Category: Home Life

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Poststreptococcal Reactive Arthritis (Probably)


BLOG readers begged for Calvin and Hobbes …

At the moment I feel sleepy but almost good, after a feeling very miserable all morning, and sleeping most of the rest of the day.

My rheumatologist, Dr. Eranki referred me to an infectious disease specialist, Dr. Strampfer.

We discussed all sort of symptoms and possibilities. He fell for our typical joke of, “I’ve had this pain in my neck for 16 1/2 years,” almost recording that as a symptom.

The two front-runners are Poststreptococcal Reactive Arthritis (PSRA) and Rheumatic Fever. Although the diseases present slightly differently, there is still debate among some doctors as to whether they are indeed separate diseases, and not merely different manifestations of the same thing. Rheumatic Fever can lead to heart damage, which I don’t have, although I may get long-term antibiotic treatment if Rheumatic Fever is considered a probable diagnosis.

Poststreptococcal Reactive Arthritis, however, is fascinating, and perhaps a better match. I had one blood test in which my ASO was elevated, showing a past Group A beta-hemolytic streptococcal infection. One of the ways in which PSRA differentiates from Rheumatic Fever is that the joint pain in PSRA responds very poorly to normal anti-inflammatory drugs, like ibuprofen, which has, indeed, provided me nearly no relief. Another strike against Rheumatic Fever is the lack of Sydenham’s chorea symptoms—“rapid, uncoordinated jerking movements affecting primarily the face, feet and hands.” (Although I have been described as an uncoordinated jerk, that isn’t quite the same.)

Other possibilities include Human Parvovirus B19, but it seems not quite as likely. Likewise, my retest in a few more weeks for Lyme disease will be carried out, although we don’t find that as likely, either, it’s very important to diagnose as early as possible, as it can cause very serious long-term damage if untreated.

Today I am back on prednisone (a corticosteroid), for a longer-term treatment. It’s offered the first significant relief in about two weeks. I cannot express how wonderful it is to be able to stand and sit without being in serious pain while moving, nor just to be able to sit or lay down for a while without being able to get comfortable. I still limp quite a bit, but my stride has gotten longer than 6 inches, and each step isn’t accompanied by pain. The fever continues, albeit more intermittently, making this day 21 with a fever, blowing away whatever my childhood chicken pox fever record was. I have been very sleepy today, but I think it’s just my body catching up on rest after being in constant pain for nearly three weeks.

But … by the next morning (18 hours later), the prednisone has mostly worn off. The fingers in my left hand are almost impossible to move, and my stride is much shorter again. :: sigh :

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Walking? Nyet.

This comic from Bloom County keeps coming to mind. (Copyright 1983, the Washington Post Company. Used under the “Get with It, This Is the 21st Century” interpretation of the Fair Use clause.) See http://www.berkeleybreathed.com/.

Today I received numerous answers from my doctor; unfortunately, they were all along the lines of “Those results were negative,” or “I don’t know.” I do know that I’m still running a fever (even after 5 days of antibiotics), but it seems to be slightly more controllable with medication, and it is nearly impossible for me to walk, even with Vicodin helping to manage the pain.

On the bright side, my echocardiogram concluded that the enlarged heart shown on my chest x-ray was simply a test anomaly. This also concluded that, if I do have rheumatic fever, it hasn’t done any damage to my heart. Still out there is the possibility of Lyme disease.

One ironic thing is that I have a severe vitamin D deficiency—just like what incapacitated Nichelle for many years. (See, there would have been ROI on that cube with a window view I recently requested at work.) However, the vitamin D deficiency isn’t likely to be the cause of my symptoms, as it wouldn’t cause the localized swelling, nor fever, and wouldn’t have set in so suddenly. (It’s also easily treated.)

I see an infectious disease specialist tomorrow, and I see my rheumatologist again on Thursday; we hope for more definitive answers. So far a large number of things have been ruled out. I’ve had so much blood and fluids drawn in the past week, that my weight has dropped 3 pounds.

I am grateful for the dedication my ever-growing medical team has shown. My fellow church members and family members are praying for my recovery. My wife and children are incredibly helpful. Nichelle keeps life manageable, and the kids typically function as my extended arms and legs, without complaint.

