Monday, November 28, 2011

NaNoWriMo Whatever Day It Is and Giving Thanks

Okay, since I've delayed the official Herald News story,  here's the incident that (sort of) kicked me out of the National Novel Writing Month.

I love antiques, and my house is full of them. One particularly heavy dresser, with heavy drawers that stick, belonged to my maternal grandmother. On November 9th at  8:15 p.m. exactly (I know because I had just looked at my computer clock and realized I was fifteen minutes later feeding the cats), I decided to grab some cozy flannels and set up for a shower while the kitties were eating.

As I was shoving the resisting drawer back into place, my calico, Faith, decided at that moment to leap across the room and grab onto the draw to peer inside. I slammed her paw flush into the drawer, leaving her dangling. I never heard an animal scream as she did. I quickly pulled on the drawer, and as I did, Faith, in pain and fright, sank her teeth into my thumb.

Owwww! PAIN!

The drawer popped; Faith dashed away; and I knew I was in trouble. I flew down the stairs and into the bathroom and started washing out the wound in hot, soapy water, forcing the pinholes to bleed. Faith stood at the top of the ladder crying, crying, crying. My thumb was already reddening and swelling, but it seemed impossible infection could be developing so soon. The redness, I told myself, was because I have chronic hives; the warmth I felt was due to the fact I was running my hand under hot water; the swelling and tenderness was trauma to the thumb bone.

I comforted Faith and then showered and climbed into bed, but the status of my thumb bothered me. I remembered the past cellulitis incidents of my children and how rapidly a soft tissue infection could spread. I recalled a neighbor who, after noting a slightly red hair follicule, took a short nap and awakened to a swollen face; he died en route to the hospital. I switched on the light and examined my hand. The thumb was definitely red and swollen. I turned the computer back on and typed in "cat bites."

I learned one could adopt a "wait and see" approach with some dog bites, depending on their severity, but cat bites must always be considered a medical emergency. The combination of their long, sharp fangs and the particular type of bacteria they carry in their mouths meant a bite from them literally injected that bacteria directly into soft tissue. I was already sleepy from the drowsy antihistamines I take at bedtime, so I needed a ride.

Ron had to be at the warehouse in three hours, so waking him up was the worst option. Timothy was already in bed and had to be at work at seven o'clock in the morning. Christopher had been dragging all day and was nearly asleep, but he works from home and had nothing pressing to do the next morning. Sooo, after enduring all of his "you're paranoid" and "this can wait until tomorrow" comments, we were off to the ER.

Confession time. I don't know if it's because I have allergies, chronic hives, and asthma (and have experienced the unpleasant consequences of those afflictions), but I have a medical phobia. I am not afraid of hospitals or needles, but of the substances I have to swallow--or have injected into me--in the name of healing. I fear nasty side effects and allergic reactions. I FEAR them. However, I feared worse what might happen to me should I not treat this a cat bite, so here I was in this unhappy predicament.

The ER trip was straightforward, as I feared it would be. One tetnus shot (My last one was in the summer of 1986) and my choice of two antibiotics. Because I'm allergic to penicllin (big surprise), the protocol is one antibiotic from each of two lists. The nurse rattled off two medicines I'd never had--doxycycline and clindamycin--which meant, if I became allergic to either one, I wouldn't know which one.

Sigh. Decisions.

Let's back up. Just two weeks ago, my daughter and web administrator Sarah Stegall had four wisdom teeth removed. Preoperatively and during the post-op period, she took low doses of prescribed clindamycin. On day nine of her treatment, she emailed me a photo of a pimply-looking rash over her shoulders and chest and asked me if it was subcutaneous emphysema. I called her.

"Subcutaneous emphysema? Do you know what that is?"

"No," she said, "but a friend had it after having wisdom teeth pulled."

"That's not Subcutaneous emphysema, but I am concerned about the rash."

Sarah was not. "It doesn't itch."

"Doesn't matter. Have you ever had a rash like this?"

"No. I woke up with it today."

"I'll call you back."

I researched clindamycin reactions and found it can, indeed, produce a distinct pustular rash. I emailed Sarah and told her to show her pharmacist. She agreed to do it later. I awakened the next morning to frantic texts from Sarah. She was in the ER, rash spreading, throat tightening, in pain with two dry sockets and waging war with the doc on call, who claimed it was impossible to have an allergic reaction to a major antibiotic. Abridged ending 9minus the unprintable comments I had about the doc): antibiotic stopped, new pain meds initiated, and an ER trip to the dentist for socket packing. Fast forward to cat bite.

