Posted 3/19/2019 10:56 AM (GMT -6)
So I have been treating for bart and babs for about 8 months now. I started with biaxin then added rifampin then added malarone and artemisinin. Then I replaced rifampin with Rifabutin around the 4 month mark after I made some progress with rifampin and herxed really bad (fever, high HR, low-ish blood pressure, nausea, feeling terrible) initially on rifabutin (around November) sending me to the ER and admitted to the hospital overnight on IV fluids on sepsis watch. Then I slowly recovered and didn't really experience any significant herxes for awhile to the point where I had about 80-85% functionality on my good days and my doctor took me off of malarone and artemisinin as she thinks we addressed Babesia symptoms (air hunger) and continued with rifabutin with the plan to increase my dosage from 300mg a day to 600mg a day if I continued to not herx too much. All this until yesterday night. I woke up in the middle of the night/morning (330a) after a particularly good day and woke up with severe chills, fever (102-103 degrees), high HR (130-140 bpm while lying down), and feeling terrible all around with bodyaches, some nausea, and palpitations. At the ER I was given IV fluids, they ran their usual battery of tests and everything checked back normal as usual except for mild liver inflammation which wasn't a surprise (last couple safety labs showed that and would fluctuate). Felt better by the afternoon and nothing else checked back so they discharged me. Felt not too great the rest of the day and kind of confused. I woke up this morning feeling good again...
I am confused because I would expect that as I continue to get better and better, shouldn't my herxes be less severe? I'm just a little concerned that I had an episode that bad this late in treatment after making so much progress? What should I make of this latest trip? Anyone have any thoughts?
Here are some of my guesses:
1. It was indeed a herx perhaps from going off malarone/artemesia and thus, increasing rifabutin effectiveness.
2. It was not a herx but an acute infection or cold. (I felt slightly congested in my sinuses and a little sickly throat after getting discharged for the rest of the day although I'm fine this morning)
3. Another underlying cause that hasn't been found? Found that my lymphocyte count was low in my CBC (usually it's normal)...is that indicative of anything?
4. I am starting to relapse because I am off the malarone/artemesia?
Any comments/opinions/suggestions appreciated.