Monthly Archives: August 2014

Whooping Cough vs Alligator Wrestling

Suppose you were forced to make a choice between Whooping Cough or wrestling alligators. What would it be?

“What a brainless question,” you say. “Wrestling alligators I’d leave for the professionals, and Whooping Cough? Well, that’s an Old World illness that babies and young children used to get. I was immunized for that a hundred years ago. I couldn’t possibly get it now.”

WRONG!

Whooping cough, Bordetella pertussis—such a pretty name—is making a comeback, and like me, you probably didn’t realize that the vaccination we received in our youth—the one we all referred to as the DPT shot— lost its effectiveness after about 5-10 years. That means you are as vulnerable as a newborn baby to this highly contagious illness.

So then you ask, “how bad can it be anyhow? Surely no worse than the flu.” WRONG AGAIN! To begin with, a flu can make you feel miserable and keep you down for perhaps 10 days or 2 weeks max. However, this bacterial infection, pertussis, could put you out of commission for up to three months or longer. Do I have your attention now? Good; read on.

Imagine waking suddenly from a sound sleep choking to death for lack of air. Instinctively you launch your body into outer space while struggling to catch a breath. Almost instantly you begin a violent and prolonged coughing paroxysm, completely emptying your lungs of any residual air while a thick bird-drop mucus, refusing to break up, rises into your throat seemingly to plug any possible vent, slit, or other aperture that the air might pass through. Then, in a last ditch effort to avoid asphyxiation, you inhale, emitting a long, drawn out whooping noise, and another, and then another until you belch, gag, vomit, turn blue, pass out, whichever comes first. Finally, some blessed infinitesimal air passage in your throat relaxes and begins to open—slowly but surely—allowing you to breathe normally once again—until the next episode. In the meantime, you may well discover that you’ve wet your pants. Multiply these loathsome and exhausting episodes by 20 to 25 times within a 24-hour day!

Consider being so enervated that you are unable to work outside the home, attend social functions, accompany your children to sports events, or simply walk your dog casually down the street. Your cough would not only terrify those around you, but also send them running for their lives like those paid extras in all the Godzilla movies. And for you, my dear performer friends, just imagine mucous the viscosity of cream of mushroom soup concentrate lining your pharynx, larynx, and esophagus, clogging your respiratory passages like a tenacious adhesive. You would not be able to talk, no less sing a note without breaking into a coughing spasm that would drive your audience out of the concert halls demanding their money back.

Think about how you might sleep while afflicted with Whooping Cough. You feel like the original Elephant Man, unable to lie down for any length of time lest you suffocate, in this case because the mucus builds up when you are in a supine position and literally plasters itself to your throat. The coughing paroxysms come far more frequently, and finally, in a thoroughgoing zombie state, you are forced to sleep upright with your vaporizer, sputum bags, and urinary guards nearby. From then on, you snooze, wake up, snooze, wake up, aching for the first light of dawn to bring an end to the long miserable night.

Have I freaked you out yet? Are you ready to rush out and run to the nearest pharmacy for a Tdap booster shot? Today and not tomorrow?

You may wonder why I’m going off on this wild and unusual diatribe. After all, it’s summer and I’m traveling/camping/exploring the great American West. I should be blogging about the dramatic cliffs and rocky beaches along the Northern California coastline, the ever present marine layer, creeping in and out of the redwood valleys like benevolent ghostly fingers. And the extreme beauty and tranquility of the Oregon Cascade Mountains—where we are hanging now—the cerulean blue alpine lakes flanked by huckleberries, currants, thimbleberries, black raspberries, trailing blackberries, the friendly atmosphere of the National Forests and BLM lands, with their myriad campgrounds and hiking trails.

Somewhere between Florida and California, an infected human either coughed, sneezed, or laughed upon Ned from within a distance of six feet transferring to him the Bordetella pertussis bacteria—it is spread through the air and breathed in and cannot live outside the body. We prefer to think Ned was laughed upon because he has this uncanny ability to engage nearly everyone he comes in contact with, should it be a Safeway store clerk, a police officer issuing a ticket, or a man standing next to him using the urinal in a public bathroom. Most conversations would end with a laugh or two. If Ned had been coughed or sneezed upon, he would have recorded the encounter in his mental journal of potential infectors. So, in a nutshell, we have no idea when, where, or how he contracted this illness within its one to three-week incubation period.