"Can I take Bactrim?" I'd had drug for the first time last year for a leg abcess (another long story), and I had tolerated it "okay."

That eliminated the doxycycline, but the nurse insisted I still needed the clindamycin. I told her about Sarah's reaction and my phobia.

"Have you ever tried Flagyl? We could use that one instead."

I didn't like that option either because that was another unproven drug for me. SIGH! Yes, I know there's only one way to prove it.

"Well," I said slowly. Rebekah did well with clindamycin. I'll try it."

The nurse brought in the clindamcyin first and suggested I wait half an hour before taking the Bactrim. That way, if I had a negative reaction to the clindamycin, I'd have it in the ER.

Well, I did fine with the Clindamycin, and then the Bactrim, so I was sent home with the next morning's dose and told to expect the hand, which was now as swollen as the thumb, to get worse before it got better. I was also instructed to elevate the hand as much as possible, although typing was not prohibited. Just what a features writer on deadline wants to hear.

By next afternoon, I was running a low grade fever, and the infection was traveling up my arm. The plan was to now temporarily stop the Bactrim and initiate ER IV anitbioitic treatments with a powerful cephalosporin used to treat bacterial meningitis. In theory, so I wouldn't have to be stuck each night for the next five nights was to leave the port in my arm. However, I ended up blowing every vein, so the result was a painful arm by day and a new stick each night.

On Monday night, after the last treatment, and as I was stepping out of the shower, I noticed a familiar-looking rash over my chest and shoulders. It was Day Five of the clindamycin. I called the ER (It was 10:30 at night), rattled off my dilemna, and mentioned my next dose was due in an hour. I was to resume the Bactrim in the morning.The nurse consulted with a doc and told me to stop the antibiotic and see my primary tomorrow.

I did, hoping I had enough germ-busting drugs in my system to skip choice number two from list number two, but I wasn't that lucky. She wrote a one-week prescription for Flagyl. From the very does, swallowed at home in a flurry of anxiety, and, within ten minutes, I felt a tightening of my body from head to toe.
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Now, let me explain that I experienced a similar reaction to an abundance of epinephrine when I had the pheochromocytoma (an adrenal gland tumor; again, another long story), so I dismissed (sort of) the reaction to my anxiety. I also had the same reaction to H2 agonists last year when a doc prescribed them as a secondary drug for the hives, but that drug also produced a rapid heartbeat, which did not happen with the Flagyl.

Do you see why I have a drug phobia?

Sooooo, since tachycardia was absent, I chalked up the reaction to nerves. The next morning, I hardly felt the squeezing, but the following night, it was back. The following morning's dose was fine and so on, until Friday night when, five minutes after I swallowed my Flagyl, I experienced a pressure so strong, I had difficulty swallowing and typing; my muscles painfully ached. That's when I realized my morning reaction might be milder because I was full of all the antihistamines from the previous night.

Shaking all over, I called my doctor, and she told me to stop the medicine and complete the Bactrim. As a precaution, she suggested I add Benadryl to my anithistamine cocktail, but since I take so many and with "off label" dosees, I decided to monitor my symptoms and go to the ER, if necessary. I was fine.

I did, noticing the Bactrim also caused the same symptoms, just milder, so it's definitely a drug I will use with caution in the future.

So what does this all have with National Writing Month? Well, these allergic reactions and infection treatments took a huge bite (so to speak) out of my already tight schedule, as I frantically rushed to complete the assignments already on deadline.

I did, however, establish a habit of working on the prequel for one hour a day. Basically, I go through every chapter, flesh out the outline in place (not quite to the first draft stage yet), and make lists of the topics needing further research. I have worked my way through nearly a third of the prequel so far and that is one-third farther along than I was October 31.

I also, for the first time, had no assignments bleeding into the four-day Thanksgiving weekend. This meant I made a nice dent into the beginning editing of Visage, of which I am highly pleased.

Finally, I found some wonderful support and understanding in the person of Tommy Connolly, Bryony's media researcher and developer, who recently appeared on Animal Planet's Extreme Animal Phobia series to treat his bat phobia.

Every day, he sent a nice Facebook, "How's the paw," message and encouraged me in my courageous facing of the medicines. While I'm not quite at the stage of saying, "Wow, I'm so glad this happened. Look at all the good that came from it," I'm certainly thankful and appreciative of those things, just the same.

And Faith? Well, she was a little shy the following morning, but we cuddled and made up. Seriously, if she would have slammed my hand in the drawer, I probably would've bitten her, too.

Harder.





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