Influenza A (H1-2009)

With the Thanksgiving holiday just past here in the United States, 2022 is starting to come to a close. It has been quite year for me, including losing a parent, starting a new job and buying a new farm. With the new job I’ve started to travel more, and for the first time in years I’ve gotten very sick from a business trip. It’s not something I’ve missed.

TL;DR; Getting the flu as an older adult sucks. During flu season mask up and take as many precautions as you can to prevent exposure.

Up until about August of 2019, I was doing about 85,000 “in seat” airline miles a year. I was away from home about 50% of the time. In July of 2019 I was in a bad car accident, and just as I was recovering the COVID pandemic hit, and for nearly three years I did almost zero travel.

The upside was I didn’t get sick. Between masks, isolation and lots of hand washing I just wasn’t exposed to anything that could make me sick, to the point that I’d forgotten how debilitating it can be.

Times are changing. People are traveling more and it seems like we as a society have just made the decision to forgo some of the habits we picked up during the pandemic. When I started traveling again in June of this year, people were still wearing masks indoors and on planes, and most events had a mask requirement as well. That is no more. Two weeks ago I got the opportunity to go to Helsinki, Finland, and I saw very few people out in public in masks either in the USA as I traveled there or in Finland itself. I found myself less inclined to wear one as well, but I usually kept it on when being inside for any length of time.

I’d been to Helsinki twice before, and as it is a really cool town I was looking forward to returning. It is also seven hours ahead of New York, my home time zone, and that can make things a bit awkward. I found a relatively inexpensive flight on Finnair direct to Helsinki from JFK which arrived mid-afternoon on Wednesday.

So far so good.

People often think of Finland in winter as being cold, and it is, but for once it was actually colder at my home in North Carolina. Usually when I travel I try to stay at Marriott properties. I really enjoyed the hotel I used last time, but all three Marriott affiliated locations were booked. It turns out that a famous European start-up conference called Slush was going on at the same time as my meeting. The Raddisson I booked was okay, but it wasn’t in a very vibrant section of town. I just grabbed some snacks at a local convenience store, tried to stay up as late as possible and then went to bed.

My meeting was an all-day conference on Thursday, and as it was being streamed they set it to start at 3pm (15:00) local time which mapped to 8am New York time. That meant it was also going to run until 10pm or so followed by a meal. Our host, Monty, had arranged for this to happen at his house, and I didn’t make it back to my hotel room until early Friday morning (I’ll post more on the conference later).

Now, usually when I travel from Europe back to the US I leave a little before noon and I get home mid-afternoon. There were a couple of flight options like this but they all pretty much doubled the cost of the ticket. Not sure why. So even though I was eager to get home for the start of the Thanksgiving week, I took the evening flight out at 5pm which gave me a little more time to spend with the folks on Friday who were still at Monty’s. The downside was that I wouldn’t land at RDU until midnight and it would take even more time to make it home.

I slept until about 8am, showered, packed and ate breakfast, aiming to arrive at the house around 10:30. I don’t remember feeling bad, although I had developed a slight cough. My body had no idea what time it was, however. I spent some more time with my gracious hosts, got to the airport and boarded the plan without issues.

The plane had a coach seating arrangement of 2-4-2 and I was lucky enough to get on a row with not only extra legroom but also I was the only person in the “4” section. Score. After the meal I pulled up all the armrests, gathered the extra blankets and pillows into a little “nest” and tried to get some sleep.

This is when I started to feel bad. Have you ever had one of those days where you were just dragging and you managed to grab about 30 minutes of a “cat nap” and then you felt great? Have you ever had the opposite happen, where the nap makes things worse?

This made things worse.

When I finally gave up on sleeping I woke up with a splitting headache and we were still a couple of hours from JFK. (sigh)

I’m happy that for the most part the rest of my trip went as smooth as possible. By this time I had added feeling nauseated to having a bad headache and I was pretty sure I was running a fever. I tried to sleep on the flight to RDU and managed to get home just before 2am.

Andrea and I came up with a routine when it comes to travel, and I always isolate for a night or two when I get back from a trip (longer for those trips involving conferences or lots of people). I crawled into the guest bed thinking that all I needed was a good night’s sleep and I’d be better.

I didn’t get that sleep. I tossed and turned and dozed a bit but then a third major symptom arrived: shortness of breath. To feel my best I had to actively monitor my breathing and pretty much force the air in and out.

At this point in time I decided to activate my medical deductible.

While we live in a somewhat rural section on North Carolina, we have easy access to the UNC Health Care System, a selection of hospitals, doctors offices and clinics. There is a UNC Urgent Care facility about ten miles from my house, so about 8:30 I on Saturday I got dressed and asked Andrea to take me there.

When I got to reception there was a sign about not being able to take patients until about 10am for some reason, but the magic words of “I … can’t … breathe” had the desired affect and I was seen pretty quickly. They noticed that my pulse-ox was a little low (97%) but if I was talking or walking that would drop as low as 92%. There first thought was that I might have had a pulmonary embolism during flight, and they took a couple of chest x-rays and an EKG in order to grab more data. They also did a nasal swab to check for COVID, the Flu and RSV. The care provider wanted me to get some blood work done but if they did it at the clinic it would take hours for the results, so she asked me to drive about 20 minutes away to the hospital in Siler City where the results would come in faster. Then I was to go home and wait for further instructions.

