It was a Monday evening when the diagnosis of pertussis was confirmed. The nurse called me and told me that I had come back positive for the bacteria. By now, my wife and I had done enough research that when we found out we were not surprised. But we should have been scared. I should have.
The treatment for pertussis is through antibiotics. The earlier you take them, the more effective they are in reducing the symptoms. Unfortunately, I had taken them too late into the life cycle of the bacteria. Yes, I was no longer contagious and this is a good thing, but I was in for the full ride. And I was not ready for what was to come next.
All of the research we had done pointed to the harsh symptoms in children and rather mild symptoms in adults. In fact, most literature said for adults it went by as a “difficult” cough. But the research did point out how long the symptoms lasted. They lasted weeks. Yes, weeks, not days. This should have been the first thing to scare me.
There are three stages to pertussis: Catherral, paroxysmal and convalescent.
Catherral is the first stage and the most mild. This stage lasts about 2 weeks and it’s when you are the most contagious. If you are vaccinated and well immunized, most adults experience this stage and stage 2 very mildly.
The second stage is the worst. Paroxysm means sudden attacks. It is in this stage that people first experience the “whooping” of whooping cough. The whooping happens as your body tries to breath air in after a coughing paroxysm, or coughing fit.
The coughing fits are violent and long-lasting (about 10 to 15 seconds straight). You cannot stop them. They are uncontrollable. The coughing fits happen because the bordetella bacteria (pertussis) sits in your airway and generates a thick mucus. As the mucus builds up, your body tries to expel it. But unlike any other other cold you may have had, you have never had mucus this thick. This is the reason you go into a fit. Your body is trying to get rid of it by coughing, but due to it’s stickiness and thickness it requires much more effort than before.
The coughing fits are so violent that two things can happen, both of which I experienced, you can pass out and/or you can injure your abdomen from the effort and frequency of the cough. The coughing fit stops when you finally expel the mucus or run out of air, whichever comes first. After I was first diagnosed, I could have between 5 to 10 coughing fits during the day and 4 to 7 at night. Each coughing fit could result in a syncope (passing out). A coughing fit did not equate to a syncope, but whenever I experienced a coughing fit I had to be sitting down just in case I had a syncope.
After each coughing fit it felt like I had just ran a marathon. It was so tiring. So exhausting. And so painful. The coughing fits require so much effort from your abdomen muscles that you can bruise them and in some cases even break ribs. I didn’t break any ribs, thankfully, but I did bruise my internal abdomen muscles. The bruising was so painful it felt like someone had kicked me on my right side to the point I could hardly walk or even raise my arm. It felt like a liver shot.
The pain was unbearable. Ibuprofen 800 did nothing and my next option was to take a narcotic, Norco. The doctor prescribed Norco for the pain, but I was too much of a chicken to take it and preferred to deal with the pain, as painful as it was.
Night time was the worst. Not only for me, but for my wife. The best way to sleep was to sleep sitting up so that mucus would build up more slowly. As you can imagine, sleeping sitting up is not very fun or restful. Worse, once the build up happened, my body would give me a very short warning to sit up and cough or else. This meant 4 to 7 times a night (almost hourly), I would explode to sit up and begin an uncontrollable coughing fit. My wife would also wake up and sit next to me in case I had a syncope (3 happened at night) and make sure I didn’t fall. Once I expelled the mucus I could go back to sleep, only to wake up an hour later.
Coughing medicine did not help because while it would reduce the coughing frequency, it would generate even thicker mucus. Thicker mucus meant a higher likelihood of a syncope and worse, a 5 to 10 second stage after the cough where I would suffocate. The mucus would block my airway and until there was an opening I could not take a breath in. At its worse, after a coughing fit, my throat would go into a swallowing cycle as it tried to clear its airway so I could breath. In most cases this would take 3 to 5 seconds. But in some cases the phlegm could be so thick that it could take me 10 seconds to get a breath in. Yes, I know what are thinking, I can hold my breath for 10 seconds. Me too. But try holding your breath for 10 seconds after being exhausted from coughing for 15 seconds, which resulted in all of your oxygen being expelled from your lungs and not being 100% sure you will be able to break through the phlegm to breath in. It can feel like you are going to suffocate to death and there is nothing you or anyone can do about it. You cannot talk, because you have no air and even if you could talk, what would you say? Help me?
The coughing fits, syncopes, suffocation and aching abdomen have lasted for 10 days. On day 26th of my illness I returned to see my doctor. She gave me another round of antibiotics and referred me to a neurologist to make sure the syncopes were not seizures. The neurologist ordered a CT scan and confirmed things looked good and that I was in fact having cough syncopes and not seizures.
On the day I visited my doctor I was experiencing the worst abdominal pain yet. So when she asked me to take antibiotics I was ready. And if you thought the ride was over and nothing else could go wrong, well, you’d be wrong.
In our next installment I’ll tell you about my visit to the ER (part 3) and the efficacy of the new antibiotics.
