Sunday, August 06, 2006

Uh oh...

Posted by Picasa On Thursday, I had a Boniva shot. This is a new thing for me, and it's supposed to last for 3 months. Since my gut's all eaten up with acid and inflamed from post-nasal drip and handfuls of meds, it seemed like a great alternative to deal with my moderate bone loss.

Only thing is, any opening in one's skin is an invitation for MRSA to enter and set up camp.

Before any medical visit, I wash from the neck down in surgical scrub soap (Hibiclens). I put it on a wet washcloth, smear it everywhere except, ah, personal parts, and let it soak in for a few minutes. At the very end, I wet the washcloth again, and use the diluted residue very carefully on parts of my face, but rinse it off right away.

I do this routine anywhere from once a week to once a day, depending. And - I'm still *colonized.*

The MRSA germs live in one's nasal passages, folds of skin, clothing, bedding...and the kind I picked up, the *community-acquired MRSA* - aka CAM - infects even healthy people through healthy skin. It is so virulent it's scary. I've been taking a powerful oral antibiotic, Minocycline, 200 mg/day, for eight months now, and I STILL get new infections all the time.

That's why I get little skin lesions, *mini-MRSA's,* when I garden. Little nicks and scratches get infected almost instantly. I do treat them carefully, but they don't worry me like injections, blood drawing, or surgeries. Those methods inject MRSA way deeper in the body. They give it contact with a channel - like a blood or lymph vessel, a tendon sheath, bone sheath...and MRSA just LOVES a channel. It travels on them, like they were little MRSA highways.

So when my hand started feeling tender by Friday night, and was warm and red and puffy by Saturday morning, I was pretty sure what I was in for.

It took about eight hours before my house and body were tidied up enough for me to feel comfortable about going to the ER. By then I was shaking with fever - for me. Like 98.6, instead of my usual 97.0. Oh, sickening stuff, MRSA. Dizzy, weak, headachy.

Since it's a hand, and that great hand surgeon works out of Imperial Point, I went to their ER instead of Holy Cross. Where, unfortunately, I encountered one of those Dismissive Secretly Hostile Passive-Aggressive Ignorant Know-it-Alls, in the person of the Triage Nurse. He made me so concerned they wouldn't take this seriously, I called the hand surgeon on my cell phone. Hm. Second time I've called him at 9:30 on a Saturday night.

He got the page, called me back, and asked what the jackass said. --One example: I said I'm very sick, and that I carry MRSA, CAM MRSA. Jackass said, Oh, everyone's got that. You're not very sick.

Hmm...Then the doc said, --Wait and see what the ER doctor says. The doctor matters, not the triage nurse.

Of course, he was right.

And the doc was wonderful. She took one look and knew.

See, if you just look at a newly forming MRSA infection, it's not a very dramatic looking thing. People sometimes get told they have a sprain, get sent home - and die. Look at the pic. It doesn't look like much. Not to me, anyway.

And I know a bit about what to look for. I can see the redness starting to creep up my fingers, for instance, and up to my wrist. I've been watching it grow since Friday night. And another thing they say about this? The amount of pain caused, compared to the minimal physical appearance of the infection, is astounding.

Once they've seen some MRSA, medicos get so very serious about it, some will do that thing I call *Giant Step Backward.* It just doesn't look like much to the uninitiated.

And not to that ignorant fool of a triage nurse. Who I expect I will never see again. Why go back? If I need the hand surgeon, he can go to Holy Cross. I know his whole crew is all set up at Imperial Point there, but I won't subject myself to that kind of treatment if I have a choice. Not even by one peon staff member.

I was pretty sure they were going to incarcerate me for 10 days with vicious antibiotic drips again. All my wonderful neighbors are set up to water the plants and such, got my ducks in a row. But! Instead I got a prescription for oral Rifampin - it's a TB antibiotic, and it's worked against my MRSA before - and sent HOME. Eat it with the minocycline and call ID in the morning.

Oh, I feel like a little kid let out of school early, unexpectedly, on a sunny springtime afternoon...

Monday I'll call the infectious disease doc. Even if I have to get serious IV stuff, she does a lot of home health care infusions instead of inpatient admissions. We already know I can handle Vancomycin, physically at least. So I know she'll keep me out of the Icky Place if she can.

And we'll see what develops.

It might clear up with just antibiotics. Hope hope hope. It might make an abscess, which has to get removed surgically, by draining, debriding. Or by removing the affected extremity. In either case, it might or might not spread further in my system.

I'm buckling my seatbelt.


Livey said...

OH honey, I'm so sorry! You are in my prayers! Love ya.

Desert Cat said...


k said...

Thanks, Livey - I need all the help I can get!

You both know what this can mean. So, seriously - thanks.

I don't want to jinx it. But I think maybe, maybe, we got it in time.

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