Not COVID-19

Meta-note: I’m writing this mostly for posterity. Sort of a memo to myself, but also useful to be able to explain to others who may ask.

TL;DR:

Summary

I was sick for nearly 3 weeks with a low grade fever, some GI issues, muscle aches, headache. Initially I didn’t think it was COVID-19, but when I didn’t get better after a week I checked with the doctor and he thought it was, but sent me for testing.

Ultimately, tests show that I have not had COVID-19.

I’m not sure how to feel about that. I feel slightly odd because I did tell others that I probably had it, because that’s what the doctor told me. And to be fair to both of us, the symptoms kind of align and I’ve never quite been sick like this before.

I’m not one to seek attention for this sort of thing. At least, I don’t think I am. So it feels kind of odd to have gotten attention but now I have to go back and tell others that it wasn’t that disease. It may be another one that is either better or worse.

At the end of the day though, I have to follow the data. It says I still have a chance to get COVID-19 (or, preferably, a vaccine). And I got to feel like crap from something not yet determined.

The Full Story

What I am calling day 0, July 4, 2020, I had some lower GI issues, (diarrhea). Since I’d eaten some questionable food that day, but felt odd before even eating it, I wondered if it was food poisoning. I just took it easy on my GI system and tried to turn in early.

On day 1 (July 5 2020), I began to have “flu like symptoms” along with some lower GI issues. Since I’ve not been doing anything particularly risky, of course I thought it was likely food poisoning. Doing what one is supposed to do, I self isolated in a guest room away from Michelle (my wife) and Josephine (our daughter). More specifically, I felt like my skin was crawly and I felt warm. I had muscle aches and lesser though continued lower GI issues.

I forced myself to take a walk on day 2, hoping that moving about would make me feel better. It did not help. Still just fever and achyness though.

The couple days isolating were not great. Partially the illness, and partially that I am not used to sleeping on the hard futon we have in that room. It’s always comfortable at first, but loses comfort over time. I did not take my temperature then, but should have. I am guessing I would have noticed a fever.

By the night of day 3, I thought I was getting back to normal and since I had not developed any respiratory symptoms, I did not think it was COVID-19. So, I moved back into our regular bedroom.

In retrospect, something odd happened between day 3 and 4. I woke up at 3am with a horrible migraine-like headache. I got up, drank a bunch of water, and took a Tylenol, eventually getting back to sleep. The reason I mention this is I felt pretty good on day 4’s morning. In retrospect, I think it was the Tylenol putting the fever I had (but wasn’t measuring!) at bay. I also noticed on day 4 that I had very dark urine– seemingly nearly brown in color to me.

Since I was on vacation and we hadn’t done anything, we took this day to go to Huntington State Beach. It’s a bit more isolated than the city beach, gives you a lot more room between people. We staked out a spot pretty far from everyone, Josephine took her nap at the beach and I even went for a run and got a sunburn on my back– a dumb move to not have somone apply sunscreen there for me.

Day 4, didn’t feel great. Slept not well, but that was partially the sunburn. Still some GI distress..

On both day 5 and 6, I was trying to get up early to take care of Josephine to give Michelle a break. Both of these days I felt odd first thing in the morning. In particular what I noticed was getting chills and even shivers, though it was 78F/25.5C in the house (looked at the thermostat going down to get some milk for Josephine. On day 6, I ended up going back to bed because I just didn’t feel well (and Michelle offered). I did a couple of errands that day. Some shopping for bike tubes (I’d hoped to take Josephine on some rides during vacation) and things we needed. Dropped off the car which started having some clutch noise. That night, had some chills when gettign up in the night to use the bathroom adn first thing the next morning.
The evening of day 6, a Friday night, just wasn’t any better. We tried to sit out in the backyard, something that would normally feel really comfortable to me this time of year, but I just felt odd. For example, one really odd symptom was that the back of my eyesockets hurt. It was just unusual in the way it felt. Moving my head around, it was like I could distinctly feel the pain on the back of the eye sockets.

