Adventures in Health Care (not for the squeamish!)

"It's got gangrene, it'll have to come off." The words came back to me from some long ago Civil War movie in which one of the characters has an injured limb requiring amputation. The sick guy, usually lying next to the campfire soaked in sweat, is then given an anesthetic (bottle of whiskey) and a chunk of wood to bite on during the "procedure" to remove the offending limb. I shuddered, then snapped back into the present; I was looking at internet photos of wounds caused by flesh eating disease ("necrotizing fasciitis," if you’re into official terms). I'd had a nasty looking pimple on the back of my shoulder, which turned into a boil, which broke open after about 2 weeks and then became infected, rapidly progressing (that’s the only delicate way to say it) after that.

It was a Friday, and though I was changing the bandage often, putting all kinds of over-the-counter preparations on it, I had come to the frightening realization that, just during the past few days, it had gotten noticeably worse, not better. It was badly infected, there was a reddish area (which was growing larger by the day) extending from the wound about halfway down my arm, where the infection seemed to originate. My coworker gleefully predicted that I probably had blood poisoning, too. I was getting fever chills and was now convinced that the flesh eating disease MUST be what I had. Being phobic about needles and doctors, and never having been sick or injured a day in my life, I had the biggest scariest decision to make EVER. Was I going to go see a doctor about this, or take a chance and see if it would improve over the weekend?

Examining the wound after work in the mirror (the only way I could get a good look at it), I faced the obvious, that I had a "situation" requiring immediate medical attention. My arm was becoming the Grand Canyon right before my eyes. There was some greenish looking tissue near the opening; even my untrained eyes could see it was necrotic, or getting that way. Finally, my fear of becoming an amputee outweighed my fear of seeing a doctor. I drove up to the closest walk-in clinic and sat in the waiting room crying. The nurse practitioner that saw me immediately identified it as a staph infection, and forced me to dispense with my needle phobia long enough to take an antibiotic injection. Without it, she stated, I'd probably be in an emergency room, on an IV drip, before the weekend was over. She prescribed an oral antibiotic (Levaquin) and a topical (Mupirocin) to put on the wound itself.

She informed me that Staphylococcus aureus is a common bacteria found on the skin of many normal healthy people, usually causing no harm. It can, however, cause a variety of infections and lesions, ranging from minor to life threatening. This usually occurs when an injury or damage to the skin allows the bacteria to invade the body and overcome the body's natural defenses. An MRSA (Methicillin resistant Staphylococcus Aureus) is a strain of staph which has become resistant to traditional antibiotics such as penicillin, methicillin and amoxicillin.1 MRSAs are treatable with newer types of antibiotics, such as clindamycin, erythromycin, floroquinolones, rifampin, and tetracycline. The Levaquin that I was prescribed is in the floroquinolones class, and was, therefore, a fortunate choice for my infection.

Often the bacteria penetrates skin that has been damaged by burns, cuts, and insect bites.2 These community-associated MRSAs often appear on the skin as a boil or pimple (as mine did) that may be swollen, red and painful and have a discharge.3 In my case, I had burned my shoulder in that area weeks before; the pimple appeared after the burn had healed, but perhaps my natural immunity in that area may have been compromised by the burn.

The following Monday, after another trip to the walk-in clinic, I was dispatched post-haste to a wound care center, where the doctor debrided the wound, leaving a hole in my arm that resembled my idea of what a gunshot wound would look like. A tissue culture from my wound confirmed that I had a community associated MRSA, and the treatment included daily cleaning, packing, and periodic measuring of the depth of the wound, for the infection had tunneled some 5 cm. into the soft tissue of my arm.

The doctor and nurses were baffled that someone like me, healthy and relatively young, would walk in off the street with a CA (community associated) MRSA infection. Historically, staph infections and MRSAs occurred in institutional settings (hospitals, nursing homes), where an individual's immunity was already likely to be compromised, and the individual was living in close quarters with many others. However, an alarming number of staph infections, including MRSAs, are being spread throughout the community, infecting people who are otherwise normal and healthy.

Another tissue culture a couple of weeks later showed that the infection had indeed responded to the prescribed antibiotic. I was fortunate that debriding, the most painful aspect of the treatment, was only required on the initial visit, but the treatment and healing process lasted for another month.

And I lived to tell this tale.


