Wednesday, July 30, 2014

Better to Err on the Side of Caution - Bat Bite - Part IV

This is picture is magnified even more than what I initially magnified and showed the ER PA.  Even he said, "Oh!"  I've cropped off the tiny line/scratch that was a bit lower and to the left of what you can see.  It seems to have come at me flying horizontally and then when it came back had dropped down for the next attempt.  UGH!  Am I a magnet for this stuff or what?!  No ...NO I am not ...God forbid!  maybe Murphy's law kicked in with me again.  No ...NO ...I am not superstitious at all.  For some reason ..I just like to invoke Murphy ...not sure why.  :)

I can't believe this happened to me ...AGAIN! what I said that Sunday night.   So what happened?  It began storming on that bat bite night and I wanted to go out to get the tubes out of the pool and also look for a hammer that I thought was left on the pool deck.   It was very breezy a relaxing way ...almost balmy (if not for the thunderstorm:), with big rain drops coming down steadily ...although not in a downpour.  It felt good to be out there.  Well except for the fact I was praying God would protect me from the LIGHTNING.  I was concerned about that.

 So I had already had the back patio light and the spot light on for a few minutes and then when I went out I was also carrying a flashlight so I could see on the dark side of the pool.  I gathered up a couple of tubes and was then holding the flashlight (on) up in air and about level with my neck.  (I never walk with one like that and don't know why then)  Wind ...blowing in a strong breeze, rain coming down and I was now under a tree and near the pool with the garden and picnic table on other side when I felt something bite me near the base of the left front side of my neck.  It was more then a mosquito bite but less then a bee sting and really hurt in an annoying way.  It was weird in that I felt this instant bit of annoyed anger which isn't a feeling I ever experienced with anything else that has bitten or stung me in the past.  Maybe because my neck is more sensitive.  Not sure.  But it was a uniquely annoying experience.  I don't recall swatting it the first time - but  remember I was distracted by the storm. being outside on rain soaked ground and under a large tree isn't the optimum place to be  during a thunderstorm.  I was also thinking of people I know of that were struck by lightning. It does happen - God forbid.  Anyway ... when it came right at me again ...I knocked it away with my hand the second I began to feel that sensation.  At that point I was wondering what kind of insect would feel like that. Admittedly I began obsessing about the possibility of a bat bite as I was headed back inside. I thought about there being a pond maybe 30-40 feet away and we do have bats in the area.  I've even seen them swoop over us while swimming in the pool at night.  (Actually - I do have a funny story about my concern a bat sprayed in my eye one night while swimming.  My neighbor and her daughter love to remind me of it.  :)  I'm not sure if I wrote about it in here previously.)  Anyway would've laughed if you saw me in the bathroom with a 10 x mirror and then finally with a magnifying glass with a light.  I couldn't see anything looking in the bathroom mirror. Hence my desire for magnification.  Then I saw the 2 symmetrical punctures with the 10x mirror.  But the two droplets of blood in the center of each puncture were only discernible with the bright light from the magnifying glass.

I thought if I could take a picture that I could enlarge it to be sure.  I kept trying to get a picture and just couldn't get it and then I tried taking a pic through the magnifying glass ...also to no avail.

Then I woke Mr SeaSpray up to look through the glass and he said , "Oh y-e-a-h.NOT what I wanted to hear from the man who usually downplays everything even when I want him to be concerned.

Then finally I just took a bunch of random bat bite pictures in the dark and then cropped and cropped said pictures in the computer until I got the picture you see above this post.  Oh and I got a cloth measuring tape and measured under the magnifying glass in mirror.  I did this because I was hopeful that I would read something that would indicate this couldn't be a bat bite.  Or that someone else familiar with these critters could tell me it wasn't from a bat.  It was definitely smaller than the other bat bite I had in 1999.  And that bite was just like a bat bite I had seen on another patient that came into the ER for the rabies series.

