19 August 2006

Paronychia, aka "Cheryl Blogs About Her Senses"

I have a paronychia.

I've gotten some weird things in my life...Hepatitis A when I was three, a chalazion when I was five. I still have the scar on my inner ankle from when the top of the birdbath fell off and crunched me (nothing broken, thank God). I pulled a large 1960's black-and-white tv over onto myself somewhere in there. I had a benign tumor removed from a buttock-which-shall-remain-nameless when I was 13. You can feel fairly secure in the knowledge that the unnamed buttock will not be making an appearance on the odd middle-aged HNT post.

(During the overnight hospitalization for that minor procedure (in 1970), I met a man, Rudy, who was in his 70's, making him the oldest person I'd ever met on this earth at the time. We watched the stars together both before and after my "surgery" from the balcony/lounge of the nursing unit we were housed on. Rudy and I corresponded for a few years, back in the days of penpals. He sent me a pair of very colorful costume earrings from the Bahamas when he and his wife visited the Caribbean. I like to carry on the illusion that Rudy is still alive.)


I had unexplained full-body hives with a high fever when I was 16. I was delirious. I thought m
y mother was Mia Farrow. They thought it was caused by peaches. I thought it was stigmata. Before I knew any better, before I became a nurse, I put their premise to the test and found it to be untrue. Thank God I wasn't truly allergic to peaches because food allergies can kill. But, damnit...I'm a Jersey Girl! I've got to have my peaches! (South Carolina peaches might be the most prolific but Jerseys are the tastiest!)

I had a dental abscess last summer that caused a cellulitis in my mandible (called an osteomyelitis) for which I required treatment with Clindamycin. Clinda is a potent antibiotic, particularly beneficial for strains of bacteria resistant to other agents. Clinda will also, unfortunately, kill off a large portion of your normal intestinal flora allowing the overgrowth of clostridium difficile in those who host the bacteria. To my distress, and no doubt to God's wicked, eternal delight, I found out I harbored that germ just a few days before I left on my three-week Westward Ho! Roadtrip (c) last year.

My medical history is, umm, interesting. Thankfully benign but interesting.

So now I have an infection along the lateral side of my right thumbnail.

I'm right-handed.

This is inconvenient.

I showed it to a doctor at work yesterday and she wrote me a script for Bactrim and elicited my promise to return today if it wasn't improved. It wasn't better
after three doses of the antibiotic. I had wanted something I could take twice a day to improve my compliance. Hey, I know me.

I went back to the ER today, practically panicked at the prospect of possibly having my entire thumb numbed to allow a physician to poke a needle under my thumbnail. Isn't that called torture? Luckily, it is not at the point of needing to be opened so I dodged that bullet (at least for now...keep your fingers crossed for me, huh?).
With any luck, I can be spared a course of Clinda this time, too. I'm now all switched over to Keflex, a much more effective agent for the most likely culprit, staphylococcus aureus.

Largely due to the overuse of antibiotics, s.aureus is following in the footsteps of so many other bacteria before her and developing resistances. (Please, please, please...if the doctor says your child most likely has a viral infection, do not insist she be put on a course of antibiotis anyway???) There is a particularly virulent strain
called Methicillin-Resistant Staph. Aureus, or MRSA. Patients who colonize (are carriers of) this bacterium must be isolated from others in the hospital and must be treated with contact precautions. Trouble is, we in the ER often have no idea what someone's MRSA status is in our initial contacts with our patients. And, yes, we strive to maintain safety for ourselves and our patients but things happen, especially in a rush...like in an emergency?...

Given the speed with which the crack in my cuticle became infected and the fact that Bactrim brought no improvement in a reasonable time frame, the doc is concerned about the possibility of a MRSA infection. I am, too. So, I'll have to remember to take a pill four times a day for the next week and a half. But, given that it's the opposable digit on my dominant hand, I'll do my God-damned best to be compliant.

The real irony? Due to my developing c. diff last summer, I had to call out sick on my last day of work before vacation. God forbid, but if I should have some vile form of s. aureus, I could be forced to remain away from work for my last two weeks there. Can you say, "Woot?"

I've been good with my new pills so far (two pills) and diligent with my warm, moist compresses (warm and moist sure sounds good).

Cheryl's Warm, Moist Digit Compress Recipe

-Take a thinnish washcloth, fold in quarters and wet it.

-Wring lightly.

-Place in a heavy-gauge sandwich or small freezer bag.

-Microwave on high for 10 to 15 seconds. (No longer than that. Don't do this if you can't feel hot things well (neuropathy, etc.) and don't sue me if you burn your fool self.)

-Stick thumb (or other infected digit) into crease in the folded washcloth and enjoy.

-Even if you don't enjoy it, do it several times a day, up to once an hour, for 10-15 minutes. If you can't tolerate that much time, treat digit for as long as you can.

-DO NOT BURN DIGITS, ESPECIALLY OPPOSABLE ONES!


The moist heat makes the digit throb and leaves it sensitive for many minutes following. As luck would have it, I have a few Percocet left over from my dental saga of last summer so I took one tonight. Well, because of the thumb and the fact that Percocet is an acceptable alternate companion for a solo Friday night.

The down side of Percocet for me is that my gut doesn't much like it. I can take a half a tablet and be fine. But that whole tab just pushes me over the edge. I get the cold sweats, nauseous, lightheaded, very tired, finally running to the bathroom and puking your guts (and all my Cocoa Pebbles dinner, damn it) into the hopper feeling. God-damned vomit in my sinuses. The taste lingers for hours. Yuck!

So, the thumb feels better, the stomach and head feel better following the barf, I'm beginning to think the Keflex might work best and I have three courses of Bactrim stashed away in case I develop the odd UTI from "rough sex."

Life is good.

Why do I post this stuff? Why do I equate sex with other body functions so freely? Because, as I've said before, they're no different.

Our senses are all about feeling things...with our antennae, our vision, our cilia. If you choose to feel things, as I've also said previously, you have to take the whole package. The yin with the yang, y'know? So the fabulous orgasms come hand-in-hand with the stench of vomit in my nostrils. And, despite the fact that one is so much more pleasant and positive than the other, they are both sensed and consequently appreciated. They are both evidence that I exist.

Sex isn't magic, folks.

Feelings are.

tags: bitchy / blogging / health and science / humor / life / medicine / self-awareness / senses / sex / sexuality / sexuality education

3 Comments:

At August 20, 2006 7:14 PM, Blogger Hedonistic Pleasure Seeker said...

HMMMMMM. Resistant bacteria. I'm fighting a recurring ear infection, trying to find an antibiotic that will work against it. I'm on doxycyclin THIS time.

I've had staph a few times. Not fun. I found it horrifically painful every time though; in fact that's how I knew I had it.

Feel better soon!

 
At August 20, 2006 8:08 PM, Blogger Cheryl said...

Thanks, HPS...the Keflex seems to be a little more effective since it already is starting to feel better. I just hate when I whack it. There's something to be said of things "sticking out like a sore thumb!"

 
At April 18, 2008 10:32 AM, Anonymous Anonymous said...

OMG!!! Thx to your advice (and antibiotics), my battle with paronychia ended in just a few hours!! Thank you soooooo much! The towel trick is so much better than soaking my thumb in water - it had the gross pus oozing out of my thumb in no time. B/c of you, I was able to get my pain-free life back again! Thank you, thank you, thank you!

 

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