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Diagnosis? A Pre-Halloween Health Scare

by on October 28, 2013 6:55 AM

Halloween is coming up on Thursday but I got my fright a little early this year.

I went to bed last Sunday night, feeling agitated at the world. I couldn't put my finger on it but, as my kids say, I was in a mood. I figured it was better to stay out of everyone's way so I took the dogs and went to bed early.

The little I remember of Monday and Tuesday was of staying bed, feeling dark and down, and of being unable to get my act together. I called off work both days, including cancelling classes on Tuesday. No pain and no real symptoms. I didn't eat much, if anything on those days and nursed the same Diet Coke for two days. I was off kilter and couldn't get my act together to get into the office to see students or go to meetings but I couldn't say why.

On Wednesday morning around 4:30 a.m., I got out of bed and announced to my husband that I was having cramping and was going to go to the ER. I insisted that I was fine to drive myself. I may have combed my hair and brushed my teeth before leaving but I'm not 100% positive. I know that I didn't bother to change out of a USMC sweatshirt (picked up on a training trip to Hawaii that I rarely wear out of the house) and a pair of old yoga pants before driving myself to Mt. Nittany Medical Center.

I remember thinking, as the car held a steady 40 mph on I-99 that "I should really be driving faster than this." I vaguely remember the person at the admissions desk and the triage nurse but the ultrasound and the CT Scan are pretty hazy. I remember the sting of the IV and the burn of pain meds going in and I remember the warm blankets but not a whole lot after that.

Diagnosis: bladder infection. I want to repeat that I had none of the typical symptoms of a bladder or kidney infection (burning, urgency, frequency). The only signs that something was happening to me medically was that something was happening to me -- confusion, disorientation, and agitation. (If you were on the receiving end of a nonsensical or incoherent text or email during that time, I apologize. Someone probably should have taken away my phone and hidden my computer). I "came to" sometime on Thursday afternoon.

The first thing I did after the fog cleared was to Google search "Bladder infection" and "Confusion."

"...causes of delirium and confusion can include infections such as bladder infection and pneumonia, particularly in older women."

I learned that in some older people, an altered mental state is sometimes the only symptom of a urinary tract or bladder infection. I learned that agitation, temper issues, etc. can be a symptom of all sorts of organic or systemic problems like a bladder infection or diabetes. I learned that with some older patients, particularly those with dementia, serious medical issues are sometimes missed because the pre-existing confusion makes it hard to determine what might be "new."

Trick or Treat. This tale is very scary. I'm not sure which was worse – realizing that I am now showing signs and symptoms frequently associated with elderly patients or that I communicated, made decisions, drove a car and interacted with a variety of medical professionals (as well as family, friends and my colleagues at work) in a compromised state. My response to my boss's caring "Are you okay?" text looked like this. "Not really. Will call qhen deugs deim ER wear off."

With a background working in hospitals, I learned then and have since taught students in Recreational Therapy classes "make clinical observations and assessments objectively and by looking at the big picture." It wasn't all that long ago that a student wrote to me about an incident in her internship at a nursing care facility.

She shared that an older woman with whom she had been assigned had started demonstrating drastic personality differences. Because of the student's interaction in recreation and social activities, she was uniquely qualified to see these personality changes. With other treatment team members saying "we aren't seeing it" and the woman denying that anything was going on, Megan continued to insist that something wasn't right. Her instincts were on track. The medical staff decided to run lab work on the resident on the basis of my student's concerns and found that the woman had a significant bladder infection. After a few days of meds, she was back to her sweet self.

That's all good when considering a clinical intervention in a hospital with nurses and IVs and prescriptions but what happens when it happens in your house and you don't see it?

The lessons learned last week were many. First, I work with some great people who were extremely supportive and understanding. I was also very impressed with the many students who, used to seeing me in the office or at my desk for so many hours each week, took the time to send get well wishes.

Second, my family is very patient, even when Mom is "in a mood." Third, my dear friends Cindy and Lori are and continue to provide amazing support (including even before I knew what was going on which meant sitting through my bizarre and emotional calls and texts). Fourth, the staff at Mount Nittany Medical Center and Dr. Laura Newhouser and her team at Geisinger Scenery Park are incredible and we are very lucky to have their clinical expertise in our community. A bladder infection doesn't fall all that high on the "priority scale" compared to what they see but further missing my symptoms could have meant a longer and more difficult recovery.

Last, it is really important to listen to our body when it is trying to tell us something.

I don't generally use these columns to reveal this much of my personal information. Kid or student stories? Sometimes. Bits and pieces about me or my family or my opinions to let my readers get to know me? Usually. My personal health issues? Never. However, the horror story of masked symptoms, an inability to verbalize what was happening and the recommendation to get medical attention as soon as possible made this feel like a public service announcement. As they say, if I can help even one other person, I will sacrifice a little privacy.

May your Halloween week be full of ghosts, goblins, pumpkins and all things "Trick or Treat." As for me, I'm still trying to get over the "common in elderly women." Seriously?

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Patty Kleban is an instructor at Penn State, mother of three and a community volunteer. She is a Penn State Alumna. Readers of State College Magazine voted her Best Writer of 2010 and 2012. She and her family live in Patton Township. Her views and opinions do not necessarily reflect those of Penn State.
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