I tried to rest up on day 7, since one day this weekend we were to help Michelle’s cousin put in some curtains. We did that on day 8. I still didn’t feel “right”. I started the day with chills again. I did treat my symptoms with Advil this day (both Advil and Tylenol work for me, I tend to Tylenol to save my kidneys) I drank a lot of iced tea that day. Later that evening while we were home and talking about how I still didn’t feel well, I finally for the first time took my temperature. It registered as a 99.7F if I recall correctly. I was immediately a bit disappointed in myself because this meant I probbably had an infection this whole time, exposing Michelle and Josephine to it, among others. We talked through it a bit and decided that it would be best that I isolate at my mother’s house, since Michelle is at high risk and it’s really hard to explain to a 2yo why you can’t play with them. And set an appointment with the doctor.

I started day 8 with chills again. Again, an odd sort of situation in that it was pretty warm, 78F in the house. I checked that morning and had another 99.7F.

On the afternoon of day 8 (a Monday), where I worked remotely from Mom’s house, in the afternoon as in most afternoons previously I began feeling sick. Sure enough, 99.7F temperature that rose a little more into the afternoon. Earlier in the morning, I’d set an appointment with the doctor for the next day as a tele-health appointment. The staff was ready with some numbers for me to be tested, but I wanted to talk to the doctor first as I’d had no respiratory symptoms. I wasn’t sure if a nasopharyngeal test would work.

Day 9 I felt a little worse than the day previous. I still had chills and my temps were in the high 99s, eventually going to 100.6F in the evening. I still had some GI issues, loose BMs. I spoke with the doctor this day.

The doctor said the symptoms I had sounded a lot like the COVID-19 cases he had seen. He said many started with GI. He asked some questions to eliminate other things such as a UTI and an ear infection. He said it sounded like COVID-19 and suggested that I be tested. I asked whether this test would be effective if I didn’t have virus in the respiroatory system, and he said it would still typically test positive.

So, I set about trying to obtain a test.

There isn’t a very unified way to find a test. As a patient, they give you several phone numbers and you check with them to find an appointment. My first check was with what the doctor’s office called “the State”. This is done by OptumServe, which may be administered or also known as LHI. When you call the number from the doctor’s office, the recording tells you that this phone number is only for people who do not have internet access. If you have internet access, go to some URL. I forget specifically what they said it was, but it ultimately was the site at lhi.care/covidtesting.

After answering where I was and a questionnaire verifying I was someone who should be tested, it looked like the next test opening within 100 miles was 8 days later (July 22). Not very positive. I signed up for it just in case.

Michelle, meanwhile, checked with CVS via the phone and wasn’t fairing much better. I checked their website at some point. The worst website award goes to CVS. You pull up with a location a list of places, then you have to click on each one individually to see if they have test appointments, usually to find they have none. It’s the kind of UI one would write if you want to rate limit your users.

I decided to go to the state website, which indicated ProjectBaseline and Verity were also doing testing. After filling out some similar questions on that site (which is quite well done, Verity is an Alphabet company and you can see they use a lot of the material design elements), I did a similar search. Initially, it was also pretty disappointing. But, after extending the search out from 25 to 50 miles, I found a spot in my county some 38 miles away and only two days later. Checking with the doctor’s office that this was a suitable test, I didn’t quite feel up to scouring everything else. I went to rest knowing that I had a spot for a test.

On day 10, to be able to work in some important meetings that day, I took some Tylenol early in the morning. For me, whenver I take Tylenol, my internal thermostat would adjust and then I’d spend an hour or more transitioning to feeling better, but also sweating a lot as my body temp tries to adjust. It was not fun.

I handled my meetings, and then as my temp went up in the afternoon, I was back in the mid 99s.

One side note on Tylenol. My wife and mother kept telling me to take it regularly. I had previously read an article on the Mayo Clinic website which indicated that one shouldn’t take any meds until a fever of 102F. There were some other articles positing that fever helped the body with what it needed to do in order to fight the infection. My mom sent over a New York Times column that suggested it’s fine to treat a fever, citing two studies. One was inpatients with sepsis (from 1997), the other was inpatients with critical care (from 2015).

Okay, so now I needed to really research it. After refining the search terms on for scholar.google.com to “antipyretic therapy in adults with febrile symptoms as outpatients prolong illness”, not initially knowing “antipyretic” (e.g. Tylenol and Advil), or “febrile” (effectively, feverish), I turned up a couple of studies that seemed more like my case.

One was in the Journal of Clinical Nursing, Literature review: should antipyretic therapies routinely be administered to patients with fever?. The key quote here is:

Results. Results were inconsistent. None of the studies found that antipyretic therapies reduced duration of illness in patients with fever. Evidence suggests that antipyretic therapies do not reduce the duration of illness, but can prolong it.