That went smoothly and I was back home just about to get back into bed they called to tell me to go to the UNC Emergency Department. The pulmonary embolism was still a possibility and they wanted to schedule a chest CT scan.

So we got back in the car.

A downside of UNC Hospital is that it is colocated on the UNC campus and last Saturday was also the day of a huge rivalry football game. That made parking an issue but since Andrea just dropped me off at the Emergency Room entrance it worked out okay. Pretty soon I was in a room of my own being fitted with a heart monitor, pulse-ox, oxygen and an IV. Between the travel, headache, nausea and getting tested I had not consumed many fluids. The nurse hung a liter of lactated ringers and I was very grateful, grateful enough to actually doze off for a bit.

Me getting settled in the UNC ED

That peacefulness ended when I woke up to see the bag was nearly empty and realizing that my bladder was nearly full. While I would have been happy with a curtain and a jar, they took the time to unplug me and escort me down the hall to the toilet.

When I got back I got the diagnosis that I had a confirmed case of Influenza A. This was actually good news as it lessened the chance of a pulmonary embolism, but they still wanted to do the CT scan.

While I waited for my turn I did try to look at my phone to keep up with what was going on, but my head hurt to much that looking at screens was painful. I did see that there had been a mass killing in Idaho, which made me want to stop looking anyway.

The scan itself was a non-event. I’ve had several in the past and they don’t bother me, although this one was “with contrast” and that it always a little weird. Just before they take the pictures they push in what is basically a dye to increase the contrast shown in the scan. But whenever I get it I get momentarily flush and it almost feels like I’ve been incontinent. The moment passes quickly but I’m glad they told me to be aware of it.

After the scan came back normal they decided to send me home. If I have any complaint about my care it would be that once it was determined that I had the flu I wasn’t given much direction. I asked for Tamiflu (although I should have asked for Xofluza) but outside of that they didn’t give me much advice for treating symptoms.

At this point in time I just wanted to get home and get into bed. This happened about 6:30 on Saturday night.

The next few days were pretty much a blur. My fever would bounce between 100F and 102F, and I would either be sweating through my clothes or shivering so hard I thought I was having a spasm. The weird part was trying to understand how my brain was trying to process this whole experience.

I like to sleep, but it often takes me a long time to fall asleep. My brain usually uses that first hour or so to unpack the events from the day and then it signals the time for “sleep”.

But by this point in time my “day” had been so screwed up that my brain really didn’t know what was going on. I remember for I time I was convinced that while I was in Helsinki my hosts had inserted some sort of probe into the base of my neck and that they were controlling what I was seeing. I was actually still in Helsinki and if I could just concentrate hard enough I could break through their technology. What’s funny is that it actually worked. There were times where I would see the vague outline of my darkened guest room break apart to reveal the light wood of Monty’s house in Finland. This was pure hallucination of course but it just made me want to try harder. The backstory my fever-ridden brain created was quite detailed.

In calmer times I was just plagued by earworms. I have a couple of albums I listen to when I travel as they provide enough background to block out the crying infant but not enough to keep me from napping. Those songs were in pretty heavy rotation in my head (in fact if I pause there is one of them roaming around back there now).

I remember there was a four-hour stretch of time where I could hear nothing but the song “Henry Kissinger” by Monty Python. I hadn’t thought of that song in years yet here it was, flowing gracefully, and non-stop, through my noggin’ for nearly four hours.

Death could not come swiftly enough.

Early into the week I started having a number of false breakthroughs. Just when I thought my fever had broken it would return, but at least it wasn’t to the levels I experienced over the weekend.

While I still slept most of the day, I was able to look at a screen for a bit (apparently the mass shooting I thought was in Idaho was in Colorado) and I would drink as much fluid as I could manage. My throat was raw from coughing, my lips were severely chapped and I I’d lost most of my senses of taste and smell.

Wednesday was the first day I could honestly say I was better than the day before. I got up around 5am for my usual fluid intake, and when I woke up at 7:30 or so I found out that I had sweated through my T-shirt, but my fever seemed to have faded. I made the decision not to join my family for Thanksgiving dinner on Thursday and instead used the time get some real rest, and on Friday I started trying to return to normal. I managed to get through a lot of e-mails and the news backlog (apparently that mass shooting I though was in Colorado was in Virginia).

I also made the difficult decision to skip this year’s Amazon Web Services re:Invent conference. I was one of the the lucky few from our department to get a ticket, but I’ve heard it can be physically challenging in the best of times and I was certain I wouldn’t be ready.

I’m writing this up on Saturday morning. If I had not contracted the flu I would be on my way to Las Vegas, and even though I am feeling much better the thought of flying brings back the nausea at the moment.

There are a number of things that depressed me about this illness, and one of them is that this is the first time “the flu” has taken so much from me. As I sometimes view bad cases of the flu as an old person’s disease I think this means I have to consider that I have become old.

Flu Test Results

The strain I contracted is the one from the 2009 “Swine Flu” epidemic, which was pretty nasty, although at times I felt like it was the one from 1918.

In any case I know that there is a strong desire if not outright need to move on from pandemic restrictions, but if you are one of the three people who read my blog you are special and I want you to take care of yourself. I don’t want you to have to expend a lot of mental energy trying to break through a spinal implant given without your knowledge.