I had never been hospitalized before. I was in my forties, and, save for a long, sadistic episode in which they WOULDN’T let me sleep, after ten hours in a steel mill in Kansas, having hit my head on pavement and requiring five or six stitches and the creepy claustrophobia of a CAT scan and nothing to eat (which I do not consider hospitalization, but, rather, the eight-hour airport layover from HELL).
As I was saying, except for that, I had never spent a night in a hospital bed.
I had walked home from a night shift at a tax office, and as I went to sleep, I began to feel chills, and then into fever dreams, and I knew that I was sick.
Very, very sick.
I managed to phone my wife, and an ambulance was called. Both my lower shins and feet had turned an angry, purple red. They fairly radiated heat. I didn’t know what it was, but I knew I’d never been sick like that before. There was a long comic episode where the stairs were too steep for a stretcher, so I gasped down the stairs and THEN they carried me to the ambulance.
The ambulance arrived with dispatch and speed
I cracked wise, as I always do when I’m really sick. Evidently I was funny. I cracked up the ambulance crew.
However, deep down in their eyes I could sense the hidden thought: “This guy is crazy.”
I already knew that.
I was wheeled into the Emergency Room, and, in due time, my carcass came up next on the abbatoir checklist and a triage doctor parted the white curtain.
The doctor took a look, shot me full of antibiotics, put me on a morphine drip and sent me straight to a hospital room. Evidently, it was serious, as we had suspected.
(Hypochondria is not in my nature, although I have to guard against its opposite. In other words, if I say I’m sick, I’m SICK.)
I was parked in that combination jungle gym/transformers hospital bed of current fashion, reclothed in traditional hospital fashion and told not to screw with my IV drip.
More timeless time passed.
A new, non-triage doc came into my hospital room, explained and drew a line on my leg with a sharpie, neatly outlining the twin islands of Infectionia, expanding the Domain of the Bacteriophages at the expense of my calves and upper shins. The Twin Citadels of my Knees were under siege from the advancing hot pink armies. At the microscopic level, an epic struggle was taking place, and I could feel, underneath the opiate haze, each and every sword blow struck or parried, and I was very sick.
I was afflicted, the doctor explained through what seemed like a bathtub filled with water, something called “Cellulitis.”
I was also on the pediatric floor, because there was no room for me in the adult section of Sacred Heart hospital. That would explain the purple saturns and golden stars painted festively on the walls of the hallway. As they had made the journey up from Emergency, my carcass on casters, I had somehow thought I was being taken to a Clown Hospital.
Funny, the things that waft through the brain when you’re sick as a dog and suddenly on a morphine drip.
King of the Clown Beasts
Cellulitis, I eventually learned, is an infection of the ORGAN we call the skin. Now, being a patient and all, they explained it as you’d explain it to an autistic five year old, not expecting any dull spark of cognition, but I got the gist.
It usually shows up in the lower extremities. Right where I got it. But I’ll tell you HOW I learned that, later.
They did explain that, as a Type II Diabetic, I was particularly succeptable to it. And, as the antibiotics kicked in, two processes began. First, that a staffer would come in to take a blood sample. And, the staffer in question invariably had difficulty finding a vein, and managed start a subcutaneous oil spill in the Gulf of My Inner Forearm. I then remembered the sage words of my second wife, the Redhead (who had been a nurse and will soon be an RN and B.S.) “They don’t teach people to draw blood properly any more.” And to “always insist on a phlebotomist.” (The phlebotomist is the person who specializes in finding veins and taking blood.)
I know that I’ve got good veins. I once had a junkie on Sunset Boulevard compliment me on my veins (which is highest praise in lowest company, I suppose), so I didn’t think it was ME. I insisted on the phlebotomist thereafter, but, inexorably, a neat Rapid Transit Map was being etched in purple blotches on my right arm. (I am left-handed, so if they want to stick me, I insist that it’s on the right.) But the new station markers were nowhere as large as the blotches from the botchers had been.
And the second thing was that the doctor would come in every so often, and draw a new topographic line to chart the steady retreat of the Army of the Cellulites to their sneaky hiding places below.
Sometime in the night of the first day, I got a roommate. He was from Washington State, and had been working on a contract job installing lockers at the refurbished community swimming pool.
His name was Rick, and he had one of those short roofers’ bodies: not so much stocky as rangy, with etched muscles from honest work and not from paying to work out. Good shape and not some wrecked hulk like me.
And Rick had cellulitis, too. He’d gotten it from a puncture wound on his leg from a sharp metal sprue that someone hadn’t ground or sand-blasted away at the metal fabricator’s. He hadn’t even felt the puncture. He’d found the dried blood on his sock and seen that he’d bled, but it had scabbed over and so he just washed away the blood, put some Neosporin and a bandage on it and forgot about it.
Until he got sicker than a dog, etc. etc.
Misery loves company, and we had a fine time, except that one of the nuns came, embarrassedly to shyly but firmly remind us that this was a CHILDREN’S floor and our language was not exactly G-Rated.
Rick said something funny that I remember to this day. “I’ll take ‘stuff you never heard about that can kill you’ for two hundred, Alex!”*
I will omit the all-important and hard-won knowledge that most people who die in hospitals die within 24 hours of eating hospital food, or, worse, of their friends and relatives eating hospital food. How I came by this knowledge is not important here.
But it was Easter Sunday, and one of the nice nuns brought me Easter candy.
And I have often wondered what sort of message it actually was? After all, my charts clearly noted that I was a diabetic.
And, perhaps in keeping with the nun’s plot, I ate the candy anyway. There wasn’t much and I’m a big guy.
