Tuesday 18 September 2012

What do you get if you cross an RA sufferer with an ear infection?

A hospital admission and a suspected brain infection. 

Apologies if anyone was expecting a hilarious punch line there, but a) I'm not a funny person and b) this was no joke - this actually happened to me last week. 

Having had at least one admission to hospital every year since I started university five years ago I was adamant that this would be my year. Yep, I was going to have one whole admission-free year before becoming a doctor...I made it to day 1 before ending up in a hospital bed. Note the use of the word 'to' - I didn't even make it to my first lecture. I'd laugh if it didn't hurt my ear so much.

The problem* with having RA is that the medication used to treat it suppresses my immune system. For the average person getting an ear infection might be a bit uncomfortable and a bit inconvenient. For someone who is immunosuppressed getting an ear infection, or any kind of infection for that matter, can be very dangerous. Because my immune system is weak it finds fighting off even the simplest infections a challenge, and this is what led to the series of unfortunate events that I will now go on to tell you about. 

*NB There are many more problems than just this with having RA

Saturday. I visit an out-of-hours GP with ear pain severe enough to keep me awake at night. She diagnoses a middle ear infection and gives me antibiotics. 

Sunday. I am now in so much pain that I am overdosing on pain relief in an attempt to get some sleep (Disclaimer: as a doctor to be I obviously do not condone this behaviour). 

Monday. I visit my GP because the antibiotics don't seem to be working and the pain is getting worse, not better despite dosing up on Tramadol (see previous blog entry about Tramadol). He touches my ear, I cry. A lot. He attempts to look in my ear, I cry. A lot. He sends me to hospital where I am seen by an ENT specialist. Repeat previous sentences re: ear touching and crying. I am admitted and dosed up on IV antibiotics and morphine. I still don't sleep. 

Wednesday. The pain is no better, I still haven't slept, my temperature is through the roof, and I can no longer eat because the pain has spread to my jaw. The ENT consultant sends me for a CT scan.

Thursday am. ENT consultant tells me on the ward round that the CT scan looks clear. He needs to get a radiologist to report it, but he's sure it's fine

Thursday pm. CT scan is not fine. My parotid gland and brain look abnormal. It is suspected that the infection has spread to my brain. I am sent for an MRI scan. An MRI scan is not a nice experience at the best of times. But when you are in agony and have to lie completely still for 40 minutes, without even crying because this would cause your head to move, it becomes an horrific experience. Fortunately the MRI confirms there is no brain infection. It has however spread to my parotid gland which is pressing on my facial nerve. Incidentally one half of my brain is apparently bigger than the other...make of that what you will. 

Friday am. I am told I can go home. 

Friday am. I am told I cannot go home.

Saturday am. Doctors discover an abscess in my ear canal. They drain it. The 'horrific' MRI scan is nothing compared to this experience. I have a panic attack. 

Saturday pm. I can finally go home with antibiotics and pain relief. 

At this point I should probably mention my long suffering boyfriend who endured the majority of this traumatic week with me. No one likes to see someone they love sobbing because they are in so much pain (especially as I am an ugly crier, he tells me). And holding your girlfriend's hand and talking crap to her for 40 minutes whilst she attempts not to cry mid-MRI scan is probably not anyone's ideal way of spending an evening, but he did it. And he even managed to sneak me in a Maccy D's at one point as well. So big kudos to the boyfriend. 

Right ok, now I've got that un-funny tale out of the way I'll try to end with a joke. 

A man walks into a pub with a piece of tarmac under his arm and says, "One for me and one for the road."

No? Told you I'm not funny.