The second one was not as applicable to my situation. According to The Effect of Antipyretic Therapy upon Outcomes in Critically Ill Patients: A Randomized, Prospective Study

Conclusions: Aggressively treating fever in critically ill patients may lead to a higher mortality rate.

I know my wife and mother were just trying to get me to feel better and thought Tylenol wouldn’t matter. For me it mattered because it might prolong the illness and the main way I could tell I was still fighting an infection was my higher body temperature.

Day 11, testing day. Felt tired and weird in the morning, but not many symptoms, including no real fever first thing. Drove the 38 miles to the test, noticing that I kind of “liked” not having the A/C running in the car much. That’s odd, since the test time was 11:30a and it is late July. The car, sitting in the sun, got quite hot.

The test collection itself went okay. I thought I was at the wrong place at first as there was no massive line for testing or anything to speak of. It was a Rite-Aid drive through. There were 2 cars in front of me. I think, based on what I saw, one did a COVID-19 test and the other was just picking up meds.

Collecting the sample was a bit uncomfortable, watery eyes and all. I had a bit of a runny/stuffy nose that day. One thing I neglected to ask the pharmacist was if I should blow my nose first. It turns out the answer is yes (I looked later), but I didn’t do that. I swabbed, stuck it in the tube, passed it through the little drawer, and that was it. I forgot to record any labels from the tube so I could follow details. There were no literature handouts.

Still felt odd and not all there. Stalled the car on the way out of the drive through. Not normal for me.

Later that evening I was back into the 100s. I hit 100.9F just before going to sleep.

I should also mention that with a little handheld pulseox from my mom, I noticed my heartrate was higher than is normal for me. At rest, sometimes laying there for an hour, I’d be in the low 80s. If I went up the stairs and immediately checked, it’d be closer to 95.

The o2 component I trust a little less on this device. I would occasionally see low 90s and in some cases, it would drop below 90 and alert me. To check if it was working in a reasonable way, I’d take some deep breaths and it would go back up.

Day 12 started with a fever and a headache. This was not good, as most days were “good” in the morning and would get worse over the course of the day. Luckily, the fever dropped a bit and I worked a bit. But, by the evening, I was back up into the 100s and feeling crappy.

Day 13 was a Saturday. With no work meetings, I planned to sleep in. It didn’t start off well. Waking up, I was at 99.1F. It went up a little bit as I got up and did the normal hygiene stuff. I hung around in the mid 99s most of the day. Finally feeling crappy around 5p, I crawled into bed. What struck me was the room was quite warm, probably lower 80s, but my feet were freezing cold. I alternated my feet on my calves trying to warm them up under the blankets. Very odd. After lying there for 90 minutes or so, I was at 101.2, still feeling like I had cold feet under the covers.

Day 14 was originally the day I was hoping to go home. Nearly a week earlier I didn’t feel too bad and thought I just needed a couple more days before I could do three days of no-symptom quarantine. It didn’t work out that way. I started the day feeling like crap and having a 99.6F. I’m not sure why, perhaps I was just tired of feeling like crap, but this day I took some Tylenol in the afternoon so I could hopefully sit in the backyard and maybe walk around a little. I was a bit tired of the bed and quarantine room. That worked, temp dropped to 98.4. Oddly though, I was super tired.

I noticed this two other days when I took Tylenol. It seemed like whenever I took it, my heart rate would drop, my fever would drop, but I would be super-tired. It’s almost like my body was fighting the infection all of the time, but if it could take a break and lower the heartrate/temperature, it realized how tired it was. Sort of sleepy tired, but more just physically exhaused.

Day ended at a 101.8. Luckily, I took the time to send an email somewhere in there that if I didn’t show up in the morning, it was because I was not feeling very well.

So much for going home!

Day 15 was more of settling into this new fever-all-day routine. I started the day at 99.4. I did not do much other than rest this day. The GI issues returned. The back of my eyeballs hurt again. And one other odd symptom, for whatever reason my left calf muscle was in a lot of pain. I didn’t injure it in any way that I know of. The problem just presented itself that morning and I was limping around for half the day. Just as mysteriously as it appearted, it later wdisappeared after sitting outside for a while.