I have gotten much support as well from my co-workers. Many have called or e-mailed to see how I am doing. “Tovarich” Gary Dlugy is going to feed my tarantula, Susan (named after one of our VPs at Kronos). Sarcasm master Joe Royal sent these words of encouragement, which would have left me rolling on the floor if I’d been able to do such a thing:

Things are a little dull without you. Meetings start on time and stick to the agenda. Management is starting to be worshiped. It’s becoming a very unproductive work environment.

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Day 13

Nichelle and I are reprising the roles we had when she was so ill, albeit we have swapped who we are playing. I get to play the part of “Nichelle, the inexplicably sick one,” and she gets to play me.

Today is Day 13 with the still-unexplained fever, leg pain, phalanges pain, and swelling. (The swelling in my leg and foot has become quite “interesting.”) None of the tests I’ve had (and there have been many) have found anything conclusive. I will see a rheumatologist soon (I hope before my currently scheduled appointment of July 8 ), and continue to work—much—with my own primary care office.

The forecast seems to call for uninterrupted fever, with a scattered chance of more severe pain, and increasingly widespread swelling.

For example, yesterday I went to church, and Nichelle drove us to Randolph to celebrate Debbie Civil’s 18th birthday and high school graduation. (Debbie is a blind girl in a wonderful Christian family who used to, along with her siblings, ride our bus to church at New England Baptist.)


The Civil Family and the Wilcox Family. Debbie is the second person to the right of Nichelle. (At this point I could even squat down for the photo, albeit stiffly.)

I hobbed about, but felt pretty good, and was able to walk almost normally for a couple of hours in the afternoon. On the way to the party I slept; on the way back we stopped at the Natick Mall to see the completion of a 7-foot-tall R2-D2 (which we contributed to on Saturday). In the very short walk through the mall, my leg got worse. By the time I went to bed, the pain and swelling was worse.


I offed to take this home for them, but they didn’t think it would fit in our van. (See the swelling in the leg?)

I awoke at 5:30 a.m. with my leg in considerable pain, my temperature up to 100.9 (at 101.5 my doctor’s office wants to know about it), and that awful everywhere-hurts-because-I-have-a-fever feeling. I was also really hungry. I gobbled acetaminophen and ibuprofen (and cereal), and then slept virtually constantly until noon.

Today I’ve managed a little bit of work, but the fever and finger pain is still there, so I haven’t accomplished very much. I am trying to let my body get the rest it needs, it just doesn’t seem to be helping much.

In addition to work, I’ve just got to get better for our church trip to Strategy Zone on Saturday.

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What’s Wrong with … Doug?

Okay, here’s the deal …

Last Tuesday (May 27) I was falling asleep in a meeting. Now, bear in mind, I often fall asleep in meetings, but not usually in meetings of only a few people and where I am one of the key participants. I excused myself and went home sick.

(As I think about it, a week earlier I had been complaining that muscle pain all across my upper back—I thought from weight lifting—had lasted more than a week, and when I sat down to do chest flies, I discovered I couldn’t put much pressure on my left arm in the direction required.)

The next few days I took half days off, plus one full day, fighting a low fever (1 to 1.5 degrees above normal), working when I didn’t feel in that brain-dead state that fever brings on.

Meanwhile, I started having more and more stiffness in my legs, especially after sitting down for a while, and developed a pain in my fingers, particularly around the proximal phalanges.

Thursday I got in to see one of my two N.P.’s at Nashua Primary Care, and she explained that it was probably viral, and ordered a slew of blood tests, including a Lyme disease titer, because a number of the symptoms matched Lyme, even though we had not observed a tick bite or the infamous bull’s-eye rash from one. The only abnormal result was a slightly elevated sed rate, which indicates inflammation of some kind. However, Lyme disease antibody tests can be negative for several weeks even when symptoms have begun to present, so I have a retest in three weeks.

Monday had me phoning the doctor’s office again, explaining that the difficulty walking had gotten much worse beginning on Sunday. Questions and answers went back and forth throughout the day and the next morning, but around noon Tuesday (day 8 of fighting the fever), after confirming some swelling in my left leg (which I was completely oblivious of, but which Nichelle spotted right away), they referred me to the emergency department at Southern New Hampshire Medical Center. (I wasn’t even up to playing World of WarCraft on Tuesday morning. Tragic.)


