Sunday, January 1, 2012

Best story ever

This will not be pretty. But it will be pretty awesome. I've been sitting on it for the past months, partially to make sure I was healed, and because other stuff was going on, but, in light of 2012 and whatnot, here goes:

I'm not particularly germ-phobic. I think dirt is good for us. Dirt, get it? But I do. And I think the fear of immediate contamination is just a fear that keeps us from connecting w/ others. Not that I kiss the puking homeless guy we pull out of a dumpster, or use the same bent fork as our buddy Josey the Junky, but, I generally try to wash my hands and not let fear keep me worrying.

At work, this is largely a good thing, for we wade through so much shit, literally and figuratively, and I see the germaphobes suffer so much, that it seems a waste to be excessively afraid. People shit themselves when they drink too much, when they pass out, when their hearts stop. They vomit from head injuries, intoxication, meds, fear. When we are trying to revive someone who would otherwise be dying/dead, the process of chest compressions, interrupted, bodily function, IV insertion, oral airway insertion, what-have-you, causes the leaking or release of the stomach's contents. Acrid fluids spilling from nose and mouth, around and through which we continue working.
Oh, and urine. The ammoniac tang of long-soaked urine in the flesh and furniture--it can burn the eyes.
Sick people hawking/hocking up chunks of lung; open wounds offering close-up vantage for the inner workings of the body, or the separation of bone from bone. Bedsores and pustules and edemic bodies. Etc. Etc. Etc.
We show up and deal with who and what we find. I wear eye and hand protection, and don't go looking for opportunistic infection hook-ups.

You see where this is going?

We responded to a shitty rehab center in August. We were covering for E6 but the name of the place guaranteed it would be a shitty call. It was.
A 43 year old man had fallen the previous evening and was now calling 911 w/ an open wound, possibly a broken hip.

Sitting overnight with a broken hip, bones protruding? It isn't wholly impossible, given how shitty this place is. We arrived and went to the room. The staff is largely African immigrant and underpaid. Someone's always rushing to find the chart of the person they've called us to help, which means a. we don't have info on hand upon arrival, and, b. the person who could/should be informing us of pertinent info is shuffling off down a hallway looking for paperwork, leaving us alone with the person, who often is unable to speak for him/herself.

This man was able to talk. He said he had 'the flesh-eating disease' and had slipped from the bed while trying to reach for something the previous night. He was stoic but blasted from long exposure to ridiculous suffering. We uncovered the layers of bandages. He lay there, staring numbly, passively. His life sucked. There was no broken hip (fortunately). There was an open wound wider than a good-sized grapefruit, with the flesh in varying stages of infection and decomposition. Sure enough, however, at the very center/core of it, there was his hip bone. The poor fucker's flesh had eaten/been eaten all the way down to the bone. Septic infections are no joke.

We recovered the wound and tried to gently transfer him to the medics' stretcher. As bad as it was, the man was calm. I kept thinking, he has suffered lifetimes to be this numb to suffering...

Afterwards, we washed up and shook our heads at his ill fortune. The staff had never arrived with his information sheet, but 'the flesh-eating disease' spoke plenty. Most nursing homes are rife with MRSA (medicine resistant Staph infection), to the extent that it's just assumed that everyone has it or is at risk. They are supposed to follow infection-control protocols, but... Yeah, well.

About two weeks later, I noticed an ingrown hair on my thigh. I sweat a lot and wearing cycling shorts & riding in the summer, I tend to get ingrown hairs with some frequency. Did I mention I sweat a lot? I do. I really do. There were two little bumps; one I picked at, as is my wont, and the other I ignored (somehow). The bothered one got angry and red, as is its wont, then went away.
A week or so after that, the one I hadn't messed with became red and a bit enlarged. It grew some more. I changed my expert opinion from cycling-related ingrown hair to spider bite. Which, for me, means contact with almost anything in nature. I have that sort of skin/blood. Bugs LOOOOOVE me, and I can't reciprocate. I swell or react to any type of bite.

Another week, and the fucker was larger and redder and sore I got a bit worried when it looked like this:
So I drew a circle around it to monitor the swelling and called my doctor's office. 'My' clinic...they were like, uh, sure, whatever your name/number is, we can see you at some point before the end of days.
So I went to the Minute Clinic. I told her I thought it might be a spider bite gone bad. I also reminded her that I was not a medical professional. She looked at it for a bit then shook her head. 'That looks bad. You should probably go to the ER or your regular doctor.' I agreed. She gave me a five-day cycle of meds.
I made an appointment at 'my' clinic anyhow.
Five days later, it hadn't spread much but it wasn't any better. I could feel the heat radiating off it through my shorts.
I went to the clinic, introduced myself to 'my' doctor, and he said, 'That's MRSA.' I said I'd been cycling a lot, that I sweat a lot, and that I tend to react badly to bug & spider bites. He nodded and said, 'Yeah, well, whatever way you got it, that looks like MRSA, and that's bad.'

He lanced it, slitting the boil in two directions then squeezing it really hard. He kept apologizing, saying, 'I'm going to be mean to you for a little bit, but it's necessary.'
Finally, I pointed out that, if he was doing something medically necessary, then it wasn't MEAN, just painful. If he stabbed my left leg when my right was a mess, that is mean, but otherwise, just say, 'This is going to hurt,' and get on with it.
After he lanced and squeezed it, it looked like this:

I had to return to see him every several days to make sure they'd gotten all the infected tissue out. He gave me some strong meds, saying the stuff the Minute Clinician had provided was the exact type that MRSA is resistant to. Go figure. So, the shit I was on was both really hard and likely to make the little monster even more-resistant if it didn't wipe it out. Super-Strain of joke.

He irrigated the wound then packed it with wadding. It was funky. He said that, as it healed from within, we'd use less and less wadding each time. Finally, after a couple of weeks, he said I could do it at home. Annie was in Philly but I figured I could do it myself, or enlist Flann if necessary.

Here's how it looked while it was healing:

I couldn't ride at all, and was trying to not bang it, or infect anyone in my house. The doc was a bit casual about how freaking infectious this thing was. I got him to show me how to clean and repack the wound, and I filmed it for later reference.
Here's how that went:

So, well-schooled in basic medical practices, I went home and did it myself, with Flann standing by to help...

Well, that was fun.
Only as it was healing and I was leaving a follow-up appointment did it click that I might have contracted/caught it at the rehab center. I asked the doc how I could have got it from a spider. He said it was possible but more likely that I caught it from someone w/ MRSA. Then I remembered the call in August.

It's only relevant because I missed some work, and the medical bills. I filed an exposure report and the city actually worked with me, but w/o an explicit connection, there wasn't enough to say I definitively caught it from the guy with the flesh-eating disease. The rehab place won't release its patients' information, but since they're also required to inform us when we're in presence of MRSA, it seemed fucking hypocritical that they were protecting 'the client's privacy' at expense of medical responders' health. Fuckers.
Here's how it looked healing, and now, several months later.

Yay, diseased flesh & strong medicine...

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