Upon our arrival in California, Ned began to express common cold symptoms, which is the first stage of pertussis, as the bacteria is at work damaging the scillia in the lining of the lungs. The following week, the cold went from his head to his chest whereby he began to cough, crackle, and wheeze. Oh, don’t I know what that sounds like! Over the years I often listened to my Mom’s persistent wheezing, which she referred to as “little children” in her chest. I can honestly say that Ned had a whole schoolyard of children in his!

After the first night of violent coughing paroxysms, we drove two hours through giant redwoods on winding mountain roads to the nearest emergency room located in the southern part of Humbolt County, CA. We were taken in right away; Ned was diagnosed with acute bronchitus, given a breathing treatment, an inhaler, a prescription for antibiotic Keflex, and steroids to break up the mucus. His condition only worsened and two days later we located an urgent care facility in a larger Humbolt County city, where the doctor, after ordering a throat x-ray, reaffirmed the bronchitis diagnosis. But then he witnessed one of Ned’s coughing bouts, threw up his hands, and sent us directly to the local hospital’s emergency room located about a block away. It was 2:30 in the afternoon. After four hours of waiting, we were directed to a tiny examination room and attended to by a very congenial doctor bent on discovering what was causing Ned’s spasmodic coughing events.

The propitious moment occurred at 2:30 a.m., twelve hours after we had first arrived at the hospital and after every other possibility had been ruled out. The doctor asked Ned where he stood with his immunizations. That was akin to asking him if he knew what his sperm count was. After all, hadn’t he arrived at the juncture in life where he was no longer procreating and contracting childhood illnesses?

The clincher came with the doc’s next statement, “Whooping Cough is going around.” I had had my laptop in my lap the entire evening researching every kind of respiratory illness imaginable … except Whooping Cough. Ten seconds later it was all over the pages before me; every symptom playing out exactly as described at the various medical sights I happened upon. I even found a You Tube video of a hospitalized man with pertussis coughing his guts out. Ned could have been in that video!

We were convinced, but the doctor said to be sure Ned would have to tested for pertussis and that the results could take 24 to 48 hours to complete. A swab was therefore inserted through his nose all the way back to the pharynx where the offending bacteria—if it were still alive—could be collected. For the next three days, we camped in our van outside the hospital in a parking lot adjacent to the emergency room waiting for the test results. When on the fourth day we learned that the tests had not yet been run— weren’t we talking about a highly contagious illness here, deadly to infants and the elderly—we left town and headed into the mountains. Two days later, we got the call from the health department. Ned’s culture was indeed positive, and he became the 76th person to be diagnosed with pertussis—now considered to be an epidemic—in Humbolt County. Why then over a period of four days, did it take three doctors, two chest x-rays, an entire series of blood tests, a throat x-ray, a fiber-optic examination of his gullet before anyone even mentioned Whooping Cough?

You probably would like an update. The illness is now in its sixth week, and Ned is finally able to sleep lying down in our camper bed as opposed to upright in the driver’s seat, his feet propped up with a five-gallon bucket cushioned with a sweatshirt, his head held in place on either side with pillows. His coughing episodes have diminished considerably to approximately 10 a day and we have once again resumed our hiking schedule although on a limited basis. In retrospect, being confined 24/7 with Ned in our camper van, I probably inhaled enough bacteria to infect all the rest of Humbolt County; however, once pertussis was suspected I took precautions immediately by getting the Tdap booster and taking Zithromax, the recommended antibiotic. Yes, I have a very mild case of pertussis, with symptoms much like that of a chest cold.

So, my friends and family, after reading this missive I hope that at the very least, you will keep your distance from those who might cough, sneeze, or laugh upon you. And at the very most, you will check your immunization records and get the Tdap vaccine. If, after reading this you choose to do neither, relying on Chance alone, then perhaps you should really consider taking up alligator wrestling.