33. IF YOU SUFFER AN ALLERGIC REACTION

(It is a complete incompatibility between your body and the drug)

If you are allergic to quinolones, as soon as you take a few pills or even one single dose, your body reacts negatively according to the patterns of a so called anaphylactic shock and is not covered by this article, you will need emergency treatment and to stop the drug immediately.

34. EXPECTED EVOLUTION FOR A SEVERE REACTION

This report deals especially with SEVERE reactions, so it is of little use for less serious intoxications, and could increase your worries and anxiety because many people tend to harbor too negative of thoughts when they are suffering reactions so strange as those that quinolones cause. Let us say that if you are looking for some information, if you do not know the severity of your intoxication, and do not know what to expect in terms of evolution, this section of the report could lead you to wrongly believe that you are facing an extremely bleak future.

For everyone with a body weight around 160 lb or less there is an extremely high risk of experiencing a SEVERE reaction for doses of fluoroquinolones of 1,500 mg of ciprofloxacion (or its equivalent potency of other quinolones) per day for 7 or more days or 1,000 mg daily for 2 months.

Severe reactions are very distinctive because they are extremely long lasting and feature many permanent injuries, especially in the 5 following groups:

neuropathies, including peripheral, central (insomnia, ...) and autonomic (heart, intestines, ..)

dry syndrome damages (eye, sinus, ears, skin, mouth)

cartilage destruction, joint and muscle pains

vision injuries (floaters, blank points, retina degradation)

organ damage (liver, kidney, pancreas, lymphatic system)

For a severe reaction, the most probable pattern of evolution consists of feeling early disorders of medium or high intensity, reduced to a group of a few symptoms, and from then on the whole state of the floxed person will worsen for many months until reaching a peak of damage. Some people feel very bad at the middle of the drug treatment, which prompts them to stop it, thus saving a lot of further trouble for them. Others feel bad after really long treatments of 4 or 6 weeks of 1,000 mg daily (always in reference to the potency of ciprofloxacin). Normally those persons took quinolones before for shorter periods and they all thought they had worked fine. Later, they discovered that they had experienced those mild inconveniences pointing to a reaction, but they had never linked both things, symptoms and antibiotic. This latter group of people tends to be hit very strongly because their higher tolerability to the drug allows them to take a lot of it before they get strongly hit.

The most noticeable symptoms have already been explained above.

If according to table 8 your profile after 6 or 9 months after drug cessation resembles a severe reaction and half or more of the symptoms are very intense, then you might be suffering a SEVERE reaction and this report is especially devoted to such cases. The evolution of the pathology is very characteristic of this syndrome. For severe reactions, new symptoms keep emerging for up to nearly two years after the last pill has been ingested. The worst disorders become apparent between months 6 to 9, but others still appear up to month 20. It varies a lot with each individual, but very typically it evolves as follows:

Month 1-2: (acute phase) Maximum musculoskeletal symptoms; possibly crutches or wheelchairs needed, high level of pain, and crippling physical limitations. Still not very systemic symptoms that affect vital functions of the body. Some people cannot even walk for weeks, and stay in bed or have to remain seated on a chair. Most have to use crutches, casts and have curtailed all physical activity.

Month 6-9: (acute phase) Maximum damage, irrespective of symptoms. Maximum vascular-matrix degradation damage, that affects eyes (floaters, photofobia, flashes of light, dead vision areas, diplopia, eye pain), joints (noises, cartilage grinding, tendon popping, enthesitis, inflammation in some cases), heart (arrythmias, palpitations, irregularities), ears (tinnitus, abnormal hearing, wave pressures moving in stereo fashion), and so on. Erosion of cartilages can be felt and also diagnosed by physical examination and imaging (only by very capable radiologists).

Month 9-30: Increasing of symptoms, people are very much affected all over. The intoxication manifests in its full force. Pains all over, with soreness, stiffness and loss of range of movement. Musculoskeletal pains on a constant basis, limiting activities. A strong feeling that something is going very wrong. New symptoms of this toxic problem may arise, like dry eye, dry sinus, dry mucous membranes in general, and abnormal reactions to otherwise normal infections like flu or colds that lead to a trail of deeper symptoms. Severe insomnia and restlessness. Brain fog and inability to form new memories. Mental implications typical of long lasting illnesses, including depression, anxiety. If dry mucous membranes syndrome does not develop or if it is not long lasting, the chances of overall recovery seem to be far greater. Very intense neuropathies in legs and other areas of the body that can be detected in ordinary testing. Maximum muscle pains, especially after activity. Subtle but clear loss of strength in muscles and weight loss.

Month 31-54: (From 2.5 years to 4.5 years). Cycling of symptoms in good cases. In bad cases there is a prolongation of the anterior period of maximum damage and misery and cycling does not start yet. Some disorders may experience an improvement with insomnia and some central nervous system issues, normally at around the 3.5 year mark. Panic attacks tend to stop by 2.5 years and from then on they recur only very seldom. Still very sensitive to any food or supplement with vaso-constrictive properties. Somewhat better from myalgic pains and stiffness towards the end of year four. In really bad reactions, there is on average an improvement that starts around month 42 or 45, that somehow equals the situation at month 30 of people with plain severe (not complicated, not highest severe) reactions. Still present are exercise intolerance, dry mucous syndromes, and vision injuries. Neuropathies and limitations, with fasciculations, pains migrating along the body, cold fingers, numbness, ulnar neuritis, etc.

Month 55-66: (From 4.5 years to 5.5 years). Recovery predominant, slow progress but firm. You can feel strong and determined and your spirit might go up too. You start to see what permanent injuries the quinolones have caused. Less neurological pains but still twitching, fasciculations, trembling, itching and other similar symptoms. Less stiffness and soreness, less range of movement limitations as the muscles start regaining some strength. Little or no photophobia; floaters less prominent but still present. Heart arrhythmias gone or recurring only occasionally. Atrophy in muscles and motor nerve death still noticeable due to the lack of function of all muscles innervated by large nerves if they have been affected.