(Enterprise E sick bay drawing courtesy of www.ex-astris-scientia.org.)

The primary reason for going to the E/R was because such swelling can be caused by a DVT (I would explain, but that would save you the fun of some Wikipedia research) or a blood clot in the lungs.

More blood was drawn. Twice, actually, the first batch turned out to be unusable. (I warned them not to expose it to sunlight or tachyon radiation …)

Nichelle dropped me off, and brought everyone by when she picked up Isaac and David from school. Shortly thereafter, as I was being wheeled to the Radiology department (my first trip on a gurney since infancy), both Isaac and David asked, “If you die, can we have your World of WarCraft gold?” Weasels.

The ultrasound and X-ray didn’t turn up any clots; however, the chest X-ray showed an enlarged heart (and you all thought my heart was two sizes too small), so in addition to still having a problem with whatever is causing me to be unable to walk, I’ll be visiting a cardiologist soon.


Admit it, this is more like what you expected.

The hospital gave me a tapered dose of prednisone, which, for 23 hours, allowed me to hobble a lot faster. It was a delight to wake up this morning and be able to move my legs with almost no difficulty, especially as on Tuesday I was nearly completely crippled, and the pain in my hands was so bad I couldn’t even open a soda bottle. But around 5:00 p.m. today the leg pain when moving set in again, and I was back to smaller steps (although not nearly as bad as Tuesday).

I have an appointment to see my own N.P. tomorrow night. I’ll have a cardiology appointment as soon as my doctor’s office can arrange one. (They are remarkably adept at getting a squeeze-in consultation; I’ve seen them turn an 8-week wait “even if your doctor refers you” into a three day one.) Possible causes for the enlarged heart are an infection in the past that caused tissue damage, or—as I learned about through my own research today—a completely benign condition called Athlete’s Heart Syndrome (see also this article) which sometimes develops in people who do a lot of cardiovascular types of exercise.

Ignoring the enlarged heart and going back to the original symptoms, I called my sister Cindy last night and learned that my niece Jenn had exactly the same symptoms, and is currently recovering finally after a round of antibiotics. The only test that she had come back positive was one that indicated an exposure to strep at some point. This matches a bacteriological diagnosis, rather than a viral one, but her case baffled her doctors for a while, and, they too suspected Lyme disease.


The weasels just want my gnome engineer Mortalan character’s gold if I kick.

Being sick like this has made me appreciate much more how difficult it is for those with movement-related disorders or painful problems like arthritis. I also have a much better understanding of just how difficult it was for Nichelle all those years when her vitamin D deficiency left her debilitated.

Still, I find many blessings. Kronos’ sick time policies are excellent, and the superb insurance for which they are paying means I do not have to worry about the medical bills. I can work from home to coordinate with going to appointments or on those mornings when I’m not sure how well I’ll feel, and keep up with work e-mail, etc., even when too sick to go in. I get to experience my children’s delightfully twisted senses of humor in a time that might have been stressful to them. Nichelle is a constant help to me as well. I continue to benefit from (and am particularly grateful for) the large amount of time coordinating my case that my N.P.’s Celine Fortin and Rebecca Cooper-Piela and my “nurse-on-the-phone” Fran have put in.

I am glad God doesn’t want my life to get too boring.

(The saga continues on the post entitled Day 13.)

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The Photos I Promised


NaNi, on her second day riding.


This is the scene that made Nichelle all teary-eyed, NaNi taking off up the street with Isaac. (We threatened to send her off with a Brides magazine in one hand and a college application in the other.)


Cuteness, as usual.

The two weasels (Nichelle and NaNi) went to DisneyWorld without us.


Phil taught Naomi to blow bubbles. I couldn't even chew gum without swallowing it until I was 6.

Sky Venture, Indoor Sky Diving, Nashua, New Hampshire.


Isaac at Sky Venture, Nashua.


Indoor skydiving: This flight suit makes me look fat.


There’s a really amusing story that goes with this picture, but I need to wait a few years for Nichelle’s anger to calm down before I can tell it.


Isaac and David with Jim, a former sailor who served on the boomer USS Henry Clay. This was taken at the Submarine Force Museum in Groton, Connecticut, home of the world’s first nuclear submarine, the USS Nautilus.


