# Me and my pal MRSA



## saucywench (Nov 6, 2007)

I was going to let y'all know what (new stuff) has been going on with me, but never quite got around to it. But today I contacted a nurse in Employee Health I've known for years and years. She was in clinic at the time, so I told her that I would e-mail her. She asked me to explain everything, which I did, so I'm just going to paste my message to her here:
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#####, here's a timeline of my experience with MRSA:

A couple of weeks ago or so a flea crawled up my pant leg and bit my ankle, outside of my knee, and somehow managed its way up to my waistline for a last bite. All three bites seemed to be healing normally (btw, I am highly allergic to most bug bites).

I had a vacation to San Francisco scheduled for Oct. 30-Nov. 5.

On Friday, Oct. 26th, I wore jeans to work, which I normally don't do, but it was Friday. The waistband of the jeans was chafing the bite area. My discomfort grew as the day progressed.

At some point, either that night or the next day, I could feel by touch that the area had become inflamed, it was swollen and warm to the touch. I visited my mother that evening; she took a look at it and encouraged me to go to the ER, but I wasn't feeling that badly and decided to wait until Monday and forego the expense and time involved in an ER visit.

On Monday (29th) I had one of our female docs in our office (########, over at the VA) take a look at it. She said that it was likely staph, then told me that her husband had gotten MRSA a few months back, and that she had had to administer IV antibiotics to him at home. She said I should go to the ER immediately but I told her I would call the clinic and try to get seen there. So I called and they told me to come on over, that they would work me in. Fortunately, I didn't have to wait very long at all. I was placed in an examining room and was seen by Dr. Xxxxxxx primarily, along with Dr. Yyyyyyyyy. They said it was staph and took fluid for a culture. By this time the infected area had become considerably larger. 

What followed was an extremely painful experience, more pain than I've felt in over 15 years [at which time one of my discs ruptured and bits stuck to my sciatic nerve]. Dr. Xxxxxxx injected the area with lidocaine (painful), made an incision (painful), squeezed the abscess to get some gunk out (painful), then inserted packing (painful). They wanted me to return the next morning. I told them of my vacation plans but that I would try to get my flight scheduled for a later time that day, so Dr. Xxxxxxx said he would come in a little early and we set an appointment for 8:00am the following morning. He prescribed Bactrim, which I filled, then I went home and contacted the airline. The best situation I could work out financially was to go ahead and try to make the original flight, so I contacted a doctor in SF and made an appt. for Tuesday afternoon, after my scheduled arrival.

During the night that Monday, however, my fever gradually increased. I took a late afternoon nap to recover from the trauma of the pain. When I awoke, my temperature was 100.8. I was up for a little bit before I returned to bed. When I awoke in the middle of the morning (around 3:00am), my temperature was 101.8. It was at this point that I realized I had to cancel my travel plans altogether, which I did later that day.

Although I was unable to meet the 8:00 appointment, I did go in a little later that morning. I can't remember now the entire sequence of events, but I was seen again by Dr. Yibirin that day. I was back again on Thursday and Friday. On Thursday, I asked if the results of the culture were back yet and they said no. But then they left the room and when they returned, they said the results had just come back and that it was positive for MRSA. That's when they prepped the procedure room to open up the incision larger, get more gunk out, repack, and redress. This time (whatever day that was) I experienced little pain at all, as I normally have a high pain threshhold. I guess it was a combination of them using more lidocaine plus the abscess was not as tightly swollen as it was initially (even though it had spread by now farther to the right and across my spine to the other side. I do know that I had to see someone else on Friday, and that they replaced the packing again. I was uncomfortable with leaving it in for the entire weekend, but they said that if I developed fever or pain, to go to the ER. 

During all of this time my sister had been coming over every morning and changing the dressing for me. But she had become paranoid that she had gotten it from me, so she didn't come by this past weekend. Well, by the time Sunday evening rolled around, I couldn't stand it any longer. My skin had broken out in a rash from the tape, and welts had formed, so I decided I would change the dressing myself. I got all of the supplies together, washed my hands and put on the gloves. I cleaned all of the area around the dressing first, then slowly removed the tape and dressing. When I got down to the main piece, the packing came out with the dressing. The wound was oozing, so I just sat here and kept dousing the gauze bandages with betadyne and swiping at the incision, throwing them into the wastebasket. Then I would swipe the area again. When I had squeezed out all that I could, I swabbed the entire area again, opened a self-adhesive bandage, placed an extra gauze pad in the middle, and applied it to the incision.

