Earlier in the week, I described this COVID infection as having intense neurologic symptoms. Every round of this virus opens its own unique Pandora's box of horrors, some last only through the acute phase, but others remain permanently. Whenever an infection starts, I fear what it will bring. I had to have a hard conversation about what COVID and bartonella can do to the mind with my therapist today. I've experienced issues with bartonella and PANS (from VZV, but also other infections) in the past. COVID has triggered emotional volatility before, but nothing like the surreality of this infection.
At onset, insomnia, vivid dreams, word finding issues, worsened POTS, and even confusion about reality began. I insisted during a conversation that rhyming names were the same word, and though funny, my inability to tell the difference was foreshadowing. As the infection progressed, I developed intense headaches and altered taste. I felt like i was floating and dissociated, as though my experience was not quite real. My emotions, especially anger, have been exagerated. I seem to be able to write well and speak passably, but then logic fails me to more emotional decision making. I scramble the order of recent events. I have difficulty sensing how long ago something occurred and also have been moving slowly, losing time. My personality and mood quickly shifts, I think paranoid things like my parents intentionally tried to infect me, and I've acted impulsively. I've thought, said, and done things that were totally out of character this week. My therapist and I talked about the most extreme effects COVID can have on the mind, such as COVID psychosis which she had seen. We both agreed that I need to stay on Paxlovid, that this is the virus or other infection, and not the drug. Rifampin's effects on liver enzymes prevented Paxlovid from being at therapeutic levels. We still don't know if Pax concentration is where it needs to be yet. It could take 2 weeks for rifampin's effects to wear off. Meanwhile bartonella is rebounding without the rifampin. Sweats have begun and petechiae have appeared on my legs. In the past, bartonella has triggered invasive thoughts, "spiritual" experiences, and general proclivity to say too much of things i would never mean or say at a normal time. There's probably a specific term for that, but I end up apologizing or losing friends over stuff I've said during a bartonella brain episode. It's somewhat comparable to being impaired on anesthesia or loopy on antihistamines.
Immuneglobulin yesterday brought some relief. I don't know how long it will last because the fatigue and headache are returning. My therapist was glad I was seemingly turning a corner after the IG. I have 4 more doses of Pax in this box, and will do at least one more box. The first box almost didn't count due to the wash out effect from rifampin, effectively making my treatment delayed over a week past onset. This infection has been a nightmare, literally in my mind and physically. The exposure was so unnecessary, and I still need to have tough conversations with my parents once my brain works and emotions stabilize. Right now they are avoiding me because they are ironically afraid of catching the COVID they likely gave to me. I am doing everything I can to treat the virus right now, but the rifampin had me at a disadvantage from the start. I hope this wasn't too rambling or scrambled- it was the best I could manage under the circumstances.