Isaac and David at the helm stations of a nuclear submarine.

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NaNi Reviews Indiana Jones and the Kingdom of the Crystal Skull

We all trekked off to see Indiana Jones and the Kingdom of the Crystal Skull on Saturday, including Naomi.*

Here’s her review:

Indiana Jones was amazing. Sam [Shia LeBeouf, playing Mutt Williams, whom she recognizes as Sam Witwicky from Transformers] was old! He had a mustache and beard, and I was, like, “What the heck?”

We asked NaNi if she had a favorite part, and she explained, “No; I loved all of it.”


Naomi can’t wait to review this upcoming release from Disney-Pixar.

(*Yes, I know you wouldn’t take your 4-year-old to see a possibly frightening movie, but she really wanted to go, even after knowing it might be scary. So we did take her, after instructing her on how to close her eyes and snuggle up with Mom if there was anything she found scary on screen, and that we would not be taking her out to the lobby. She did need to close her eyes once or twice, but it was David—age 9—who was the most frightened, but only in one part, and he used the same technique to deal with it.

Hey, she’s our kid, and has been raised on a steady diet of appropriate action-adventure, fantasy, and sci-fi films, such as Star Wars, Superman, The Lord of the Rings, and Barbie Swan Lake. Get over it.)

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A quick family update….

When Naomi woke up this morning, I asked her if she slept well, and also told her that I was happy she slept all night in her own bed. With the cutest glimmer in her eyes, she then told me that she had “the most wonderful dream in the world.” She then explained that she dreamt about Speed Racer, and that she was 5, and they went on vacation and they visited her and they talked. She had this twinkle in her eyes and the sweetest smile. She said that she never had this dream in her whole life.

Naomi’s been using Isaac’s scooter in the house for a bit now and has great balance. Phil pointed out to her that she may be ready to use her bike without training wheels because she can balance so well on the scooter. Man, oh, man, did she like that idea. She was quick to ask Doug to take the training wheels off her bike and is doing amazingly well. We took video of her mastering her skill at the two wheeler. It’s too soon for my liking, although that’s a mom thing!!! I’m, of course, proud of her accomplishments, but she’s growing up too fast.

David, after years of begging for glasses, got his wish. Doug took the kids to their appts a few weekends ago (Naomi’s first eye exam, too), and David was told that he needed glasses. He picked out the ones he wanted, and was told that they’d be ready in a week, but … the week came and went and still no glasses. He was disappointed to find out that he needed to wait several more days because there was a problem with the lenses and needed to be returned to the company to have them corrected. He finally got his glasses yesterday, and of course, he’s thrilled.

Isaac celebrated his 13th birthday the end of April and we’ll be celebrating with a party this weekend. Can’t believe he’s already a teen. [Doug’s note: He’s had the attitude of a teen for at least five years now, it certainly doesn’t surprise me.]

At the end of April, Naomi and I spent 4 days in DisneyWorld. Yup, just us girls, with two of Phil’s sisters and niece. We had a great time. Loads of fun watching Naomi’s expressions on the rides and just the fun she had with MacKenzie. Doug and the boys had a great time, too, as expected by me anyways. He took the boys indoor skydiving, which I’ll be doing sometime soon. We have a video of that along with pictures that David took. Those should be posted soon, too.

More from Doug. Nichelle is the biggest weasel in the world for going to DisneyWorld without us. I would certainly never go on such a trip without my wife.

In addition to indoor skydiving, David, Isaac, nephew Andrew Roberts, and I visited the U.S. Navy Submarine Force Museum, which is home to the USS Nautilus, the world’s very first nuclear-powered submarine. For technophiles like us, this was a perfect trip. In fact, we were late picking Nichelle and NaNi up at the airport because we got to talking to a submariner who was stationed on the USS Henry Clay (a “boomer”—a ballistic missile submarine) in the 1960s. In addition to touring the Nautilus, we got to play with various submarine control stations, see a lot of weapons, including a disassembled Polaris 3 MIRV, use working periscopes, and learn a lot about the history of the US submarine force. Jim, the sailor from the Henry Clay, also answered a question that was very important to me: Which movies about submarines are actually accurate. He said the Widowmaker was highly accurate, but admitted that others could still be entertaining. I’ll post pictures from this trip soon.

