Category Archives: Acute Phase

Leading into Day 1 of Symptoms – Saturday, July 12th

I define the “ACUTE PHASE” as the first ~11 or so days of the virus. Here is where I begin documenting my symptoms day by day, starting with Day 1 of symptoms.

When my husband and I were coming up with plans for the 4th of July this year, we decided to leave the country contrary to the norm. We are the truest of patriots. We were both under immense stress (me from work, him from school), so we decided to go for one of the lie-on-a-beach-and-do-absolutely-nothing vacations. Sun? Check. Pool bar? Check. We had been to Turks and Caicos in 2011 and absolutely loved it, so we stayed on the exact same part of the island in the exact hotel that we had before. It was a truly fantastic vacation, sunny every day, and we spent all of our time outside between boat trips, beach time, and walks along the long Grace Bay beach. We ate every meal outdoors, sipped drinks outdoors, and even watched the the Netharlands spank Costa Rica in penalties during the World Cup on a TV that was outside (Hup Holland Hup!). It was an outdoor paradise.


We were incredibly OCD about putting on mosquito repellent throughout the trip since we had read about some mosquito virus (which we didn’t know the name of) spreading in the Caribbean in the news before the trip. We brought “Off! Active” with us, which contains 15% deet according to the spray bottle. We applied this daily at dusk, but during the day we did not normally wear it since we didn’t seem to get bitten. At night, however, we still got bitten despite having this stuff on (we could see the mosquitos landing on us despite the Off!), so I came home with roughly 10 bites total. According to some of the research I’ve done, the mosquito which transmits chikungunya bites during the day. That said, I do not have any specific recollection of getting bitten during the day, but I suppose there is a lag time between when the mosquito bites and when the bite starts to itch. I thus have no idea when the bite occurred that transmitted the virus to me, but I don’t have any specific recollection of daytime mosquito bites.


Anyway, we were there from July 2nd through July 9th (2014),  which was a Wednesday to a Wednesday. I took the following Thurs/Fri off from work because I had the vacation time and if I don’t use it, I lose it. The day after we returned home, Thursday, I went straight back into my gym routine after a week off in the Caribbean. I wound up deadlifting to a point that was close to a personal record despite the time off, and I did a number of assisted pull-ups. I did kettlebell swings, rope slams, and tons of foam rolling. It was a workout where I really pushed myself to the edge, but I appropriately warmed up and cooled down.


The day after, Friday, my body was tired from working out and I had plans in the city. It was a big day of walking around in the city and I felt great.  In the evening I went home and had dinner with my husband. We relaxed and drank a bottle of wine between the two of us.


Day 1 of symptoms – Saturday, July 12th

The following day, Saturday, I woke up with a strange pain in my left  middle finger that I noticed before I got out of bed. The middle joint of the finger was really sore when I opened/closed my fist. It was not swollen. Once I got out of bed and put my feet on the ground, I noticed that my ankles were sore, too. It felt like the pain radiated to the sides of my feet from the ankles, and it would be a screaming pain if I rolled to the outer edges of my feet (as if I was balancing on the outside of my shoes). It was painful to walk, but it wasn’t painful enough that it affected my mobility too much. I dismissed this joint pain pretty quickly and blamed it on the deadlifts. Sometimes I get weird pains after workouts. I got up and walked around the house like a discombobulated crouching tiger in pain. (Although I wore this pain like a badge of honor, thinking that it was caused by pushing myself so hard in the workout the day before.)


Once I got up and started moving around, I noticed that my shoulders and back were incredibly stiff, both the muscles and the joints. WAY more stiff than after a normal workout. I got up, took a shower, and moved around the house, which usually helps muscle soreness from the gym. This did not help me at all, in fact, it got worse and more intense as the day went on. I tried foam rolling and using a lacrosse ball to roll out the most sore areas in my shoulders and back. This did help a little bit. The pain in my back was mostly concentrated on the upper back and shoulder area, but there was pain in my lower back that quite possibly was from the deadlift. I’m always sore in my back after deadlifting. Both shoulders were sore, but the right shoulder was worse.


Over the course of the day, the hand pain spread to the rest of my left hand (all finger joints except my thumbs), and became pretty painful. I dismissed this pretty quickly, thinking the pull-ups caused this.


