Surfacing and Reflecting

Wednesday, November 1, 2023

This piece started to take shape towards the end of the summer. It is now the last day of October. I was just coming out of recovering from pneumonia, which I had contracted in Portugal though at the time I did not know what I had, and wanted to document for myself what had happened to me over the space of a few months over the spring and summer. Why? Because the experience had been so…so many things to me…debilitating, frightening, humbling, helpless. As I say in the opening sentence, I cannot remember a time that I had been so unwell.

I am now in the air en route from Lisbon to San Francisco, returning to Maui after a further month in Portugal. A good month, but a month that I was apprehensive about of what happened during the previous visit. Let me try and explain.

Short of loosing the tip of a finger before I was ten, and having an urgent operation just after I was born which I have no recollection of except for a scar on my stomach, this is most unwell that I can remember that I have been, and an experience that has left a mark on me. A mark as to my own vulnerability, and how one’s health can take a very sharp and sudden turn for the worse. I’d like to think that this experience has left me recalibrating priorities and what is important to me, but I don’t think that it is the case. What it has done though is show me how the body can slow down and loose its vitality quite quickly. As I have just past my 60th birthday, and while I hope that I have many more years left, I am left reflecting on how each day is a blessing and to be grateful for all that comes my way, however small.

Starting at the beginning

This all started towards the end of May, I am going to bookmark the day as May 20th. My wife and I were in Portugal. We have a house there in a small town about fifty minutes south of Lisbon. We had been there for a month working on the house. We were looking forward to moving from work mode to fun mode. To that end, we had just been joined by my step-daughter and her family.

Seasonal allergies were bugging me, and although they can be a very unpleasant, I was coping (sort of!). We had all travelled led to a hotel towards the eastern boarder of the country. There was something in the air. Dust from the Sahara maybe? One could feel it and a very red sunset one evening confirmed my felt sense. This was all aggravating a sense of feeling unwell.

The night before we had been to a local restaurant which turned out to be a stretch for bellies informed as they were by a US diet. We left quickly having not eaten that much - though me, being my ’noble’ self and not wanting to be seen to be dismissing the work of the restaurant staff, ate as much as I could.

Early the next morning, after an uncomfortable night, I threw up. I put that and subsequent experiences through the day, down to food poisoning. Though reflecting now on how I felt the previous night - seasonal allergies, mixed with whatever was in the air - I just felt yuk, and I wondered if I was going down with something else?

The drive back to our Portugal house was very uncomfortable. My body was aching all over and I just yearned to stop and flop into bed. As soon as we were back home and the car was unpacked, I did just that and did not surface for the rest of the day.

I expected this to last for a few days, for me to get better and then to meet up with family and continue to enjoy our time together. But whatever I had either ended and morphed into something else, and maybe something else again, or was just with me for a very long time.

Development

The symptoms appeared to change and vary. For example the vomiting which was present at the beginning, maybe for a week, disappeared. Sitting here now, I remember a potpourri of symptoms, but what is less clear to me is what happened around them. Some days felt better than others, I could do more, or make myself do so. Other days, I simply cancelled all plans.

My energy varied, sometimes very little, other times it seemed that I could do more, though invariably it also felt as though I was pushing against something just to function.

I was waking up in the middle of the night drenched in sweat, more often than not more than once. At times during the day sweating became my experience as I tried to function in the world.

My appetite dropped right off. I ate less, sometimes nothing, and played with any food that was put in front of me, slowly nibbling away at it. And then a day would appear when I ate well. On my return home I found that I had lost 15lbs (6.8kg).

Nothing was clear, apart from an underlying feeling of something definitely not being right.

Treatment?

So one question that might come to mind is why did I not seek treatment?

Our house in Portugal is in a small, very local town, only fifty minutes drive from Lisbon - sadly the train service has been discontinued. The localness of the town and its proximity to Lisbon were two the things that attracted us to the town. That and the coast only being twenty minutes away.

Two well stocked pharmacies in town provide us with prescription and non-prescription drugs. Accessing what we needed in that department was not a problem. The problem was getting that diagnosis and a corresponding prescription.

There is a small health center in the town which offers basic medical facilities. We made two, or was it three visits there? One visit was for my wife who was diagnosed with bronchitis. Another visit saw us both being treated, myself for a fever which they managed to bring down. However, as I said the facilities were basic, this was no hospital, and language was a problem. There were staff members who spoke some English, but we also had to rely on our translation apps.