NOTES

1 “Healthcare-associated MRSA,” <http://cdc.gov/ncidod/dhqu/ar_mrsa.html>, October 10, 2006, Centers for Disease Control and Prevention. March 18, 2007

2 Davidson, Tish, Haggerty, Maureen, and Gale, Thomson, “Stapholococcal Infections,” Gale
Encyclopedia of Children’s Health, 2006, <http://www.healtline.com/galecontent/staphylococcal-infections>, 2007, Healthline Networks, Inc. March 18, 2007

3 “Antibiotic-Resistant Staph Now Epidemic,”<http://www.everydayhealth.com/PublicSite/ShowArticle.aspx?IsP=news/%20534/news534715.xml&dp=2006/09/01>, September 1, 2006, Everydayhealth.com, March 18, 2007

Odyssey 2007?

For the first time this spring, tonight I was able to leave the windows in my room open without the dog barking at every single little noise. It was another very pleasant evening with a nice cool, not cold, easterly breeze. At some point I became aware of a noise, loud but some distance away, that gradually worked its way into whatever dream I was having as my smoke alarm going off. As I woke up to the sound, a steady, annoying drone, I realized that it was the fire alarm at the Lido, a condominium at the end of my street.

As I became more and more aware of, and annoyed at the sound (it persisted noticeably even after I closed the windows), and I realized I hadn't heard any sirens on Gulf Boulevard (imagine THAT!), I thought, "That sounds like something else." But what?

It took about 10 more minutes of that awful sound piercing my semiconscious brain, then I remembered. One image found its way into my now fully conscious brain: The ape throwing the bone into the air in 2001: A Space Odyssey. It was that same sound, the sound that emanated from the monolith that indicated the presence of the aliens and drove the apes, well, ape-shit.

SO. If anyone reading this heard what I heard at around half past midnight (am still hearing and now it's almost 1 a.m.), and you don't live within 500 feet of the Lido's fire alarm, then we may now be under the aliens' control! Get your Nikes! Be prepared to evolve! Or something.

Musical Musings #1 - REALLY Good Lines

I've been working on a little project with my CD collection for the past week. I guess that means it's not such a "little" project. I've taken my entire collection of discs out of their variously filthy, cracked and broken jewel cases and filed them in several bulky, unweildy CD binders. Doing so has sparked a bunch of blog-worthy topics, such as best and worst of, most embarrassing, my "eclectic" tastes, passing fancies, etc. I may do a bunch of posts, or just a few. I would LOVE to get some comments/contributions, if anything comes to mind!

One of the topics I found myself contemplating recently was REALLY good lines from songs. I could only come up with two, but they're SO good, I just had to write about them. In fact, saying they're good, or even REALLY good, doesn't do these justice:

From "The Long December" by the Counting Crows: "All at once you look across a crowded room and see the way that light attaches to a girl..."

And, from Al Stewart's "Year of the Cat:" "She comes out of the sun in a silk dress, running like a watercolor in the rain..."

Both of these lines hit me right between the eyes with images so powerful I could paint a picture!

So, if anyone has anything to contribute, I'd love to read them. But keep it real! If anyone writes, "Our house, in the middle of our street," "I get knocked down, but I get up again" or anything from "My Sharona"...instant death. You get the picture!

And I'll keep thinking, too.

Piercing Pagoda Redux

You gotta watch me every minute! I got my ears pierced (a second time) during my lunch hour today. I was on my way from the Bath & Body Works store to Yankee Candle, and was passing by the Piercing Pagoda (how '70s is THAT?), so I stopped just to peruse their earrings. Then I was chit-chatting with the clerk, and before I knew it I had two more holes in my head!

There was considerably less drama surrounding this event than the first one, which occurred two days before Christmas, in a mall jam-packed with Christmas shoppers. My friend Bonnie gave me the earrings/piercing as a Christmas gift. She had been pestering me for weeks to do it. On this particular night we had dinner at one of the mall restaurants and then segued into the trip to the Piercing Pagoda. Yes, they tricked me with food.

I was actually pretty nervous, being the weenie that I am regarding needles. Then this mom and her little girl happened by, and Mom told daughter to watch and see if she wanted to get her ears done. So in exchange, I asked her if she'd hold my hand, and she did! So Bonnie held one hand, a little girl held the other, and then it was done.

So I offered to hold the little girl's hand next, and she said, "I think I'll wait until I'm nine."

Such a big girl I am. I went and did this all by myself. Of course it WAS an impulse kind of thing, but how surprising that I would do such a thing on my own, on the spur of the moment, without someone to prevent me from fleeing at the last minute!

