Monday, November 24, 2008

Washington Social Diary

DPC and Carol Joynt at Nathans Restaurant.
By Carol Joynt

The last time I remember feeling remotely normal and part of the world was November 4, standing in line to vote, near my home at Georgetown’s Christ Church. But to a few close friends I confided to feeling a bit off. I’d had my annual flu shot the day before – the latest of many – and for the first time ever it seemed to be biting back. A slight fever, a few aches.

“If I could I’d just go home and get in bed,” I said.

By evening, that’s where I was, mildly alarmed by more aches and a temperature rise. I scratched plans to mix it up at Obama victory parties in the service of NYSD, and watched TV coverage through a haze of pain.

The next few days I became more listless. Less time up, more time in bed. Acetaminophen was my bedside table staple as I used it to keep the fever and pain in check. I talked to the doctor, and went in for an exam on Friday. My only symptoms were fever and pain. Ears, nose and throat were clear. No vital organs had pronounced pain. But the aches I had were as much in my toes and fingers as every other moveable joint. And the headaches. Oh my. They were migraine-class.

I begged off everything I was supposed to do, but on that Friday afternoon I felt certain I would turn the corner and be better Saturday and able to attend that evening’s book party for David Baldacci, to celebrate his latest, “Divine Justice.”

Carol, with Chris Matthews, a week before illness hit.
But by Saturday evening I was in a fetal position in bed, with my temperature near 103. At this point my diet was popsicles. Nothing else appealed. My doctor was out of town for the weekend, visiting his son at school. I thought, “If I can just make it to Monday.”

The weekend was a blur of fever, chills and pain. Only the Acetaminophen helped, but I was trying not to take too many. My teenage son was conflicted. Was I seriously ill or being a drama queen? We both began to ask, “Can this really be only a reaction to a flu shot?”

A friend, Dr. Arthur St. Andre, of The Washington Hospital Center, and who is a critical care specialist, kept in touch all weekend. My symptoms remained the same: fever, chills, joint pain. Nothing else shouted out for attention.

I welcomed Monday and the chance to see my doctor, James Ramey. I writhed on the examining table. He knows me to be dramatic at times, but this was over the edge. He examined me, took blood, sent me home. That’s when the bacteria in my blood first showed up. Ramey sent me immediately to Sibley Memorial Hospital for more sophisticated tests. I couldn’t drive. Myra Moffett took me, sat with me, waited with me, as I did two different types of blood tests. There were no results until Wednesday morning, Nov. 12, but when those results arrived they were a shock: my blood showed gram negative bacteria, aka, blood poisoning, septicemia, spawned somehow from e coli.

My neighbor Ellen Charles drove me back to Sibley. I had Dr. Ramey on the phone. “Am I going to live?” I asked.

“Yes,” he said.

“Is this serious?”

“Yes,” he said, “moderately serious.” He was comforting me. Blood poisoning is very serious. People die from blood poisoning. Our bodies, especially baby boomers, have been bombarded with too many anti-biotics, making infections more resistant to the drugs. You pray that whatever you have will respond to an antibiotic.

At the Sibley emergency room they put me on an IV drip of the powerful anti-biotic Cipro. I recalled Cipro was used on the area postal workers and others who were infected in the anthrax attacks of Oct. 2001. The ER was too bright, of course, and hot, and scary, and I felt horrible, but I was relieved to be where I could get fixed.

Naively, I asked my new infectious disease specialist, Dr. Siham Mahgoub, “can we just do this IV and I go home today?” She looked at me like I was out of my mind. Well, I was.

Carol, photographed by son Spencer, with the rest of the Joynt family, shortly before illness hit.
Five days later, my fevers were under control. I was still at the hospital, still on IV, but had turned the corner. My white count was nearly normal. I had a long way to go, but it seemed I could get there. I existed in a bubble of wellness, and anything that didn’t relate to getting well would have to stay outside the bubble (chiefly any talk of my business, the landlords and an unresolved lease). My friends, my colleagues, the people who rely on me, collectively understood and agreed this would be the plan. I thanked my good fortune that whatever challenges may come, with owning a corner saloon in hard times, it gave me the freedom (thanks to GM Jon Moss) to go home, and to stay home and to get well.

The doctors did send me home last week, but not without something to remember them by. I have a catheter implanted in my left arm, a so-called PICC-line, which enables me to administer IV drugs to myself at home. Yes, at first this was hugely intimidating. A nurse visited to give lessons in how to shoot myself up with Ceftriaxone, my new anti-biotic. Better still, good friend Scott Sforza is a former paramedic and has come by more than once to observe and encourage as I go through my paces. Add to that a teenage son who does what he can to help, friends who bring soup and flowers, bread and cake, and a 9-pound dog who is happy with short walks; I’m a lucky woman, indeed. Every day a little stronger. Soon enough, I’ll be eager for dinners and little black dresses.

There are obvious questions: how did it happen? We may never know precisely how the e coli got into my bloodstream. I’d had some minor dental surgery a few weeks before, but I took lots of Penicillin for that. A little later I had a small cut in my mouth, from something I ate. Could that be it? We do have these germs around us all the time.
Carol, DPC, and Jane Hitchcock.
They are on supermarket carts, door knobs, foods, water fountains, in public bathrooms, at the manicurists, etc. In my case, it made its way to my kidney and turned into a monster there. The odd part is I never felt any obvious kidney pain, and that’s where the symptoms were misleading. I kept thinking it was the flu shot. Nope. Just a coincidence of timing.

Lessons learned: keep the hand sanitizing lotion nearby and use it. When in doubt, call the doctor. Even the smallest doubt. Also, hospitals are for healing, not socializing. I was happy to have some friends visit, close friends who know me well, (Deb Nichols who brought flowers from the church), and doctors who are friends, like Dr. St. Andre, and Dr. Mark Weller, who came in from San Francisco, but most of the time I wanted to be alone to get well. I didn’t even watch TV or read. It’s odd, though.

Sibley Memorial.
Almost anyone can walk into your hospital room. Maybe the rule should be that if you haven’t been in a patient’s bedroom, you shouldn’t show up in their hospital room, either. There’s got to be a zone of privacy. If nothing else, for simple reasons of vanity.

Who wants to be seen with days old hair, pale skin, bloated and in a hospital gown? Of course, no visitors would be too lonely. It’s a thin line.

The nurses are the oil in the machinery. They run everything. They will never get paid enough. They are the people you see round the clock. They are your lifelines. At the very least they are competent, and at the very best they are competent, friendly, caring, engaged, thinking outside the borders and listening. I had many good nurses at Sibley, especially on the night shift, when all the demons are more fierce and the big and little hands on the wall clock slow to half their normal speed. The nurses are the first to tell you no one sleeps in the hospital and that you want to get well and out as fast as possible.

The IV gets removed from my arm Dec. 3, and Dr. Mahgoub says at that point I will be ready to gradually re-enter the world. I’m counting the days. DPC, with his usual editorial foresight, said, “Write about what happened” and suggested I also “tell-all” about Georgetown husbands and wives. Haha. That part will have to wait. It needs a little investigating and marinating. Stay tuned.
Carol Joynt is the host of The Q&A Cafe, a talk show at Nathans Restaurant in Washington, D.C.