A Taste of My Own Medicine

I woke up at 4:30 am with an itchy spot on my left wrist. Using the light from my phone I saw a little raised bump on my skin.

“Marisa, wake up,” I said. “I just got a spider bite or something.”

We pulled back the covers and looked under all of the pillows, but there weren’t any bugs. “Alright, go back to sleep,” I said, and pulled the covers back over her. I think she was asleep again before I turned off the light and left the room.

But there would be no sleeping for me, as itchy as I was. I went downstairs to read my scriptures and then work on my music, and as I sat there I became aware of a few more itchy spots. “That spider must have crawled all over me,” I thought, as I scratched a spot on my back and then another on my neck. Within 30 minutes I was scratching at a dozen or so places all over my body.

“What is going on?” I thought. “Was it the swimming pool I went to last night? But I had a shower before I got into bed.”

I resolved to take another shower, thinking that maybe this was some kind of allergic skin reaction. But the shower didn’t seem to help, and with every minute in the water the itching grew more intense. As I felt the raised welts spreading across my skin I realized that I was in trouble. Turning the water temperature down made my skin feel a little better, but it didn’t slow down the advance of the hives.

“Marisa, you’ve got to see this!” I said. I hated to wake her up, because it was only just after 5:00 am, but I was certain that my terrible case of hives would interest her. Also I wasn’t exactly sure what to do and wanted some help.

“Oh, my goodness!” she said as she came into the light.

“It’s hives,” I said, “and it’s so itchy that I’m going crazy.”

“That’s terrible! Oh, look at your armpits! And your waist line!”

“My butt is one huge hive!”

“Honey, I’m taking you to the hospital.”

“Oh, I don’t wanna go. Just give it a few minutes.”

“Did you take some Benadryl?”

“I just took 50 mg, and I also took 20 of loratadine. Doesn’t seem to be doing anything though. Do we have some hydrocortisone?”

We spent the next 10 minutes or so applying various creams to my skin: hydrocortisone, benzocaine, menthol. The itching became almost tolerable after that, and I could go a few minutes between paroxysmal eruptions of scratching. I squatted down on the cold tiles, and placed my hands flat on the floor, trying to prevent any friction or pressure on my skin. Putting some weight on my hands reminded me not to scratch the itching that grabbed my attention every second or two.

Marisa was still watching me with concern, and pointed out that the hives were at that moment marching down my thighs.

“This is bad, Honey. You need a blessing. Can I take you to the hospital yet?”

~~~

Five minutes later our neighbor Dave knocked on the front door.

“Thanks for coming over, Dave. Sorry to wake you up so early.”

“Oh, it’s fine,” he said cheerfully, half-yawning, and then he shrugged his shoulders as if it were no big deal. “I was going to get up in a couple of hours anyway.”

Dave has been to our house at all hours of the day and night to help give priesthood blessings when members of our family are sick, and I have done the same at his house. Just a few months ago I helped give a blessing to his daughter who had a migraine. Dave’s wife Heather walked me downstairs, and said, “Last time she had a headache like this she started throwing up right after the blessing, and then she felt a lot better.” Sure enough, as I walked back up the basement stairs after the blessing I heard her start to barf, and then call out, “Thank you!” between her retches. It was an oddly satisfying experience.

Once again Dave administered a blessing in our home, this time for me. The medicines would work, he declared in the blessing, and I would get better. I had faith in that blessing, and in the power of the priesthood, and in Dave’s worthiness to pronounce it.

~~~

20191120_063547It’s a little embarrassing for a doctor to show up at the hospital and ask for help, but I didn’t put up much resistance that morning when Marisa herded me out to the car. On the drive over I watched with mixed interest and alarm as the hives erupted on my lower legs and spread toward my ankles.

It only took a couple of minutes to check in and get escorted to the treatment room. Most EDs aren’t busy at 6:30 in the morning. I showed off the rash to my doctor colleague, and he left the room to order some IV medicines.

“Is it okay if a student places the IV?” the patient care tech asked me.

“Sure, go ahead,” I said. “You have to learn somehow.” Just a few years ago I was the student, practicing my skills on willing patients. In that moment I felt a new dimension of gratitude for those people. It was time to pay it forward.

The student did a good job on the IV, with just a little coaching. I was actually more bothered at the time by the advancing urticaria on my legs, and was shifting my legs from time to time to resist the urge to scratch them. There was also a new crop of hives erupting on my left wrist where the hospital ID band had been placed.

“Okay, the first one is Benadryl,” the nurse said, connecting the first vial to the IV and slowly pushing the syringe. After a couple of minutes he connected the second one, which was Solumedrol.