Was she trying to get even with me for having inadvertently poisoned the impressionable minds of a dozen sick children by casually speaking in workman’s language with a fellow workman? We had meant no offense, but had the nuns taken it that way?
The most ambiguous candy Easter egg that I ever ate.
The topographic lines of the black sharpie tracked the ebb of the Army of the Cellulites like the wave lines of a dried up reservoir.
And, as the rapidly expanding BART map on my arm finally reached its terminus at my wrist, the IV was removed and I was given the all clear to leave.
I was, by hospital rules, required to exit my temporary medical domicile to return to the Land of Streptococci, and I bid the pink unicorns and blue ponies adieu, as I was wheel-chaired from my room in Sacred Heart on Easter Sunday, delivered from the Cellulites and their egregious color sense.
But, thereafter, I have learned that the cellulitis lurks, waiting to prey on me, and I have had annual visitations, like the Grim Reaper taking a pH test strip to my mortality.
Time for your annual test!
I learned what cellulitis actually was when I got back home, by taking my (seriously) autographed copy of the Merck Manual, and looked it up. (A book is like a Kindle, but the actual pages are made out of very thin paper and you have to turn them manually.)
Here, via Wikipedia is an approximation of what I read:
Cellulitis is caused by a type of bacteria entering the skin, usually by way of a cut, abrasion, or break in the skin. This break does not need to be visible. Group A Streptococcus and Staphylococcus are the most common of these bacteria, which are part of the normal flora of the skin, but normally cause no actual infection while on the skin’s outer surface.
Predisposing conditions for cellulitis include insect or spider bite, blistering, animal bite, tattoos, pruritic (itchy) skin rash, recent surgery, athlete’s foot, dry skin, eczema, injecting drugs (especially subcutaneous or intramuscular injection or where an attempted intravenous injection “misses” or blows the vein), pregnancy, diabetes and obesity, which can affect circulation, as well as burns and boils, though there is debate as to whether minor foot lesions contribute.
Cellulitis in the lower leg is characterized by signs and symptoms similar to those of a deep vein thrombosis, such as warmth, pain and swelling (inflammation).
This reddened skin or rash may signal a deeper, more serious infection of the inner layers of skin. Once below the skin, the bacteria can spread rapidly, entering the lymph nodes and the bloodstream and spreading throughout the body. This can result in influenza-like symptoms with a high temperature and sweating or feeling very cold with shaking, as the sufferer cannot get warm.
In rare cases, the infection can spread to the deep layer of tissue called the fascial lining. Necrotizing fasciitis, also called by the media “flesh-eating bacteria”, is an example of a deep-layer infection. It is a medical emergency.
Yup. They are normal bacteria, but once they get INTO the skin, they set up little bacteria factories and when that infection gets into the blood stream, it’s bad. REAL bad. Death is one of the nicer things that can happen. Like Rick said, “I’ll take ‘stuff you never heard about that can kill you’ for two hundred, Alex!”
But I recognize the stealthy approach of the fever and then the chills and the hot pink skin, and I immediately take Cephalexin, which my doctor and I agree is better than a visit to the hospital. Thus far I have always been successful. But I have to have it with me at all times.
And that brings me to that awful new Federal Regulation. According to NPR, the FDA notes that 80% of all antibiotics sold are used on animals. One type of antibiotic, cephalosporin is at issue:
The [FDA] announcement affects antibiotics called cephalosporins, drugs used widely to treat things like pneumonia or skin infections in people.
Cephalosporins are especially useful for children with infections; unlike other antibiotics, like fluoroquinolones and tetracyclines, there aren’t any restrictions for for pediatric use of cephalosporins. They also are important for treating bacterial meningitis and bone, urinary tract, and upper respiratory system infections.
Cephalexin — the antibiotic I use to keep cellulitis at bay — is a cephalosporin.
Not the actual drug
The problem is that the more drugs are used, the more drug-resistant bacteria are engendered. Thus, the FDA decided that regulation was needed, because so many cephalosporin drugs were being used on chickens, turkeys, cattle, etc. etc.
This turkey required immediate treatment with Cephalexin
Today, the FDA said the drugs remain critically important for humans, so their use should be restricted only to humans.
An association of veterinarians says the new rule on cephalosporins won’t have a big impact. They can still use these other antibiotics to keep animals healthy.
The new rules will take effect in April.
Now, while I, as someone who depends on a cephalosporin drug to stay a) out of the hospital and b) alive, applaud the new regulation, for selfish and personal reasons, I am certain that harsh ideologues in favor of smaller government and less Big Government regulation will stand right up and decry this absurd regulation that will cost potential (i.e. hallucinated) profits, and undoubtedly cost jobs.
Anti-health care protester and terse prose
Gosh-darned sick people, anyway. (To lapse into Mitt-speak.)
Don’t get them started on the Affordable Health Care Act. (They won’t recognize it unless you call it “Obamacare.”)
Anyway, that’s the story of my first stay in a hospital, and an annoying new Federal regulation, stomping on the neck of average Americans who only lack having their entrepreneurial spirit unleashed by discarding all those pesky rules and sechlike.
A writer, published author, novelist, literary critic and political observer for a quarter of a quarter-century more than a quarter-century, Hart Williams has lived in the American West for his entire life. Having grown up in Wyoming, Kansas and New Mexico, a survivor of Texas and a veteran of Hollywood, Mr. Williams currently lives in Oregon, along with an astonishing amount of pollen. He has a lively blog His Vorpal Sword. This is cross-posted from his blog.