Death in the Afternoon

Last year, I applied to join Rokko Train Run, 40km of perilous adventure climbing mountains after mountains. I already completed several marathon competitions and I thought I was ready to participate in trail run. But my ambition did not get realized as I suffered terrible URI then, which led to secondary bacterial infection, i.e. this guy.

Yes, the most dangerous species on earth and I succumbed to them. I had to cancel my schedule to run my first trail run and that was the end of the story. On the following month, I participated in another trail run in Kyoto, with much shorter distance, and I climbed Mt. Hiei and moved to Biwa lake, which was quite a fun, but surely different from one you get at Rokko.

So my pay back time. I applied again to Rokko trail run in 2017, which was held on memorable March 11. However, I was so unlucky that I suffered acute diarrheal illness after coming back from Cambodia. I recovered without any antibiotics (of course), but it was followed by another upper respiratory infection, which again I did not treat with antibiotics as standard of care. My condition was not bad and I remained afebrile. Cough continued but I knew cough can last for several weeks on average, so I was not concerned much about cough, just checked my sputum regularly to make sure I was not suffering from TB, which I must have a lot of exposures.

Two days before my first Rokko trail run, my sputum became suddenly purulent, and my temperature increased above 39 centigrade. I became weak, sick and I knew I have to give up my second try of attending Rokko trail run.

On the following morning, I brought my sputum to laboratory and it revealed「青い奴、、！」

 

 

Another pneumococcus with neutrophils, but not that many.

「前世で、いや、現世で殺しすぎたから、呪われてしまったんだろうか」

was my concern. I thought I was catching the beginning of URI turning to bacterial pneumonia, but not yet. Urged with my thought that I wanted to attend trail run desperately, I decided rather unusual "preemptive therapy" for bacterial infection. I took amoxcillin 750mg  q4h, which is outrageous based on Japanese package insert, but perfectly reasonable pharmacologically.

My family doctor, literally, was against me attending trail run, which she thought is absolutely stupid. However, she was also the world best expert in "(my) value based medicine". Knowing that I will continue to insist that I would attend the trail run, she just said, "Do whatever you want, I do not care,,,", with a sigh.

My family doctor was also my family ID consultant, and she even suggested my amoxicillin going up to 1g q4h, and it might have decreased my disease specific mortality as well as all cause mortality. I knew she was right but I was worried about potential GI side effect while running which could significantly impair my quality of life. Again, the world best authority of (my) value based medicine understood my concern fully and I kept swallowing amox 750 q4h, hoping this brings down my fever.

It did.

My family doctor was still against my running, but I was really really into it. I do not mind failing, losing things, but I hate losing again and again.

「やられたらやり返す、倍返しだ！」

Fever was down, and cough turned dry. I knew "blue guys" already died. I am the winner this time.

But I was not.

When I started running, I soon realized that my body was not really my body. It was so weakened by one of the strongest bacteria on earth. My muscle was not moving well, I was fatigued at 3km. I thought I was going to give up. I thought the same thought again, again, and again. I even thought I was going to die with this running.

I was exhausted. My muscles hurt. I thought my CK in blood be around 15K. My kidneys are shutting down. My heart is in agony. I remorsed that I joined this running. Climbing a mountain, going down, and climb again, go down again. Why I keep doing this, this is irrational. I thought I will give up if I run another km, but I just kept saying that to myself.

So I finished my run. I spent more than 7 hours for it and it was not a great record, but I was very happy that I did not give up. Anyway, all parts of my body aches now.

So today's lesson. Always follow what your family doc said.