On this first day I also felt an intense headache-like pain behind my eyes that started in the morning and progressively got worse as the day went on. The way I described it to my husband was “a headache that’s only right behind my eyes.” I had never experienced a headache like this before, so I took a couple of Advil. I’m a really stubborn person, so it takes a lot of pain for me to take something. I thought it was dehydration from both the workout the day before and the bottle of wine we drank the night before. I also felt a little nauseous and had absolutely no appetite, which I thought may have been a result of the headache. A lack of appetite is odd for me, because I am normally a proud foodie with a strong sweet tooth.


That day we so happened to be painting one of the rooms in our house. I had gone to the store to buy paint brushes and help out. I was mobile enough to leave the house and accomplish what I needed to do, but looked like a jackass because of the stiff way I was walking throughout the hardware store. By late afternoon, the pain behind my eyes and the pain in my shoulders, hands, and ankles was so bad that I had to lie down and could no longer help paint. Note that I also had glute muscle soreness because of the workout (typical for deadlifting/kettlebells/rope slams 2 days after working out). My muscles and joints were a full blown mess, and the pain signals were confusing. I was limping around and walking really stiffly all day. I especially had trouble getting up from sitting down because of my back, my glutes (from the workout) my ankles, and my shoulders.


Later that night my husband and I watched a movie, and I was very cold, bundled a blanket with pants and long sleeves while my husband had shorts and a t-shirt on. I felt pretty unwell and tired about half way through the movie, so I decided to go to bed early and skip the end of the movie. Once I got up into bed, I had multiple layers of clothes on, and I started to violently shake with chills. I knew at this point that I had a fever, but our thermometer ran out of batteries (mercury ones really are the most reliable), so I don’t know what the temperature at this point actually was. I knew it was a fever because when my husband cuddled me to warm me up and stop the shivers, he felt cold(er than me), when he normally feels really warm in comparison to me.


Once I lied there with chills, sore joints, and a horrible eye pain, I laid there in bed unable to sleep. I knew at this point that there was something seriously wrong with me. My husband had fallen asleep, but this particular moment was the only time throughout the illness where I thought to myself, “am I going to live through the night?” I felt terrible, but thought I was being slightly over-dramatic. I knew there was something wrong with me, but had absolutely no will to go anywhere, and didn’t think that on paper it was serious enough to warrant a trip to the ER. After a couple of hours of chills and general fidgety-ness, I fell asleep and stayed asleep until the next morning.


Day 2 of symptoms – Sunday, July 13th

When I woke up in the morning, my husband was standing over me with a thermometer he bought at CVS. 102.2F. I rarely get fevers, and I also woke up with itchy welts on my left forearm (the underside of the forearm close to the wrist). They were raised, not red, and fairly large. Maybe each was ¼-1/2” in diameter, and not perfectly round – some were oval shaped. When I tried to get out of bed, I realized that the joint pain had spread: all fingers, wrists, elbows, ankles, feet, toes, and neck — all symmetrically on both sides. Two joint pains were only on one side of my body — my shoulder was only sore on the right side, and my knee was only sore on the left side. If my knee had been sore on both sides, I would not have been able to walk. I’m very lucky that the disease didn’t take out both knees at the same time!


None of the joints appeared swollen, and my husband helped me get out of bed. It was very difficult for me to walk, especially up and down the stairs, which resulted In my husband half supporting me and the handrail taking on the rest (it sure passed the test!). I still had the awful pain behind my eyes, a severe headache, and a new weird symptom: I felt like I completely lost my sense of taste, but it was replaced by a really strange chalky but bitter/maybe metallic taste in my mouth. I brushed my teeth and it did not go away.


With no appetite, I skipped any breakfast and my husband brought me straight to the emergency room.


In the car on the way to the local hospital, a startlingly red, itchy rash started appearing on my legs. This rash is the fastest spreading rash I have ever seen. It started on my legs just looking like a reddish tint on my legs, turned very blotchy (small red adjoining blotches all over my skin) and went all the way up my legs. My arms also developed this rash. It never appeared on my trunk, back, face, or chest. The rash was not on my hands and feet, it was raised in some areas and flat in some areas, and it itched like crazy.


