A hospitalization due to shingles highlights post-transplant risks

A funny thing happened the other day on the way to the Pulmonary Fibrosis News Forums. In the blink of an eye, everything changed, and off I went to the emergency room at Inova Fairfax Hospital in Virginia.

I should start at the beginning. On June 12, I began having pain in my groin, left hip, lower back, and left leg. It became significant enough that I called my primary care physician, only to discover she was away for the month. Another doctor in her office saw me, diagnosed me with a urinary tract infection, and prescribed a 10-day course of Bactrim (sulfamethoxazole and trimethoprim), an antibiotic.

The pain in my groin, hip, back, and leg diminished over the next eight days, but on day 9, my left foot turned bright red and blisters began to appear on it the next day. I took pictures and sent them to my primary office for guidance. At first, the triage nurse scheduled an appointment for that day, but I was soon directed to go to the emergency room.

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A diagnosis of shingles

I was diagnosed with idiopathic pulmonary fibrosis (IPF) in January 2017, and received a bilateral lung transplant four years later, in July 2021. My lung transplant committed me to a lifetime of medical surveillance.

Fortunately, since my transplant, I had been admitted to the hospital only twice — once was for the flu and then for COVID-19. That changed on June 22 following my visit to the emergency room, where the blister-like scabs migrating up my leg to my calf were identified as an infection, which is dangerous for an IPF patient. The emergency room physicians were joined by my transplant care team, and the decision to admit me came quickly.

I was soon moved to a room on the post-transplant floor and reinforcements from my nephrology team, infectious disease, internal medicine, and pain management began consulting on my case. The consensus was shingles, a viral infection related to chickenpox. I had been vaccinated, but because I am so immunosuppressed, the infection defeated my defenses. Without the vaccine, the infection could have been worse.

A tough week

Antibiotics were administered to halt the spread of the infection, and an intravenous ketamine drip was started, along with some other drugs, to treat the pain. My foot continued to swell over the early day, but the pain was held at bay.

The blistering scabs were scraped for culture in the lab. During this time, several broad-spectrum antibiotics were delivered by IV. My team was able to identify which could be delivered together via the same IV line, to accelerate the process of getting them into my system.

There were challenges along the way. On the third and fourth days, my IV sites failed, indicating my body was tired. A team of nurses worked three hours to establish two new IV sites, but in the meantime, my antibiotic treatments and pain management were halted. I was tired and dozing at times during conversations. Constipation due to medications and stress did not help.

It’s been a tough week. When you see me miss a column, it should tell you something is wrong. I write these columns for our community. They are a part of the rhythm of my life.

I expect to still be in the hospital when this column publishes on June 30, but I will emerge as a victorious warrior to return to the battle front to make every breath count.

Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.