They had scheduled me to return again yesterday, so I did. Dr. Yyyyyyyyy removed the dressing and repacked it. I am due to go back one more time tomorrow morning to have this packing removed, as that was as far as we got with return visits. They had initially prescribed 10 days of Bactrim but extended that 4 more days. They also prescribed me some ointment for my nostrils and under my nails. I got those two scripts filled this morning.

I had asked at work if they could change my vacation time to sick time. I told them I would be back to work no earlier than Thursday. I have experienced no additional pain or fever since the first couple of days last week, although I had some lingering weakess and lethargy. I feel fine now except that I know I will probably still have some seeping of the wound, but I imagine that tomorrow they will just remove the packing and redress the wound. As I mentioned to you on the phone, I wanted to know what the UAMS guidelines are for employees who have contracted MRSA. I don't work directly with patient care, but the dialysis unit is right next door to my office. Also, I think I noted that I'm located in the VA although I am a UAMS employee. I will call them and see what their guidelines are, but ###### said that, generally, with employees who do work directly with patients, as long as the affected area is not on an open area of the body, such as the hand or forearm or whatever (mine is not), and the wound is not oozing (which the remaining infection I have would be covered by a bandage), that it would be OK to return to work. Or...should I just wait until I have taken all of the Bactrim, which would put me out until next Monday? I have plenty of sick time, so that is not an issue. Let me know what you think, thanks. 

Cindy


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## Miss Vickie (Nov 6, 2007)

Oh wow, Cindy, you've been through the wringer with this. I'm so sorry.  I've heard that MRSA can be very painful, and have seen scars 3-4" in diameter (not exaggerating) from patients who let their MRSA get out of hand. I'm so glad you listened and got seen, got your wound cleaned out, dressed, and some antibiotics. I hope you heal up quickly.

Our infection control department has recommended that we do nasal swabs on admission to our hospital and it's making for some interesting situations. Most of the time the swabs don't come back until the patient is gone or getting ready to go, but if it comes back while they're there they are placed on contact isolation. Even if they have no open lesions. This usually isn't a big deal with the patient but it does cause problems with the babies (who are also on contact isolation and who often need procedures done). It's been really frustrating because patients often have questions that we can't answer and I got a family member pissed at me the other day because I couldn't tell her at that exact moment how/where/whether they would do a circumcision on the baby.

What's scary to me is just how much we DON'T know at this point. I'm sure a lot of people would swab positive, but that doesn't make them contagious since it still requires a vector of transmission (it's not airborne). But how many people pick or wipe their noses and then touch things -- shopping carts, door handles, etc. I haven't been very germ phobic, even after becoming a nurse, but the MRSA thing has me spooked.

I'm glad they gave you an antibiotic for your nose and nails. I wonder, will you get follow up nasal swabs to determine if you still carry it. Also, if you don't mind saying, what kind of topical antibiotic did you use on nose/nails?

Again, I'm so sorry you're going through this. Your situation illustrates that MRSA is not something to mess around with. It can KILL people with compromised immune systems and even those who are hale and hardy, like yourself, still suffer from it. 

I hope you'll be able to reschedule your travel plans. Sounds like you need/deserve a nice, long vacation.


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## saucywench (Nov 6, 2007)

You know, I was curious, Vickie, whether or not I had given it to myself, or if I caught it at work or simply just out and about. Even if they had done a nasal culture, there is no way to know for sure. Once I realized I had staph, then, more specifically, that I had MRSA, I educated myself on the subject a little further. The Wikipedia entry is a fairly good treatment on the subject in general, especially with regard to statistics on how most of us carry the bacteria on our bodies, anyway. The problems arise, of course, when the bacteria is transmitted and becomes colonized elsewhere (open wound, or, as in my case, the flea bite). As careful as I am, what with washing hands often and not opening doors with my bare hands if I can help it, these things happen.

They prescribed Mupiricin ointment 2%. I haven't used it yet as I just picked it up this morning and have not gone out in public. I imagine it's as much for my health as it is for that of everyone/thing I come into contact with, until I have completed the round of antibiotics.

As far as my travel plans, I'm going on the premise that everything happens for a reason. In other words, I will go when it's meant for me to go (as long as that happens within a year, before my plane ticket expires).


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## mossystate (Nov 6, 2007)

Wow, Saucy, your story sent chills down my spine and I thank you for sharing it. I hope you have no additional problems with all this and that you get to doing better very soon. And, yeah, a vacation is certainly in order, when you feel up to it!


