Pneumonia, your friend? How could that be? Well, most life threatening illnesses take you down slowly and painfully, you waste away a day at a time gradually giving up your life force. The reason pneumonia can be benign comes with the modifier ‘old’ and the likelihood that geezers would have other illnesses giving them pain and hardship. When pneumonia comes along, if your system is already compromised with other ailments, it takes you out without pain or any consciousness of what’s happening.
At least that was my experience. I went out to have a few beers, as was my habit, on Saturday, December 30, but after the first bar I decided I should go home rather than bar hop. That’s the last I remember. I must’ve gotten up on Sunday and gone through my daily routine, at least some of it, because neighbors reported me wandering somewhat aimlessly around the neighborhood. I can visualize that, but only because I was told it happened. That was a strong clue that something was wrong since I always ride my bicycle around the hood, even if it’s only 30 meters. After that, the next thing I remember was my friend trying to startle me awake in the hospital on the following Tuesday.
I had no inkling that something might take me over and no warning whatever. Now my friend, who accompanied me to the hospital and who spent 35 years as a nurse in Australia, insists I had lots of warning since for a week before the event I had been coughing hard and producing great gobs of phlegm. But that had been happening a couple times a year for 5, even 10 years, I can’t say for sure how long, only that it was long enough for me to think it normal. It happened in a pattern though that did make me wonder. I’d catch a cold and drop some Chinese medicine to take the hard edge off the stuffed nose and such. I’d also stop smoking weed for the duration. Even a relatively long time after the cold was vanquished, I’d still be coughing. Maybe it’s some type of bronchitis I’d think.
Maybe pneumonia was sitting there dormant most of the time, while my generally healthy immune system kept it in check. Only 1% of pneumonia cases are fatal and only 10% of cases need to be hospitalized so I assume people can have mild cases without realizing it.
Another prominent symptom is shortness of breath and I did seem to be breathing harder, however it wasn’t debilitating in any way and I figured at 76 shortness of breath is normal. Fever, chills, chest pains are also common symptoms, but I experienced none of that. I went very calmly, peacefully and painlessly into a coma. I didn’t know any thing about pneumonia or its symptoms beforehand, I didn’t even know what it was.
What I’ve gleaned about pneumonia from reading over the Wikipedia entry several times is basically that it’s an inflammation of the lungs and that it affects the small air sacs called alveoli. Pneumonia results in scaring of the alveoli thus making it difficult to take in much air, which accounts for the long time it takes for many people to recover. There can also be a build up of fluid in the lungs with the same results.
Most cases are caused by bacteria, but can also be virus, parasite, or fungi based. Surprisingly, in half of cases the causative agent cannot be identified; it’s pneumonia but they can’t tell you where it came from. That’s backed up by the experience of a friend who came down with it after returning to California from Cambodia. He was in the hospital for 10 days but they couldn’t identify the actual cause. A similar thing happened to a friend here in Kampot. She spent four nights in the hospital but she didn’t have pneumonia… well, pneumonia is also really a broader term that encompasses all types of lung infections.
Another surprise is that a large percentage of infections occur in hospital or other health care facilities, and the infections that are contracted there are more resistant to antibiotics. In total, there are about 450 million cases a year, 7% of world population, with 4 million fatalities. That’s only about 1%, but of those cases where hospitalization is required mortality bumps up to 30%. It’s basically the young, the old, those with chronic illnesses and those people whose immune systems are already compromised who die from it.
Conditions and risk factors that predispose to pneumonia include smoking, immunodeficiency, alcoholism, chronic obstructive pulmonary disease, asthma, chronic kidney disease, liver disease, and old age.
Smoking is the most prominent risk factor, but Wikipedia doesn’t differentiate between tobacco and cannabis. While any kind of smoke will cause irritation, there’s a vast difference between tobacco which is a leading cause of cancer and cannabis which has never caused any disease. No one has ever died from smoking weed, at least not in medical terms. The others are quite obvious. The one thing you can’t correct for or do anything about is old age, though staying healthy clearly makes a difference.
My approach of the edge came because my condition wasn’t recognized early enough. Anybody who knows me who saw me on that Sunday when I was wandering around aimlessly would’ve known right off that something was wrong. I must’ve been confused and incoherent and needing attention. Confusion is a common symptom found in oldsters. Even if I didn’t look like I had any medical problem anyone would’ve realized I needed an eye kept on me.