Timmahhhhh......

Timmy is at the doggie beauty parlor this morning, being "coiffed." He gets his hair cut more often than I do, and it's more expensive! But like the lovelies in the L'Oreal commercials, he's definitely worth it. It's awfully quiet without him in the house; the cats are basking in the calmness and safety of his absence, and Pancho, for this brief moment in time, is The Alpha Dog.

People think I named him after South Park's Timmy (prounounced "Timmahhhh," using a voice like the Budweiser "Wassup" guys--a little hard to explain if you haven't seen it), the paralyzed kid confined to a wheelchair who is unbelievably cool, in spite of his disabilities and the fact that his own name, "Timmahhh," is the only word he can say. And that's ok, it's fun when people ask his name and I say "Timmy," and they respond with "Timmahhhh," then we both say "Timmmahhh," and it's like a little inside joke that makes me feel kind of cool, too, for giving a dog such a clever name. But that's not the real reason for his name.....

I'd had a pug named Fred since he was a puppy; he was almost 8 (not that old), and he'd been like a sick child all his life with various health problems, the curse of the "puppy mill" dog. His last malady was an apparent inner ear infection, causing him to run around in circles, lose his balance, etc. He seemed to be responding pretty well to the treatment for that, but he woke up sicker than usual one morning (didn't want food, no energy at all). I went off to work anyway and made arrangements to leave early because I planned to take him to the vet as soon as I got home.

When I got home, he had died. Hours earlier. When I left for work that morning, I had a dog. When I got home, I found this thing on the kitchen floor, this awful, dead, thing. I kept circling around him, not wanting to touch him, not quite believing that this happened, that he was really THAT sick. That he was really dead. I called the vet, and they said I should put him in a trash bag and bring him in. A TRASH BAG? How could I take my Fred to the vet in a trash bag? But I did what they said, then I stuffed that into a gym bag, with some difficulty, and hopefully no one knew I had my dead dog in it, the dog that died because I was a crummy parent.

The next day, I went to work but was pretty useless...the following day began my "summer vacation." Not only was I devastated at the unexpected loss, but I was feeling a lot of guilt over going off to work and leaving him, not realizing how sick he really was. I was even more guilty because waited way too long to take him to the vet in the first place, so I felt responsible AND guilty. A pretty heavy load.

I had a doctor's appointment up in Clearwater that first day of my vacation, June 30. I stopped at the SPCA on my return trip, since it was on the way, "just to look." The SPCA, had only one smallish dog up for grabs, a cocker-poodle mix called a cockapoo. He was a handsome but frou frou-y fellow with white curly hair, reminiscent of a muppet. He seemed to have a friendly disposition, we went outside to the play area and he ran around a little bit, behaving very noncomittally, as was I, because I really just wanted my Fred back. Of course the price was right, and I knew if I left to think about it, he'd be gone when I got back. And, if it didn't work out, I could "return" him. So, without a whole lot of conviction, but knowing it wasn't an un-doable decision, I adopted him on the spot, deciding that I wasn't ready for another pug anyway.

I spent the next couple of days trying to decide what to name him. He came with a name, "Beji," which turned out to be a typo for "Benji." I didn't like it with or without the "n." I ran through all of the cool names I could think of: Spike, Chester, Max, Fozzie, Oscar (the cat's name is Felix), Zippy, Einstein, Scooter, even Timmy (the South Park Timmy), but nothing seemed quite right.

Finally, sitting in the back yard one afternoon, I was pretty much down to "Spike" because of my weird sense of humor, or "Fozzie" because of his muppet look. Then, out of nowhere, I found myself thinking about a friend of mine that had died sometime the previous year. An old bartender friend named Tim who had moved up north a few years earlier and ended up dying of liver failure. He was a good natured heavy drinking Irishman who apparently drank himself to death.

Tim had the same color hair as the dog. White-white. I thought what a nice tribute it would be to Tim's memory if I named this dog after him. So then (and here comes the weird part) I went to the archives of the local paper and looked up his obituary. While I was waiting for the page to load, I got this weird, pee-shiver kind of feeling. There was going to be something freaky about this, I just knew it. The obituary finally appeared, and there it was. He had died on June 30 of the previous year (2005), ON THE SAME DATE I got this dog.

He was Timmy from that moment on, and (I swear I'm not making this up) he responded to the name from the first time I uttered it. Some things just have no explanation other than synchronicity, and this is one of them. This frou-frou muppet dog was sent to me.