We soon realized that we did not know how to access the health care that a hospital could provide. We were unsure of where to go in Lisbon, which hospital, and what to do once we got there? With the help of a friend we managed one visit to a Lisbon hospital, but that was to the A&E department to treat my wife. I was having a good day and with the way the system worked, we would have had to wait longer than either of us could manage. I, who was doing most of the driving, became too sick to face the drive and figuring all of this out. This oversight, ”you don’t get sick while you are abroad, right?”, we rectified and were better prepared for on this current visit. One lesson learnt the hard way.

Towards heading home

By the end of our two months in Portugal, I was not doing much. We were not going far. Evenings were spent at home watching HBO or Netflix. The experience, though there was little that I could do, was becoming a strain on our relationship. We had not come all of this way to sit in a house each and every day.

As my energy diminished, I was beginning to wonder how I would get home - really. The energy needed to pack, lift suitcases, navigate busy, chaotic airports, I just did not see how I could do it? Walking around town was an effort that I rarely made. I even caught myself wondering if this was where it was all going to end? That was a visceral feeling that still sits with me.

I had decided against going to England to visit my mother. I wanted, needed to get home and see a doctor. Thankfully, through phone calls made over a few days, I was able to get myself onto the same flights as my wife. But I still did not know how I was physically going to manage the travel?

I then heard of a doctor from Lisbon who holds a clinic in our town a couple of times a week. One such visit was about three days before we left. All I wanted, if that ”all” was not too great an ask, was something to give me a little boost in order to get home.

I got in to see the doctor early in the morning. Thankfully he spoke English and asked me to describe my symptoms. He gave me a very simple exam, and somehow from that diagnosed that I had a stomach infection. He put me on antibiotics which I started taking straight away. Whether I had a stomach infection or not, I don’t know, but those drugs gave me just enough energy to manage the journey home. It still wasn’t an easy trip. I slept a lot, had to get a separate hotel room to my wife at one stage as I was coughing so much, but was only too happy when we landed back in Maui.

Diagnosis and Recovery

A day after returning I was seeing a doctor and getting a whole raft of tests - blood, chest X-Ray, CT scan. I was diagnosed with Community Spread Pneumonia. I was taken off the antibiotics that I was given in Portugal and put on two new ones. I was told that the recovery would take time, upwards of two months.

Now, as I said at the beginning, I had not been this unwell before. I was use to taking antibiotics and starting to feel better within a couple of days. Two weeks later and both antibiotics completed, I was feeling no better - weak, coughing, my heart racing. I took myself back to the hospital and went through the same lot of tests, eventually being sent home told that I just needed to rest and to get another chest x-ray in a couple months.

So that is what I did. I went home, rested, started acupuncture treatment to help boost my recovery, and started very basic exercise…just walking up the road a little way, going far was not an option. It was humbling to feel how my restricted lung capacity withheld my ability to be able to walk far, lift much, or simply do anything requiring anything beyond a modicum of exertion.

With time, with rest, with exercise, I slowly started to feel better. I eventually got a follow up chest x-ray which showed a clearing of my lungs.

Returning to Portugal

With our next trip approaching, I was anxious about returning to Portugal. I was looking forward to seeing our house again and reviewing work done on it since we were last there. Of seeing the small town that it is in, the people who we had met there. At the same time I was fearful. Was this a form of PTSD? Portugal was where I got pneumonia. Would I get it again? I told myself that I had to go otherwise this fear would sit in me. It’s like taking a tumble. Pick yourself up and get back on your bicycle, horse, surfboard. If you really want it, get back up and do it again otherwise the tumble is all that will remain with you. Fear will become your commanding emotion. Anyway, this time we were much better prepared than last, though I return home understanding that some fine tuning is still called for.

So we sit through the first leg of the journey back to Maui. I look back on the last month with happy memories. This was a good visit, enjoyable, and I very much look forward to the next one. I wrote the following a couple of days after our arrival in Portugal,

We have been here for a couple of days now. We are settling back in, getting back into the rhythm of life here. The weather is very hot, too hot, and we are blessed with a lovely little house. I can feel voices in my head reminding me of earlier this year, and when something happens - I can’t sleep, I sneeze, I just feel a little off kilter - I checkin with myself to see if I am unwell, or if it just one of life’s small ups and downs.

A heatwave morphed into autumnal weather. We started off sitting on a beach, and ended up sitting around our wood burning stove in the evening. The seasonal change caused some coughs, but we were both fine.

It still feels hard for me to believe how unwell I became, and how quickly it happened. I am looking forward to a further follow up with the doctor once I am back, but consider myself very much out of the woods…for now.