pentamidine

Pentamidine  is an old drug used for the treatment of Pneumocystis, a form of pneumonia.  Pneumocystis (PCP) is an "opportunistic infection" that I first learned about during the early AIDs epidemic.  PCP was in those days (and still is) a leading cause of death with AIDs.  According to Wikipedia, it is a yeast-like fungus.  Opportunistic infections are bugs that many normal people are infected with but do not get the disease because the bug is kept in check by the immune system;  they wait for the chance to take over if the immune system gets weak.  

Here at Mayo they treat PCP prophylactically post-op to keep the PCP population down.  Typically they treat with an antibiotic Bactrim which is given as a pill.  I developed an allergy to Bactrim, so I was given the pentamidine as an inhalent.   A small fume-hood was wheeled to my bedside and I sat for about 45 minutes with my head under the hood deeply breathing in the fumes.   This treatment will be repeated in a few months.

In May 1983 at the age of 26 Meg and I left Berkeley so that I could die among family and friends in my home town of Montclair New Jersey.  She had postponed our wedding which was to have been on May 9th.  I had the extreme ascites (fluid in the abdomen) of "end-stage" liver disease.   I could not wear any of my pants, so on the way to the airport we stopped on College Avenue and bought the largest pair of overalls they had in the store.   In New Jersey, I went directly into Mountainside Hospital in Montclair.  Mountainside was where I was born and where my Dad (who died in 1980) practiced medicine back in the day when the doctor who saw you in the office made rounds on you in the hospital.   It was there that Richard Flyer suggested I go to Pittsburgh to get evaluated for a liver transplant.   Richard's parents had been close friends of my parents, and Richard had been inspired by my Dad to become a pediatrician.  He had a patient who had undergone a successful liver transplant in Pittsburgh. So from Mountainside I went to Presbyterian Hospital in Pittsburgh in early June of 1983.  

 I did not leave the hospital in Pittsburgh until new year's eve.  Some time in early spring of 1984 I took my first trip out of (the city of) Pittsburgh to my Mom's house in New Jersey.  (Meg went back to her parents in Westport, CT for much needed R&R.)   On the afternoon of my flight to NJ,  I was lounging on a lawn chair in the backyard of my youth, taking in the early spring day and listening to 

Comfortably Numb (Pink Floyd) on a hand-held tape player (do you remember the Walk Man?) .  This song reminded me of one of my lowest points in the hospital in Pittsburgh, when a raging CMV infection was frying my brain with  fever of 105 and above.  My hands had puffed up from fluid retention and looked like two balloons.  Listening to that song that afternoon in NJ was a bit too much for me.  I turned if off and went inside.  I felt a bit warm.  I went up to my room and (to be safe) took my temp-- 103!  I made a call to Pittsburgh who told me to take a plane back that very same day.  (My mom held up well and drove me to the airport.)  Meg met me in the ER.  In the Pittsburgh ER they knew me and they knew my history.  Reasoning that nothing ever happens on the weekend, the ER doc sent me back to my local apartment on Tylenol with instructions to watch my temp and return on monday.  He did not do a blood gas.  Meg and I went back to the apartment.  A few hours later I was having trouble breathing.  Meg looked very worried (bad sign!) and said I had to go back to the ER now!   Back in the ER, they did a blood gas.   I was admitted on IV Bactrim.  I dodged intubation  and a trip to the ICU by a matter of an hour our so.