Rheumatic Fever

When I was a fourteen year old high school freshman, I developed Rheumatic Fever. This resulted from a strep infection that I’d developed from infected blisters on my heels. These blisters came from my first new shiny pair of football cleats. These brand new football cleats weren’t properly fitted to my feet — so the resulting blisters occurred. The Rheumatic Fever began with a sore throat and shortly thereafter, turned into a fully symptomatic episode that lasted for nearly six weeks. I was bedridden during that time.

I felt horrified and frightened because my breathing was so restrained. It felt as if someone had tied a strap around my chest after I’d exhaled, then synched it down so I couldn’t take a full breath. All I could take were short — shallow breaths; this lasting for nearly a month. It was extremely taxing physically and I was never the same afterwards. What had once been an energy level in me that seemed to run circles around my teammates — like the energizer bunny — became a much more intense effort to attain the same level I’d so easily attained prior to encountering the Rheumatic Fever.

Rheumatic Fever is an inflammatory disease that occurs following a Group – A streptococcal infection, (such as strep throat or scarlet fever). Rheumatic Fever is believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain, the illness typically develops two to three weeks after a streptococcal infection. Acute rheumatic fever commonly appears in children between the ages of 5 and 17, with only 20% of first-time attacks occurring in adults. The illness is so named because of its similarity in presentation to rheumatism—medical problems affecting the joints and connective tissue.*

During the episode with this illness, my joints — starting in my legs and migrated upwards throughout the rest of my body—medically termed as Arthralgia. My ribs ached — most likely from the constrained breathing I experienced as my muscles reacted from the stress. I had a fever which drained my energy. As a young teenager in his first year of football, all I wanted to do was to be back out with my friends playing football. My skin also developed red bumps on various parts of my body.

In terms of the way the heart was affected by this disease; I fell in line to those adverse cardiac effects associated with Rheumatic Fever. A few short weeks after I’d returned to normal school and athletic activities, I had an episode of tachycardia—rapid heartbeat; that lasted from onset for nearly four hours. My heart was finally converted to a normal rhythm in the emergency room. Upon final evaluation after a series of tests had been completed, my cardiologist determined that I’d developed a heart condition known as Paroxysmal Supra Ventricular Tachycardia.

Tachycardia comes from the Greek words— tachys (rapid or accelerated) and kardia (of the heart). Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heartrate (heartrate in an inactive or sleeping individual). It can be dangerous depending on the speed and type of rhythm.*

About 30-50% of people who develop rheumatic fever will experience inflammation of the heart. It is therefore one of the most common, but also most serious, complications associated with rheumatic fever. Rheumatic Fever can cause thickening and scarring of the heart valves, making them narrower (stenosis) or causing them to leak. It can also affect the pumping power of the heart, limiting its ability to efficiently circulate blood around the body. This type of heart damage is known as rheumatic heart disease. If the damage is severe, surgery may be required to repair or replace the damaged valve, and prevent the disease from causing heart failure.*

Other severe forms include inflammation of the heart muscle which can manifest as congestive heart failure with shortness of breath, pericarditis — an inflammation of the pericardium (the fibrous sac surrounding the heart) with a characteristic chest pain most often present; or a new heart murmur.*

My heart condition would become permanent. I was placed on Dilantin — also called Phenytoin; it’s used to control certain types of seizures, and to treat and prevent seizures that may begin during or after surgery to the brain or nervous system. Phenytoin is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in the brain. It was given to me to control the recurring tachycardia bouts I’d encounter with these recurring episodes.

I was later treated with Propranolol — a non-selective beta blocker mainly used in the treatment of hypertension. This medication was discontinued as it made me hyperventilate and I had to have a paper bag close by to breathe into to alleviate my hyperventilating. As a result, I was placed back on the Dilantin until my episodes became manageable after time and my cardiologist took me off the medication. I had numerous episodes during my sophomore year which put a scare into my coaches and my parents.

I always had to conscientious of any sore throats in the future. I possessed an innate fear of a recurring bout of Rheumatic Fever. My doctor always told me to be extra cautious with my sore throats or any chest illnesses. After what I’d experienced as a first year football player chasing a childhood dream—I was always quick to tell my coach that it would be best to sit out if I was developing a sore throat.

Three years later as a high school senior, I developed chest congestion and suggested to my head coach that I sit out practice for a couple of days. He didn’t agree. Two days later I was home in bed with a fever and a sore throat and immediately placed on Penicillin to ward off any possible strep throat concerns. As a result, I missed that week’s game. My coach, in restrained humility, apologized for not listening to me. It wasn’t so much because I was sick and he felt remorse for insisting that I practice and “Suck it up!”— But moreover in the fact that my backup was very ineffective in the game as my replacement at nose-tackle on defense.  A game that we were heavily favored to win resulted in a tie because our pass rush was virtually non-existent. C’est la guerre!

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