Where in the hell am I?

February 21, 2008

Snakebite! Part 2

Filed under: bite, rattlesnake, snake, snakebite, story, Texas — John @ 3:22 am

DCP_0206
Originally uploaded by Miss_Colleen

So I had just gotten to the hospital and into the emergency room. I got into my gown and got into bed. Some of the nurses came in and did the usual tests, then they drew a line on my leg (visible in both pictures) so they could track the swelling. The doctor came in and ordered me up some antibiotic and antivenom. They hooked me up to an IV bag on oen arm and some antibiotic (because snake fangs are apparently very dirty) on the other, gave me a tetanus shot, and offered me morphine. I declined, because it didn’t hurt too much yet and I had just lost an acquaintance to an OD.
It was at this point that people were allowed in to see me, including Tina and Colleen (who took the pictures of me). They were worried, but figured I’d be out in a few hours. One of the nurses then told us that I’d be on the antivenom for 24 hours, then I’d be monitored for my recovery.
The visitors had to leave shortly as it was time for more exams. They measured my swelling and asked me how I was feeling. I could feel the pain moving up my leg, tracking to the inside of my thigh. I could see that I was still swelling, that it was moving up my leg, and that one my veins was bruising. I asked where the swelling would stop and they said they didn’t know. I was then informed that it was possible that my goods could swell, possible pretty badly. I was not excited at this prospect. I then asked when they were going to draw the venom out. I was told they don’t do that anymore, because rattlesnake venom is a hemotoxin (affects the blood) and that cutting open the bite can cause massive bleeding. One should only do that if they’re a long way from proper medical treatment, and then only very carefully.
At this point, my leg was really starting to hurt. Imagine the worst charlie horse you’ve ever had. Now imagine your entire leg feeling like that. So I broke down and asked for some morphine. However, all their patient-controlled drips were in use (or so they say, I think we just made one too many jokes about it). Let me just say that, while it did relieve my pain, the first 2 minutes of the drip were sheer hell. I could feel it go cold into my arm and move up into my chest, which would tighten. My stomach would go queasy for a few seconds. Then it would hit my head and I’d be dizzy for a couple of minutes. Eventually, the pain would subside and I’d feel a little loopy and generally fall asleep within an hour.
Not much later, the nurse (a very nice male nurse, like my friend St. Denis) came in with the antivenom. Apparently, it is kept in a refrigerator and needs to be agitated before being given to the patient. But it can’t be shaken. It needs to be slowly swirled for 20 minutes. My nurses would pick up the dose and carry them around and check on a couple of patients before dropping in.
The regimen for the antivenom required 12 doses in a 24-hour period. I was given 6 doses initially, then 2 more doses every 6 hours until they were done. I might also mention that one dose of antivenom costs four thousand dollars (so don’t get bitten if you’re not insured or on the job! On second thought, don’t get bitten period!). I swear that I could feel the antivenom working when the first doses got to my leg. It was similar to the feeling of putting hydrogen peroxide on a scrape, only inside.
I forgot to mention the cardiac monitor. I was hooked up to some machines (complete with sensors stuck on my chest) to monitor my heart rate (I don’t think it was an actual EKG. It’s in the background of the photo). Since rattlesnake venom is a hemotoxin, the antivenom effectively thickens your blood as part of it’s magic. This leads to the possibility of a heart attack, stroke and/or blood clot.
I was supposed to spend my first 24 hours in the Cardiac Care Unit, but there were no empty beds (February in Brownsville = lots of winter Texan retirees). So I spend the night in the ER. It was pretty calm most of the time, although I was asleep for a lot of it. In the middle of the night, someone came in who was in a bad car accident and they were screaming and moaning loudly, which freaked me out. I also got peeked in on by pretty much every intern and most of the doctors in the hospital!
Somewhere in there, I was asked if I needed to use the bathroom. I had no intention of using a bedpan, so I kept telling them I didn’t need to go, trying to hold out for a toilet. Eventually, I was informed that I had more than a gallon of fluids in me (I didn’t even think about the fact that IVs are fluids!) and if I didn’t need to go then there might be nerve damage and they’d have to get a catheter. Needless to say, I caved and they brought in a jug for me to pee in. I filled it and needed a second one. On a tangent, IVs are also chock-full of calories; I figure I had 5,000+ calories a day while I was laid up!
The next afternoon, I was checked in to a regular room. I was still hooked to an IV with regular antibiotic doses. One of the first things I did was ask to use the bathroom. They brought me crutches and I stood up for the first time in 25 hours. I was immediately struck by a case of pins and needles that was probably equal to every previous time in my entire life! Eventually, I hobbled my way 15 feet to the bathroom and got down to business.
The doctor would check on me every few hours during the day and tell me I was improving. However, he refused to tell me when I might be able to leave, saying it could be a couple of weeks. As I had a trip to Mexico scheduled for the next week, I was a little freaked out.
A physical therapist came by to show me how to use my crutches and help me walk around the hospital wing a little bit. It was pretty easy, and I was glad to be mobile. I was also easily worn out, and my left leg would still tingle really badly for a couple of minutes when I stood up. Eventually, I got to take a shower. This was wonderful, as I had been very sweaty and covered in sunscreen from the field for 36+ hours. No sponge bath for me!
I got to where I could hobble around without the crutches, occasionally using my IV for support. The swelling was down. 73 hours after first checking in, with no hints, the doctor examined me one more time and told me I was ready to check out! I called rlb, since everyone else was out in the field, and he came to get me. We swung by the project area so I could surprise everyone, then I went to the pharmacy to get my prescription for antibiotics and heavy-duty pain relievers filled.
What was the damage? As I said yesterday, I can find no physical scars. I’m pretty freaked out by snakes, but I’ve come in contact with rattlers since and not freaked out. I do watch my step a little more closely, and I always wear snake guards on surveys and in heavy brush (which makes me a step slower than most people). The bill was $65,000, of which 48k was for the antivenom. Workers comp took care of it all, thank goodness. I was the first blemish on our safety record in 3 years. I made it to Mexico and climbed the Pyramid of the Sun at Teotihuacan 10 days after being bitten!

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