“How much Solumedrol?” I asked.

“125.”

A few minutes later the third vial was Pepcid. “Oh, that’s a good idea,” I said.

“What’s Pepcid?” Marisa asked.

“Famotidine,” I explained. “It’s an H2 blocker, usually used for heartburn, but it can be used as an antihistamine for allergic reactions.”

I felt safe, and I knew that I was going to be okay. There had been a slight concern, a remote possibility, that this allergic reaction could cause airway issues, but I never really worried about that.

~~~

“Whoa! Look at that!” the nurse said as he walked in the room a few minutes later. “You look a lot better!”

Marisa had been taking pictures every few minutes with her phone, and she pulled up one she had taken a few minutes ago. “Yeah, look at that!” She held the picture up so I could see it. Sure enough, the hives were starting to recede. About that time I noticed that the intense itching stopped altogether.

20191120_064902Over the next few minutes we watched the bumps fade away, starting with the most recent ones and progressing to the oldest. Not five minutes after the first medicine had been administered it was visibly obvious that the tide of my condition had turned. I was getting better!

Then drowsiness washed over me like waves on the rising tide, stronger and higher every few minutes. And I was drifting off, for brief moments at first but then deeper, deeper …

I jerked awake. I was still in the ED lying on the gurney, and slowly sliding down so that my feet were off the edge. Marisa took another picture of my receding hives.

That Benadryl is powerful stuff. I’ve never had 100 mg before. “It’s a good thing I called in and cancelled my clinic today, because I don’t think I can stay awake.”

The ED doctor poked his head in the room, and I woke up again. By this time my calves were on the edge of the gurney and my neck was cricked. “Do you want to go home?” he asked.

About 2 hours after I had arrived at the hospital I found myself walking back out to the car. I was no longer itchy, and the hives were still fading. Marisa noticed that I was walking upright now, instead of the crazed hunched-over gait I had used on the way in.

“Thanks for taking me to the hospital,” I said.

“I’m glad I could help you,” she said. “You’re never sick; it’s nice to do something for you.”

When I got home I went back to bed and slept until noon.

~~~

“PREDNISONE 20 MG TABLETS. TAKE THREE TABLETS BY MOUTH ONCE DAILY FOR 5 DAYS.”

I browsed the aisles for some famotidine while I waited for the pharmacist to fill my prescription. She probably knew me, because I send prescriptions to that pharmacy several times a week, but she didn’t say anything. Maybe she did a double-take when she saw my name in a different place on the script.

Prednisone is a drug I have prescribed hundreds of times. It is a steroid, not the kind that makes your muscles grow but the kind that quiets down your immune system, and I have seen it work well for a number of autoimmune diseases.

Unfortunately it has a lot of side effects. I remember one patient with myasthenia gravis who came back to my clinic after a month of taking prednisone. She said something like, “I feel so much better, and you are the best doctor in the world!” Three months later she had gained 50 pounds and had been diagnosed with diabetes. Even though her myasthenia was still under great control, her overall verdict was something like, “I hate this drug, and I hate you!”

Five days isn’t enough time to see most of the side effects of prednisone, thankfully. The only thing I really noticed was some insomnia, but I counteracted that by taking 50 mg of Benadryl every night while I was on it. One other thing I noticed was the awful taste. If the tablets spent any more than half a second on my tongue they would fill my mouth with the most bitter flavor, and I learned that I needed a “chaser” after taking them.

Little bits of knowledge, learned through experience like this, help me understand what my patients are going through. It’s good for me.

~~~

My little adventure with urticaria, antihistamines, and corticosteroids happened just last week, and it got me thinking about a few things. First, this story illustrates how we can turn to the Lord and to medicine at the same time, that faith and technology, science and religion, can work hand in hand. The blessing that Dave promised was fulfilled within the hour, at the hospital.

Second, it makes me see how many things I have to be grateful for: excellent health, a wonderful wife, good neighbors, doctors, hospitals, effective medicines, and many more of God’s blessings in my life. All it took was a few hours of hives and 5 days of prednisone to get me to feel all of this gratitude.

But is it possible to feel such gratitude without experiencing the trial? Can we, by sheer act of will, force our minds and hearts to feel the same? I suppose not. At least, not to the same depth or degree. Just as a radiograph cannot discern the plane between adjacent structures of the same density, so too do we need contrasts in our lives in order to see things as they are. We don’t appreciate happiness until we have known sorrow; experiencing misery is what eventually makes joy so wonderful. And in my case, a little taste of my own medicine helped me see how sweet my life really is.


Alan B. Sanderson, MD is a member of The Church of Jesus Christ of Latter-day Saints and is a practicing neurologist.

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