What you need to know about the GI bug (and other stories)

11.16.2019

Today, I feel like crap.  No pun intended – but I think I’m getting the GI bug.

You know, the GI bug??  Otherwise known as hell on Earth?  Where I am known to descend every few years due to no fault of my own?  Last time I had this bitch, I puked up my grilled cheese and slept for 24 hours.  The time before that, I was in fellowship, and woke up thinking I was on that show “I didn’t know I was pregnant,” because I was apparently in labor – that’s how bad the cramps were.  What’s more, not only do you feel like absolute garbage when you’ve got this, you instantly become a pariah to everyone around you, even your loved ones.  I had a friend whose wife, upon finding him with his arms wrapped around the porcelain god, handed him a bottle of Lysol, backed out of the bathroom, slamming the door, and bathed herself in Purell.  And that’s fairly typical.

It all started early this morning, when I was standing there doing a procedure, when I distinctly felt that there was a cat inside my intestines, and it was trying to claw its way out.  And it didn’t get better throughout the day; in fact it got worse, because I was feeling so nauseous and hungry at the same time, that I couldn’t think of a thing to eat for lunch, and ate salad.  Let me tell you, salad is not your best choice if you’ve got angry intestines.  No, it is NOT.

So, I’m standing there thinking, Wow, this is unpleasant, perhaps I am newly afflicted with the bug of GI.  And what would you think my first thoughts are?  Don’t think too hard, I’ll tell you: oh motherf*cker, I have a full day today, and 29 patients scheduled for tomorrow!  Am I going to have to see patients between trips to the bathroom?  I can’t possibly re-schedule a veritable stampede of patients, or I might get a “reputation…”  But then again… Do I want to be responsible for spreading this plague around?  Shouldn’t I be a conscientious physician and human, and contain the contagion?

How sad is that!  I belong to this massive physician mom facebook group that has over 70,000 women on it.  One post asked “What things have we done that we would recommend against?”  The number of ridiculous answers was over a thousand.  And by “ridiculous” I mean staggering in its confirmation of the pervasive culture of “don’t show weakness” in medicine.  Like, a mild example is, “I don’t drink water and don’t pee for upto 12 hours bc I’m too busy running around (yours truly)”.  Or “I had pre-eclampsia, and was supposed to be on bedrest, but I didn’t want to burden my coworkers with extra call, so I just kept working.”  Or “I knew I had appendicitis b/c I was puking and had severe pain, but I couldn’t abandon my shift, so I finished it and then was in the OR in 2 hours, where they removed a hot ruptured appendix.  And I was back to work next week.”  Or “I was having a miscarriage, but I had to round, so I just kept going through the cramps and the grief.”  Or “I broke a hip, but I had surgery in morning, so I just stood on one leg and did it…”   Don’t show weakness, don’t make mistake, don’t show human side, don’t get sick, don’t eat don’t pee don’t sleep…

My little GI bug stands no chance next to appendicitis, broken hips, and pre-eclampsia when it comes to validity of excuses to call in sick.  Ironic, because I’m a gastroenterologist, and I know better.  I keep asking this question and I have not yet gotten any answer:  When will the paradigm shift??

But, since I am a gastroenterologist, I’m just going to drop some knowledge about the GI bug here, for you all to peruse at your leisure.

bathroom sign

The GI bug symptoms

Diarrhea and vomiting, mostly.  Obviously.  It’s the “GI” bug.  Also, you feel like you’ve gotten beat up.  It’s pretty simple.  Oh – but red flag!  If your symptoms are prolonged, you have high fevers, or if your diarrhea isn’t nice and watery, but bloody or pussy (baaahahaha.  They teach you in medical school never to write “pussy” on the chart.  The proper word for “of pus”  is “purulent.”), I mean filled with pus or mucus – you don’t have the GI bug.  You’ve got something much nastier.

The GI bug deets

It’s most common in the winter months, and it spreads like wildfire among close communities, like barracks or cruise ships.  Or dorms.  Or homes.  It has an incubation period of anywhere from 24 to 60 hours and infection duration of anywhere from 12 to 60 hours.  What I’m saying is, it’s finite.

The GI bug causes

Usually, it’s viral.  Norovirus and Rotavirus are the most common.

The GI bug diagnostic tests

There aren’t any.  It’s a virus that lasts 12 hours.  By the time any expensive and complicated test comes back you’ll be all better and dancing around.  Diagnosis is made based on your symptoms and the history you give.

The GI bug treatment

There isn’t any.  Any that will make it go away any faster, that is.  Treatment is supportive, meaning bowel rest, fluids (IV if necessary.  A healthy strong person can hack it, but in a child or an old person, it can lead to dehydration and other issues), and maybe anti-nausea drugs.  Wouldn’t recommend anti-diarrheals, bc those halt motility, but the secretory nature of the illness will persist–your intestines are going to keep making the diarrhea–and the stuff will have nowhere to go.  Highly unpleasant, I think.

The GI bug prevention

I have two words for you.  Hand.  Washing.  Three words if you want to get fancy: Hand. washing. lysol.  This bug is contagious AF, and spreads, as I said before, like wildfire.  If someone in your household gets it, hate to say it, you’ll probably get it also.  And for goodness sake, be a responsible human and stay HOME!

how-to-handwash

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