Saturday, July 2, 2011

INSECT BITE AND INFECTION – PART DEUX

Never have much liked crawly things like bugs and frankly, all insects, perhaps with the exception of the docile, beneficial and colorful lady bug (excuse me – ladybirds) which is actually a beetle. Folks who have had fall infestations of lady bugs in or on their homes (literally by the thousands) probably don’t share my admiration. Having said that I do understand the natural order of things and that without insects and other like critters we (Homo sapiens) probably wouldn’t be here…

Then there are spiders that are not insects, rather members of the class Arachnida. I have a personal and up close relationship with these critters. Last year (2010) my Montana spider bite and subsequent staph infection required almost three months of treatment and as my Mother would have surely and rightfully observed, was a “ghastly” experience. It was far from my mind this new year though a continuing, healthy reminder that none of us are immune from the slings and arrows of Mother Nature. One of my brothers was bitten by a Brown Recluse spider while attending Baylor University many years ago. That bite became staph infected and even with aggressive, state of the art treatment he now sports a deep scar that reminds me of the Grand Canyon… Like some now fulfilled rite of passage I thought my 2010 experience was behind me. I was wrong

Now this isn’t going to be a whiney pity-party post, rather an alert for all you folks who think this can’t happen to you. Please take heed and use my experiences for your benefit. I am in good health and have no underlying health issues so no compromised immune system. Like the doctors have said, just pure bad luck and being at the wrong place at the wrong time?
Yes, they really said that…

Three weeks ago I had been working in the yard, strained my lower back and went to my doctor for a quick consult. While I was there I had him look at an insect bite I had received the evening before on my right knee. He verified that it was, indeed, an insect bite, advised me to keep it clean (I had) and let him know my status the next day. Mind you, I was leaving for a wedding in Colorado Springs in a week and didn’t want a repeat of my 2010 spider bite episode. I was cautiously optimistic since after the wedding we were headed on to Montana for a relaxing week in the Beartooths.

By the next day (Saturday) my knee was raging and the doctor prescribed a multi-purpose antibiotic which I started that weekend though by Monday my right knee was even worse. I saw my dermatologist on Tuesday who confirmed that the wound had become infected, verified that it was that run of the mill staph [Staphylococcus aureus (S. aureus)] and went to work with his trusty scalpel. That was fun, not… Mind you, there was concern that the infection might spread to the knee joint so the doctor prescribed a much more powerful antibiotic and anti-inflammatory that I continue to take as of this posting.

By Thursday (we were leaving the next day) I thought it wise for the doctor to see my knee once again as it appeared to be worsening. I was unable to make an appointment though he prescribed yet another antibiotic and on Friday we started for Colorado Springs.

I won’t go into much detail but the knee closely resembled the Pacific Ring of Fire (Popocatépetl), an apt metaphor appreciated by one MD, PhD. It wasn’t pretty though the pain was tolerable. I was hopeful that when the antibiotics finally kicked in the mend would start. After all, this was probably just a mosquito bite and did not manifest the ever expanding necrotic tissue of my spider bite. Everything was going to be OK….

By Saturday there was no improvement though an alarming indication presented that the infection may now be spreading up the leg (not venous). We went to the wedding where two young people were beautifully married and became as one. The Father of the Bride along with another wedding guest are eminent physicians though they certainly had other personal Family business on their minds. I wasn’t going to belabor them with my problems.

The wedding reception was held at The Broadmoor, the five star/five diamond, iconic and constantly updated resort hotel property that may be the epitome of the greatest hotel and hospitality available in our country today. The Broadmoor resort was formerly the site of the Broadmoor World Arena, a historic ice arena where many of our figure skating Olympians (and hopefuls) trained. I vividly remember as a young man watching on TV the World Figure Skating Championships held five times between 1957 and 1975 at The Broadmoor. So, this place has special meaning for me on both the sporting and hospitality levels. Little did I know that I would be attributing yet another significant experience to The Broadmoor.