The difference between back then and recently is that I had what I thought was a bat bite from one residing under a rug that had been on the line all weekend.  It was a large dark rug and I never felt a bite and only noticed the 2 punctures when I went inside.  I freaked (sort of) that day because I had seen so many patients that summer get the rabies series.  And it looked like what one man came in with on his hand.  The same space between the fang marks.  Well  ...he had a puncture and a tear because the bat bit him on way out of a drawer he reached into.  And I could see that bite clearly without a magnifying mirror or glass... and for a few days.

Anyway ...I never heard flapping wings or saw anything either time.  I can still see that a bat could've flown out of that lg rug and not have known it but surely I would've heard or felt bat wings this time since I was out in the open.  But what else could it be???  What kind of a bug flies at night, in a storm and leaves tiny puncture wounds?  Although ...I don't know if a bat would sting under varying circumstances.  Or maybe that was the pain of the bite in my neck?  But then why didn't I feel anything the last time?  Although I had whipped the big rug off the line and then walked off to get the mail.

I set all that up for just in case case anyone might know what kind of insect would/could do that.  I also began thinking it was a bat because the back lights had already been on, drawing more of them into the yard as they headed for the lights and then there I was with a light close to my neck and what if a bat was flying in for a bug and instead got me ..twice?

I was so BUMMED about this because I did NOT want to go for the rabies series again ...especially if I didn't need it.  Especially since I reacted the last time with swelling lasting in my hand and forearm for years.  I believe I discussed this more in the previous posts.  :)

So on the one hand I was obsessing... but that part of this SeaSpray was fighting against the Queen of Denial SeaSpray.  That being said ...I do think that both SeaSprays knew how this was going to end.

Even though I was concerned ...I was more inclined ...okay the denying ...wishful thinking side of me ...wanted to believe it's wasn't a bat bite. But there is always a couple of killjoys in a group  ...well not always and they really are fun ...nice people ...but for me this time ...Killjoys with a capital "K".

I consulted with a couple of medical friends of them an ER nurse I had worked with.  Predictably (remember I said we knew how this would end?), they basically said that because I couldn't rule out a bat bite and because rabies is always fatal ...that the recommendation would be to get the vaccine.  Killjoys I tell you!  Also the nurse said it could've been a baby bat.

I was hoping for a flying snake ...flying spider ...or some kind of flying insect.  You know the kind that come out in thunderstorms in NJ while the wind is blowing and the rain is pelting down?  Maybe something was blown out of the tree?  A SeaSpray could only dream.  I even googled but my search was futile.

There is a five day window to get the vaccine, although the recommendation is to get it immediately.  Of course I waited until late in the afternoon on the last day of opportunity to do so.  (See previous post)  It turns out I may've screwed myself too because our insurance states one has to been seen in the ER within 72 hours of the incident.  I forgot about that and didn't initially see it on my card.  But ...GEE ...TWENTY years working in emergency registration ...I should have known better.  Like I said ...denial runs strong in me.  The insurance rep went on to say that my ER charges will be covered at regular insurance rates.  NOT good for ER charges.  But ...hope springs eternal and I will throw myself on the mercy of the rep I call if indeed that happens.  a can't blame a SeaSpray for trying.  :)

I admonish anyone that thinks they may have been bitten by a bat ...even if they aren't certain, to also go to the ER to get the Rabies vaccine.  Because just like my two friends in the medical field and the ER PA that also saw me said ...rabies is always fatal.  Most bats don't have rabies, but the disease IS fatal.

And that's all I have to say about this debacle.  Oh and I am glad that I did follow through with getting treatment.  I should've just gone in in the first place.

For anyone interested, previous posts about this are below or you can check my sidebar.  :)

 Okay LAST thing about this subject.  if you and your family discover that a bat has been flying in the house while you were all sleeping, the recommendation is that the entire family get the rabies series.  This is because bat's teeth are so small that you might not know if you were bitten in your sleep.

Needless to say I am a stickler about leaving doors and windows wide open ...especially at night when the lights are on.  Lights draw bugs ...and bugs draw bats.  need I say more?

Monday, July 21, 2014

(Revised - Update and stuff) Fast Track in the ED WILL be Fast - Part III

Hope is the word which god has written on the brow of every man hope quote

I opted to have fun vs going to the ED earlier today.  I'm not going to hate myself for putting the rabies booster off until now ...Sunday ...late afternoon.