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The Wii Fit / Whee Fit

Again attacking the stereotype that video games are for people who only wish to exercise their fingers, Pretendo® began preorders for its Wheeâ„¢ Fit home exercise product, just in time for Mother’s Day. Get Fit and have Fun with this latest home fitness device for the Pretendo® Wheeâ„¢!


Nichelle Wilcox, a personal fitness trainer and Mom in Nashua, N.H., loves her Wheeâ„¢ Fit!

Enjoy these thrilling exercises:

Thank you for choosing the Whee™ Fit exercise peripheral from Pretendo®, for use with your Pretendo® game system.

Enjoy the following exciting exercises (we recommend starting with Dialing Panic, shown on page 2):

Snowboarding (core muscles, legs)
Play your favorite snowboarding game while standing on your Wheeâ„¢ Fit. Imagine the thrill of controlling the onscreen movements via your
Wheeâ„¢ Fit device.

Basic Balance (core muscles)
Close your eyes and try to balance on the Wheeâ„¢ Fit.

Advanced Balance (core muscles, cardio)
Close your eyes and try to balance on the Wheeâ„¢ Fit while in the middle of a busy freeway.

Shower Power (core muscles)
Close your eyes and try to balance on the Wheeâ„¢ Fit while taking a shower.

Advanced Shower Power (core muscles, cardio)
Close your eyes and try to balance on the Wheeâ„¢ Fit while atop a tall hill during a thunderstorm.

Bumper Jumper (hands and fingers)
While standing on your Wheeâ„¢ Fit, grasp the rear bumper or side mirror of a vehicle stopped at an intersection. The Wheeâ„¢ Fit will score points for each second you remain gripping the vehicle. If you hear the sound of approaching sirens, discontinue use.

Advanced Bumper Jumper (hands and fingers)
While standing on your Wheeâ„¢ Fit, grasp the rear bumper or side mirror of a vehicle as it enters the freeway onramp. The Wheeâ„¢ Fit will score points for each second you remain gripping the vehicle. If you hear the sound of approaching sirens, discontinue use. Game ends if an arrest is made.

Push ’em Up (arms, chest, and shoulders)
Place the Wheeâ„¢ Fit in front of you on the floor, and use it as a platform for performing push ups.

Advanced Push ’em Up (arms, chest, and shoulders)
Place the Wheeâ„¢ Fit in front of you on the floor, and use it as a platform for performing one-handed push ups.

Super Advanced Push ’em Up (neck and tongue)
Place the Wheeâ„¢ Fit in front of you on the floor, and use it as a platform for performing push ups with your tongue.

Press Stress (arms, chest, and shoulders)
While lying face up on the floor, grip the Wheeâ„¢ Fit in both hands, and press it up toward the ceiling.

Advanced Press Stress (arms, chest, and shoulders)
While lying face up on the floor, place a small child on the Wheeâ„¢ Fit device. While gripping the Wheeâ„¢ Fit in both hands, press it up toward the ceiling.

Super Advanced Press Stress (arms, chest, and shoulders)
While lying face up on the floor, place a small automobile on the Wheeâ„¢ Fit device. While gripping the Wheeâ„¢ Fit in both hands, press it up toward the ceiling.

Mallet Fun (arms and shoulders)
Using a 3-pound sledgehammer, strike the Wheeâ„¢ Fit directly in the middle. Try for 100 reps!

Luge Run (arms and shoulders)
Lay down on the Wheeâ„¢ Fit, and use your arms to propel yourself across the floor.

Advanced Luge Run (arms and shoulders)
Lay down on the Wheeâ„¢ Fit, and use your arms to propel yourself down a steep hill.

Super Advanced Luge Run (arms and shoulders, cardio)
Lay down on the Wheeâ„¢ Fit, and use your arms to propel yourself down a steep hill that bottoms out onto a freeway.

Luge Flight (arms and shoulders, cardio)
Lay down on the Wheeâ„¢ Fit, and use your arms to propel yourself down a steep hill that terminates in a ski jump.

Dialing Panic (fingers, cardio)
Using an ordinary telephone, practice dialing 9-1-1 and describing the current situation to the friendly emergency operator.