I parked the car, hobbled into The Broadmoor and while seeking out my understanding and sympathetic Partner spied our hosts in the person of the Father of The Bride and his distinguished medical associate. The good doctor greeted me then immediately looked in the direction of my right knee. Someone had been talking.

He immediately posted hotel staff to secure the entrance to the men’s room where he and the other good doctor waited until the bathroom emptied (there was a long waiting line) and then thoroughly examined my knee with what seemed great consternation. He notified me that I would not be going to Montana, rather heading back to Dallas. He recommended that I see a top notch infectious disease (ID) doctor preferably at UT Southwestern.


With the very able and critical assistance and direction of another outstanding MD now at UT Southwestern I was able to see a specialist who confirmed the observations and diagnosis of the Colorado Docs, stating that he would have hospitalized me had he seen me then. My very supportive and empathetic partner verified that the Colorado Docs were also going to admit me in the Penrose St. Francis Hospital in Colorado Springs though the assurance of my hasty retreat back to Dallas cooled their ardor. All sorts of activity was going on around me and I didn’t have a clue. Some things don’t change…

The doctor at UT Southwestern’s Aston Clinic upped my medication and kept the regimen of my dermatologist in place. He forbade me to return to work so I lost a whole week of vacation time which we have, thankfully been able to reschedule for the first week in August. I was home-bound and with my leg elevated, slept much of that time. Were it not for the sympathetic ministrations of one Cairn terrier named Willa (she was constantly at my side), I would have surely reached the utmost depths of boredom.

I earnestly thank all of the doctors for their great service including the Father of The Bride in Colorado Springs and especially my partner who always seems to know best.
She is very wise….
The raging wound is subsiding though it would appear that this battle will continue for another couple of months. My message is clear for all you folks that think you are above the same experience. Well, we all know that Ned is getting long in the tooth and probably starting that long slide to senility. While that may be true, staph is everywhere, literally on your skin and by extension throughout your home and business place. With the evolution of the more resistant forms of staph (MRSA), frankly, we can’t use enough caution. Just ask any hospital where there has been an alarming uptick in the incidence of staph. This bacterium is incredibly opportunistic and that small, innocuous insect bite or seemingly minor scrape or cut can be a wide boulevard beckoning staph to come, pay a visit and stay a while.

Always pay special attention to objects and areas that are handled or frequented often to include doorknobs, light switches, tables, chairs, desk surfaces, counters, banisters, railings, etc. Pay special attention to shopping carts in grocery stores and exercise equipment in health clubs. Most retail outlets and clubs/spas (and even churches) now offer sanitary, anti-bacterial wipes. Use them often. When you go into a public bathroom and are required to sit on the toilet, always use sanitary covers if provided.

Wash your hands often and vigorously especially after touching your mouth and nose. Pretend you are a doctor preparing for surgery every time you wash with soap and water just to make sure you’ve really cleaned them. Use hand sanitizers when soap and water aren't available.

Don't share towels and washcloths with other folks. Wash your clothing and towels in hot water and bleach. We went to Costco and bought a pack of white hotel towels and washcloths which are for my exclusive use.

If you are member of a Christian Church and denomination that celebrates the Eucharist/Holy Communion, beware of the communion chalice which could contain more than wine or grape juice. Experts tell us that while there is no real evidence that drinking from a communal cup will prompt additional exposure to disease, they admit to the potential. We have all seen folks with a cold or flu taking communion. We have not drunk from the communion cup for years and practice intincture where the bread or host is dipped into the chalice and then consumed. In the Episcopal Church the priest dips the bread in the wine and places it on the tongue of the communicant. Likewise, after we “pass the peace” we wash our hands as soon as reasonably possible.

Again, we can’t be careful enough. Trousers and long sleeved shirts and a ready supply of duct tape will help… Be clean, stay well and live long.

Aye,

Ned Buxton

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