PITA PITN Update

Sometimes, trying to find information on the Internet leads one into a mind-boggling jumble of and an overwhelming feeling of WTF?!!...

Meet my new, little friend, Zyvox. Linezolid, aka Zyvox, is a relatively new drug made by Pfizer (well, really, I think I read somewhere in my 'net travels that it's made by Pharmacia & Upjohn... but that's owned by Pfizer). This pill is what has recently replaced Vancomycin for me. You see, over the past few weeks, each dose I took of vanco made me feel increasingly more ill. The next dose would pick up where the last dose left off, and I wouldn't know if the sick-feeling jump would be a baby step or big leap... that is, sometimes I would feel just as sick as the previous dose, other times, it'd be like a punch in the face. I spent quite of bit of time laying on the sofa, and I'm sorry to admit, bawling. That shit really started doing a number on me. I had to take vanco twice each day, and there were some moments when the dose was due, that I'd sit there at our dining room table staring at the little end of the tubing that I had to screw into my PICC line to start the vanco... I'm proud to say that I did not ever skip a dose, but there were moments where I felt like I would rather go through labor and delivery again than screw that tubing into my PICC line. I think it would have been easier to have someone else do it, but that's not how it works. Then when I think about cancer patients, and others, who have chemo treatments over and over, knowing what it will do to them, how sick they'll get, I would feel foolish over my little vanco pity party. *sigh*

I had appointments with both my doctors this past Thursday afternoon. First I saw Dr. Abter, the Infectious Diseases specialist. Dr. Abter is from India or Pakistan or somewhere like that, and he has a strong accent. He's very tall and has a very dignified bearing, yet when I talk with him, I feel strongly that he cares about me and curing me. As soon as I started to tell him about the progressive sick feeling with each dose of vanco, he interrupted me and asked how good was my medical insurance. Long story short, the remaining 12 days or so of vanco that I had to take would continue to make me ill, likely very ill. I don't think I could handle vanco another 12 days. Dr. Abter told me to stop the vanco, and he prescribed Zyvox, an antibiotic to finish the job the vanco started, and I take 2 pills each day, 12 hours apart. There were a great many phone calls about my prescription for this... turns out, it is a very expensive drug. I have good insurance, and my share of the cost of 28 pills was $388.38. I believe my insurance paid about $2,000. For 28 pills. Oy.

I still have my PICC line because I still must take my evening dose of Invanse via IV. Officially, my last day of taking these drugs is April 8th. If all goes well (blood test results), I will be able to get the PICC line removed around April 15th.

I took my first Zyvox pill Thursday evening. I had read the information provided by Wal-Greens with the prescription Thursday evening. Unfortunately, Kevin and I read that after we had our dinner, which included aged cheese. I also took the pill and did the dose of Invanse at the same time... I'm not sure if it was just the cheese or also the timing with the Invanse or something else I ate that day, but Thursday evening, I was really sick. And worried that I had just spent almost four hundred bucks on 28 pills that I wasn't going to be able to handle. Not a fun night.

This morning I took my 4th Zyvox. Within a short time I began to feel ill. So I decided to follow Kevin's advice, given several times yesterday, and look it up on the World Wide Web. I immediately learned that with Zyvox, one should avoid eating foods containing tyramine. Thus began my gallimaufry of Internet research today.

I learned that eating foods with tyramine while taking Zyvox can increase one's blood pressure to dangerous levels. It's not only the tyramine, but one should avoid those foods and beverages that naturally increase blood pressure, like coffee and Mt. Dew. Since I have hypertension, and I've been taking medication for it for a few years, I am, of course, concerned about how Zyvox and my food and beverage intake can affect my blood pressure.

I discovered that tyramine is a natural substance formed from the breakdown of protein as food ages. The chemical tyramine appears naturally in a variety of foods, especially those that are aged and those containing a large amount of yeast.

I found many sites listing foods and food types to avoid (one site even contained rancid meat in the list of foods not to eat... !). I did find helpful information on various sites, but the info I found was like this:

Foods that are riper or have been longer standing tend to have higher tyramine content than fresh or freshly-prepared foods. Thus a piece of fruit that is fresh and firm may be well tolerated, but a ripe or especially over-ripe piece of the same food may provoke a serious reaction. Furthermore, bacterial action on protein sources such as meat and soy products can cause an increase in the food's tyramine levels. In summary, the caution regarding foods high in tyramine is that firm and fresh is more likely to be safe than over-ripe or over-exposed to potential bacterial overgrowth.

or this:

Avoid eating or drinking large amounts of foods and beverages containing tyramine while taking linezolid. These foods and beverages include alcoholic beverages, especially beer, Chianti, and other red wines; alcohol-free beer; cheeses (especially strong, aged, or processed varieties); sauerkraut; yogurt; raisins; bananas; sour cream; pickled herring; liver (especially chicken liver); dry sausage (including hard salami and pepperoni); canned figs; avocados; soy sauce; turkey; yeast extracts; papaya products (including certain meat tenderizers); fava beans; and broad bean pods.

Good to know... but... please, just give me a damn list of foods not to eat when taking Zyvox, Internet!

Then I found this site. Sometimes when you talk to the Internet, it hears you.

So... this morning Kevin and I together drank almost 2 pots of coffee, and then we each had a nice, big bowl of Raisin Bran Crunch. Also sitting on the end table near my recliner are a couple of left-over Valentine's Day heart-shaped Lindor chocolate truffles, and I ate one of those with my last cup of coffee.

Then I took my morning pill of Zyvox. Not too long after, I began to feel unwell. I went to the "TeleHealth" machine that is provided by the home nursing company which is used to send my vitals each morning to them, and I checked my BP... 158/97. Yes, indeed, I felt like crap. Today I will prepare a list of foods I like and have in my fridge, freezer & pantry that I can eat.

My appointment with Dr. Adams, the neurosurgeon, went very well, also. I can discontinue use of the collar... not only can, but should. I can drive my car. I can work from home as much as I am able. I can now lift up to 10 pounds. Still many things I cannot do and must be careful about, but things look good. No signs of fluid pockets. The incision is looking ok, a couple of places to watch, but so far so good. Here is a link to today's photo of my incision for those interested. It's healing well, and my hair is really growing back.

I am still home-bound for the duration of the antibiotics, and basically until the PICC line is out. Dr. Adams wants me to limit my ventures out into the general public until my next appointment with him, which is May 5th. I'll have blood tests and x-rays on that day, and then he said he would discuss with me my return to work date. I told him I thought I could perhaps begin going into the office once my PICC line was out, but he won't approve it. After all this, and after all the stories I've been reading this morning on the 'net about fighting infections, I'm following his advice To The Letter. These antibiotics are pretty major, and I'm going to do everything I can to not cause a relapse. I want my life back.

Oh, by the way, I finally did discover the exact infection I got; it's staphylococcus epidermidis. Again, mind-boggling 'net research, but I did find this web page on the CDC web site that I found interesting and almost understandable.

It's so crazy that when I went in for surgery on January 18th, I thought I'd be back at work in the office at the latest by March 1st. Here it is almost April. This has been definitely one of life's curve balls for me. But I also realize how lucky I've been.

So now my hopes are pinned on May 5th. Celebratory plans are already being made. Not to jinx it or anything, but my sister, Kathy, told Kev when it's all over, we're taking a night out and living it up. Doubt we'll paint the town red, but definitely I'm going to be eating some cheese and drinking some alcohol!!!