Thursday, August 6, 2009

VALLEY FEVER!!!!!


It has been a scary time here the past week. After my 88-year old Mom and I returned from a fun trip for family reunions in Montana and Wisconsin, she was enjoying showing everyone her pictures, telling them of all her fun experiences, and happy to be back in her pool. About a week later she started saying that something was funny with her eyes..not painful, but some problem focusing. She had called the eye doctor's office where she had her laser surgery for catarats, and they told her she could wait a couple of months and come in when she had her yearly follow up check. I went over to see her on the morning of the 29th and found her laying on the couch with chills , nausea, shortness of breath and and headache, and not at all her usual busy, fiesty self. She said she had slept most of the day before. Making it more disturbing, she seemed to be having some mental confusion, and she is usually a pretty sharp cookie. I wanted to take her to the doctor, but she said she had to play bridge at noon! After another half an hour, she admited she need to see a doctor and I took her to the ER, as her doctor couldn't get her in until the afternoon. After a number of ultrasounds, CAT scans, blood tests and x-rays she was admitted to the hospital with possible pneumonia after ruling out a heart attack and stroke. I questioned the doctor about possible Valley Fever, so he had a blood test taken, which takes 7 days to get the result.

She was started on IV antibiotics, but daily chest x-rays bothered the doctor as no improvement was shown. The tests also showed a mass in her lung that didn't change. The doctor said it could be TB, Valley Fever, or cancer, so a Mantoux test was done. He doubted cancer as she has never smoked, and because of sudden onset. She would go from feeling pretty normal, to suddenly feeling weak, feverish, sweaty, and nauseated again. Her blood pressure and oxygen levels stayed normal, but her temp would spike up 2 degrees when she would have these episodes.

After 5 days in the hospital with no improvement, she was getting very discouraged. She loves to look at clouds and try to find angel formations. On this day she said she had seen an angel in the clouds all day and that she thought they were ready to "take her home" that night. She had me bring her Living Will to the hospital, and told me she was ready to go. She still misses Dad, her husband of 62 years that she has been with since a teen, and said she looked forward to reuniting with him and her family. She admonished me not to call my sisters and have them worrying. Of course, I disobeyed this and called my older sister who shares Power of Attorney with me. It was a worrisome night for both of us.

She lived through the night, but was no better. A pulmonary specialist comes to this small community hospital every Tuesday, and was arranged to see her. He agreed with the diagnosis of Valley Fever, and said she could go home on a fungacidal medication, and told her to return to see him in 2 weeks and have another chest x-ray and Valley Fever blood test , as the one taken in the ER came back negative. He felt it may have been taken too early to show the fungus.

So I brought her home to my house...she had wanted to go to her house, but as we approached it, she said maybe she could stay with me for the first night.

She has been here 2 days now, and has had a couple bad episodes, but now has gone almost 20 hours without one of the episodes of weakness, nausea, shortness of breath, and fever that is so scary to see. She showered this morning, packed up some of her things, but now has returned to bed and is sleeping. She says she feels like when pregnant...just the sight of food makes her nauseated. She has eaten some fruit and pudding, but little else. She says cold things taste best, so I am stocking up on fruit, cottage cheese, popcicles and will get some ice cream today to try to up her protien intake. She has craved bananas and pears!

Valley Fever is caused by Coccidioides immitis, a fungus which produces spores and is found in soil in the southwestern US and parts of Central and South America. It is spread through the air, and when soil is disturbed due to construction, agriculture, archeology, ranching, etc, the spores can be released and if enough are inhaled, can cause Valley Fever, or Coccidiodomycosis.

Although about 60% of people never develop any symptoms, the rest develop flu-like symptoms that can last from a few weeks to several months. Some cases are very mild, and other can spread outside the lungs to the brain, bone and skin. Without treatment, it can lead to pnuemonia, meningitis and even death....especially in the elderly and those with compromised immune systems. It has been on the rise because of the number of people moving to areas such as Arizona, and all the resulting contruction.

There is no vacine available yet, but may be in the future. The only prevention is to avoid exposure to dust and dry soil, or wear a mask when disturbing the soil or during duststorms. I guess that helps me better appreciate the laws in Arizona which require those in construction to be watering the soil that they are working in, and why there are sprinklers on round pens and arenas that are put on before events.

We just learned yesterday that a friend of my mothers has a husband who also has Valley Fever. He was in this week to have the spot on his lung biopsied. They are not optimistic, as he is a former smoker, and is having a lot of difficulty breathing and has no energy, and they feel his mass is cancer. If Mom still has the spot on her lung when she returns to see the pulmonologist in two weeks, he will send her to a larger hospital for a biopsy, too.

So that is how I have spent the past two weeks! Has been a frightning learning experience, a time of wondering if I would lose my wonderful mother, and of time of contemplating the "what ifs". I am glad I was here for her during this time. I had considered returning back to Minnesota with my horse for the remainer of the summer after bringing her home from Wisconsin. I was also supposed to be in Flagstaff this weekend riding with a Singles Lone Ranger riding group, and had looked forward to riding in the cool air in the pines and the mountains. I haven't been doing much riding lately in this summer heat of Arizona which has broken records for July, night time temperature, etc for the past month. Now I am glad it all worked out so I could be her for her.

So that is your education on Valley Fever!

No comments: