I need to give you a little background before I get into my story about my side effects from taking erythromycin.
I was a pilot during the 1970s, and with over 1000 flying hours I never experienced a sinus problem. I was also not very sympathetic with those who did since it created more work for me as a flight scheduler. But that all changed in 1979, on a commercial flight from Denver to Corpus Christi, TX. As the airliner started its descent, my head felt like it was going to explode. I knew right away what it was and went through all the ear clearing procedures I had learned while flying for the USAF. They did relieve the immediate symptoms but over the next few days I started have distress in my upper canine teeth and the headaches started.
The doctor I took my sinus problem to prescribed erythromycin and after a full course of it my symptoms disappeared.
Over the next few years I infrequently experienced sinus problems but once I moved back to McCook, NE, my old home town, they have become more frequent; up to once or twice a year but a full regiment of erythromycin always took care of them.
This past April, 2015, four of us flew to Budapest and rode a river boat up stream then a bus over to Prague. The day before returning to the US, my canine teeth started aching and I had difficulty sleeping from all the coughing I was doing when in the prone position. I hacked all the way home aboard the aircraft and the change in pressure altitude just made things worse.
Once home I started my usual routine of 2 – 250 mg of erythromycin tables four times a day and I felt so bad I did two nasal rinses with my Waterpik each day. It was almost three weeks before I felt back to normal for me; about a week longer to recover than my usual 10 to 14 days.
I spent the summer at the family summer cottage in Grand Lake, CO at an elevation of 8269 feet as I do each summer. This summer was a little different in that I drove back to McCook (elevation 2510 feet) for my 50th high school reunion the last weekend in September. I had a good time with my old classmates and on the following Monday drove the 350 miles back to Grand Lake. I felt fine the entire drive.
That Monday night after going to bed I started coughing from the drainage coming from my sinuses. I got very little sleep but did my usual routine of coffee with the other old geezers at The Hub, then worked on one of my older out buildings in town. After spending most of the day applying red cedar shingles to the north side of the old building, my arms were so tired I quit a little early and downed a couple of iced teas at The Hub before driving back to the cottage. That night, I again spent most of my time coughing and did little sleeping.
Wednesday was almost a carbon copy of Tuesday and my level of energy was about the same. I was not getting more than four hours of sleep. Thursday started out just like Tuesday and Wednesday but by 1400 hours I had no energy to do more shingling. Some how I was able to get more sleep that night (slept in a more upright position) so I was able to do a full day’s work on Friday. I took Saturday off to run some errands and help a friend on his computer. I had very little energy but kept at it until late in the afternoon. On Sunday I had used up all my shingles by 1330 hours so I went to one of the sports bars to watch the Bronco’s win another game while downing a couple iced teas.
Monday morning arrived and it started out like it was the end of the day. I did make it The Hub for coffee but did not feel well enough to down even one cup. Finally, about 0900 hours I threw in the towel and drove Mia and myself to Granby to find a physician to give me a prescription of erythromycin. The local small hospital was not going to be able to get me in until Tuesday so I drove across the highway to a private physician’s office only to be turned away because I am on Medicare and they were not taking any Medicare patients because Medicare was too difficult with which to work. I even told them I would pay for the service in cash but they told me they could not do that either. If Medicare learned about it, they were in trouble.
It was back to the ER half of the hospital and I was immediately seen. After completing a couple of forms my vitals were taken and shortly the ER doctor on duty sat down with me and I explained what I needed. After a few questions he asked me what dosage I usually took. I told him 500 mg. Shortly after that I left the ER with my prescription and drove the 1/4 mile to City Market to get the solution to my sinus problem.
Once the pharmacist filled my order I went to their drinking fountain, took a sip of water, threw in two tablets and swallowed. I had always taken two initially on direction from my primary physician, my father. I then drove back to the cottage to wait for them to kick in and start my recovery. Only it did not happen.
Once home, I laid down on my bed to see if I could get some sleep. I did manage get a few minutes but awoke when I started having difficulty breathing. I was so tired I kept dozing off only to be awakened by my need for more oxygen. It reminded me of the time when I was scuba diving and got very low on air. Eventually, I called the ER and told them I was coming back in and was going to need some oxygen.
When I arrived back at the ER, they immediately took me to one of their examining rooms, started me on 3 liters of oxygen and took my vitals, then some blood. Once on the oxygen I started feeling much better. Shortly after that the doctor came in looking rather concerned. He told me I was in atrium fibrillation, had some high liver enzymes and my blood sugar was also high. In just a few minutes I was hooked to an IV and Mandy, my beautiful blond nurse, was explaining they were giving me something to try to lower my heart rate, which was in the 140 bpm range, to a more normal resting rate and to try to convert me back to a normal heart rhythm.
Once the first round of the medication was gone they put me on a second one. My heart rate was lower but Mandy pointed out to me that I had not converted. My initial heart rate was 145 with a blood oxygen of 92. I had six liver enzymes out of the normal range with a blood glucose of 281 and elevated WBC of 18.6 (probably due to the sinus infection).
The doctor came back and said they were not staffed to handle my heart problem and I would need to go to Denver. He also did not understand how I could have gone from normal vital signs at 1000 hours to the state I was presently in at 1400 hours. He tried to get me admitted to the VA hospital in Denver but they turned me away. He was able to get St. Anthony’s to accept me and ordered an EMS crew to drive me there. By this time my heart rate was down to 126 bpm.
Knowing that I had been in the ER for several hours and had not used the toilet and the ride was going to be about 1.5 hours, I asked to be able to go to the bathroom. Mandy handed me a portable plastic male urinal and told me to use it. My output was not much but what I did deposit was not dark yellow, as I had expected, but brown. I just shrugged it off and pulled my trousers back up and got ready for transport.
The ride to Denver was uneventful and before I knew it I was disrobed and in a different bed. I still had not converted so they continued the IV drip with medication. As usual, with all the in and out traffic I did not get much sleep. I must have dozed off at some point because I awoke and noticed that the IV was gone so I had to have finally converted. At some point they did take some more of my blood to see how I was doing. Eventually during the night, a tall blond female doctor visited me. Other than initially getting me confused with another patient she told me I was doing fine and ordered several tests for me in the morning.
Once it was light out, they took pictures of my beating heart, two x-rays of my chest and photos of my liver. At some time that morning a lady come in and told me I probably had type 2 diabetes and talked about what it was and some techniques to manage it. Shortly after that the lady doctor came in and said I was being discharged in the afternoon. I wanted to be out by 1500 hours so my lifetime friend, Roger could pick me up. She also handed me a small plastic bottle of pills, called them beta blockers, and told me to take one each day at the evening meal. I was out of there by 1400 hours and waiting for Roger to show up. He was right on time and we were gone by 1500 hours.
The next day Roger drove me back to Grand Lake where I closed the cottage and boathouse down for the winter, packed up my stuff, retrieved Mia and followed Roger back to Denver. The following day, Thursday, I drove the 265 miles back to McCook. On Friday, I called North Platte VA and set up an appointment with my primary care doctor for the following Friday.
I still had my sinus problem so I started taking the erythromycin, one pill every eight hours and with the help of nasal rinses I was able to start feeling better.
On Friday, October 16th I drove the 70 miles to the North Platte VA clinic for my blood letting and to talk to my primary physician. I explained to my doctor what had happened, gave him a copy of all the reports I was given by Granby ER and St. Anthony’s. He looked through the material, had it copied and asked a couple of questions. He also ordered a prescription for my beta blocker and suggested that I use the VA choice program to get a local doctor in McCook to deal with my heart problem.
When I returned from visiting the Denver VA (skin and eye checkups) the following week, a VA letter was waiting for me. My glucose had dropped to 79 so I was not a type 2 diabetic and 5 of the 6 liver enzymes had returned to their normal ranges. He ordered another follow up blood text in 30 days, Nov. 20th and I was told not to consume any alcohol until after that test. I now have those test results back and all of my liver enzymes are in the normal range.
The next week, while resting in bed waiting for the clock to finally get to 0420 hours, I got to thinking about the latest blood test results and Dr. Paulsen’s statement about not understanding how I could go from normal vitals to atrial fibrillation in such a short time.
Shortly after that a thought drifted through my mind. One that my father had been making for year, “The young doctors today do not take a good patient history. You have to look at more than just the medical tests.” So I decided to go back through that day, Monday October 5th, step by step. I ask myself what happened between my first visit to the ER and my second one? All that came to mind was that I had taken two of the erythromycin at City Market and tried to eat a PB &J once back at the cottage. I could not even force that 1/2 sandwich down. It was more than I could swallow. Once I started having trouble getting enough oxygen I had returned to the ER.
When I returned from my workout at the YMCA that morning I looked at the empty erythromycin bottle and noticed each tablet was 500 mg. Then I compared it to the one in my medicine cabinet and it contained 250 mg tablets. Ah, the light came on. I took my first cup of coffee to my online computer and started researching the side effects of erythromycin.
It turns out there are quite a few possible side effects but most are rather minor ones like skin rashes and itching. The list is rather long but when you looked toward the bottom of the lists I discovered some which fit my situation; rapid irregular heat rate, liver problems, dark yellow or brown urine, swallowing difficulty, and finally, difficult breathing. It certainly looked to me like I had over dosed by taking two 500 mg of the antibiotic at the onset.
At the end of the first week in November I took myself off the beta-blocker. About the only things that have changed since withdrawing that med ss that I am less lethargic and sleepy. I’ve given myself a clean bill of health from my self-inflected overdose of erythromycin. Ah, my becoming aware.