There is another pug now, but that's another story....

Ch-ch-ch-changes...

Yesterday was like Christmas in my world, a geeky girl's dream come true! I know I'm probably the last computer literate person on the planet to do it, but I FINALLY got a DSL internet connection! I have no idea why it took me so long. Well, yeah I do. Resistance to change, the comforting and reliable sound of the static and whining of a modem connecting to its server, and the fear that getting switched over was going to involve extreme pain and suffering at the hands of a telephone repairman, with a Snake River Canyon butt crack, poking around my computer and phone line .

There was a repairman involved, but I never saw him. Apparently the rocket scientists at the "Central Office" cut off my phone service while they were enabling the DSL. So they sent someone over yesterday to check the service coming into the house, couched with many dire warnings of the extreme charges involved if the guy actually had to go into the house to do any work, due to my (utterly irresponsible) lack of insurance coverage on the inside lines. The repairman called me at work mid-morning and told me the problem had been fixed, no inside-the-house-butt-crack-revealing activity or home equity loan required.

When I got home, I had my phone line back AND my DSL up and running. A short while later I was all hooked up and actually sent an e-mail and made a phone call AT THE SAME TIME. But wait! That's not all! I had a router that I got free with my laptop, never thinking I'd actually use it, but hey, it was free. So I found my box of mostly useless old computer stuff, dug around til I found the router, connected it, and now I have WIRELESS access, too! To test that, I sat IN MY BED with my laptop, unconnected to anything, really far away from the router (well, it was probably about 15 feet), and sent an e-mail WIRELESSLY! So I sat in my bed for the rest of the evening sending wirelessly generated e-mails, just because I could! It boggles the mind. My mind, anyway. Not ONLY because I'm blonde, but because my house is over 50 years old. Nothing EVER happens this easily in MY house.*

I wonder if I'll be able to cancel my dial-up ISP account that easily.


*My new cooktop, for example, is still seated inside an opening that's approximately 1/4" larger than the cooktop. That is to say, the opening in the counter is 1/4" larger than it's supposed to be, so now I have to figure out how to shim the cooktop in, somehow, without it looking like, well, like I shimmed it in myself.

Is there hope for me yet?

I've been reading A Three Dog Life, by Abigail Thomas. It's a personal memoir about Thomas' life in the years after her husband was hit by a car and suffered irreversible brain damage. I started reading and in the beginning thought, "I won't be able to relate to anything in this book." For one thing, she didn't write enough about the dogs, IMO. However, it is the kind of book I could see myself writing. A memoir/personal experience type of book surrounding a particular subject.

Reading it reminded me once again of how envious I was when I read about the publication of Julie and Julia ( http://tinyurl.com/3dt67u ), in which the author, Julie Powell, sets out to cook all of the recipes in Julia Childs' famous cookbook, Mastering the Art of French Cooking. In a year. In a kitchen even crappier than mine. At the time I was heavily into cooking as a hobby, learning new things and experimenting on an almost daily basis. I once spent a whole weekend and several dozen eggs making (and ruining) souffles. I had discovered foodie writers like MFK Fisher, Ruth Reichl, Michael Lee West, and Laurie Colwin (I liked Colwin best because she seemed so "ordinary"). As I spent time goofing around in the kitchen with different things, I even began drafts of a handful of essays, with the idea of coming up with a collection of 30 or so to try and sell as articles or publish as a book.

But something was missing. I couldn't come up with a good "hook." In addition to a killer hook, J&J had a number of other themes running through it, too, such as Powell's attempt to get pregnant, her job as a temp at Ground Zero after the 9/11 attacks, her online blog about the cooking project, and frequent dramas involving her friends. Plus, the whole thing was hysterically funny. Without some other thread of readerly interest running through it, I couldn't imagine that anyone would want to read about my souffle experiment or anything else I had written. And I certainly had nothing notable going on in MY life.

I also did too much research. The more I researched, the more discouraged I became about my potential for getting anywhere without some sort of formal culinary training or restaurant experience or connection to someone in the publishing world. Even Julie Powell had a kind of "connection," her husband is the editor of a national magazine (Abigail Thomas, I just discovered, is the daughter of Lewis Thomas, a science writer whose works I've read and enjoyed immensely).

Eventually my enthusiasm for my idea waned, and I drifted off onto something else, some other pastime. I still cook from time to time, but nothing like I did during that year. I guess my problem is that I don't really have any one subject that I'm passionate about or an expert on, nothing that has held my interest over the long haul. I flit from hobby to hobby and I usually bail out at the point when I could actually get good, or progress beyond the novice stage.

