I'm Naming My Firstborn Phenergan

Last Wednesday morning, I woke up at 5 a.m. with a sore throat.

It wasn't that kind of achy, pre-cold sore throat either.  It was a raging, fiery sore throat that was so bad, I actually got up out of bed, made myself some tea, and swallowed a few echinacea.  Usually, echinacea and zinc are my go-to weapons against viruses, and usually, they also work.

[Dramatic irony]

Around 10 a.m., I was totally congested, and had a headache.  The zinc, orange juice, and commitment to not leave bed had also not helped.  Muscle aches came not too long after that, with a fever, and by the time The Lawyer came to rescue me that night, I was buckling my knees up against my chest in the car to combat the nausea.  

The thing is, I had my flu shot.  I dragged myself into the petri dish of young adult infirmity and let some nurse at Student Health inoculate me in October.  Every year since starting medical school, the flu shot has worked.  I expected this year to be no different--especially since I'm not even in the hospital seeing sick people right now!

Well...

By Friday night, when I had been vomiting for six hours straight, I finally relented and let The Lawyer call my PCP's emergency number.  My PCP is pretty nice, in that he doesn't take offense at my ability to self-diagnose and/or request a specific medication.  I understand that for the general population (I'm looking at you, Mom), doing this to your doctor—especially after using the words “Google” or “Dr. Oz” is super annoying.  Thankfully, my doctor recognizes that I'm not part of the general population and if I can make a convincing case for what I need, it's basically just saving him time.  

So, The Lawyer left a voicemail telling him that I was having constant vomiting and begging for him to call in a prescription for Zofran.  (At this point, that some saavy doctor is going to jump in and comment that Zofran is the wrong drug and I'm not having chemotherapy and blah blah.  To you, I say, I KNOW THIS.  This is the argument that I watched the interns have with the attendings every day of my internal medicine rotation.  And, you know what?  Every single nauseous patient got Zofran, because that's how the teaching hospital where I did my rotation rolls.  So, in the throws of vomiting and limited brain functionality, I told The Lawyer to ask for Zofran, and it is the fault of the teaching hospital where I got my training and not my own ignorance, OK?)

After two hours had passed, I called again the PCP again myself.  No one called back.

Up until this point, it had occurred to me that I was going to need to go to the ER if I couldn’t get things under control.  I was really dehydrated and not getting better.  The problem was that the closest hospital is my hospital—said teaching hospital where I know the students, attendings, and sizable wait time involved in getting seen.

And, while I’m not ashamed of being sick, I was mortified at the thought of showing up bra-less, in my boyfriend’s undershirt, while I vomited uncontrollably on a hallway gurney (as the exam rooms are almost always full) and explained my medical history to one of my classmates.  As I frantically thought of my options, I also realized that I had no idea how to get into the ER.  As in, where is the public entrance?  This is a large, urban hospital with multiple entrances—including secret ones for the president and other government officials.  I have always used back entrances that required swiping my hospital badge or flashing my medical school ID.  Even if I could muster the strength to get to the ER, I had no idea where to go when I got there.

While this was happening, The Lawyer was getting very worried, and looking up options online.  When he found an urgent care facility three blocks away, he told me we were going.

“We’ve got to go right now,” he said authoritatively. “I’m going to get the car.”

As I pulled on a pair of soft, fleece pants and zipped a half-dirty workout jacket on over the undershirt I was wearing, I immediately felt light-headed.  It was going to be a struggle to get to the car, even if it only required taking an elevator downstairs and walking outside to a waiting car.

I sat on the couch to muster my energy, and clutched a small plastic bowl we had been using as a makeshift emesis basin, until I could will myself up again.

Once at urgent care, I was taken immediately back and a nurse swabbed me for strep (negative) and the flu (positive).  Then, I waited for the doctor to come in.  When she did, she looked visibly surprised at how sick I was—especially after I told her that I had gotten the flu shot. 

I didn’t know how she’d react to my request (Read: pleading) for an anti-emetic, since some doctors seem to take great offense at medical students asking for what they know they need.  Like, we’re only supposed to know absolutely everything—including drug interactions, allergies, names of first cousins once removed, and social security numbers—about our own patients.  But heaven forbid we know what’s wrong with ourselves!  Then, we’re just assonine and arrogant for saying it.

Thankfully, the doctor looked right at me and said,

“Well, I don’t have Zofran here, but you need a shot of promethazine.”

I nodded a hearty yes and then, proving that she was clearly an angel sent by God himself, she said,

“And, do you want something for the pain?”

It was at that moment that the heavens opened up and a hallelujah chorus of angels started to sing, because not only was I actually going to get something to stop the vomiting, but I was getting something for the pain!

A few minutes later, the nurse came back and gave me two shots and two prescriptions:  one for Phenergan suppositories (because let’s face it, nothing was staying down) and one for Tamiflu.

By the time The Lawyer dropped me off at his condo again, I felt downright blissful.  I was finally free from the awful stomach cramping and vomiting, and whatever they gave me for the pain was making me slightly dazed and sleepy.  I happily sipped a bottle of Gatorade and when The Lawyer returned from getting my medicine at the pharmacy, I proudly showed him how much Gatorade I had managed to consume.

“Keep going, honey,” he encouraged, knowing that urgent care warned him to take me to the ER if I didn’t improve.  But, we were both delightfully surprised by how much the medicine was helping. 

Then, I got cocky.

Even though it had been a full 24 hours since I had solid food or liquids, I decided to take my first dose of Tamiflu.  Had I been in my right mind, I probably would have read the side effects (nausea, vomiting) first, but I didn’t.

Annnd, two hours after getting home from urgent care, I was violently vomiting that precious pill (which I later found out cost $10) along with all the Gatorade I had painstakingly tried to keep down.

The next step was the Phenergan suppository.

Now, my brother-in-law has been suffering from vertigo and its associated symptoms for over a year and I remember my sister telling me that he was vomiting so much once that the doctor told her to administer the anti-emetic rectally.  She was horrified.

I remembered this as I was pulling my pants down and The Lawyer was retrieving my suppositories, because let me tell you, I would have done anything to make the vomiting the stop.  It’s funny when you hear of someone else having to do it, but if the antidote to vomiting is a suppository, my only real question is, how fast can I get it in?

The Lawyer, techie that he is, also Googled a quick how-to video on suppository insertion for me, since medical school teaches you a ton about rectal exams on others, but not so much about suppository insertion on yourself.  Then, The Lawyer stood by ready to…help…if I lost my nerve or started vomiting again.

I didn’t.  And, it worked.

That Phenergan worked so well that I fell asleep pantless on a towel and didn’t care, because at least I was pantless on a towel in my own bed and not heaving bile into a tiny emesis basin in the ER. 

I also slept soundly through the night and was holding down both food and liquids the next day.  The Lawyer was a great nurse and also amazingly calm and collected about the quantity of vomit he saw (and had to dispose of), which is kind of impressive considering that he’s neither a medical student or parent—both of whom are professionally and morally obligated to handle bodily fluids without flinching.  He did admit, though, that I was the sickest person he had ever seen.  (I think I should be proud somehow, right?)

Now that I’m sort of feeling better, I am appalled at how much Tamiflu costs ($100 after insurance AND a $10 manufacturer’s coupon), but thankful for it and drugs like Phenergan.  The Lawyer is also pleased about our surplus Phenergan in the fridge and exclaimed,

“This is awesome!  If there’s a drug you want around, it’s that!  I mean, you might not need other things on hand, but you’ll always need something for nausea and vomiting.”

I think he’s just looking for an excuse for me to go pantless again, though.