It's Never Lupus

So tonight I caught up on House! I actually took a much-needed break from reading. I can't believe that I missed two of its previous episodes! House is actually one of my favorite t.v. shows. I can't stand Grey's Anatomy. It's too artificial to me (too much drama and it's not as realistic). I like House because they have to figure out what the patient have. Tonight's episode of House was interesting to me. Especially when they mention her suffering from pain, fatigue, light sensitivity, and depression. I automatically told my roommate, "That sounds like Lupus." Because I have experienced the pain from walking, body aches (not being able to put on clothes, so I usually slept in my clothes from the night before), extreme fatigue (can't concentrate, became forgetful), light sensitivity (rashes came out), and depression (during that time I didn't know I had depression, but looking back now I realize that I was a completely different person). Watching Alice suffering made me remember all of the things that I went through. It was difficult getting a diagnosis. It took over a year and a half before I was diagnosis with having lupus (I was wrongly diagnosis many times before all hell broke loose). However, once again "it's never lupus," on House.

I absolute love the dialogue between House and Alice about pain. Because it is up to the patient to decide to fight the pain and continue to live his or her life or decide to let the pain win. I personally have chosen to not let the pain affect me too much because there is a lot out of life that I have yet to live or experience. Yes, somedays are harder for me than others, but I choose to think positively about it. To me, giving up is the cowards way out. It is easier to give up than to continue each day in extreme pain (hence my love of staying in bed since I can't get out of bed sometimes). I think of people that are least fortunate than me and it confirms my resolve that I can get through the day.

I can't wait for next week episode of House!

Here is what happens in tonight's episode:

In the study in her Gothic house, Alice, the famous writer of the Jack Cannon series of young adult detective fiction, puts the finishing touches on her latest novel, then locks it away in her safe. She makes a little small talk to a teenaged boy in the room with her, and then acknowledges that he’s no more than a figment of her imagination. She opens the drawer to her desk and pulls out a pistol and holds it to her mouth. Just as she is ready to fire the gun, she has a seizure. The guns goes off early, just grazing her cheek. Upon hearing the gunshot, her maid runs in and Alice is rushed to the hospital.

House takes it upon himself to examine Alice in the Emergency Room because he is a huge fan of her books. After he accuses her — correctly — of attempting suicide, she tries to leave the hospital, but House has her placed on a seventy-two hour psychiatric hold. He calls the team in to examine her and then monitor her for another seizure. They find her an extremely unpleasant patient to deal with. Meanwhile House and Cuddy head out for a date that is actually an evening of poking though Alice’s house for clues. They talk to her maid and learn that Alice has been having a great deal of back and hand pain recently. They also learn that she eats several cans of tuna fish every day. House is unable to open the safe to find her latest manuscript, but is able to take the typewriter ribbons from which he hopes to suss out the novel.

Back at the hospital, neither Foreman nor Taub have seen any seizure activity. House arrives and shows them that Alice is sweating profusely, but only on one side of her body. Given all her tuna consumption, the team suspects that she has mercury poisoning, but the initial tests all come back negative. Nevertheless, House wants to go ahead and start her on chelation therapy while obtaining the definitive tests, but has Cuddy go in since Alice has asked for a female doctor. A short time later, after Alice fires her maid and makes snide remarks to Cuddy, she tells them she wants the male doctors back. When Taub and Chase arrive to set up the chelation, she reads Chase like a book. When she is asked to what she thinks of Taub, she remarks that he reminds her of her ex-husband and suddenly develops a severe headache and dangerously elevated blood pressure. Chase thinks it is a reaction to the chelation medication until Taub point out he hasn’t started it yet.

Alice is having symptoms of pain, seizures, and hyperhidrosis, along with episodes of elevated blood pressure. Mercury poisoning has been ruled out. Hemolytic uremic syndrome is mentioned but quickly dismissed. House points out that both of her severe episodes (the seizure and the high blood pressure) occurred at times of stress. He wonders if it may be an issue of excess adrenalin. This suggests the diagnosis of a pheochromocytoma (an adrenalin secreting tumor). The team tries to get an MRI, but the magnet in the MRI machine rips out the surgical screws in her leg — metal screws she had apparently deliberately not told the team about — causing severe burns and tissue damage.

House decides to try a different approach. He goes to Alice and tells her that she’s been going about suicide the wrong way as gunshots are painful. He offers her access to a painless lethal drug if she’ll cooperate with the team. She agrees, and when he gives her the syringe to hold onto for later, she immediately injects it into her leg. Of course, it wasn’t a lethal drug, but instead a sedative. It allowed the team to obtain a PET scan, and also allowed House to extend her psychiatric hold for another 24 hours. The PET scan is negative. However an ultrasound obtained the next day shows a pericardial effusion (fluid build up in the sac around the heart). To the team this suggest something viral or cancer. House takes a different approach, he looks at the character of “Helen” in her novels — the characters that he believes to be an analogue of her. Helen suffers from pain, fatigue, light sensitivity, and depression. When combined with Alice’s symptoms, these strongly suggest a diagnosis of lupus. Tests are run, which apparently are negative as they are never mentioned again.

Later, after Cuddy complains of seatbelt-related neck pain from an evening of go cart racing, House wonders if Alice is suffering from thyroid damage from a seatbelt injury from a long ago car accident — the same one that injured her leg. She gets angry during their discussion and develops suddenly paralysis - which doesn’t fit with House’s hypothyroid hypothesis. Taub suggests that she may have a trauma-related syringomyelia. The symptoms fit, but she is refusing any further testing or treatment. Finally, with some help from her old medical records, House is able deduce what happened. She has a syringomyelia from the accident, but more importantly, her son was killed in the accident, and she blames herself for his death. House tells her that she is not at fault for her son’s death — he points out an aneurysm on his autopsy report that shows he was likely already dead at the time of the accident. Relieved of the burden, she agrees to begin treatment.

xoxo,
Kat