One in a million

The following is about an incident that happened to me a few weeks ago involving, dare I say……… a vaccine.
In a nutshell, I had a very severe reaction to one.

Ive been hesitant to write about this, because I didn’t want to give the wrong impression or provide ammo for the vaccine nay-sayers. But I feel compelled to share my story, not only because this event was so traumatic and unexpected, but also because the odds of something like this happening is reportedly around one in a million. Leave it to this weird asthmatic to be that one in a million. Why couldn’t it be a Good one in a million, like where I win a huge jackpot or something?

First off, let me assure everyone that I’m not an anti-vaxer, quite the opposite. I’ve had just about every vaccine there is, and up until now I’ve never had an adverse reaction to any of them, not even the flu vaccines. I believe everyone should be vaccinated for at least the preventable childhood diseases, the planet simply has too many humans not to do otherwise. Well, my luck changed 3 weeks ago when I received the new shingles vaccine and had a reaction to it so severe, that I ended up in the Intensive Care Unit on life support

Due to the timing of events, there is low suspicion for actual anaphylaxis, though the verdict is still out on that. More likely, the vaccine set off some sort of potent immunological response in my system, which then triggered a severe asthma flare that eventually led to respiratory failure and a bunch of other fun stuff. All I know, is that the day before I received the vaccine I was feeling fine. Then just a couple hours after getting it, I was sick as a dog, and a day later I was in the hospital on a ventilator.

The full story actually begins 10 months earlier when my primary care physician recommended that I be vaccinated against the shingles, which is common medical advice for those over 50 years old and who had chicken pox as a child. I didn’t think much about it at the time and figured it was just something else I needed to do to protect my health. Side tracked by asthma and other health issues, it took me almost 6 months to actually follow through. When I finally did, I was told by the local pharmacy that there was a nationwide shortage of the vaccine and that they would have to add me to an already long waiting list. It took another 4 months, but the pharmacy finally called me to come in for the first injection.

At about 11:45 on the morning of March 13th, I finally got the first shot. Wow, an $83.00 co pay? I thought to myself, for that price this stuff better work. The jab itself was a lot more painful than most vaccines, because its given intramuscularly.. No biggie. After receiving the shot I left the store and went about my day.

Well it couldn’t have been more than an hour or two later when I started to notice that I just didn’t feel right. It was like someone unplugged my battery and zapped me of all my energy. As the afternoon wore on I felt progressively worse, but I shrugged it off as just being the typical side effects of a vaccine.

Fast forward to around 4:30 pm (5 hours after receiving the jab), I started to develop the chills. I took my temp and sure enough I had a fever 101.5 . Just to make sure I wasn’t experiencing anything unusual, I Googled the side effects for the Shinrx vaccine and sure enough, fever was listed as a common side effect. With that assurance, I wrapped myself in a blanket and parked myself in front of the TV.

By now Doug had just gotten home from work and concerned that I might have something else going on, he had me recheck my temp. This time it was 102.9. Not only that, but it was getting more difficult to breath. I thought that maybe the skaking chills were making me feel more breathless than I actually was. To make sure, I measured my peak flows, which were indeed dropping. I thought great, not only am I burning up, now my asthma is flaring. I increased the frequency of my neb treatments to about every 2 hours. Throughout the rest of evening I took ibuprofen to lower the fever and took extra albuterol treatments now and then to quell my increasing shortness of breath. At 11 pm that night I rechecked my temp and it was 104.2! Something isn’t right.

Unable to sleep because of the fever, shaking chills and now increased breathlessness and muscle aches, I kept going back online searching to make sure that the severity of my symptoms, while uncommon, were not totally unheard of with this new vaccine. To some degree I was satisfied with what I read and figured I was just one of unlucky few who got all the bad side effects.
But then at about 2 am the headaches started. OMG, I don’t mean a stress or fever induced headache, I mean a major headache with what felt like lightening bolts shooting through the top of my head every few minutes.

Something definitely wasn’t right, I was getting sicker by the minute and these headaches were starting to scare me. I thought my skull was literally going to fracture because of the pressure inside my head. Could I have Meningitis or something? I didn’t know what was going on. On top of the that, my breathing was getting more difficult and was not responding to the neb treatments anymore. It was then that we decided that I needed to get this checked out by a doctor. I was able to hold on for a couple more hours till the morning traffic eased up, then we hightailed it to UCSF.