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## Risible (Nov 6, 2007)

I'm glad to read that you're on the mend after that scary experience, Saucy! Thanks for sharing your story.


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## GenericGeek (Nov 6, 2007)

saucywench said:


> ...
> They prescribed Mupiricin ointment 2%. I haven't used it yet as I just picked it up this morning and have not gone out in public. I imagine it's as much for my health as it is for that of everyone/thing I come into contact with, until I have completed the round of antibiotics....



Saucywench, that Mupirocin stuff is AMAZING. Get started on it ASAP; it made a world of difference for me.

When I was in hospital for brain surgery in 1980 (!), they shoved a nasogastric feeding tube up me several times, perforating the nasal septum. It left a wound that never quite healed for *27 years*.

I finally got over my embarrassment, & asked my "new" doc (that I've been going to for about 5 years) if there was anything that could be done. She took a swab, ordered a culture... and when it tested positive for staph, got me started on Mupirocin. Within 5 days -- NO MORE SORES!

This stuff is a "big gun" topical antibiotic, not to be used routinely like Neosporin. But it's perfect for nasty bugs like MRSA.


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## Miss Vickie (Nov 7, 2007)

saucywench said:


> You know, I was curious, Vickie, whether or not I had given it to myself, or if I caught it at work or simply just out and about.



Yeah, hard to say. Up here it's common among Native Alaskans because they share steam baths. Great medium for infection, which is why we get a lot of it here, coupled with the lack of hot running water in many villages.



> Even if they had done a nasal culture, there is no way to know for sure. Once I realized I had staph, then, more specifically, that I had MRSA, I educated myself on the subject a little further. The Wikipedia entry is a fairly good treatment on the subject in general, especially with regard to statistics on how most of us carry the bacteria on our bodies, anyway.



Yeah it's very common, and for most people it's not a problem. It's only when it gets to the "inside bits" of us that it causes a problem. Sadly, what my patients seem to want is antibiotics which is of course how we got in this mess to begin with. 



> They prescribed Mupiricin ointment 2%. I haven't used it yet as I just picked it up this morning and have not gone out in public. I imagine it's as much for my health as it is for that of everyone/thing I come into contact with, until I have completed the round of antibiotics.



Oh yeah, that's good stuff. I had that for when I got cellulitis from being savaged by my friend's cat. That was the worst wound I've ever had. I went from a few little scratches and puncture wounds to my arm swelling up, getting really red and painful as all get out. I made it to the hospital barely in time to avoid IV antibiotics -- and that was only about 4 hours after the bite.

I'm curious, though. Is the ointment for your nose and nails, the idea that you won't spread it? Also, how likely do they think the antibiotics will make you nasal swab negative? I'm curious about this and our infection control dept is not very helpful (they're not even testing the staff, which pisses me off). 




> As far as my travel plans, I'm going on the premise that everything happens for a reason. In other words, I will go when it's meant for me to go (as long as that happens within a year, before my plane ticket expires).



I'm glad you were able to keep your ticket at least. Airlines can be positively draconian about stuff like that. I like your attitude though. I, too, am a believer that everything happens for a reason. It makes dealing with setbacks so much easier.


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## saucywench (Nov 11, 2007)

Here's what the stuff looked like before I went to the clinic (before it got worse and was lanced and all). So--if you get anything like this, go see your doc pronto!
View attachment 30532

It's kind of hard to get a shot of yourself from that angle/location; I did the best I could. That's my side, more toward the back, at my waistline (or what passes for a waistline).


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## Miss Vickie (Nov 12, 2007)

Oooh, owie. That definitely looks like something that needed treatment. 

I'm so glad you went. Are you feeling better now?


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## Risible (Nov 12, 2007)

Saucy, that wound at the center is the flea bite? Oh, and - OUCH!


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## saucywench (Nov 12, 2007)

Risible said:


> Saucy, that wound at the center is the flea bite? Oh, and - OUCH!


Yeah, that was where the flea bit. And I'm assuming that, when they made the incision to lance, they did it on (or very near) the initial point of entry. I don't know, it's hard to see back there (let alone take a photo of it).