Because ...

Hope springs eternal ...

Miracles do happen ...

And this SeaSpray shall remain ...optimistic!
Update Monday night:  The wait wasn't bad.

I asked the patients sitting outside waiting (not a good sign - but hope was still springing eternal in me.), how the wait was.  They said people told them they were there for hours.  While I was registering a lady came up to the counter with her son, stating she would return in the morning. (Also not a good sign - I was still hoping tho.:)  Of course not long after she left ...nurses came out for patients.  I can't tell you how many times I've seen patients do that.  Personally if I had an *emergency* ..I would NOT leave I'd figure time already invested in waiting ...and there is no guarantee it will be better at another time.  Maybe likely to better in morning but no guarantee.  Plus since it apparently wasn't a major emergency ...couldn't she just see a private doctor which would be cheaper?  I am judging and should not.

Well one more thing about that.  So many times patients would get annoyed and leave the ER I worked in and state they were going to the one I was in last night.  This is after waiting a while in our ER waiting room ...they then decided to drive the half hour over to the busier ER.  I guess people feel they have to do something.  And ...just like with the lady last night ...often times their turn was up next.

Anyway ...My wait time was an hour and a half or less.  I didn't look to see when I arrived.  Definitely an hour wait.  And I would've been out sooner if the nurse didn't tell me I had to wait to be sure I didn't have an allergic reaction.  Last week the PA let me go right away because I didn't have problems with the series years ago.  (Only swelling from the Immune Globulin)  They gave me the discharge papers and I was in my way.

And I thought about just leaving but I'm the person who is afraid to rip the tags off sofa cushions, etc., because I believe those "Do not remove under penalty of law ", threats.  I would feel disrespectful.  I was seriously tempted to leave when I saw that ambulance pull in.  But then I thought I'd be leaving my discharge papers that I don't care about anyway.  It turned out I could have left because I didn't get papers for the 2nd booster.

So now I'm done with that.  And I'm bat proof now ...or bat sh*t crazy ...or something like that.  ;)
My next and last bat post will go up with the picture of the fang marks on my neck.  "I VANT to SUCK your B-L-O-O-D!"  Don't mind me ...a bat bite to the neck causes me to think of vampires.  :)

Anyway ...I'll add the pic and write about what happened.

It was just so random ...and so stupid.  And really can we know if kids are safe outside ...or people that may not realize they may've gotten a bat bite?  And most bats don't have rabies.  But the disease is up here.

Also, the ER staff will tell you that even though most bats don't carry rabies ...because it is fatal ...the recommendation is to get the rabies series.

Thursday, July 17, 2014

Amused Orthodoc, ER Staff and Me :) Bat Post - Part II

This could me with some urology procedures and the endometrial biopsy.  Actually - I really don't react until the pain hits.  But today was EASY PEASY.  :)

Boy sure is a good thing I'm not a trypanophobic.

Or else this would've been one b-a-d day.  I knew I was going to the orthopedic office and then over to the ER.  I had been dreading the ER visit because I didn't want to go through it all all over again. (See previous post) And so my focus was on that.  I wasn't stressed or anything.  I was just hoping it would go the way I hoped.

So anyway ...after getting my 3rd set of Orthovisk injections (one in each knee - not fun), and then a Cortisone injection in my right hand for the trigger finger that has been bothering me since February (yes ...I resisted that too.), my orthodoc with a little almost smile says, "So you're getting more injections?"

No ...I'm done now.

"But you have more injections to get?"

No ...this was the third week of Orthovisk injections and I'm done now.

And then seeing his now grin light bulb goes on and I said in agreement ...O-h-h-h right.  Now I'm going over to the hospital to get the rabies vaccine. FOUR needles in one day!

Then I laughed as it hit me ...that not only did I get 3 injections in his office in 3 body parts but that now I was getting those topped off with a rabies vaccine at the hospital in what I hoped would be my arm.