Less than one day after this all started I was now in the hospital Emergency room, gasping for air, shaking like a leaf and not knowing what the heck was happening with my body. Despite the fact that 22 hours had already passed since the I got the vaccine, and having triaged very few patients with symptoms similar to mine, they rushed me into the cardiac resuscitation room where a flurry of people ran in and initiated their anaphylaxis treatment protocol, which is basically an EpiPen shot, benadryl and famotadine plus they set up of several IVs for access. I have a VAP, so only needed one extra IV, which of course took forever because I have crappy veins. Because my asthma was also getting worse, they set me up on a continuous neb, gave me more steroids, Mag sulfate and started me on Bipap.

Not knowing exactly what they were dealing with, they took blood cultures, tested me for all the major flu viruses and contacted the CDC to inform them of the reaction I was having to the vaccine. They then transferred me to the 9th floor IUC and inserted an arterial line. Shortly after this is when my memory gets kinda fuzzy. Essentially I don’t remember anything from the time they gave me a bolus of Ketamine to help me tolerate the BIPAP, till I woke up a few days later on a ventilator with full-on ICU delirium. Thankfully the psychosis only lasted about 8 hours this time around.

I was told later on that I did not do well on Bipap, and the decision was made to intubate me. They used a pediatric size tube because of my tracheal stenosis. They also had problems with keeping me sedated. I developed an acute metabolic encephalopathy and apparently became so agitated and combative that they actually had to call a “code Grey” in order to restrain and medicate me further.

According to my partner, few days later when they extubated me ( took the breathing tube out), I stopped breathing and almost coded. I was either too sedated or they pulled the tube out too soon. They had to manually bag me and do sternal rubs to get me breathing on my own again. I don’t remember any of this, but needless to say, it was traumatic for Douglas to see all this going on. He thought I was dying. Also, different than in previous admissions where I usually complain about how difficult it is to breath when they take the breathing tube out, this time they said I kept complaining about how bad my head was hurting. Apparently I also suffered the some post extubation delirium, which lasted about 8 hours this time(part of which I do remember).

After that, things quickly came back into focus for me. I could think more clearly, my fever was down and my head was hurting less. By the end of that day I was sitting up in a chair and walking with the Physical Therapist.

On the evening of day 6 after being transferred to the stepdown unit, I suddenly developed a loud inspiratory stridor, which wasn’t going away. It was concerning enough for myself and the doctor on call that night, that he requested the ENT doctors come and evaluate me the following morning. They indeed did stop by and scoped me. They saw that one of my vocal cords was moving paradoxically, a condition called PVFM (Paradoxical Vocal Fold Movement), which they told me is fairly common in a person with glottic stenosis and scarring, and which is usually made worse by stress. PVFM can come on at anytime, and other than speech therapy, there’s no corrective treatment for it. They said that the glottic stenosis itself looked OK and unchanged from the prior week’s surgery, but that I will most likely need a 3rd surgery in the near future to dilate my airway again.

Later that morning,having been given the all clear by the ENT docs, the medical and ICU teams, and my own desire to make a hasty retreat from the hospital and recover at home, they wrote my discharge orders, decannulated my VAP and set me free. At 3 pm that day I was back a home, 7 days from when I went in.

While at home I continued to have the”Ice pick” headaches on and off for another week or so and then they gradually diminished, as did my inspiratory stridor. Whether they will return or whether I’ll have any long term side effects from all this, I don’t know. I’ll I can do is cross my fingers and hope for the best.

To emphasize once again, what happened to me was probably a freak thing. The shingles vaccines are vastly safe and severe reactions are extremely rare. But, if you have serious pre-existing health issues, especially severe breathing problems, be aware that any side effects that you might experience could be amplified and more severe than usual. So it’s probably good idea to check with your doctor to make sure it safe to be proceed.

Lastly, if there’s a bright spot in all this, even though it’s too risky for me to get the 2nd dose of this vaccine, my titers from the first one are probably high enough to provide me with at least moderate protection against the shingles. For what I went through, I better damn well NOT get the Shingles.