Anyway, last night, as I was finishing A Three Dog Life--it's short, a small book of less than 200 pages, I came to the part that I SWEAR was written just for me. Thomas wrote: "I didn't start writing until I was forty-seven. I had always wanted to write but thought you needed a degree, or membership in a club nobody had asked me to join. I thought God had to touch you on the forehead, I thought you needed to have something specific to say, something imortant, and I thought you needed all that laid out from the git-go. It was a long time before I realized that you don't have to start right, you just have to start. Put pen to paper, allow yourself the freedom to write badly, to get it wrong, stop looking over your shoulder. You idiot, I would say to myself after half a page. What makes you think you can write, and then I'd crumple it up and aim for the wastebasket....that's the voice I need to banish every morning."

If I can keep that in mind, maybe there is hope for me yet.

I Loved the 70s, too...

One of my recent afflictions is the inability to get songs out of my head (is it OCD or Old Age?). All I have to do is hear a stray chord from, say, "Rubber Band Man" on my coworker's radio, and (I can Name That Tune in one note) I'm stuck listening to the whole song over and over again in my brain, til another comes along to take its place. And this station plays Margaritaville EVERY SINGLE DAY, and WAY too much Fleetwood Mac. The strangulated sound of Stevie Nicks' voice makes me want to pierce my eardrums with a knitting needle. But I digress.

Anyway, yesterday I found myself thinking about Helen Reddy. So I did a quick search, and there it was, her official web site. Yes, she's still alive and a "practicing hypnotherapist" in Australia, near Sydney. "I Am Woman" plays while I peruse lots of photos and the promotion of her autobiography, "The Woman I Am," which I promptly reserved at the library, and the latest greatest hits CD. She doesn't look much like her glam shots from the 70s, but I think there's something to be said for just growing old the way we're intended to. I was appalled to see recent photos of Barbara Eden, who still looks much like she did back in the Jeannie days, but her skin is so taught and shiny you could bounce a quarter on it. Plus she has this one droopy looking lip going on that kinda gives it all away...but I digress.

SO. Last night in a feverish fit of nostalgia, I dug through my CDs, which had been packed up when I put the house up for sale (that's another story), and selected my Helen Reddy's Greatest Hits, along with Boz Scaggs' Greatest Hits, and America's "Horse with no Name," another greatest hits compilation, thankfully without the inclusion of "Muskrat Love." I haven't listened to much music during the past few years, since I evolved from my techno phase and got sick of Partridge Family tunes for the second time around (yes, I admit it; I actually have remastered CD versions of most of the Partridge Family albums).

I've always been a fan of one hit wonders. My absolute FAVE was Bo Donaldson and the Heywoods. Remember that annoying "Billy Don't be a Hero" song? (HA! Now YOU can suffer like I do--I'll bet you my David Cassidy Fan Club certificate that you'll be hearing THAT one all day!). They had a couple of other songs that I really dug, songs I'll bet YOU'VE never heard of, like "Who Do You Think You Are?," "Don't Ever Look Back," and "Deeper and Deeper." These songs are Vintage bubble gum, chartmaking singles and, in MY humble opinion, truly should have elevated this band beyon OHW status. Bo Donaldson was cute and multi-talented. I clearly remember being awed watching him playing a keyboard with one hand and a trumpet with the other on the late Bob McAllister's "Wonderama." But I was in love with Mike Gibbons, the lead singer. Actually it was his voice I was in love with, typical 70's, Bobby Sherman meets Rob Grill (The Grass Roots, think "Temptation Eyes").

On a whim, I typed "Bo Donaldson" into my Yahoo search engine, and there they were. www.bodonaldson.com , the Official Web Site. The Official promo shot shows five 50-somethings with short hair and dorky suits--Bo's blazer is fire engine red (the rest are black, unmatched), their last known gig on New Year's Eve in (where else) Las Vegas. Bo is still kinda cute, but alas, the Voice, Mike Gibbons, is no longer with the band. But they now have a Greatest Hits CD AND an Official Newsletter. I looked around to make sure no one was watching, signed up for the newsletter, and ordered the CD but stopped short of buying a T-shirt and an autographed band photo. I can admit this stuff here because no one will ever read it. It's as good as writing it in a little pink diary with a lock you can open with your fingernail.