It was.  YAY!  :)

I don't think most people would be smiling about this if it was them but it is kind of funny.

Then the ER PA was concerned when I said that this was going to be 4th shot of the day and so I showed him.  By then I was laughing at it and they laughed with me.  My blood pressure was up though.  I think it was because I figured it would be a booster but still had the concern about getting whole series and what if the big one has to go in my neck???  Also the PA wanted to hear my bat story (next post) and I was animated while telling it which must interfere with the cuff on my arm.  And it did come down ...although not as low as it should have but I was still a bit keyed up.  They should've done it just before I left.  But they probably figured it was on it's way back down.

Oh and the PA explained that even if I did have to have the Immune Globulin injection that in this case they would not inject into my neck because that could be risky for other reasons.  I'm just glad that shot was a moot point.

Had a nice chat with the nurses while he checked CDC protocols.  And I heard my urologist paged and it seemed so weird to me in one way because it seems like another lifetime ago that I was the frequent flier urology patient and emergent at that.  But no more.   I admit it took me a long time to believe I was done.  I feel like I received a miracle healing.  Someday I will do a final urology post to sum it all up.  :)

Anyway the shot in the arm was uneventful.  I just have to return Sunday for the 2nd booster.  Actually the PA said to come in in the morning because I will wait a long time if I come in in the afternoon.  Also ...I have to say I was surprised that I was in and out of there within about a half hour.  From registration to discharge.  That was a pleasant surprise.  I brought TWO books with me just in case they were backed up or emergencies came in.

And this SeaSpray says wistfully ...I miss working in a hospital.  Maybe someday ...after my knee replacements ...I will work in one again.  Or a medical office, urgent care ...something medical. I just feel so drawn to the environment (I see hospitals as a place where people are helped and have loved being a part of that process) and to staff and patients.  Of course I am not limiting myself to only working in a medical environment.  Something completely different might be presented to me that could take me off in an entirely different direction.  Time will tell.

But I sure am glad to have had the 20 years working in the hospital, with the emergency department and ancillary departments ...but especially Emergency.  And I loved being a support person to medical staff, other staff and patients.  I always saw that job as a gift and still do.  It was a great experience. :)

Now I have a couple other things to do and I want to get in the pool because I heard it will be 50 degrees tonight and I just want to swim a bit.  And I'll write about my Sunday night bat (?) experience in post #3 on this topic in my next post.  I suppose I should link them for future reference.

Ha ha ...I almost asked then for a sticker foe all my injection sites but thought better of it. :)

Oh and after I get the second rabies booster can call on me to get the bats out of your life.  Apparently I am protected from rabies for the next two years.

Bats in your house?

Who ya gonna call?

SeaSpray!  ;)

Wednesday, July 16, 2014

Just Warning You ...and STUPID BAT! ??? - Part I

I think this might work.  Nice touch with the ostrich feathers ...which I think will be functional too.  Only thing missing is a bit of bling.  ;)

So ...I just opened the bathroom door to holler into Mr SeaSpray (behind the shower curtain), a warning:

I just want to warn you that I am feeling VERY grouchy!


I don't know!  Maybe it's my hormones.  So if I get snappy or grouchy is NOT you - it's ME!


And then I shut the door and walked away.

This is actually funny that I should warn him because believe me when I tell you HE is the king of testy with a capital "T"., and that is putting it mildly.

I am the easy going one.  (I think that is a good thing - to balance things out :)  Ha ha ...hence my feeling I needed to warn him.  :)

Anyway ...I don't really think it is my hormones.  Great to blame it on though.  :)

Frankly the moment I feel irritated over a lot of things.

 This too shall pass.

Oh and before warning him ...I called a friend who I saw left a product order on my website and I wanted to respond.  I warned her I was in a bad mood and didn't want to talk (So counter to the usual me), but would call her tomorrow.  I only did that because she is a good friend that I know I can be honest with.  I'll vent to her tomorrow or maybe surprise her down at her store soon.  She sounded busy anyway.

It is kind of funny (says me) that I feel I have to warn people.  I mean when you think of how many people just come out with whatever.
Okay ...I'll share one STUPIDLY ANNOYING thing.

