Mono -- More Than Just A Kissing Disease

By Laura Havice

Most teenagers know what Mono is—it’s the kissing disease, but what most teens and adults don’t know is how debilitating infectious mononucleosis can be. Mono can sideline your life for weeks or months and leave you feeling extreme fatigue beyond the initial symptoms have passed as well as other more serious complications. Mono can also strike long after your teen years have passed.

As a 28 year-old working adult, I was not expecting to get mono. I've always been a very active person, someone who enjoys packing two minutes of living into ever one minute of life. But in the late summer of 2005 I started to feel different, having fevers at night, sneezing, aching--all the symptoms of a cold that wouldn't go away. It wasn’t severe enough to make me worry; I just thought that traveling, working and school were catching up with me.

This lasted for approximately one month until the symptoms started getting extreme, a sore throat so raw that I could barely swallow water, splitting headaches that even migraine medicine couldn't touch and heavy fevers would soak the sheets at night. I had these symptoms for around two days and headed to the first doctor (on a weekend) for a visit. It was an urgent care office, and I felt I had strep throat again. The doctor advised it wasn't strep but probably a bad cold. She sent me home with a Z-pack for the cold.

By Monday the symptoms were worse and I could barely get out of bed. So I went to my regular physician and she thought that it had to be a severe cold and gave me a shot of steroids. No blood tests were done and no additional options were given. After two more days
I went back to the same doctor and begged for them to give me anything that would help. At this point they did a blood test that showed mono. They advised they couldn't give me anything. I was to just ride it out. The doctor also told me that mono takes six to eight weeks to incubate, which means I probably contracted it at a recent conference I had attended.

Infectious mononucleosis, (also known as the kissing disease, or Pfeiffer's disease, is more commonly known as glandular fever, is a disease seen most commonly in adolescents and young adults. Teens tend to show symptoms of fever, sore throat, muscle soreness, and fatigue but can also be present in small children with white patches on the tonsils or in the back of the throat. Mononucleosis is usually caused by the Epstein-Barr virus and is typically transmitted through blood or saliva ("the kissing disease"), or by sharing a drink, or sharing eating utensils. The disease is so-named because the count of mononuclear leukocytes (white blood cells with a one-lobed nucleus) rises significantly. Although not usually serious, the mono virus stays in your system for life.

I ended up being out of work for two months with the first two weeks being the absolute worst. Once diagnosed correctly, I was in bed for almost two weeks, switching between fevers and chills, so weak I couldn't take a shower and with extreme pain both in my head and body as well as my throat. I've never felt so much pain. It was blinding.

Eventually the symptoms subsided but I was left with a high level of weakness that lasted for months. I couldn't walk down steps without help. Taking a shower was impossible because I couldn't lift my arms that high due to the pain probably due to my swollen lymph glands. I also didn’t have the strength to stand that long. Instead, I would sleep for 18 hours a day and then get tired again simply walking to the bathroom. I had to drop out of school, (I was finishing my BFA degree with a few night classes) and take a medical leave of absence from work and depended on a boyfriend’s daily care just to do the basic things. He did not contract mono, and from what I’ve read about this disease, it’s not as contagious as most people think.

Typical Symptoms of Mono:
• Fever--this varies from mild to severe
• Enlarged and tender lymph nodes--particularly on both sides of the neck and under the arm pits
• Sore throat--White patches on the tonsils and back of the throat, perhaps strep throat that doesn’t get better with antibiotics
• Fatigue (sometimes extreme fatigue)

Other Symptoms of Mono Include:
• Swollen tonsils
• Headache
• Skin rash
• Loss of appetite
• Soft, swollen spleen
• Night Sweats
• Aching muscles
• Jaundice
• Depression
• Weakness
• Dizziness or disorientation
• Dry cough
• Enlarged Prostate/Inflamed genitals
• Puffy or swollen eyes (may occur in the early stages of infection)

Fever and fatigue are the hallmark initial symptoms of infectious mononucleosis and can last from one-two months. Many people exposed to the Epstein-Barr virus do not show symptoms of the disease, but carry the virus and can transmit it to others. Children present milder symptoms, which often goes undiagnosed. Due to the long (four to six week) incubation period, mono is difficult to control or track (epidemiological control). About 6% of people who have had infectious mononucleosis will relapse.

Mononucleosis can cause the rectum to swell, which in rare cases may lead to a leakage of feces. Other complications include hepatitis (inflammation of the liver) causing elevation of serum bilirubin (in approximately 40% of patients), jaundice (approximately 5% of cases), and anemia (a deficiency of red blood cells). In rare cases, death may result from severe hepatitis or splenic rupture.

One of the major concerns of mono is a splenomegaly (enlarged spleen) can occur from infectious mononucleosis, therefore contact sports should be discouraged for four to six weeks after diagnosis. The longer mono symptoms are experienced, the more the infection has weakened the person's immune system and the longer the recovery time will be.

In December, I was able to go back to work but I found that I was highly susceptible to any type of cold. I contracted every cold and flu bug I came in contact with. It was over a year before I began to feel somewhat like my old self. I ended up with weight gain and muscle loss from the lack of exercise, and two years later, this is something I’m currently addressing.

Treatment
Acetaminophen or other non-steroidal anti-inflammatory drugs (NSAIDs) may be used to reduce fever and pain. Aspirin is not recommended due to the risk of Reye's syndrome in children and young adults. Steroids are sometimes used to reduce swelling of the throat or lymph nodes.

Rest is recommended during the acute phase of the infection and contact sports should be avoided to reduce the risk of splenic rupture, for at least one month and can be determined by an ultrasound scan.

Laura Havice lives and writes in Jacksonville, Florida. Her stories have been appeared in many publications including The Osprey, Andwerve, Starry Night Review and Fiction Fix.

Medical facts were gathered from:
www.mayoclinic.com/health/mononucleosis
www.wikipedia.org/wiki/Infectious