Medical mysteries: Ian Liu’s back pain was horrible, but no one knew the reason

(Original artwork by Owen Freeman) - Coast Guard officer Ian Liu’s back was killing him. But his problem wasn’t a slipped disk.

(Original artwork by Owen Freeman) - Coast Guard officer Ian Liu’s back was killing him. But his problem wasn’t a slipped disk.

Liu had a more immediate concern. He, his wife and sons had reservations to fly to San Francisco to see his extended family, and Liu wasn’t sure how he would be able to manage the long-anticipated trip. He was in so much pain that he could barely walk.

He loaded up on prednisone, a corticosteroid, and painkillers; using a wheelchair to board the plane, he made the cross-country trip. “I was really out of it the whole time,” he recalled of his days in California. The painkillers made him “dopey and tired,” and he noticed that he sometimes had double vision or felt winded, which he assumed were side effects of the drugs.

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His parents, he said, were alarmed by his condition and kept urging him to go to a hospital emergency room.

“I deflected,” he recalled. “I thought, ‘Why sit in an ER for hours and have them tell me I need to see a neurosurgeon when I already have an appointment?’ ”

Liu said his wife, Julie, was “fed up with me” and exhausted caring for three boys younger than 7 and a husband who was increasingly out of it. Liu said he told himself that everything would be sorted out when he saw the surgeon, even if it meant back surgery.

‘Just man up’

The Jan. 4, 2005, appointment with the neurosurgeon started on a sour note. Liu’s MRI had been performed without contrast dye, so the surgeon ordered a new one that would provide more information. But after viewing the results of the new scan, the specialist had disheartening news.

“He told me, ‘I don’t know what’s going on, but I see nothing surgical to fix,’ ” recalled Liu, adding that this was the lowest moment of his ordeal — even worse than what would come later. “I felt like maybe this is just in my head and it’s not really that bad. Why couldn’t I just man up and take it?”

But Liu’s wife had grown increasingly alarmed; while her husband was out of the room, she told the neurosurgeon that he was showing signs of confusion and disorientation and seemed short of breath.

That evening, after the couple had returned to their Springfield home, the phone rang. It was the neurosurgeon, who told Liu that his labored breathing and confusion might mean that something was wrong with his heart. Liu needed to come to the hospital right away for further testing.

“If you want, I’ll send an ambulance,” Liu recalls him saying. Liu opted to have his wife drive him.

At the hospital, the medical technician checking his vital signs asked him, “Do you know you’ve got a [heart] murmur?”

“I didn’t even know what that was,” Liu recalled, “but they seemed very concerned.”

That concern deepened when an echocardiogram, a test that provides a detailed picture of the heart, revealed the reason for Liu’s unremitting pain, shortness of breath and confusion: He was suffering from infectious endocarditis, a bacterial infection that had eaten a hole in Liu’s mitral valve. Testing showed that the infection had spread to his brain, lungs and spine.

Endocarditis is an inflammation of the interior lining of the heart or the heart valves. Usually caused by a bacterial or fungal infection, the illness typically occurs in people with underlying cardiac problems, such as a defect in a heart valve. It can occur when bacteria are introduced into the bloodstream during medical or dental procedures, according to Medline.

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