When I limped into the emergency room hanging onto my husband for assistance, itching my really gross rash, the nurse asked if I had been stung by a bee and was having an allergic reaction as soon as I walked through the door, before I approached anyone. I told her no, that I was having joint pain, a rash, and a fever. I was processed, instantly given Tylenol for the fever, and asked to wait in the waiting room with a face mask in case I had something communicable by breathing. I felt like “that asshole” sitting in the waiting room with the really bad illness that nobody wants to sit next to. I was also, in all seriousness, pretty scared at this point. I didn’t want to wait in the ER long in case this skin reaction was also indicative of something that was happening to me internally that I couldn’t see, and fortunately I didn’t have to. 5 minutes later, I was called in.


As soon as I saw the ER doctor, I told him all of my symptoms and he inspected my rash. He pointed out that I had very red eyes (I had not looked in the mirror so I never saw my red eyes), but my husband also confirmed. My eyes did not itch. He asked if I had been traveling anywhere recently, to which I replied “Turks and Caicos.” He left the room for a while, then came back with a printout from the CDC detailing all of the symptoms associated with Chikungunya. My initial reaction: chicka-what?? Excellent, I picked up an exotic disease that nobody knows about. Instantly, I googled it. (Yup, I broke the rules and used my phone in the ER.) “Potentially life threatening”, “not life threatening at all”, “disabling”, “can last for months, or even years”…. I was pretty scared and confused.


Meanwhile, my rash was spreading and becoming more and more raised in areas, forming welt-like bumps in some places and remaining flat in others. The itch was burning and I was actually reaching a point of mental mania (not an exaggeration) from all of the itching, so the nurse gave me benedryl. Another doctor visited and asked permission to take photos of my rash since he taught at a local university and this was the first case they had ever seen in person. I was a celebrity for a day, great, just what I wanted.


Some bloodwork was taken, but not a specific Chikungunya test. I was diagnosed by presentation only. To date, I have no idea what the doctor tested my blood for and what the results were from this initial visit to the ER. (spoiler: later on in the illness my blood was taken again and I did get results from that. Keep reading.)


I was sent home with my piece of paper from the CDC. I was told to go home and rest, “good luck” (literally, the nurse said this to me), and to go stick my thumb up my butt waiting for the symptoms to resolve on their own. (The last part I’m definitely exaggerating, but you get the point.) I was frustrated because there was nothing anyone could do for me, and I was scared. Obviously my fear and my feeling as though I was not being cared for were not the doctor’s fault, but it was the situation. There is nothing they can do. We waited until the fever went down, then I was discharged.


I went home, assumed my lazy-person position on the couch, and the itch and rash calmed down within the next 4 hours. The red rash faded to a red “patina” as I like to call it, so my arms and legs remained redder than usual. It was a solid red, and much lighter than the rash. It no longer itched or bothered me at all. Although my face did not have the original rash, it appeared red later in the day. Now keep in mind that I was very tan and a little burned from my vacation, so at first I wondered if this was some sort of a delayed sunburn. It didn’t hurt, though, so I wrote it down as a symptom.  There wasn’t any pattern – just the entire face more red than usual. I also was extremely tired and slept most of the day.


This next symptom I experienced is going to be TMI, but all day (and many days following) I had a very heavy clear vaginal discharge. It was like water: not viscous, instantly absorbed by my underwear, nothing visible in it.


As far as eating went, I had no appetite all day, but did have an insatiable thirst. Probably a good thing since they say it can help lubricate the joints (I personally don’t know if there is any truth to this, but whatever. Hydration never hurts). I drank Gatorade, water, and chicken soup, all of which tasted disgusting because of the gross taste in my mouth/lack of taste. Obviously this made me urinate frequently, and getting up to go back and forth to the bathroom was really difficult on my own. Thank god for my husband!

Day 3 of symptoms – Monday, July 14th

Woke up on Monday and put my feet on the floor. My joints felt slightly better as compared to yesterday, to the point where mobility was possible on my own. The pain was more of a stiffness, and I found that from early in the morning, some of my joints cracked (knees, ankles, fingers in particular). The cracking felt like a release and eased the stiffness. Going down the stairs was still a challenge (again, the stair banister passed quite the robust test after all these days of putting my full body weight on it to go up and down the stairs!)


This was supposed to be my first day back at work after vacation, but I was absolutely not feeling well enough to work. I felt weak from the second I stepped out of bed, and although I was mobile enough to get from my bed to the couch, I wasn’t too keen on getting up at all, even to go to the bathroom. Sick Day #1.


