… finally. Relief from the cat-bite infection, which turned into cellulitis around the bites and along my shinbone to the ankle. Blessed relief from the 100-degree-plus, week-and-a-half-long heat wave (today it barely topped 80 degrees). Relief from repeated runs to the VA medical center for emergency care, from the hospital stay, and from follow-up appointments. Relief from IV needles, blood draws for tests and cultures, and blood pressure cuffs.
And, best of all, relief from worry.
Today, the infection is but a tiny glimmer of its former bad ‘ol self. The punctures have completely scabbed over and are drying up, and the angry redness under and around them, while still present, shrinks smaller and smaller each day. There is absolutely no pain any longer, even when I press down near the wounds or along my shinbone. The huge needle-caused bruises on my inner arms are fading slowly. And instead of feeling like my get-up-and-go got up and went, I feel normal. Not trembly. Not low. Normal.
As Martha Stewart used to say, “this is a Good Thing.”
Of course, my RA hands and bursitis hips are back to their normal, too, which is stiff and twingy and achy. Hey, no prob. I can take it. But I still think it’s amazing how the body can abandon its usual joint-and-bursae-bullying to wage war in earnest against a real enemy. I’m thankful that it does, too.
And I’ve learned another thing about fighting off a serious infection while being 55 years old and immuno-suppressed: don’t think you can just hop up and resume your normal routine after three days in a hospital bed connected to IV antibiotics. It’ll take you anotherweek to recover from such feather-headed foolheartiness.
I’m going to try shopping and cooking for my aunt and uncle again tomorrow. I think I’ve rested and healed long enough this time.
…the entire weekend, which I spent in the hospital when the cat-bite infection went south on me. I went to the ER on Friday afternoon because the bites looked like they might be getting worse, expecting nothing more than a stronger antibiotic prescription. Instead, they put me in the hospital for a round of stronger IV antibiotics and so they could keep a close eye on the infected bites. I came home today, armed with more oral antibiotics. The condition of the bites is back to about how they were at this time last week. I’ll write more when I’ve got a little more time, gang; probably tomorrow night. Right now it’s getting late and I’m due at my aunt and uncle’s house early tomorrow morning …
Here’s a puzzle: Since being bitten by Mouse-the-cat a week ago, I’ve had very little RA or bursitis pain.
Could it be because my attention has been more focused on the bite wounds? You know—this immediate pain is more noticeable than that other, older and more routine pain?
Like that old joke: “Aw, you’ve got a headache? Here, let me bash your hand with a hammer. You’ll forget all about your head!”
Or could it be that my body’s immune system has been so busy fighting the infected bites that it hasn’t had antibodies to spare for its constant, erroneous attack on my joints? And if my body isn’t attacking my joints and making them become inflamed and painful, maybe those busy antibodies aren’t attacking my hip bursae either?
I have no idea if either situation, or both, could be possible. But it’s not the first time that some immediate, temporary pain has pushed my RA pain out of the way for a while. I’m not alone in this, either—I’ve read several other RA bloggers who’ve mentioned this phenomenon.
Whatever it is, it’s real, odd and fascinating. Any thoughts on this out there? I’d love to hear them.
In my previous post, I wrote in a sort of brief, tongue-in-cheek style about how I managed to get bitten by my cat-friend, Mouse, on Thursday night last. She was terrified when it happened; in retrospect, I shouldn’t have tried to untangle her back feet from the thin purse straps that had gotten wrapped around them. But honestly, it all happened so fast! I was bitten and bloody before I knew it.
That was almost a week ago. Here’s an update:
First off, I’m doing just fine. But just as it was a couple of years ago, when I was bitten by my dear old dog, I have serious reason to be grateful to the VA medical system. I’ve no doubt at all that my life would have been at risk without them.
Because I’m taking disease modifying anti-rheumatic drugs, or DMARDs, for my rheumatoid arthritis, my immune system is somewhat compromised. These drugs suppress and inhibit the body’s normal biological defenses in an attempt to keep them from mistakenly attacking and destroying its own joint tissues. But those defensive antibodies also protect the body from foreign bacteria and viruses. By taking DMARDs, I’ve made myself more prone to infection and have a harder time fighting it off than most people do. It’s the trade-off that so many of us who have autoimmune arthritis choose to make to avoid awful pain and disability.
