Age: 42.0
Sex: F
Vaccine: TYP
Symptoms: Protein total normal, Red blood cell count normal, Red cell distribution width normal, Urinary incontinence, Vomiting
Clinical narrative: 8/15/17 @630pm-Received three injection vaccines: Polio, Meningitis, Yellow Fever; 8/16/17 @500am-first dose of oral typhoid vaccine with glass of cold water; 8/17/17 @800pm-vomited after attending wine tasting event (did not drink enough wine to cause that); 8/18/17 @500am-second dose of oral typhoid vaccine with glass of cold water; 8/18/17 @700am-terrible nausea, fought off vomiting 8/18/17 @1100am-could not hold off vomiting any longer. From this time until ~4pm, I vomited many times, mostly any water I attempted to drink and bile, as there was nothing else to vomit. I tried drinking water a couple of times, but others, I vomited without any input of water. A pounding headache developed from all of the vomiting. The last vomit before going to the urgent care was so violent it caused me to urinate on myself. 8/18/17 @400pm-went to Urgent Care and was given a 4mg Zofran and a bottle of Gatorade. They needed to do bloodwork before administering an IV. The technician could not get the needle into my vein to acquire blood. I began vomiting within 5-minutes of taking the Zofran (as instructed) on top of my tongue. I did not attempt the Gatorade, and left the office when insisted on trying other veins to acquire blood for testing only prior to making the decision to administer fluids. My stomach was tender when palpitated, but I assumed that was due to the excessive vomiting. 8/18/17 @500pm-went to Emergency Room. My color was pale and I started to struggle more with memory (i.e. I couldn't remember that it was a typhoid vaccine without looking it up on my phone). IV line was started, and I was given: Sodium Chloride 0.9% IV, Route=IV, Dose=1000mL, Started: 17:59, Duration=30min morphine Sulfate, Route=IVP, Dose=4mg metoclopramide, Route=IVP, Dose=10mg  8/18/17 @700pm-felt well enough to drink a glass of water and was able to keep it down. I was discharged after that and was okay, but started feeling nauseated again on the ride home. I did not vomit and went to bed as soon as I got home (I did not consume any food on 8/18/17). 8/19/17-I woke up after a poor night's sleep still feeling nauseated, but not to the point of vomiting. I was able to eat a few bites of bland food and have water, but I did not overly push eating or drinking. I rested most of the day due to little energy and lingering nausea. 8/20/17 @430am-Took 4mg Zofran tablet under the tongue. 8/20/17 @500am-third dose of oral typhoid vaccine with glass of cold water. A couple hours later, the nausea increased some, but not to the levels of the previous day. I also had abdominal cramping and low-grade fever (~99.5 degrees). I took another 4mg Zofran at 11am. I continued with the cautious eating (small, frequent meals of bland food) and drank only water and banana milk. I had a bad headache develop in the afternoon which I took a 80mg ibuprofen (actually, a Duexis) for the headache. I tried a small amount of slightly more adventurous food in the afternoon in two small amounts and it seemed to settle okay. By around 400pm, my nausea subsided to a small amount, but the low-grade fever remained. I continued to rest and went to bed without eating another meal. 8/21/17-I woke up after a poor night's sleep and moderate nausea returned. I attempted to work out, but after ~15-20 minutes, I started feeling very nauseated, so I stopped exercising. Currently, I have low-grade nausea, abdominal cramps, and a headache. I forgot to take the Zofran this morning, but will do so this afternoon. I am still able to eat very cautiously and drink water. I don't feel like I should push it yet. I have one more typhoid pill to take tomorrow morning, and I plan to do so with the Zofran, not exercise, and continue to eat cautiously.