Tuesday, August 10, 2004

unidentified pediatric-acquired nastiness (UPAN)

yesterday, i was irritable. i was tired. my legs hurt, my neck was sore, and my arms ached. i just thought it was because i had gone on a hike on sunday and because i didn't want to go back to work. little did i know that i was actually coming down with a case of UPAN, or Unidentified Pedatric-Acquired-Nastiness.

for the unfamiliar, UPAN is an undefined infectious agent transmitted via large droplets (baby drool, kid sneezes, and teen coughs) and in some cases via aerosols, leading to transmission without direct secretion-contact. in addition, fomites are often involved in transmission, particularly stethoscopes that are not religiously alcohol-wiped between every use (hmmm).

the strain of UPAN with which i am currently afflicted seems to present first with a 24-hour prodrome of malaise, muscle aches, and generalized whininess. this prodrome is then followed by an active phase, characterized by mid-grade fevers and the sensation of weird drainage stuff going on in the back of the pharynx. some early-morning nausea may be experienced. as photophobia, continued muscle aches, and fevers may all be prominent during the active phase of the illness, this particular strain of UPAN seems to bear some resemblance to a typical case of influenza (uh oh).

notable physical exam findings include the aforementioned pharyngeal drainage which may or may not be exudate, big-ass (technical term, forgive me) cervical lymphadenopathy, and normal vital signs except for fever and occasional tachycardia.

while optimal treatment for this particular strain of UPAN is yet indeterminate, empiric options for therapy might include staying home from work, wallowing in self-pity, and a lot of ibuprofen. a 1-subject non-randomized non-case-controlled trial is currently underway, investigating the impact of the above treatment modalities on the duration of the illness. further details will be available once the study has been completed.

* * * * * *

yes, i am sick. i even (as suggested above) stayed home from work today, languishing in durham while i was supposed to be 2 hours due south, working like a good little medical student. i was supposed to wake up at 4:00 am to finish packing and make the 2:00:00 drive back to lumberton. i dutifully set my alarm last night for that ungodly hour, even though i was starting to feel like crap.

after the most restless night of hot/cold/headachy/stomach-hurting sleep ever, i came to the realization at 3:57 am that either the house's thermostat had broken or i was infected with something. when my digital thermometer beeped with "101.1" on it, i resigned myself to wimping out on work to recuperate and perhaps save vulnerable children from catching the nastiness i had come down with.

ahh, pediatrics. i suppose there are disadvantages.

i felt bad calling in sick, but i had to do it. i would have been useless at work and it would have been painful. plus, i'm probably contagious. the med-school-marine side of me was all, "it's just a VIRUS!", but fortunately i didn't listen. i managed to even get some work done while at home (during my periods of afebrile-ness), and my goal is to go to bed really early tonight. i am still spiking to 101 but i am hopeful that this is just my immune system's last push towards total annihilation. we'll see.