Thursday, February 17, 2011

My Trip to India: The Backlash

A couple months ago, I visited Hyderabad to explore some research collaboration possibilities. Little did I know that the trip would ignite one of the more stressful periods of my life. To sum it up, I'm now finally infection-free after four weeks pain, medication, and a trip to the ER.

The origin of my malaise is unclear, since bacterial infections can happen anywhere. But at the very least, my susceptibility to contracting an infection was dramatically increased due to my trip to India. To start with, it never really gets cold in Hyderabad, so there are insects and arachnids around all year long. I never found out if the bites on my leg were caused by spiders or mosquitoes or something else entirely, but at the time I didn't really pay it much heed. After all, I'd dealt with my fair share of bug bites before, and none of them had ever caused me much trouble (queue ominous background music).

But for whatever reason, the bites didn't heal properly. I suspect that my immune system was especially vulnerable at that time due to the exhausting 30 hour trip from Hyderabad to Phoenix. And since holidays with the parents typically involve large amounts of socializing interleaved with frantic efforts to get work done during the down hours, the status of my bite wounds was never at the forefront of my mind. In fact, I engaged in multiple activities that most likely exacerbated the condition (basically anything that involved moving around).

By the time my vacation was drawing to a close, it was clear that I had an infection at the site of the bite wound. Actually, to anyone who wasn't me, it would've been clear I had an infection several days earlier -- not that anyone else knew about it (way to be a macho idiot, Yisong).

The physician I saw in Phoenix suspected a staph infection, so he prescribed ten days worth of Bactrim and Keflex. The next day, I boarded a plane back to Pittsburgh, expecting things to clear up in the next few days. (Note to everyone: DO NOT search for images of staph infections.)

Things took a turn for the worse almost immediately. I'll spare the gruesome details, but my infection starting oozing "substances". To make matters even worse, the infection had swelled to the point where even just walking hurts.

Luckily, the city of Pittsburgh is dominated by the University of Pittsburgh Medical Center, which I must say offers some of the best medical service possible. Within thirty minutes of entering the urgent care facility, a physician had inspected and operated on my infection. The procedure was fairly straightforward: after applying anesthetics, the doctor made an incision and manually drained the infection by squeezing it out. After some standard wound packing, I was discharged only an hour after I was admitted.

Over the next several days, my wound slowly healed and I finished my prescription. Thinking the issue resolved, I treated myself to a fine glass of Malbec.

A couple days after my prescription ran out, I noticed a small bump close to the site of the original infection. Using all the common sense that I could possibly muster, I decided to hold off seeing a doctor for a day or two just in case it was just a fluke bump on my skin (yes, that did make sense at the time).

Lo and behold, a second infection (or maybe it was a remnant of the first) took hold. A trip to the doctor procured me another ten days of Bactrim and Keflex. The doctor hoped that no draining would be necessary this time, due to taking the antibiotics in the early stages of the infection.

As it turns out, I'm allergic to Bactrim (or I'd developed an allergy to it). The next evening, I noticed a rash on both my upper thighs. Thinking the situation not too serious, I decided to try to sleep it off and see what the doctor had to say the next morning.

Now, one of the reasons I am able to see a doctor so promptly and without a prior appointment is because I am using the urgent care service. Unfortunately, this leads to significant variability in which doctor I get to see. In retrospect, the professional incompetence of this next doctor was pretty off-the-charts.

The doctor (a) did not prescribe new antibiotics or attempt to treat the infection in any way, instead telling me to let it heal on its own, and (b) did not prescribe any allergy medication nor provide any advice on what I should do regarding my rash. At that time, the rash on my thighs had faded, but I was developing new rashes on my arms and face. Since I have never had reason to distrust a doctor before, I simply took his advice and expected my rash to dissipate over time.

I worked at my office until late into the evening. By the time I finally went home and looked in the mirror, I realized with great dismay that my rash had intensified and now covered my entire body from head to toe. A simple web search revealed that the threat of asphyxiation was very real. Thus, for the first time in my life, I checked myself into an ER.

I was given an IV with steroids and monitored overnight. I was also admonished for not taking any Benadryl or related medication (to which I blame the incompetent doctor). The ER physician decided to incise and drain the new infection, thus giving me the impression that ER doctors are less conservative than other doctors (no other doctors had recommended draining such a small infection). I was also prescribed new antibiotics, this time clindamycin, as well as various medication for my allergy.

Luckily, my condition gradually improved from that point until the infection finally cleared up. A culture test revealed that the bacteria was not staph, but some unidentified species (which increases the probability that I contracted it from India). I am now the proud owner of a couple new scars, a gamut of wound treatment supplies, excess medication that I'm allergic to, a newfound respect for competent doctors, a distrust of doctors who recommend no treatment, a modicum of common sense, and a healthy fear of all things microbial. All in all, it was a very memorable experience.

5 comments:

Nikos said...

Sorry to hear you went through all this. As the following blog post argues, systems like Watson help raise awareness that advances in AI have made it possible for machines to deal with uncertainty in a satisfactory way. Maybe in the near future they can assist/replace incompetent doctors. Here's the blog post: http://modeledbehavior.com/2011/02/17/cowen-malthus-and-watson/

Yisong Yue said...

I definitely think a Q/A system of the sophistication of Watson can help in this regard. One aspect of this issue that Watson doesn't do is summarization. But I definitely think a system which outputs a set of candidate illness when given a a set of symptoms (think inverse keyword search) is very valuable.

Lev Reyzin said...

Wow - I'm glad you're better now. It seems an internet search is often good enough to find what's wrong. What Watson also needs is a prescription pad!

Danny Bickson said...

I didn't find any reference to my non-conventional medication. Please fix your post and let me know.

Parisa said...

Geez, what a mess. Glad you're feeling better Yisong!