I was scared
I waited for the report hour by hour till I could have my hands on my report. the report of such an invasive test was also non specific. The plan was lymphno Kimde biopsy. I sat it the corner, shed few tears , gained courage for next exam like every other day. If you don't get your back then who will?
My fever spiked up like day one. The fear that it could be COVID sprung out. I isolated myself yet again , planned to retest myself.
The more people sent me get well soon wishes , the steeper my fear of missing out and not getting back to form became.
All I would say myself is I am born to create a dynamic change in field of emergency medicine. I believed it 100%.
The counseling by my friends started to reconsider my career , as work seems to be making me ill. My thoughts on it were , when you are a weakling you work on your immunity not an alternative. Leaving something I've been so driven by is not in my plan.
I know this is a phase and it shall pass...
While my mother and my best of friends think that its evil eye. I am just figuring out.
29/4/21
Swab therapy
I wake up sick this morning again to a text from surgery team that they want to see me only after a COVID test. Its a pandemic. You have to repeat it ,also that I have typical symptoms. So , I give my 12th COVID test in 10 months. I need to compartmentalise an area for the swabs now , they are frequent visitors.
The covid test is negative. Now what. I feel better already.
30/4/21
Uncertainty and gloom
I see the plastic surgeon, they were hardly able to palpate the Lymphnode. So they planned to do the excision biopsy under General Anaesthesia. It freaked me out. I sat outside the OPD and tears started rolling down. It was not just invasive but kind of a risky. procedure. I have second thoughts on if its required right now. The protocols say it is required. My instinct refuses to believe. I am so confused
I am so confused that I am going to sleep. The plan changes. My mom sensed my low mood offered me couple of slices of pizza . I listen to someones autobiography. I don't know autobiographies make me feel good. While my body decides whether to feel low or get hot (with fever) , I plan to work on my baby project "The EM Code" so that overwhelming emotions drain out and what I am left with is plain truth. Oh yeah! One more COVID test .
1/5/21
Reassurance and role of counseling
I decide to switch surgeon. Meet somebody else who seems convincing , agree for general anaesthesia. He asked me to meet him when certain tests are done.
This made me realise that how important it is to sound convincing. I hands on agree about the fact that if give proper time 30-40% people can be convinced to undergo point of care investigation. Its understood that ER doesn't have that luxury , but I have not seen senior consultants do it in the OPDs either. Things are supposed to be understood. They are supposed to be... But honestly when you're a patient and a doctor yourself. Things are not obvious all the time. You've a utterly critical brain who is proposing and disposing your decisions.
I come home . My mom connects me to a relative who is looking for a ventilator bed. I made a video call to see , if she actually requires ventilator. she was short breath on oxygen , very hypoxic , conscious. I arrange for a bed in the emergency department of the hospital , forward details. I get back to them , send them details of where they have go. 15 min later , I get to know she expired. The vehicle ran out of oxygen .
I sat there Blank , fidgety , trying to get hold of my phone, wishing if I could do anything to get the condition under control. She was gone.
I lay in a quiet room. I hear my phone ringing again. Its my doctor again. Hey since you're undergoing a procedure under general anaesthesia, why not do the next procedure also simultaneously . You will experience less pain. I nodded asked her for sometime to think. I put the phone down. Ran into my room quiet literally in tears and broke down.
I still don't know what the tears were for... For the fear of procedure or the death of relative that happened.
I turned quiet repulsive towards anything and everything. I felt like a guinea pig . I started asking doubts from everybody. Qualified , overqualified or underqualified. I was freaking out.
A friend pointed out ... Arey you need both counseling and the procedure. With a common man's perspective I didn't find the investigation necessary. But I had no other way to find the cause of my fever. My fear just kept building up and I opened up about my concerns to my treating doctor. It took 30 odd minutes to convince me to undergo the procedure. I am difficult person when I don't get you... But who isn't? I don't back out of things ... I may come stand next to you ... But help me understand why would you do it... I stood by them agreed for the investigation. I was surprisingly ready for a scar and hole in my bone.
4/5/21
The day !
This was the day of procedure.
The anatomical marking was all done. I was prepped up for the OT. I was hell scared to allow my mom to be my attendant (Thank you second wave) . I pulled in my younger sibling to do the formalities. So , I wait in the OT.
The Anaesthesia :
I saw my blood pressure around 90/60mmHg on the digital cuff. Didn't bother me .They asked me to relax and close my eyes. I don't remember when they knocked me down. I remember the surgeon telling me , will do it under general anaesthesia... I opened my eyes and said. I am not knocked off yet. Oh I guess I napped. Go ahead. He stared at me and asked me to relax. I don't remember a thing after that.
Out of Anaesthesia :
The next moment I hear the anaesthetist telling me . Stop screaming amma! everything is being taken care of. I thought to myself , why am I screaming first of all? I dozed off again. I open my eyes again . Nauseated. Saw my heart rate fluctuating from 50-80/min . My BP 90+ and fluifd gushing into my body. Aware of the surroundings.