After getting out of bed, I went straight to the bathroom and brushed my teeth. I noticed that, even with pretty gentle brushing, my gums bled and felt sensitive to the brushing. I floss regularly, wear retainers every night, and am very good about going to my 6-month routine teeth cleaning (my dentist gave me a high-five last time I went for a teeth cleaning), so my teeth never bleed when I brush them. However, most of my teeth bled and felt really sensitive. Speaking of the mouth, I also had a few white ulcers on the tip and side of my tongue that hurt like those little painful tongue zits, as I call them (I think they are ulcers or little inflamed taste buds), that I sometimes get. They were white, and there were a few of them. One of them was probably the size of 4 normal “tongue zits” combined, and it was white. They hurt pretty badly for such a small dot!


I took my temperature shortly after getting up, and it was normal. Fever over, thank goodness! I noticed that I had ~1cm lymph node swelling in the rear of my neck on both sides, as well as on the left side of my neck. The ones in the back of my head were right at the base of my skull on either side, and the one on the left side of my neck was slightly smaller than the other two, but more round and pronounced. This is gross, but I could squeeze it since it was on the side of my neck and not at the back. This one was below and slightly behind the ear. All day I had a pain in the back of my neck/a stiff neck, and I’m assuming this was from the lymph nodes being so swollen. I’ve never had swollen lymph nodes before (first time for everything I guess). On top of the stiff neck, the base of my back also felt a stiffness and a pain. I used a heating pad (and took Advil) and it seemed as though those helped dull the pain slightly, but not significantly. The warmth did feel good on my back.


My skin on this day was flushed red on my face, chest, arms and legs, and I was pretty itchy all day. No raised  rash or hives, but my skin just itched. I took benedryl which didn’t really help.


My headache went away, but I was abnormally moody. I felt great one second, then felt really depressed and hopeless the next. Didn’t think much of the mood swings, but definitely felt a little not-myself. I also felt really fidgety and wired all day, which is definitely odd because, as an engineer, I do best and am most comfortable focusing on one thing at a time. I am also normally very patient. I watched TV and movies all day (shout out to my Real Housewives of NYC), which normally, if I had a day to completely relax in front of the TV, I’d do willingly and enjoy the relaxation. However, I had to be multitasking. I had to be watching the TV while reading a magazine while playing on my phone while frantically looking around the room and thinking about all different things. I became frustrated that I couldn’t exercise or leave the house and expel my energy somehow. I’m not usually fidgety, but I noticed that I had a very short attention span and just felt absolutely wired to the point of “wow, I wish I could chill the f-out.”


I also had absolutely no appetite, but managed to eat some chicken noodle soup and drink a ton of Gatorade and water. And eat popsicles. (sick person food, right?) I still don’t know if the hydration helped at all, but I like to think it did.


Two other odd potential symptoms to note this day were:

1) that I had a very acute pain when wiping after going to the bathroom (going #1). It felt like something tiny on my skin was on fire when I wiped. I used a mirror and inspected myself, and I saw a little white ulcer-looking spot on the outside of my vagina. Very similar to what I saw on my tongue that morning. Don’t know if this vaginal ulcer is related to what I saw on my tongue, but they both appeared on the same day, looked similar, felt equally as painful, and I think are worth noting.

2) that evening, my husband and I were watching TV (as I was doing all week), and my nose started to feel like it was dripping on the inside. I used a tissue and wiped it, and one of my nostrils bled just one drip of blood. It wasn’t a gushing nosebleed, but it was enough to drip out. It could have been a scrape on the inside of my nose (although I never saw it), and it took about 15 minutes for the paper to wipe away with nothing on it. Odd since I’ve never had any blood come out of my nose in my life (except for that one time in 2005 when I broke my nose — well, someone else broke my nose — but that’s a story for another day). I suppose this could be completely unrelated, but it happened on the same day my gums started to bleed. I guess it’s worth noting also.


I went to bed that night, but was still feeling wired. Took me a couple hours to fall asleep despite taking benedryl. I felt like a complete insomniac because I was so fidgety and kept tossing and turning trying to fall asleep. Normally, as soon as my head hits the pillow, I’m out like a light. Boy, do I take that for granted!