Slightly concerning, around 8pm, I checked my o2 and it was 89. Did this mean the respiratory symptoms were catching up with me? That’s where things get dangerous. I did have some other oddities like my voice was not working. It was almost like I was slightly hoarse after yelling. But, I also didn’t trust this pulse oximiter.

After a few deep breaths, it was was back up to 97.

Temperature this day hit 101.9F just before bundling up to sleep.

Day 16, had some work things that I needed to get done, so I took a Tylenol early in the morning at about 7am after measuring my temp at 100.1. I went through the sweating thing, etc. I did have a loose BM that morning again.

I was functional most of the day. But this day more than others, I noticed the exhaustion. It was like when I was under the fever, I couldn’t tell how tired I was because of the elevated heartrate. It was hard to focus with this other symptom of exhaustion.

As the Tylenol wore off at the end of the day, around 7:30pm, my skin started feeling creepy crawly and by 8pm, I was back to 100.7F, ending the day earlyish at a 101.4. Or, so I thought…

This evening, even though I was tired in the morning after taking the Tylenol, I could not sleep. It semed to me like my heartrate just kept up. I also noticed something new. Pulsitile Tinnitus. I’d never heard of it before, but in my right ear I could hear blood wooshing along with my heartbeat. Terribly annoying.

After lying there barely sleeping most of the night and knowing that I needed to do a presentation the next day, I took some Tylenol at 3:40am. After sweating it off, I slept a bit. It was not easy, as I was in a pool of sweat and I couldn’t regulate my temperature very well. It worked though as moving to…

Day 17, starting on Tylenol I had a 96.5F temp. Felt okay, other than this extreme exhaustion. I even tried to nap at one point in the mid-afternoon, but I couldn’t get to sleep. Temp then was still a reasonable 97.5F.

Of course, as the Tylenol wore off, I could feel it escalating again. Again, rather odd symptoms. A bit of my belly was exposed as I sat in the bed, and that part that was exposed to the air was freezing. And the Pulsetile Tinnitus came back off and on. Ended the day early at a 100.2 and thankfully slept better that evening.

Day 18, woke up at 7:10am a bit sweaty with more of the tinnitus. Temp was 98.7F. Maybe the fever had broken? This morning I had a bit more mucus. Nope, after a shower and checking 40 minutes later, I felt like crap and was back up to 99.7F. Ended the day with a 99.7F.

Day 19 was finally a bit different. 98.6F in the morning. Was this the first day of three with no symptoms so I could return home?!?

All morning, did pretty well. Just really tired. I hit a 99.1 later in the day writing a note to myself “Doing better today”, and closed the day out at 98.8.

Day 20, another Saturday. Finally feeeling like the fever is gone. Just tired. Temps were in 98.8-97.5 range this day. I was mostly able to rest since I didn’t feel compelled to work.

Day 21, going home day? Originally the CDC guidelines called for three days without symptoms before returning home. A few days earlier they made that a little less draconian, it is now “At least 24 hours with no fever without fever-reducing medication and symptoms have improved” as of July 16. I was satisfied the new rules, but didn’t quite meet the three days rule. We talked thorugh it and figured it was good enough.

I returned home, but was really exhausted that day. We went for a walk in the neighborhood in the morning and another one in the evening. I still felt compelled to lie down to rest. In one instance, I wasn’t able to sleep, but I was just so exhausted.

Day 22, first day back at normal-ish home/work. Mostly a normal day, except I feel drained. I didn’t sleep super well, waking up at 3am, 4am, 5am, 5:15am, etc. This day I got up early to go to Quest for the blood draw and other specimens, a fasting lipid panel, etc. I was just tired this day. Needed to rest a couple of times over the course of the day.

Day 23. A more normal day, despite starting at 7:15a. I felt better this day. The two mile walk with the family in the evening didn’t wear me out as much as the shorter walk did on Monday, so that’s good. Body temperature is normal, in the 97s.

I received my Quest results this day, but hadn’t talked to the doctor yet. The result show… no COVID-19 antibodies. I won’t explain all of the other numbers, but some of them are concerning. And, nothing that really pinpoints what had me in a high fever.

Day 24, still normal body temperatures. The only odd thing this day is that I did wake up once overnight very sweaty. It was warm, but not that warm. Our windows were open.

I’ll close this entry for now. It’s probably too much of a post already. Next steps, more doctor consultation, but hopefully no more infection and fever in the near term. And hopefully, COVID-19 antibodies only from a vaccine.