Trust Issues :
I asked the nurse to call my friend from the ER . Honestly, I wanted a friend to reassure that nothing has been missed out. Sorry , trust issues / overthinking issues/reassurance whatever you call it.
As soon as he walked in , I asked him to check if the samples were sent. He surfed through the drug chart , read through all the sedatives that had been administered with a smile.
Post anaesthesia :
I stared at him for a while , and shrugged out clueless. The antiemetic had begun acting and I dozed off again. I woke up again. This time it was my bladder. I called in the housekeeping to help. She said . 3 hours tak kuch nai hoga. I rolled my eyes. 3-4 hours later , my bladder started functioning. I felt like a 80 year old male with prostatomegaly unable to pass urine. It took me 10-15 minutes to empty my bladder.
Realisation:
My treating doctor came and asked which bone was pierced for bone marrow biopsy. I said , I feel a plaster on my right. I guess here. 🤣. With a weird bladder and palpitations, I rush home to find some good sleep.
Anxiety :
I receive some reports which got evaluated, and were negative for anything significant. I didn't know if I should have been happy or sad . I expressed my concerns to a senior who said, You dont interpret . Wait for the Histopathology. I nod and wait.
When you don't understand things. That's when divinity takes over. Meanwhile my mother points out that she was happy that I am home away from the COVID wave and not working. These procedures apparently are harmless things according to her. You can't change people or their perspective.
Of all shit I have been experiencing for a month now, my take home point is , listen ... wait... think... and then react. The order was otherwise.
6/5/21
While I wait for my exam and test result, the fever pops in . I look at myself and the sky which is not visible from by dabba room... Patience ... I don't know what path I am being guided to. All I am doing is going with the flow.
7/5/21
Nothing but grace :
I wake up with fever with chills and myalgias again. everyone is still clueless about the cause of fever. As I keep waiting for my reports. My exam results were released. I didn't have high hopes. I just prayed to almighty that whatever the result is to give me strength to embrace it gracefully. With the kind of problems I was facing everyday , I honestly had no bucks on the results. I saw the result.I failed. Shed a tear ot two.
Moved on. I usually sit down with analysis of what can be done better. I didn't feel like doing it either. Patience. I told myself and was quiet.
8/5/21
Career Change suggestions:
I receive my reports. All come out to be negative. Nothing! I mean all the scars and the holes mean nothing. Optimist mind set would be , you should be glad, everything is normal. But dude... I still have symptoms. Battling with them for more than a month now. Why treating physicians team is yet to get back. Its scary . I ask somebody to recheck the symptoms because the fear of being a hypochondriac is huge. My mother and family actually could see the same symptoms. So , no its not a mind game. Then what is it? My friends suggest that I drop out of the field. But why? Why would you? Did your mom shut your school because you got infectious diseases home? No right.
You can't be a coward/ stupid.
I text my Consultant. Put my concerns before him. Honestly speaking why would anyone else be even bothered. Its a non life threatening condition. I am not super sick. Like I am able to take oral medication. If you don't understand what it is. You can't help it.
Nobody said life would be easy. I hope its worth it and meaningful.
10/5/21
Following up with the scar and perceptions:
I follow up the scar. Switch on the front camera. My surgeon burst out laughing. Would you not look at something that caused you so much of trauma? I wanted to see how huge it was, whether it was healthy.
The first thing I did after I came home was looked at it again and took a picture. You ought to have images of the scars your body has sustained in the wars it has fought for you.
I sent it to a couple of close friends. One was bothered about how it affected my appearance, the other was glad it was healthy , another was glad I got through the demons. This shows so much about human perspective. My mother ran around with ointment, because the scar DID bother her.
16/5/21
Evil Eye Syndrome:
The fatigue got better. I was able to move around, eat things. My body kept on getting heated up. The histopathology reported it to be reactive lymphnodes with no other finding then asked for markers. Everything came negative. subsequent tests also came negative for any infection.
I would wake up with 500 rupee notes under my pillow with my mother intending to ward off evil by giving them to the needy. Don't ask me the science. I ask you to excuse me out of the topic already.
I consulted a psychiatrist and psychotherapist to check by any chance if the symptoms were mind illness related. They said , its not your mind. Its your body. I don't know when your body is sick , the common sense gets sicker.
17/5/21
Healing
The treating team decided to stop the investigations as I began to get better with no fever. All they wanted me was to rest. While I would try new things on my phone , the domino effect, NOTHING would work out. I would go to sleep saying , probably its not the best time to try anything and just let it pass.
Next morning would be another attempt to try something new as I was supposed to rest . An ER Physicians mind is like New York City . It HAS to be busy.
26/5/21
Trial and error
I have tried 18 different things , all of them failed. I won't tell you what all I have done They would either get rejected / postponed indefinitely/ their business would get shut ( Yes , cruptocurrency was one of them).
So, I can't wait to live for next 2 years to see what my life had to teach me out of this experience. I can't wait to join the dots.
So far so much.
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