Day 4 of Symptoms — Tuesday July 15th

I had barely slept that night. I was tossing and turning despite taking Benedryl. First time in my life I’ve ever had insomnia.

All night, not only was I tossing and turning, and frustrated watching my husband sleep, but I also was incredibly itchy all night. My arms and hands were itchy, and my legs were even itchy in patches as well. Certainly didn’t help the insomnia.

I got up really early in the morning and went downstairs. I noticed that I actually had this sense of well-being, as if I really turned a corner. My joints felt as though they really improved; I was fully mobile on my own, just with a minor stiff sensation. However, I had really bad neck pain. I noticed that I now had 4 swollen lymph nodes — the two in the back, and now two on the sides. The largest one was in the back of my neck and it was about 1″ in diameter. My tongue sores were really hurting, and I had a headache and the pain behind the eyes came back. Although I had some minor pains, overall my joints felt pretty good and I was even feeling as though I was on the upswing after only 4 days, lucky me!!

I basically laid around all day still assuming the lazy position on the couch (shout out to my Dance Moms). Despite captivating reality TV, I generally felt pretty depressed. Just down, no real reason to be down, after all, I felt pretty good and I was off work with a great excuse! Just generally felt down in the dumps. When I tried to explain why I felt down to my husband over the phone, I couldn’t explain it.

When my husband came home from work, he wanted to talk about something that happened at work. We’re both engineers, so we sometimes discuss work at home. When I was ready to formulate my response, I actually had a really hard time formulating my sentences… I felt like I needed to talk slower, and take a lot of pauses. I would forget words, and get frustrated mid-sentence when I couldn’t continue the thought. I found this foggy thinking only occurred when I was either talking about technical things, or when I was telling a story — almost like my linear thinking was off. Didn’t think much of it at the time, but wrote it down as a potential symptom. Normally I’m pretty articulate, especially about work stuff.

The last semi-new symptom I felt this day was weak. I tried to flex my bicep to see, since I hadn’t been exercising, and since I guess I’m a workout narcissist, if it was still there…. I didn’t even have the energy to flex it. Generally just felt weak and lethargic.

Went to bed early that night and, although I tossed and turned, I wound up in a really deep sleep finally.

Day 5 of Symptoms — Wednesday, July 16th

Woke up feeling great! I was still off work, but the worst pain I had was pressure in my neck/lymph nodes, and now severe pressure and pain in my groin/pelvis on both sides. I called doctor Mom, who told me that there are lymph nodes in the groin that can also swell. I used two heating pads — one on the neck and one on the groin — and this significantly relieved the pressure. I also took some advil.

Joint pain? Still mildly stiff, but better! Headache? DIdn’t really have one — guess the lymph node pressure was my main focus. I had a faint red rash all over my body (the red “petina” I was talking about), but I generally had this sense that I was going to get better soon. The rash wasn’t that noticeable, but I could see it on my legs as well as my chest. I even showered for the first time in a few days and ventured out to Dunkin to get coffee and a bagel.

That night, I thought about picking out clothes for work the next day. I felt pretty good, was fully mobile, and fending for myself. Although my lymph nodes were still swollen, I could still go in. I felt guilty after having so much time off — vacation plus sick time — so I was ready. My husband told me not to be ridiculous, so I ultimately decided to take one more day (or maybe was pressured to take one more day) just to make sure I was better. I went to bed that night, tossed and turned for about an hour, then wound up in another pretty deep sleep. Guess my body needed it!

Day 6 of Symptoms — Thursday, July 17th

Woke up itching my hands like a maniac. They itched so bad and burned like hell. The heel of my hands and my wrists especially. I had a bracelet on that was tied to my wrist that I had worn for months fairly loosely, and the thing felt so incredibly tight that I had to cut it off. My wrists were really swollen. I went into the bathroom to put some aloe on the itch because I thought the cool sensation would help the burning. When I stepped into the light, I noticed that my whole body was covered in a rash (rash #2!). I swear this thing is the 7 plagues — each new morning is a brand new joyous symptom. The gift that keeps on giving!

This time, the rash was really bright red, and scarier looking than the first rash. It was RED, burning, had tiny splotches that covered my arms, legs, and was randomly throughout my trunk. It also appeared on my palms and on the soles of my feet. Not on my face. My ankles were also incredibly itchy and appeared swollen as well.