Yes, folks, this is what we gave Nichelle for Mother’s Day, along with a promise to buy her a real Wii Fit when they were available.

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Gin, Television, and Social Surplus

While I am working on posts about “The Weaker Vessel,” and “Verbal/Emotional Abuse” (and looking into how a ‘bot hacked my BLOG files to include hidden Spam links), here’s a bit to get you thinking:

Clay Shirky published a lightly edited transcript of his speech at a recent Web 2.0 conference, entitled, “Gin, Television, and Social Surplus.”

You will definitely want to read the whole post, but here are a few noteworthy excerpts:

Starting with the Second World War a whole series of things happened–rising GDP per capita, rising educational attainment, rising life expectancy and, critically, a rising number of people who were working five-day work weeks. For the first time, society forced onto an enormous number of its citizens the requirement to manage something they had never had to manage before–free time.

And what did we do with that free time? Well, mostly we spent it watching TV.

How much television do we watch?

[H]ow big is that surplus? So if you take Wikipedia as a kind of unit, all of Wikipedia, the whole project–every page, every edit, every talk page, every line of code, in every language that Wikipedia exists in–that represents something like the cumulation of 100 million hours of human thought. I worked this out with Martin Wattenberg at IBM; it’s a back-of-the-envelope calculation, but it’s the right order of magnitude, about 100 million hours of thought.

And television watching? Two hundred billion hours, in the U.S. alone, every year. Put another way, now that we have a unit, that’s 2,000 Wikipedia projects a year spent watching television. Or put still another way, in the U.S., we spend 100 million hours every weekend, just watching the ads. This is a pretty big surplus. People asking, “Where do they find the time?” when they’re looking at things like Wikipedia don’t understand how tiny that entire project is, as a carve-out of this asset that’s finally being dragged into what Tim calls an architecture of participation.

This reminds me, I was listening to “This American Life,” episode 328, “What I Learned from Television.” In a live broadcast, Ira Glass announces to the audience that average Americans watch 29 hours of television a week. There is a loud, collective gasp from the audience, which is composed of course, of not merely NPR listeners, but NPR listeners who paid to go out and see a live presentation of the radio program. Twenty-nine hours is the average? Suddenly I don’t feel so bad about playing World of WarCraft.

As Shirky writes,

In this same conversation with the TV producer I was talking about World of WarCraft guilds, and as I was talking, I could sort of see what she was thinking: “Losers. Grown men sitting in their basement pretending to be elves.”

At least they’re doing something.

But I digress.

As I write this, our pastor is speaking on “Reflections from the Back of a Bike,” noting how we prefer to ride in a car metaphorically driven by the pastor, instead of providing our own power on a bicycle, comparing the early church’s prayer to “speak the Word of God with boldness” as recorded in Acts 4:29 to our typical prayers of, well, whatever; of how we fail to really act on our belief in an Almighty God and actually serve Him with actions, every hour of our lives. How we need to embrace the mission of Christ and actually do something to reflect what we say we believe.

To be honest, I have heard many such sermons over the years, but this one is different. It’s Scriptural. It isn’t designed to evoke an emotional response. Its success won’t be measured by the number of people who raise their hands or “go forward” to the altar. Its success will, rather, be measured by how we let Christ give us boldness to use our associations and talents and burdens to change others’ lives. It’s real. It’s a reflection of how he actually lives in following Christ.

And the Word of God convicts me, that I ought to be so focused.

P.S.: Shirky makes some fascinating conclusions based on analyses of both current society and the Industrial Revolution, getting into such subjects as cognitive surplus, shared information projects, and participatory media. It’s one of the few must-read pieces I’ve encountered in the past year. He wraps up with a look into this gem (which in this context of excerpts seems disconnected, but in reality is not):

I was having dinner with a group of friends about a month ago, and one of them was talking about sitting with his four-year-old daughter watching a DVD. And in the middle of the movie, apropos nothing, she jumps up off the couch and runs around behind the screen. That seems like a cute moment. Maybe she’s going back there to see if Dora is really back there or whatever. But that wasn’t what she was doing. She started rooting around in the cables. And her dad said, “What you doing?” And she stuck her head out from behind the screen and said, “Looking for the mouse.”