Ever heard of "Labyrinthitis"?

Dear Kari:

On Sunday, the diagnosis was labyrinthitis. It came across the lips of the ER doc around 9pm or so.

Here is the story - if you are delicate of stomach you are warned!

I went up to San Francisco to participate in the SF Chronicle 1/2 marathon. I completed it in 3hr14min. I felt a little tired which isn't surprising for just having jogged 13.1 miles. Last year, you saw what I was like after doing the Kansas City 1/2 marathon, a little out of it but still quite able to do things. After cleaning up, you showed me some signature sites of Kansas City like the Negro League Baseball Museum and the Jazz Museum.

I was looking forward to a leisurely rest of the day in SF to be capped off with a visit to SBC Park where I had tickets to the game purchased through a "third-party" vendor. As a side note, I did hear about the drastic trades the Dodgers pulled off! Like most fans, I was stunned they would part with both LoDuca who is a huge crowd favorite and Mota the overpowering 8th inning set up guy. But I guess when you are in need of starting pitching you have to give something up.

Around 2:30 in the afternoon, I began to get sweaty and dizzy. Figuring it was probably dehydration, I took some fluids and rested. But I threw up. I continued to take fluids slowly for another couple of hours and rested but the symptoms didn't diminish and I threw up again. At this point, my cousin and I after talking to a doctor friend decided it was time for the ER.

UPDATE: I found out that dizzy is a common layperson's description of how they are feeling. It can have two meanings: (1) I feel dizzy and I am about to pass out or (2) I feel dizzy and I see the world spinning around. I experienced the second definition which is more precisely described as experiencing vertigo.

Upon arrival, I threw up several times and they carted me into the ER on a wheelchair. They did a quick BP, pulse rate and temperature on me. I am guessing my BP and pulse were up as I was somewhat anxious! I'm guessing my temperature was normal as I didn't have a raging infection. They did ask some questions: my age (41), any medication (10 mg/daily lipitor), was a I drinking Saturday night (no). I volunteered that I completed the 1/2 marathon Sunday morning. They carted me to an exam room and put me on a gurney and poked an IV with 1L normal saline into me with some anti-nausea medication.

At that point, I'm sure my priority score in the ER fell considerably.

Next door there was a couple and one of them was sick and eventually was released with a prescription for antibiotics.

Meanwhile, the doc asked if I had any chest pains. I said no. Perfectly reasonable question: forty-something male engages in strenuous physical activity while on anti-cholesterol meds, you got to think heart issues! Anyway, they hooked me up to an ECG. The tech ran the test and said, looks normal to me. Whew.

Next door, a new patient was wheeled in. I could figure out it was an elderly parent with two children (I'm being vague about details for privacy reasons). As the 2nd liter of IV was draining into me, I could hear the doctors talking to them. I imagined myself in their shoes hearing the news. It wasn't good. In fact, at one point the doctor plainly said, the patient might not survive another 24 hours. The doctor said, I feel I need to be upfront about the possibilities so there are no surprises.

I could only silently pray for these people I could hear but not see as my exam section had a curtain and they had one too. For me, I felt confident that in 24 hours I'd be much better. But being next door to someone who probably wouldn't made me feel very sad and I felt for the children. It may not be too long before I'm in their shoes as my parents are getting up in age.

I felt thankful for the technology and medical skill of the people around me. I also counted myself blessed that my life has been relatively free of health issues. I had every reason to believe I would feel "normal" soon enough.

After 2 liters of IV fluids you do need to use the bathroom. I went and the world started spinning around. The stupidest song started to play in my head, Fool on the Hill:

Day after day alone on the hill,
The man with the foolish grin is keeping perfectly still,
But nobody wants to know him,
They can see that he's just a fool,
And he never gives an answer,
But the fool on the hill
Sees the sun going down,
And the eyes in his head,
See the world spinning around.

At this point, if I had simple dehydration, 2 liters ought to do it. So something else was amiss.

At this point, I mentioned to the doctor, you know while I was lying here I did notice a slight pressure in my left ear. On the scale of 1 to 10 with 10 being excruciating and 1 barely noticible it was probable 2 or 3. He looked inside the left. Looked in the right. Looked in the left. Then asked, did you have an upper respitory infection recently?

I said, yes, earlier in the week, I had a mild cold.

And you flew up to SF?

Yes, on Friday.

Hmmm, could be labyrinthitis. The flight with the pressure change could irritate the inner ear. I'm ordering a head CT just to be sure about other things.

In the meantime, one of the nurses did a bp check on me while I was lying down and while I was standing up and did one on my right side and left side. I'm guessing that is probably another check on the stroke angle? Any MDs out there who could confirm this?

UPDATE: I'm told that the resting versus standing blood pressure could be a way to check for internal bleeding. Any other ideas?

The stroke angle is of concern to me as I've had some relatives who died of strokes. But since the doc had already mentioned labyrinthitis, I wasn't too concerned about that option but it was on the table.

I was carted up for the head CT and then carted back down.

Results were negative and they "cut me loose" with prescriptions for meclizine and pseudoephedrine.

I was advised not fly as that could irritate my inner-ear and since a auto ride from northern California to Los Angeles is a 6-8 hour affair, I rested Monday and Tuesday before hitching a ride from a family friend who was coming down to Los Angeles on business on Wednesday. The trip went without incident and I hope to be "normal" in a few more days. I'm advised not to fly for at least a couple more weeks. Suffice to say, I'm not planning on it!

Take care,
Rene