So, being infection-prone, I made a beeline for the local VA medical center for emergency care. I arrived at the ED just before midnight. Once I was called back to an exam cubby, a nurse thoroughly cleaned the many puncture wounds Mouse had inflicted on me. Some were on my left hand over the large knuckles. The rest were on my right leg, about halfway down my calf. All of them were angry, raw, ugly and beginning to swell. And they hurt about as much as you might expect such wounds to hurt; to me, the pain was about a four on the pain scale—unpleasant but bearable.
The nurse drew vials of blood for analysis and cultures and sent them to the lab. Finally, after looking the wounds over, the ED doctor prescribed oral antibiotics and told me to come back on Sunday for a progress check. I took the first dose of antibiotics when I got home.
By late afternoon the following day, it was clear that rather than healing, the wounds were getting worse. Both my hand and my calf had become grossly swollen. Both were also becoming increasingly tender and now were quite painful. Walking on the injured leg hurt enough to make me limp; dropping my injured hand below my heart made it throb angrily. It appeared that the cat bites had become badly infected. But since I was taking antibiotics, I decided to wait before running back to the ED.
By the evening, the wounds were so much worse that I decided that making the 30-mile trip to the ED would be prudent. Sure, the doc might tell me that all my symptoms were normal, not to worry and send me packing. But I figured it was better to be safe than sorry.
The ED was surprisingly quiet for a Friday night (I’d expected a packed waiting room and a long, long wait). But after only a few minutes, I was called back and they got started. I was having my temperature and blood pressure taken when one of the docs wandered by. “Whoa,” he said, stopping dead in his tracks, his eyes on my arm. “Look at those streaks!”
Sure enough, in the ER’s bright lights, several ominous red streaks were clearly visible running from my hand up to just above my elbow. In the much dimmer light at Mom’s house, none of us—Mom, me or my sister, who’s here visiting from New Mexico—had seen them. Their significance was dire. Not only were the wounds on my hand infected—it was traveling. Without much more aggressive treatment, my wounds could start to gangrene. I could lose my arm and/or my leg to amputation. The infection could become systemic. I could die.
The doctor wasted no time. Within a few minutes I was hooked up to an intravenous drip containing a much stronger antibiotic. When it was gone and the nurse removed the IV, he drew a thick black line with a Sharpie along the border of the hot, red, tightly swollen area that now surrounded the puncture wounds on my knuckles. He drew a second black line around the wounds on my leg, too (although there were no red streaks coming from them, yet).
“If the redness expands past those lines, I want you to drop everything and come
right back here,” he said, the seriousness of the situation clear in his voice. “Don’t delay. Even if it doesn’t, I want you back again tomorrow for another infusion.”
I agreed to do as he said—and that’s what I did every day until Monday, when that day’s ED doc decided that day’s infusion would be the last. The streaks on my arm had disappeared, the heat and swelling in my hand and my calf had gone, and the wounds were healing nicely. The pain was mostly gone, too, except for some tenderness immediately around the punctures. He changed the oral antibiotics I’d been taking to a stronger variety and told me I didn’t need to come back unless things went south again on me—in which case I should run, not walk, back to the ED.
Yesterday, I saw my primary care doctor, who had called me Monday afternoon, wanting to see the wounds. She gave me a thumbs-up and told me to be sure to finish the oral antibiotics.
No problem, doc.
And that brings me to today. The wounds on my hand are now just small scabs. They look like I scuffed my knuckles. The leg wounds still look a bit scary, but they’re also healing well. I’m doing great.
If there’s a moral to this story, it’s this: If your pet is in a terrified frenzy, don’t get anywhere near those teeth and claws. She will bite you, even if she’s normally the gentlest kitty in the world. When they’re scared, animals react defensively to protect themselves, and they do it indiscriminately.