Out of all the days of Chikungunya, this was the only one where I took any pictures, so here they are for your disgusting viewing pleasure. Here’s 3 pictures of the rash on my arms this morning, and one of the rash on my legs that I took in the car on my way back the ER (yup, went back to the emergency room.) It’s hard to make it out on my legs because of the light, but basically my legs are completely splotchy red.

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Lovely! You can sort of see how swollen my wrists were from the side angle photo. Don’t know what the wrist version of the word “cankles” is — perhaps wrankles?

I also had joint pain, but it was only in my wrists and hands this day. I took my temperature and it was 96F, which is on the low side, but glad I didn’t have another fever.

I called my husband and asked him to take me back to the ER since this rash scared the bajesus out of me, but this time I went to a much larger and more well known hospital with a world class Infectious Disease department. I had read that this particular hospital had seen other cases of Chikungunya, and it also is probably the best hospital in New England. It was about an hour away, so my husband drove us there. My parents also surprised us and came, so this time I was “that asshole” with an entourage taking up all the chairs in the waiting room.

They “fast tracked” me through the ER line since I looked absurd sitting there with my rash scaring all the other poor patients, and since they were all shocked when they heard the words “chikungunya”. A flock of ER doctors came right in to see me and took a few pictures of the rash on my palms. Great! They asked me a thousand questions (the answers to which all live in this blog), and then made me wait about 3 hours for the Infectious Disease specialists to come down.

Three ID docs came into the room I was in and they did a test on the spot. They took one of those blood pressure cuffs and put it around my bicep and inflated it so that my circulation felt like it was being cut off. They then waited for a couple minutes. They were looking for red spots on my arm, indicating fragile capillaries. I learned that this was a test for dengue fever. I wound up with a few red dots, but nothing significant. The head doctor in the room said that, although this tourniquet test did not strongly indicate dengue fever, if he had to put money on it, he said he thought I had dengue fever from the story I told and my presentation on that day. They took a blood test for both dengue and Chikungunya, took liver enzyme and blood platelet tests, and sent me home, again, to basically stick my finger up my butt. Can’t blame them, there’s nothing anyone can do. They did give me a prescription for hydroxyzine HCl, an antihistamine, to stop the itch, and to help me sleep. At least I felt like I had some small token to take home instead of the last hospital that sent me home with a “good luck” and a “don’t let the door hit you in the ass on the way out”.

One other thing they asked me, when my parents and husband were not in the room, was whether it was possible that I had HIV. I guess the acute symptoms of Chikungunya can mimic that of an HIV patient. I told them that I am 100% sure I did not have HIV, as I was tested in my most recent blood panel (which occurred after I was married and monogamous). It’s ridiculous that I was tested during my yearly panel, but hey, the information came in handy didn’t it!! I was a little thrown off by that entire discussion to be honest, and quite shocked that HIV came up during this visit. Can’t blame the docs for being thorough.

I scheduled a follow-up with the ID doc and went home. Assumed lazy-person position and promptly turned on Teen Mom so that I could think about other people’s problems for a little bit. My husband was such a good sport and put up with my terrible taste in television, letting me watch whatever I wanted. I had absolutely no appetite, but my husband made us chicken noodle soup that night.

Day 7 of Symptoms — Friday July 18th

Woke up after a solid night’s sleep — probably thanks to the hydroxyzine HCl that they prescribed me yesterday for the itch and to help sleep (it’s a strong antihistamine). I woke up noticing that yesterday’s rash was faded, but still there, and had a slight itch to it. I still found that I had bleeding gums when brushing my teeth first thing in the morning. I went downstairs to have some breakfast, and noticed as soon as I put my weight onto my feet that the bottom of my feet were swollen and tender. I could still walk around, but needed to put my feet up for most of the day. I also found that I had to take my wedding and engagement ring off as my hands were really swollen. 

I also was mildly nauseous, and really tired despite the solid sleep I got the night before. This fatigue lasted all day. I generally had muscle weakness. And, of course, my joints were still swollen, especially my hands, elbows, and knees. In my hands, all of the joints in my fingers hurt, and my wrists were really bothering me as well. The knees were sore, but not sore enough to stop me from walking… just make it difficult. The pain in the groin lymph nodes was bad. Back to the heating pad!