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Valley fever patient who lost valiant struggle leaves journal as a beacon for others
| Saturday, Jul 19 2008 10:12 PM
Last Updated: Friday, Jul 18 2008 2:50 PM
Valley fever cost Edith Preller her left lung, at times her sanity and, eventually, her life.
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Valley fever is a disease contracted by breathing in a fungus found in the soil. It is endemic to Kern County. Last year, 1,229 Kern residents were diagnosed, according to the county Department of Public Health Services.
But that takes into account only a fraction of total cases, considering about 60 percent of people infected have no symptoms. Forty percent have cold- or flu-like symptoms, and the rarest and most severe cases cause nodules, ulcers, lesions in the skin and bones, swollen joints and meningitis, an infection of the membranes and fluid surrounding the brain and spinal cord. Some people die from valley fever.
It can’t be spread person to person.
How can you prevent getting valley fever?
• Avoid activities associated with dust and airborne dirt, like dirt biking and archeology.
• Wet dust and soil before disturbing it.
• On dusty days, close windows and stay inside.
• After dusty conditions, wet and clean dust collected on window ledges or porches.
• Also, change clothes and shower after being outside in windy and dusty conditions.
Source: Kern County Department of Public Health Services
Photos:
Elizabeth Mulikin holds a photo of her sister Edith Preller, who died from valley fever in May.
Elizabeth Mulikin, left, and her sister, Sherry Shamblin, play with Sparky in Shamblin's home. They are trying to raise awareness of the signs and symtoms of valley fever following their sister's death in May.
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But it didn’t silence her voice.
Her first journal entry, written as she lay in a hospital bed about three months before she died, started with her motive.
“I wanted to write to let people know what valley fever does to your body and family.”
In perfect cursive on the pages of the tan and blue ringed notebook, Preller detailed how she went from flu-like symptoms to surgery to hallucinations.
“I only ask that if I am unable to write things down, someone will and make sure that the public is made aware of what valley fever is and how it destroys your life,” Preller wrote at the end of her Feb. 25 entry. “Mine is not over yet, and I am doing my best to NOT be another statistic to this disease!!”
When Preller could no longer write, her sisters and niece took up her pen, either in Preller’s journal or in journals of their own.
“It breaks my heart when she gets tears and can’t tell us why,” wrote sister Sherry Shamblin on April 10. “She just crinkles up her brow and tears run down. How much pain must she be in.”
Valley fever is endemic to Kern County and is contracted by breathing in a fungus found in the soil. While fewer than 1 percent of people infected by valley fever get the infection in multiple parts of the body or require intensive care, it can be deadly, said interim public health officer Dr. Claudia Jonah.
Preller — an in-home health care worker, avid reader and hostess to anyone who crossed her path — died May 18, a week after her 61st birthday.
“She wanted people to understand what valley fever is. It’s not the flu. It’s as deadly as cancer,” said sister Elizabeth Mulikin, 47. “She beat cancer, but she knew she wasn’t going to beat this.”
'THE FUN STARTED'
Preller, a Bakersfield native and Lodi resident when she died, used to farm potatoes and cotton as a child, said her two younger sisters, who live in Bakersfield.
Preller writes that gardening, a favorite pastime, might be how she came in contact with the valley fever spores that wreaked havoc on her body. She first got sick in 2005 with fevers, chills, coughing and vomiting.
And since she did not have health insurance — she worked as an independent contractor and couldn’t afford it — she did not seek medical care at first.
Jonah urges residents to seek care as early as possible when sick, especially if you notice something abnormal or if you don’t improve after three or four days.
“Now the fun started,” Preller said of when she first went to the hospital in 2005 and was diagnosed with pneumonia.
Residents need to ask for a valley fever test if they are diagnosed with pneumonia, Jonah added.
Preller spent 12 days at home before going back to the hospital.
“I had valley fever, and it was bad,” she wrote. “My left lung had a crevice about golf-ball size full of mold or ‘cocci.’”
Cocci, or coccidioidomycosis, is another name for valley fever.
“I was losing my hair by the handful and was still very weak.”
Patients with any severe illness sometimes experience hair loss, said Dr. Daniel Boken, adult and pediatric disease specialist at Kaweah Delta Medical Center in Visalia, where Preller was treated. Some valley fever treatments can cause hair thinning.
By July 2007, Preller had gotten worse, and her doctors decided to remove the infected lower lobe of her left lung.
“I found out just how bad I really was,” Preller wrote. “The family was told I might not survive the surgery, but I had a short time to live without the surgery.”
'THE END’
Preller also suffered hallucinations.
“I know you all think I have lost my mind, but I can assure you I have not,” Preller wrote in a letter to family. “I laid here last night while Sherry was able to get some nap in and listened to how the plot to overmedicate me was caught by the pharmacy.”
Hallucinations, along with seizures, can occur when valley fever infects the brain, Jonah said. Boken does not remember the valley fever spreading to Preller’s brain but said that can happen.
“She said she was in the 1940s in a book store in Visalia, and it was burning,” Mulikin wrote on May 9. “And she asked the cleaning lady if she could return her purchases, and then she called me a liar.”
Throughout Preller’s battle, tubes were inserted in different spots of her chest to help her breathe. She underwent several lung surgeries, and during one procedure, her aorta ruptured.
She also fought a drug-resistant staph infection, according to her discharge summary from the hospital.
Still, Preller seemed to improve.
“Today is GREAT! Edie was sitting up in a chair when we got here and sound of mind,” Mulikin wrote four days before Preller died. “It is so great to see such a turnaround.”
On May 18, Preller went into cardiac arrest when hospital staff were putting her in a chair for physical therapy.
“She started turning purple and started bleeding in the chest cavity,” Mulikin wrote. “God love her and hold on to this family and wrap them in God’s loving arms.
“The End.”
The family started journaling, hoping that Preller would be able to reflect on her journey once she was well.
Now their pages are part of a mission to educate the community on valley fever.
“From a public health perspective, we should be aware that more people die from gunshots and car accidents than valley fever,” Boken said. “But that doesn’t mean we should not take it seriously. We just need to keep it in perspective.”
The sisters have started working with the Valley Fever Americas Foundation, a locally based nonprofit that raises funds for research, development and clinical testing of a vaccine.
“I hope somebody gets use out of this,” Mulikin said. “Because I know with her giving heart, if her going through this could help somebody else, it was worth it to her. I know that.”