MRSA

I thought I would end up with a huge scar on my face.

So I almost didn't keep the appointment with Dr. Armstrong, a surgeon who my main care provider, a nurse practitioner named Angela, had said would probably want to lance and drain the small lump on my cheek, just to be on the safe side. Angela had also prescribed an antibiotic, because she was pretty sure the lump was the result of a staph infection. My facial-scar-fearing self was hedging my bets: I could skip out on the blade-wielding Dr. Armstrong for now, and just take the antibiotic. It would probably work, the infection would clear, and I would escape the scar.

But then the lump got bigger-- within just a few hours-- and I remembered the other thing Angela had said, about MRSA: methicillin-resistant staphylococcus aureus, a strain of staph that does not respond to many antibiotics. It had rung a bell, a huge one, because I'd been hearing reports over the last few months about MRSA getting into people's blood and killing them swiftly. But, she'd assured me, it's not always a big deal, not even close, not if you catch it early.

Dr. Armstrong poked at it for a while but wielded no blade, which seemed like a good sign, and sent me home with a second antibiotic to take. This was Tuesday afternoon.

It was the wee hours of Wednesday morning when something started to seem really drastically wrong. Lea woke up crying at about 4:15, so I went down to tend to her. I was in no pain, but while she nursed away, I started to notice that my face felt weird. Fat. I touched my cheek and promptly had a panic attack. The whole right side of my face had ballooned. Now, I don't swell easily. Nothing swelled during pregnancy, or when I had my wisdom teeth out. My one serious food allergy causes no swelling. So this is unusual for me, and therefore very scary.

I drove myself to the ER, and there again, they kept mentioning MRSA. They took blood and took a culture of the oozy stuff hanging out in the tiny opening of the lump. "We have to admit you," the doctor there said immediately. "We're putting you in isolation." Well, shit.

The next notable thing was when the nurse brought forms for me to sign, indicating my consent to be put under general anesthesia, receive a blood transfusion, be resuscitated, etc. And yet: nobody was acting like it was an emergency. "They're going to take you down to surgery to lance it," Lisa, the nurse, said, "probably today." Huh? How could it possibly be any day other than today? How can you admit me at five in the morning and say MRSA and not do something immediately??

I kept asking questions. I got a lot of sympathetic smiles, but nobody said much except "No food or drink-- you're pre-op."

I started to reason with myself: if they're not rushing around, it's not an emergency. I am not in imminent danger of this bacteria getting into my blood and making me suddenly and gravely ill. Still-- nobody could tell me so.

"I'm really scared that this is going to get bad," I kept saying to Lisa.
"Well, they're just gonna find out what it is, and then we'll see," was her response.

Finally Dr. Armstrong came in. He said what everyone else had said: it's almost definitely staph, very probably MRSA, and they're going to cut it, drain it, and keep me on strong antibiotics until it's gone.

"I'm really scared that this is going to get bad," I tried again. "Is there a risk that this is going to spread throughout my body?"

"Hmmm," he said thoughtfully. "Is there a risk? Well, sure, there's a risk that if a lot of unlucky things happened simultaneously, this could make you pretty sick. Similarly, there's also a risk you could get hit by lightning. We're doing what we need to do to prevent this from getting bad."

Whew, OK. Now we're getting somewhere. My mood improved drastically, even though the IV antibiotic I was on was teaming up with my empty belly to make me miserably nauseated.

Meanwhile, Brian had scrambled to piece together round-the-clock childcare for Lea. She had school all morning, and would go home with our friend Lindsay until Brian's mom arrived late in the afternoon. This way, Brian could be with me. My mom was on her way, too.

The procedure got delayed, of course, and by the time they wheeled me down to surgery I was frantic. I got into a fight with the nurse-anesthetist (more on that later), so instead of counting backwards from ten, I heard myself going on a little bit of a tirade. Everyone's words sounded buzzy. I fell asleep.

Brian got word about a half an hour later that everything had gone fine, that they'd been able to remove a whole lot of infected fluid from my cheek without having to make much of an incision at all. What I remember is waking up, thinking for a split second, "I feel great! It must've gone ok!" and then thinking, one second later, "Wait, no, I feel horrible! I'm going to puke." And I puked.

They took me upstairs and I puked some more. Then I started shaking, and hyperventilating, and no matter what they did I just kept vomiting. The nurse pumped my IV full of one anti-nausea medicine, then another, then another. Apparently the second one can cause mental confusion and disorientation, which is a relief because otherwise I would have no explanation for the fact that at one point, I was pretty sure that there were raccoons in my room. Another time, it turns out, I told Brian "she's getting too heavy, you'll have to take her, I can't hold her anymore" while holding my empty arms in a cradling position.

Eventually, after several hours of dry-heaving that involved noises Brian described as "like Gozer from Ghostbusters," I fell asleep.

Things got better. My mom arrived, my swelling started to go down, my nausea eased away, and I could finally eat something. Still: it sucks to be in the hospital. I mean, it's just the most rotten place to be. Everyone had to put on gloves before coming into my room, which freaked me right out. I felt like I had the plague. I smelled bad, and I got reprimanded for taking a shower when I wasn't supposed to. I had to keep a hot-water compress on my face, and twice, a clamp came loose, the compress burst, and warm water soaked my whole bed. The IV kept jabbing into my flesh every time I bent my arm, which made using a breast pump excruciatingly painful. (Seriously, that was the most painful part of the whole experience. More on that later.)

