Doctor, why am I still feeling sick? Do I still have the infection? Do I need stronger antibiotics?
When any one of us gets sick, we want to get better as soon as possible. Where infections are concerned, in the first one to two days of recovery, we have a notable increase in energy and overall well being. In the subsequent days however, the remainder of the recovery can be more protracted. It can be very frustrating having to wait to get back to normal levels of strength, activity, appetite, etc.
Sometimes, patients who I am treating in the hospital will start feeling a little exasperated when they still feel lousy after 4 days of antibiotics. Especially male patients, particularly those who were up and about working until just before coming down with their infection.
So why is it that someone will continue to feel unwell for days after being on the appropriate antibiotic therapy?
The simple reason is that it takes a lot of energy for the body to fight an infection. The more serious the infection, the more energy required to fight it. Yes, antibiotics are given to kill bacteria, however the body also goes to work producing its own natural antibiotics to assist in fighting the infection. Cytokines and other chemicals are produced to help flush away remnants of dead bacteria (or other causative germs) and other toxins produced in the process of the infection.
Because the body is allocating extra resources to fighting off the infection, less are available for vital organs such as the brain (resulting in lack of concentration, drowsiness), the digestive system (loss of appetite), the muscles (soreness and weakness), for example.
The more serious an infection, the more prolonged is the course of the illness. So pneumonia involving a large area of one lung, or both lungs, will cause a longer recovery. If along with the pneumonia, an abscess formed within the lung tisssue, the recovery is further prolonged.
Infections complicated by bacteria leaking into the blood stream, are among the worst when it comes to speed of recovery. These infections are extremely draining. Most infections can be complicated by bacteria getting into the blood stream. Common examples include pneumonia, kidney infection (called pyelonephritis), bowel infections such as diverticulitis, and joint infections.
Factors that influence speed of recovery from an infection
There are many factors which influence an individual’s speed of recovery from a serious infection. Some of these include:
1. Age – younger people are generally stronger and better able to fight off infections. Older persons, tend to have more medical problems and are on more medications. These things may have a negative effect overall on the immune system and the ability to make a full recovery.
2. Activity level before infection – active people tend to bounce back quickly after an infection. A person who was sedentary, or even bed bound prior to the onset of an infection, tends to have a more protracted recovery.
3. Duration of infection before treatment was started – some people, especially men, wait until they are practically ‘dying’ before they seek medical attention. By then, the infection has gotten so extensive that it takes much more time (and energy from the body) to eradicate it.
4. Association with an abscess – infections such as pneumonia, or pyelonephritis (kidney infection) may be complicated by the formation of an abscess. A pocket of pus in the body tends to cause a stronger inflammatory response in the body, and therefore more prolonged fever. With that comes persisting fatigue and body aches, etc.
5. Association with infection in the blood stream – as mentioned earlier, the presence of bacteria or other germs in the blood is extremely taxing on the body, resulting in a much more prolonged recovery.
6. Strength of the immune system – if a person’s immune system is weak, be it from medications, underlying medical conditions such as cancer, kidney failure, poorly controlled diabetes, there is less efficiency in fighting infections, thus prolonging recovery.
7. Presence of other diseases – the more medical conditions a person has, the more rundown their body may be, frankly speaking. A rundown body is not able to efficiently fight and recover from infections.
8. Positive mental attitude – anecdotally, I have noticed that the more positive patients do better overall with recovery from infections and disease in general. The droopy, moping patients take forever to get better.
9. Moral support from family/friends – again, anecdotally, I have found that patients with great support from loved ones tend to get better a little quicker. Of course many of the other factors noted above could be at play, diminishing this effect, but I find that when ill people have loved ones around cheering them on, offering encouragement, they have a feeling that there is a reason to keep living.
In medicine we are not always able to cure every disease. Sometimes people succumb to their infection no matter what we do. Sometimes, we are unable to make a definitive diagnosis and tell the patient what is the cause of their infection, or if they even have one at all. As always, I encourage everyone, to focus on prevention of disease as much as possible, rather than cure.
Have you been disappointed at how long it has taken you to overcome an infection? Did this make you doubtful that the doctor got got the diagnosis right? Please comment below!