Tomorrow ...I am trying to decide if I should go in the morning or wait until after my afternoon orthovisk injection.  When the ER is mostly likely to be the least busy ...even though I know that there is no rhyme or reason to an ER waiting room.

Oh and why am I going?

*BIG ...BIG ...annoyed sigh!*

Because ...during a thunder storm this past Sunday night ...there is a P-O-S-S-I-B-I-L-I-T-Y  that I was bitten and then scratched by a bat. 

I don't even want to have to go in there and tell the story.  I also have a picture that I've cropped and magnified.

And I don't want the injections.

I do not not... want to do this!

I really hope they can have another hospital fax over the records.  Of course I am waiting until day 5 ..the last day in the window of opportunity to have the vaccine be effective and they actually recommend you go immediately, but I have been busy.  Also I wasn't sure it was a bat.  I should've called the other hospital about that instead of assuming.  They should have records of my having the entire rabies series in October, 1999.  The good news as told to me by one of my former ER coworkers is that I am good for life except that I need to get a booster shot or two in the arm.  It was a relief to hear that because I could not even fathom how awful it would be to get that first injection in the front lower side of my neck.   The last time my hand (site of the initial injection) and forearm swelled up a couple of hours later and remained swollen for years.  No one could offer a reason why that happened.  I hope I don't react again.  And at least I am current with my tetanus vaccine.

And I am grateful for the vaccine.  I am just so frustrated by the absurdity of this happening again and yet it's not conclusive ...and yet the protocol is to get the vaccine ...and I hope it doesn't wreak havoc with my immune system ...and I also have to get a cortisone injection in my finger at the ortho appointment tomorrow and I hope that doesn't cause any problems that would interfere with my healing process after I have a total knee replacement in September.  I've read cortisone can stay in your adrenal system for a year and lower your immune responses ...and I am thinking that hospital infections are always a concern ...and maybe I am not understanding all of this.

I recently told someone I know enough to be concerned but not enough to know better.

And actually ...I am appreciative of 2 ER people who have been supportive along with their guidance to do what I really knew all along what I was going to have to do.  Ya can't blame a SeaSpray for just hoping someone would say ..."Oh n-o-o-o SeaSpray ...of course that wasn't a bat and you do not have to go get the rabies vaccine".  And believe me even though I heard their opinions ...I was still so very much trying to ignore what we all knew I should do.  And I absolutely would be telling someone else they should go to the ER to discuss it with the doctor.  You know ...the old do as I say - not what I do.  :)

Stupid BAT!

Anyway ...this little bit of venting has calmed me down a bit.  There are some other things going on ...but at least I'm not going to be snappy toward anyone.  Blogging is cathartic and I really do want to get back to it.  I have been so busy and just haven't felt I could put a thought together to write when I do have down time.  And I still want to write about the biopsy experience.  And other things.

And I will follow up with what happens with the shots and what happened Sunday night that set all this in motion in the first place.

And now I think I am going on Amazon to see if I can buy a safari hat with netting that I can wear in our yard as I duck at all the incoming bats nearby.  ;)

Just saying.

Sunday, July 6, 2014

Happy July 4th Weekend! :)

 I hope everyone is enjoying their Independence Day weekend.  And if you are working ...I hope it's the kind of shift/experiences you enjoy on the job and you can still get some celebrating in.

We are having BEAUTIFUL weather here in our area.  Just perfect! 

Today we are celebrating both our d-i-l's birthday and Independence Day.  (I bought something she is just going to ...LOVE and I can't wait to give it to her.:)  Everyone will be here in just a bit.  I'm sure the kids are anxious to get in the pool.  Ha ha!  "Can we go in the POOL?!", is their mantra every time they walk in the door.  Children after my own heart, for sure.  :)

I feel so very blessed to live in this great country of ours ...for so many reasons.  And I am most grateful for all the sacrifices made over the years so that we can live in the land of the free and the home of the brave. 

Thank you to God and all those that have sacrificed for this country and all of us.

God bless you and God bless America.