Whew! Whadda week!
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.
I’ve learned my lesson, I think.
This is quite a story, Wren. Glad it has such a good outcome. I’ve been wondering how you’ve been and glad to have stumbled over here to find you still blogging and telling the stories of life.
Crumbs – great that the medics did such a good job, but how awful for you!! A very good warning about how infection-prone one can be on DMARDS too.
Wow, how scary that you got an infection. Just shows how potent these DMARDs are. So glad you’re on the mend!
YEOW that looks bad!! Glad yu go to the doctor quickly.
I am so glad you’re healing and had the good sense to go back to the ER when you did! It’s a wonder they didn’t keep you in the hospital. Hope you continue to heal and Mr. Mouse doesn’t turn into a werecat anytime again soon!
That all sounds very scary – but I’m glad you listened to your body & made the trek back to the ER. Glad to hear things are improving!!
Scare-y! Wow! Glad you listened to yourself and went to the ED. I am always terrified of infections since I began Enbrel. I have had many but none as serious as yours! Take care of yourself and heal well.
It isn’t just the lesson about keeping well out of the way of pets when they are scared though Wren – just think where her feet may have been and what cats eat/chew on. Whether you are on DMARDs or not there are bacteria on those claws and teeth that you don’t want floating around in your blood stream – and anyone is at risk from them. Cat scratches are always a bit dodgy.
Whoever you are, a cat scratch or bite needs checking out soon after the deed and if you are given antibiotics and the wounds still get worse – go and ask advice sooner rather than later. It isn’t like abx for a chest infection or something – that will take a day or two to improve but it still shouldn’t get noticeably worse.
But with this sort of scenario it isn’t gangrene that is the real fear – it is good old-fashioned “blood poisoning”. If the toxins from the bacterial infection get too overwhelming and you go into scepticaemic shock – it’s a major journey back. And there is a very fine line between OK and not OK – sometimes only minutes. Organs that have started to shut down are difficult to revive.
Don’t mess with scared kitty-cats – and don’t mess with the wounds they inflict.
So glad you’re on the mend,
You have learned your lesson more than once and well you have taught me to be more careful – although I could have done without the graphics. 🙂 I am glad that things got better. From experience, I know things get worse before they get better. Anyway, be kind to yourself.