Bacteria Grab a Windpipe and Hold It Hostage
I eagerly anticipated the Labor Day weekend last year.
As a work-at-home mother with a toddler and a newborn, the idea of a long weekend rendered me giddy. I was looking forward to a few days with nothing more ambitious planned than some walks around the block. Instead, I spent the weekend in an intensive care unit where my husband, Nathan, was in an induced coma.
On the Thursday before Labor Day, Nathan came home with a sore throat. Assuming that it was a summer cold, I made him tea with honey. He was able to drink, but he said his throat felt constricted, as though he was choking.
After a feverish and sleepless night, Nathan felt worse, but still well enough to work. He asked me to find him a doctor who could check him out in the afternoon, and said goodbye.
We had lived in our suburb in New Jersey for just under a year and had yet to find a good primary care physician. By a stroke of luck - how lucky, I had no idea - our neighbor was an ear, nose and throat physician. I called his office and left a message. As it was the day before the long weekend, his junior partner called me back.
I described Nathan's tight feeling in his throat, his harsh raspy voice, fever and failed attempts to expectorate. And I remembered that he was having trouble breathing.
The doctor insisted that Nathan call immediately. "It sounds like epiglottitis to me," he said. "But I need to hear his voice to be sure."
After e-mailing Nathan to call the doctor, I did some quick research. Well, it can't be epiglottitis, I thought. An inflammation of the cartilage covering the windpipe, the disease is most common in children 2 to 6, I learned, an age range that Nathan passed about 30 years ago.
The cartilage swells rapidly, over a few hours and can cause the airway to close completely, meaning certain and immediate death. Well, that seems like an overzealous diagnosis, I thought.
The doctor called back. "I told him to meet me at the emergency room," he said. "I'm on duty and I want to take a look at this personally."
Slow day in the E.R., I thought.
An hour later, Nathan called me from the emergency room. "I need you here."
"I'll be there in about 15 minutes, O.K.?" I said distractedly, balancing the telephone between my ear and shoulder as I turned on the coffeemaker. "The babysitter just got here."
"Well, they're about to intubate me and have me unconscious for a few days, so could you come right away, please?" he rasped.
I drove to the hospital, five minutes away, and ran into the E.R. The doctor was there, along with two anesthesiologists, the chief E.R. surgeon and six nurses.
The doctor said that it was in fact epiglottitis and that Nathan's symptoms were advanced and severe, adding, "If we sedate him and intubate him within the next 10 minutes, the chances of this being fatal are 1 in 100,000."
The intubation, he said, would ensure that his windpipe would remain open and that Nathan could breathe while being given antibiotics.
"And if we don't?"
"We'll either have to do a tracheotomy or he'll die."
Needless to say, we opted for intubation. I felt as if I had been catapulted 50 years into the future. I was not supposed to be in the E.R. being asked if I had a copy of my husband's living will. We had a new baby and an "old baby," not yet 2.
Nathan and I said our goodbyes before he went under.
The intubation went perfectly, and he was kept in a coma for two days in the intensive care unit until the swelling eased.
After coming to terms with the shock, I asked the doctor what had caused his sudden ailment. Epiglottitis is usually caused by Haemophilus influenzae bacteria, he said, but could stem from other bacteria. The doctor said Nathan's recent traveling and lack of sleep might have left him more susceptible.
Because my toddler and I had received the H.I.B. vaccine, we were not at any real risk. The doctor was, however, concerned about the newborn.
As a preventive measure, the children and I were placed on an antibiotic so that we could not be carriers for the illness. Nathan's tube was removed two days later, and he was pronounced cured. He left the hospital just in time to return to work on Wednesday.
It was not the best Labor Day weekend. But the fact that we all lived through it was suddenly something to savor.