Sometime on Thursday I got a visit from the hospital's infectious-disease specialist. She confirmed that all the tests had come back indicating MRSA. She said we'd basically have to scrub our entire house down with bleach and disinfect every cut or scrape, but that otherwise, we shouldn't be alarmed, because MRSA is everywhere. So wait. We shouldn't be alarmed? I'm just now coming to the certainty that, no, we don't need to be alarmed as long as we are careful. As long as we wash our hands frequently and pay attention to any broken skin, life can go on as usual. I don't like knowing that there's a strain of bacteria out there that can spread so fast and laugh in the face of so many otherwise-powerful drugs, but I'm calming down. Fear of germs is no way to live.

Here's the other thing. MRSA exists most likely because of overuse of antibiotics and possibly even antibacterial hand sanitizers. The bugs are outsmarting the bugspray, in a sense. The infectious-disease specialist told me this as she was slathering Purell on her hands, while my body was being pumped full of antibiotics. I remarked on the irony, and she nodded and acknowledged that yes, it can be a vicious cycle, and that's one of the things that's scary about this stuff. (Although, to be as accurate as possible, my understanding is that using antibiotics to treat bacterial infections was never the problem; the problem has been many people's insistence on taking them-- and some doctors' willingness in prescribing them-- for viral infections, for which they are essentially useless anyway.)

They kept me in the hospital until mid-morning on Friday. By then, the swelling had gone away entirely but there was still-- and IS still, as I type on Monday afternoon-- a spot on my cheek that is firm and well-defined and very obviously still full of fluid. This is disconcerting, though I am told it's normal when they drain something out of your flesh for something else (harmless fluids) to fill it back up and take a while to dissipate. I go back on Friday for a follow-up. I am ready for this to be done.

OK, so the other story, which might invoke some eyerolls from people who are sick of hearing me talk about it, but: I am a nursing mother. This is a fact. This is a part of the biology of my body right now. We'll leave aside for the moment Lea's diet, because I knew she wouldn't starve, and the wrenching emotions of having to stop nursing suddenly, because I would have had them being separated from my kid under any circumstances. Let's consider just the effects on my body, and it's still more than enough to make me absolutely livid about the way it was handled. Please, pretty please, oh health care professionals of Abingdon: understand that I am lactating. The fact that you don't think I need to be at this point does not make a difference. Here's what I expect from you:

(1) I expect you not to badger me about the reasons my 14-month-old is still nursing.
(2) I expect you to look for a nursing-friendly medication whenever possible. [NOTE: I did NOT say that I expect that one will always exist. I also do not expect you to advise that it's ok to nurse unless you're really sure it is. I'm not a fool. I know I need treatment, and I know sometimes that means no nursing. But let's start with a little creative problem solving and see if there's an alternative, ya know? Let's make that a priority.]
(3) I expect you to understand that stopping abruptly is not only incredibly painful, but puts me at a pretty high risk for a breast infection, which, I dunno, doesn't sound like something we want to mess with in my current state, so I'm going to need to pump. A lot.
(4) I expect you to find someone who can offer guidance on using a pump around the clock, since this is a matter of necessity, and I've never had to do it before.
(5) Seriously, I expect you to KNOW that this is a matter of necessity, that the milk needs to be dealt with somehow, that I'm not just being a stubborn hippie.
(6) And especially you, nurse-anesthetist, I expect you not to shake your head and say "You just gotta get over this nursing thing, honey, the time has come. This will be a good way to break her of it, since you're separated anyway. You know she's just gonna get more and more attached and spoiled, so this is a good thing." Right. I wish I hadn't been slipping under sedation. My tirade could have been a lot snappier, I bet.

In sum:

LEAVE YOUR PIMPLES THE HELL ALONE. YM magazine was right, girls: don't pop them. It's not just about scarring. If it bursts the wrong direction, or the skin breaks, and you happen to have been exposed to MRSA (which remember, is everywhere), you could be in trouble in a hurry. Last Sunday, I had a pimple. I don't remember intentionally popping it, but I was scrutinizing and messing around with all the little blemishes that had sprung up over the weekend. Monday, I had a pimple that felt a little funky. A little firm. Tuesday, I had a marble-sized lump. Wednesday, I was in the ER, and then in an isolation room, and then in surgery, and then barfing my brains out and seeing raccoons and swollen with poisonous milk and scared out of my mind.

So just don't do it. If you absolutely must intervene on the pimple life cycle, wash your face and hands beforehand AND afterwards. Dab on a little Neosporin for good measure.

Carry hand sanitizer with you. Don't use it all the live-long day; just use it after you've touched something like a towel at the gym or pool, or anything else that is likely to have come in contact with someone else's body fluids.

Above all, just pay attention to any broken skin. If it starts to seem weird, get it checked out. Keep your appointment with Dr. Armstrong. Don't mess around.