Not saying I wouldn’t have needed hospitalization or required more than three months to recover as is typical for old geezers, but it certainly would’ve saved me from the problems with my legs and feet caused by dehydration; I was without any food or water for 2 days. When I first woke up in the hospital I was so weak and my legs so stiff I couldn’t lift them a centimeter off the bed. Now I get around okay, but I walk funny, hobbling just a bit because my feet are still not working right. I can flex my ankles and toes, though not fully, but my feet feel numb. It’s been three and a half months and I see steady improvement, but it feels like at least another month or two before my feet are back to normal… if they are ever going to be totally back to normal. A health care professional I talked to recently said it took him a full year to recover… sure sounds like a long time.
The scary thing is having no warning, so even if I now know the symptoms, would I recognize what’s happening if it hits again? Actually, I think I might have an inkling should it return. That last Saturday night before I went under, after I’d had a couple beers I was thinking of a couple more, my usual amount, but I felt a bit strange inside and thought I’d better head for home instead. I think I might remember that feeling and recognize it next time as impending doom. I sure hope so.
Now I breathe hard at times just like before, and I often also tend to breathe through my mouth. Is that because I’m not getting enough air through my nose? I also cough up a bit of phlegm a few times a week. It’s nothing like before, but is a bit of the infection still there, just enough to eventually take me over again? Is it gathering strength waiting to pounce at its opportune time, with me still unawares? Should I be getting blood tests every couple of weeks just to make sure? Not likely, though I probably should on occasion.
Should I be taking antibiotics as a preventative measure? My nurse friend says I should be popping those antibios at the first sign of a cough. I misinterpreted what he was saying for a while thinking he was suggesting I take them proactively, but what he really meant was if I get another chest infection with the hacking cough and lots of phlegm I should go right for the antibiotics. He says they might prevent another bout and it can’t hurt taking them. That I can agree with.
I take antibiotics only when the need is clear and obvious, like against the clap, for instance, otherwise every time you take them you’re wiping out your good bacteria as well as the evil ones and weakening your immune system; that is, not giving it time to do its job or try to do its job, and taking a chance that you’ll build up resistant bacteria and the antibiotics won’t work when you really need them.
With few exceptions, I shun all pharmaceuticals. I don’t take uppers or downers, painkillers or mood enhancers. More than 90% are petrochemically based and all come with nasty side effects. Of course, I wasn’t going to tell the docs when I hit Calmette that I don’t like drugs; I couldn’t say anything because I was totally out of it. When I did regain some level of consciousness, I just took whatever was given to me, only going off the drugs at home when I ran out. However, if it had been a slow moving sickness, I might well have done the research and decided for myself what to take. Ultimately, I credit my general health and strong immune system a least partly to that dislike of drugs.
Except for a hernia operation back in 1960 when I was 19 and a hairline fracture in my foot about 20 years ago, I’ve only been to a doctor a handful of times in my adult life. Hepatitis, Dengue, I just toughed it out. As stated by a couple different doctors, my state of health is what saved me. As an old fogey having any other serious health problem I would’ve been a goner.
I credit Calmette, Cambodia’s number one public hospital, for keeping me alive, but according to my friend, the level of care there is about the same as it was in Australia 40 or 50 years ago. The way he described his experience there hanging out with me, it’s almost like I survived in spite of the care at Calmette rather than because of it. Regardless, that’s where I was brought back from the depths. While the head doctor at Kampot’s public hospital was quick to send me off to Calmette, he thinks I could’ve been taken care of just as well locally. The one advantage Calmette has over the local facility is an MRI. The original diagnoses that I’d had a stroke was disproved by the MRI I had at Calmette.
There’s also a local training hospital run by Australians that could’ve taken care of my needs but money up front would’ve been a problem there. Calmette will take you as long as you bring your passport, which they don’t give back until you pay. Sounds fair to me. Of course, I was fortunate to have a friend show up my second day in the hospital to cover my bills. He made everything much easier.
By some miracle, I was able to raise the money to pay him off. The total bill came to $3500; that was for 10 nights in the hospital, doctors, medicines and tests. Amazing. The money came through online fundraising, personal gifts and a fundraiser/survival party I did here in Kampot in mid March. My benefactor friend suggested he’d be more inclined to help in another emergency if I was able to cover his costs this time. While I don’t plan to get sick again (well, of course) it’s good to know he’d be there for me. At 76 there’s no such thing as buying affordable insurance. I admit I have been a wastrel at times: when I had money I pissed it away. It was a great time, but now I’ve had to bring out the beggar’s bowl. Such is life.