Sunday, April 27, 2008

{CAUTION!!! GROSS-OUT ALERT!!!}...It Was Just a Little Cut on the Hand...

Not being a good blogger about the technical bits, I don't know how to put things *below the fold.* Please take this caution for what it's worth: if you're squeamish at all, you may not want to read on, okay?

What started off a chain reaction of incidents was a cut on my hand.

There I was up at the dig site, in the pole barn. This is a primitive site, as most are. We camp in our tents, circled around a large clearing. There's a pole barn where we gather to eat and talk and play Scrabble at night and hear interesting, short, and always fun, talks put on by the curators or students.

The pole barn has electricity and a nice hot shower. The curator leading the current dig doesn't mind us plugging in our Electrical Stuff. I think I brought the first laptop to the site four years ago. Now there's lots of them. We plug in our electric toothbrushes, cell phones, all that.

And at that pole barn, we eat well. Our curator loves to feed us.

This year, however, the chef reneged just before the dig opened. Oh no!!! But! Our esteemed camp leader, fossil identifier, and general all-around *Go To* (for everything) person, Eureka, is a fine cook in her own right. So she cooked for us through the whole dig, and did a great job.

The kitchen knives in the pole barn weren't very sharp. A young man from Louisiana sharpened them. Eureka told me about this, and I just HAD to brag about something to her. Last summer, in my travels, I acquired a rather ridiculous looking knife sharpener, the sort of thing you see advertised on late night TV for $9.95. And it's entirely unprofessional looking. But boy oh boy, can it sharpen a knife!



So I sharpened her knives even sharper.

Unfortunately, I tend to be unsafe. This sharpener is something you hold in your hand. Since I didn't watch the late night TV commercial that sold the product - I got it used - I'm not sure how you're supposed to hold it as you sharpen the knife.

I bet you can see where this is headed.

So, yeah. I cut myself. Badly.

Sorry, no pix of the original cut. It went through all the layers of skin; I could move the skin back and forth and see the muscles underneath. It was only about an inch long, just deep. It's on the knuckle of my left forefinger, where the finger meets up with the hand.

argh! I felt like a fool and a half.

I washed it and slathered it with Silvadene. Eureka told me where I could find superglue. After I let the Silvadene soak in for a bit, I wiped it dry again and superglued it shut. The cut was so deep it took three to four applications to fill 'er up.

Then I wrapped that hand in some serious padding to protect it and finished the rest of the knives.

The next day, half of the hand was swollen and red. But it didn't feel warm, and it didn't feel like MRSA, which has its own particular pain. As one of the other volunteers said, it looked like trauma swelling, and that's all.

See, they don't like to stitch folks like me. If a wound heals shut too quickly, trapping MRSA germs inside, we usually grow a big icky abscess. As I found out with Poor Mr. Foot, that can be a real mess.

There was really no point in leaving the dig and going to the ER. I did everything they would do, with the exception of a nice big shot of novocaine. I take antibiotics every day. I would have loved the shot, but hey. It wears off anyway.

I didn't want people to know what happened; or if they found out, tried to hide how bad the cut was. I was definitely embarrassed. This is what I get for showing off.

For several days, the wound healed without infection. It did fine until I got home. Then I hit the yard. Way overdid it. A very good idea would have been to fill my latex glove with Silvadene.

Well, hindsight's 20/20.

When this all started it struck me as humorous. Here's where my sense of humor began to deflate.

I felt it the minute the germ entered. Intellectually, I recognize this sounds ignorant and ridiculous. But I can tell when it comes in. I can tell the difference between a MRSA infection and some other kind. It just plain feels different, it has its own particular pain. Every time I've said that, and a doctor doubted me and cultured the wound, I've been right.

Oh God above, I hope I'm wrong this time.

Within a couple of days it was hugely infected and *draining:* dripping clear to cloudy fluid, constantly. I would do all I could to sort of squeegee it clean, but the pus never stopped dripping out no matter what I did. The hot redness would flash up from my fingertip to the wrist, then decrease again after I took my antibiotics, then flash out again....

One exception: I went to bed one night wearing a latex glove filled with egg white. The antibiotic in raw egg whites has done wonders on some of my wounds. The next morning, the wound was bleeding. I took this as a good sign, that the infection was clearing and the blood itself was helping kill off the infection.

Wrong. Next morning, it was back to the messy ooze.

In these two pix, it's almost healed. It looks so deceptive. Like nothing, really. Just a little swelling and redness.

That deceptively innocent appearance is one of the reasons more Americans die each year from MRSA than from AIDS.




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You may have to click the pic to see what's happening here. It's draining fluid: as my hand is closed, then opened, it forces the fluid out. The stuff dripping down is the fluid in question. This is what came out again, just after I'd blotted it dry.

We have NO idea what's in there until the cultures come back. But the dermatologist who cultured it, Dr. G, knows as well as I do that it's highly likely to be pus caused by MRSA. Pus isn't always thick and white. It comes in an amazing variety of colors and consistencies. Believe me.

I know this can be awful to hear and to look at. That's why I put that warning up there. It's unpleasant stuff, and it's stuff I have to deal with pretty often. I'm sorry to inflict it on you.