Some crazy lady in chat (OK, if you must know, her name is *BERNA*) wanted to see more of it, so I took a picture this morning.
View attachment 30590

Here you see my lovely backfat *gestures in _Price Is Right_ fashion* and how much the swelling has gone down. Of course, I'm keeping it mind that you didn't see it at its worst. I don't know what the red bump below it is (hey, maybe _that _is/was the flea bite), but the area has been itchy, so I've been scratching around (not on) it. You can also see some remains of tape that I seem unable to reach. I guess it will wear off after a few more showers.


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## Jes (Nov 13, 2007)

good lord, lady! things have not been easy for you of late, have they?!

i'm glad you're on the mend. keep positive!


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## Theatrmuse/Kara (Nov 14, 2007)

Wow, so glad you are on the mend. This stuff scares me....it really does! Take care, rest and take that long awaited vacation!
Hugs, Kara


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## SESouthendGuy (Nov 14, 2007)

read this in the paper the other day, seams scientists are developing a new antibacterial made from volcanic ash that is effective against even MRSA http://news.independent.co.uk/health/article3104663.ece


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## mariac1966 (Nov 18, 2007)

I was diagnosed with MRSA after I could not get rid of a sinus infection for 2 years. I was always plagued with sinus infections but in 2004 I had a sinus infection that would not go away. I was sent to an ENT doctor who did a culture of the sinus cavity and it came back MRSA. I was placed on IV antibiotics for 3 months. Then I found out that I have an immune deficiency and that is the reason I get sinus infections so frequently to begin with.


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## SocialbFly (Nov 24, 2007)

we have swabbed kids coming from home for a couple of years before open heart surgery, and you would not believe how many come back positive for MRSA, BEFORE they get to the hospital.

MRSA exists everywhere, it is not until we get sick or have a problem that it becomes a problem...for example a bite or a nasal tube when you are immune compromised by a life threatening problem.

The problem is too, so many people have decreased immune systems, too long of hours, too little sleep, exercising long periods of time, not good enough nutrition, anything like that will lower your immune system...of course, drinking, and smoking also contribute to that as well...so you can see, our society has made this an easier bug to acquire...(so say our docs at least)...

it is a scary bug, but we accentuate the problem by taking antibiotics when our viral conditions dont clear quickly enough (they dont work, it is just time that finally clears things up, not the 7 days or more of antibiotics), by not seeing to ourselves, by using too many antibacterials (that dont allow us to build up natural immunities) and i could go on and on...

i am so sorry this happened to you Saucy, but it sounds like you caught it early, thank goodness....i hope and pray they come up with new ways of treating the bugs, cause right now there are three bugs out there that could cause serious problems and MRSA is only one of them....


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## SocialbFly (Nov 24, 2007)

that post made a lot of sense, dont post when one is very tired....good grief...

ok, what i was trying to say is yes, healthy people can get MRSA, as you did, through a bug bite, or a break in the skin. 

The problem becomes increased in knowledge when media gets a hold of it to bring in a sensational story, but what we should be talking about is the whole issue, but of course, society as a whole, doesnt want to hear what they are doing wrong, as it seems we prefer someone to blame...

so many things are to blame for why MRSA is such a big problem...antibiotics use, stressors, poor diets, you get the big pic, it is so many things, but the worst is when it happens for no reason. 

MRSA can exist on surfaces, we try in the hospital to isolate the patient who turns up positive, but you would not believe the resistance to it from families, even after explanations. 

This has no easy solution.


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## Miss Vickie (Nov 24, 2007)

SocialbFly said:


> that post made a lot of sense, dont post when one is very tired....good grief...
> 
> ok, what i was trying to say is yes, healthy people can get MRSA, as you did, through a bug bite, or a break in the skin.
> 
> ...



Great post, Di. I agree with all of it. There are so many issues at play, and yet when I explain it to parents and their families -- like you say -- there is a lot of resistance. I got written up by a patient's mom because "the nurse made me feel like a leper". Why? Because I entered their room -- per protocol -- gowned and gloved and because I wouldn't let them warehouse the baby in the nursery while they went gallivanting around. Geez, lady, sorry I hurt your feelings but I'm just a titch more concerned about not infecting the sick baby down the hall.  Technically family members are supposed to gown and glove up too but they NEVER do. So we have kids coming and going from these rooms -- not washing their hands, touching everything in sight -- spreading Goddess knows what.

Bottom line to me? Keep yourself as healthy as you can, minimize use of antibiotics, use them correctly when you must use them and practice reasonable hand washing. I'd say that's about the best we have to offer.


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## SocialbFly (Nov 26, 2007)

Miss Vickie, all i have to say is "you rock!!!!"


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