Month 66-72: (From 5.5 years to 6.0 years). In roughly 40% of the cases, noticeable recovery for sedentary people (recovery is not complete but normal inactivity prevents the endurance damage from showing up). Slow recovery for active people because strenuous exercises make symptoms reappear; endurance is still low, and the body is not still able to recover normally after physically demanding activity. In the remaining 60% of the severe cases, by month 72 (6 years out) people feel better than a year before but are still far away from recovery.

IN SHORT:

Severe reactions present themselves with intense, long-lasting joint and neuromuscular symptoms as well as eye disorders and dry mucous parts.

From the 6th year on: depending on the individual, near complete or partial recovery is reached in another one or two additional years. This means that a severe reaction takes from 6, 8 or more years to recover from, and in many cases a lot of permanent injuries remain. This matches quite precisely with the information given by a reputed doctor of an American university, based on his experience with floxed persons. Typically irreversible damages include dry eye, dry sinus, dry ears, dry skin, floaters, blank points in vision, some palpitations, liver and pancreas injuries, muscle destruction (high CPK and aldolase), neuropathic pains-bearable, soreness, stiffness, cartilage erosions, permanent muscle function loss due to nerve necrosis, intolerance to many products due to injuries on neurotransmission, exercise intolerance and occasional muscular pains.

Total recovery time: ranging from up to 3 to 8 years or never in some cases that end up with different permanent injuries.

35.EXPECTED EVOLUTION FOR AN INTERMEDIATE REACTION

Symptoms from a quinolone antibiotic intoxication of a lesser intensity start with mild pains during the treatment or soon afterwards, that are of small intensity and can even pass unnoticed. In any case, during the first months, most of the problems are musculoskeletal and tend to resolve without complications. All the rest of the symptoms can be present. But some six to fourteen months after cessation of quinolone antibiotic therapy, the active athlete can become suddenly prostrated and severely affected, normally in one single or a very few joints.

Month 1-12: Minor musculoskeletal symptoms; limited activity, incorrectly associated with overuse, or mechanical problems. Acute phase for other minor effects.

Month 12: (Acute phase, for active, athletic people only) due to accumulated damage, peak symptoms are reached. Collapse of a joint is typical. There are no or very mild accompanying symptoms (vision, neurological, etc...).

Month 12-22: Recovery predominant, relatively fast progress.

Active and athletic people will see their endurance drop a lot and they will develop osteoarthritis early, perhaps some ten years earlier than non-floxed people, and depending on dosage.

36.EXPECTED EVOLUTION FOR A MILD REACTION

In these cases, apparently there are no symptoms associated with the quinolone treatment and the individual can feel no adverse reactions after taking a quinolone prescription, especially a short one or one with low doses. But the quinolone takes its toll and after several treatments spaced weeks, months, or even years apart, subtle symptoms will begin to develop, and the sufferer will probably never link them to the antibiotic.

These symptoms will probably be: restlessness, especially at night, brain fog, some minor twitching, increased coolness of hands and feet, slower recovery after strenuous activity, increased stiffness after exercise. And the unavoidable erosion of cartilages will be inevitably added to the list.

In MILD reactions, recovery is reached between months 4 and 12 on average. In some cases they have an acute phase of up to 3 months.

37.TYPICAL PATTERNS OF EVOLUTION OF RECOVERY

As explained above, the typical progression of the intoxication and its recovery follow quite typical patterns that have been outlined in the diagram-figure 4.

Figure 5. This figure shows the typical evolution of several sorts of reactions as classified in the present paper. Do not take it as a reference for your case. Each individual develops different patterns. The coloured lines in the graphs show the OVERALL status of the floxing and average tendencies. A floxed person may have an overall intermediate reaction and at the same time one or two symptoms of a very high level, corresponding more to a severe reaction.

SEVERE-DELAYED REACTION. Is the most dreadful. There is an acute reaction soon after finishing the treatment, and then for more than a year all the symptoms develop until reaching very dangerous levels and surpassing well beyond the point of irreversibility of injuries. Then until about the 3-year mark, the floxed person experiences a desperate and miserable life. By then an improvement plagued with cycles starts. By year 6 permanent aches and irreversible damage is common.

SEVERE ACUTE REACTION. Is similar to the severe-delayed one, but the symptoms develop in a shorter time and then resolve more rapidly. Cycles are not shown for simplicity purposes, but are typical. Usually it leaves less permanent injuries.

INTERMEDIATE REACTION. Does not reach very high intensities of injuries, but the affected persons are equally anguished and tend to think that something very severe is happening to them. It can heal without sequela, although not in all cases, because at least some loss in endurance (only perceivable by push-to-the-limit athletes) is always present.

38.WHICH KIND OF ADVERSE REACTION TO QUINOLONE ANTIBIOTICS ARE YOU SUFFERING FROM?

Reactions to drugs vary among individuals. This report can provide little help in assessing any particular case, because all information stated here is based on average experiences. But there are some very common patterns of bodily responses to quinolone intoxication. First of all, you should discern among:

Ø ACUTENESS. Some reactions are sudden and very acute, causing a lot of distress to their sufferers, but they resolve in a few months because the reaction has manifested abruptly but not deeply.

Ø SEVERITY. Other reactions have a medium intensity of symptoms at onset but they insidiously develop progressively to very severe reactions over time (usually 12 or 18 months).

In other words, a person suffering from QTS (QUINOLONE TOXICITY SYNDROME) cannot infer from his/her initial symptoms what kind of reaction he/she is experiencing.