But this is an exceptionally bad situation, for a lot of different reasons.

The infection itself is one. My other hand is already partially crippled from a different infection; I don't want to lose one bit of function in my remaining *good* hand. Something else happened too, a sad incident with a doctor. And last but not least?

Even after my dermatologist referred me to a hand surgeon for immediate evaluation and possible debridement, I've been refused treatment because of the MRSA. Over and over and over, four refusals. Three other hand surgeons were out of town. There's no one else left on my insurance plan. None.

Get this: They told me they won't operate until the infection is cleared. But to clear the infection it needs that little operation called debridement.

It's a perfect Catch-22.

I try to stay calm about these things, take them in stride. But hearing that? It kicked me in the gut. I went through the most incredible series of phone calls, an ER visit to force treatment, shock from my other docs who'd also never heard of this refusing surgery business, offers from them to personally call their hand surgeon colleagues for me...and at the end, it was all to no avail. It's not just the doctors. The surgical facilities themselves won't allow me across their threshold.

And now it's too late.

The infection has closed, trapping the germs inside. The infected area is clearly much smaller. But it's still in there, in the joint and finger and hand. It's still in there and still incredibly painful.

Tomorrow we'll see if I can find a hand surgeon who's both back in town and willing to treat me. Since the wound is already closed, they'll probably wait now, to see if it forms an abscess. If so, the scarring will be far worse than if they'd debrided it last week.

There's lots more to this story, but that's enough for now. It's bedtime for me.

And thank you, all you readers, whether you comment or not. I draw so much strength from you, just knowing you're out there, listening. Knowing I'm not alone.
.

8 comments:

Nancy said...

Damn, damn, damn, damn, DAMN!

Desert Cat said...

ARgh.

SeaPhoenix said...

Kind of stepping on Pretty Lady's toes here, but I send healing energy visualized as, cliche as it sounds, as little red crosses streaming out from my hands to yours...hope it turns out ok...we luvs ya, blogmom.

pepektheassassin said...

O, poor Ms Hand....I hope you find someone today to take care of her (and you). Sending little red crosses, too.

Pretty Lady said...

No toes stepped on--these things increase exponentially with help.

I got to perform ad hoc surgery on a boyfriend's cyst, once. He'd had this lump on his back for years; I'm the sort of person who can't resist picking other people's zits, so I squeezed it. Then he spent the day under a car, scraping the bump across the pavement, and rubbed it raw. I ended up going into it with about a gallon of peroxide, a sterilized needle and antibiotic ointment. It was one of the most deeply satisfying experiences of my life. There's something about draining ancient gross gook from a wound that floats my boat.

It healed just fine, all flat and smooth.

I can't believe those stupid surgeons. They're surgeons, for God's sake! This is what they do! You think they'd be just as into scraping off gross infected tissue as a humble Brooklyn massage therapist!

Jan said...

K..I am so sorry that you have to go through this stuff all the time.

It is hard to believe that a doctor could refuse to treat you when you are in so much danger..what happened to that oath they take? It is sickening.

I suppose it is because MRSA is so contagious, but they should know what to do about that.

It probably happens more than we realize, though..once an EMT crew got all incensed with us because my mom had MRSA, and we hadn't told them before coming to pick her up..never mind the fact that they had just transported her home from the hospital five days before.

What happened to human compassion?

I guess that is something else that has gone by the wayside.

I will be praying for you.

k said...

Nancy, Desert Cat, SeaPhoenix, Pepek, Pretty Lady, Jan - and any and all lurkers: There is no doubt in my mind that all of your kind thoughts and prayers and little red crosses made a difference here. I felt that again today, calming me as I went forth.

Jan, your mother is so often in my thoughts at times like this. I seem to see her as a very calm sort of person - accepting, understanding, being patient with basic human nature. Maybe I'm reading too much into this, but she strikes me as a woman who would forgive those EMT guys on the spot. I try to remember that when I get mad, because that's harder for me to do.

Today is Wednesday and the wound opened up again on its own and started draining, and the hand surgeon sent me right back to the ID doc, but with clear xrays and an assurance that I've been doing things right.

Poor Ms Hand! She feels better knowing you all are there, and waves *Hello!*

Pretty Lady, you crack me up! I've already learned I'm not the only one who leans that way, but you're the least shy one about actually saying so that I've ever heard. I think it must be encoded in our DNA, huh? Surely that sense of great satisfaction from wound cleaning has helped further the species along, all these years.

And that's precisely why I was so shocked by this Refusing Treatment business. I mean, this is the ultimate in battling disease and curing patients, isn't it?!

The goal those doctors have chosen is this: *Only operate on the essentially healthy.*

How incredibly unsatisfying. At the depth of what makes our souls what they are, what gives them meaning and any kind of essence that reaches beyond us, these surgeons have chosen the cheap and near-meaningless option. They CHOSE IT. With eyes wide open, with will as free as a bird, they opted for the least rather than the best.

I'd expect that from one or two, here and there. But five out of seven? That's a sorry state of affairs.

Pretty Lady said...

Least shy? Really? You hang out in the wrong crowds...

I think the instinct must come from monkeys grooming each other, and eating each other's lice. ;-)