My trip to the ER
I'm one of those people who would rather tough out just about anything at home, writhing in misery until it passes, then go to the ER. I once tried to ride out cholelithiasis - insisting it would pass ("Tis just a stomachache! I'll be fine.") before riding to the ER via EMS transport, hollering like I was having my leg sawed off 3 days later.
Two days ago events occurred that this choice was taken off the table and I had no alternative but go, or risk dire consequences.
Let me back up a bit, and first explain I've cared for a couple of feral cat colonies for around 5 years, and my family helps out with the trap-neuter/spay-release (TNR), feeding and watering. Our neighborhood had been over run by feral cats, but lately our efforts have started to pay off and the breeding has decreased dramatically. That being said, they are still domestic animals of a sort but without a home, and require food, water and shelter or they would die.
Some are obviously lost or abandoned and very used to human interaction, while others are wild and have never been touched by a human - ever.
All should be treated with extreme caution because they are not spoiled, pampered house pets, having more in common with their wild cousins running on the African plains than Fluffy the house cat. The only difference is having been domesticated in their lineage they have lost their innate ability to hunt enough to feed themselves, even if they weren't living in an urban area.
The other night a scuffle broke out behind me and I got bit in the ensuing chaos. Not my first cat bite, not by a long shot. Of course it was my luck (or lack there of) to have been inflicted by one I hadn't trapped and neutered, or got shots for yet. Lucky, lucky me.
I bet you didn't know the average domestic house cat has 7 rows of long, sharp, serrated teeth tipped in flesh eating poison? Well ... perhaps that is a bit of a stretch - but it sure feels like it when one is biting you!
Cat bites are nasty business and should never be taken lightly. This is partly due to their unique teeth: their fangs are extremely long and wicked sharp. When a cat bites their canine teeth puncture the skin and inject bacteria from the cat's mouth and the environment deeply into tissue. Because their teeth have small diameters, the seemingly minor wounds heal rapidly. This is unfortunate, because this bacteria thrives in an anaerobic environment - such as when trapped in healed over bite wounds, and severe infections result.
The other reason is due to one organism in particular, a pretty potent and aggressive bacteria known as Pasteurella multocida (an aerobic to facultatively anaerobic gram negative coccobacillus bacterium). This bacteria is the frequent cause of infection after cat bite injuries. Symptoms usually are swelling and local infection around the wound, which left untreated will lead to a very painful abscess.
I knew I would be quite sick very soon, so rather than expend energy trying to trap the cat now (if I was lucky and actually caught the right one immediately) I opted for the rabies vaccine and immunoglobulin injection along with the inevitable antibiotics.
After calling the health department I soon discovered the ER is the only place that carries the rabies immunoglobulin. I had no choice but to go. Rats!
My childish ER aversion stems in part from bad past experiences, and also from not wanting to inappropriately utilize the services of the ER which is in the life saving business. If I could meet my needs any where else then that is where I would be going.
With trepidation I trudged into the ER, sheepishly smiled at the front desk staff and apologetically told them what idiocy had brought me in that day. No one blinked an eye, and all were very nice and professional.
I want to add there was nobody else in the waiting room (which was unexpected). I spent a few minutes chit chatting with the woman at the check in desk about caring for cats on the family farm she grew up on, then I was brought right back.
I'll skip over the immunoglobulin injections, which were horrible and made me cry like a big baby (they have to injection into the wound, and all around it too - like an immunological solar system or something). The ER PA kept up a series of nonstop chatter about his son the whole time in an effort to distract me, which was sweet. Then the actual rabies shot (one of a total of four: day 0, 3, 7 & 14) in the shoulder with a large bore needle that could also double as a drinking straw.
I'm not sure why I lied about my pain level but I did. ER nurse: "How would you rate your pain?". Me: "Um ... a 1?". Everyone's eyebrows went up, but I got no challenges about it. Even still, the nurse brought me a ibuprofen 800 mg tab along with my first dose of augmentin. Again that was pretty nice, since the area surrounding the bite already appeared to have cellulitis less than 12 hours later, and was hot, red and shiny - sort of like a mini sun blazing behind my knee, putting out enough heat to warm a small house.
In my short time there I was offered refreshment more than once, and spent time hanging out with some of the staff who had wandered in just to look at the bite and scratches - then debate amongst themselves on whether a set of scratches were in fact another set of bite marks, and with others who came in to carry out orders then sat and told me hair raising stories of their own. Although I brought my own entertainment (a battered, much loved ) I rarely used it.
All things considered I was in and out as fast as someone needing the full rabies package could be - in just under 4 hours. The longest part was the wait while pharmacy mixed up the immunoglobulin as it is weight based (which is kind of funny, because they had a difficulty convincing me to get onto the scale to begin with). The staff were kind and friendly, and overall treated me like an old friend instead of the the imbecile that I am for turning my back while a cat fight was brewing.
I can't honestly say I hope to go back any time soon (or ever) but two days ago all the stars aligned for an unexpectedly pleasant ER experience.Last edit by traumaRUs on Oct 16, '17
About 3ringnursing, BSN, RN
Joined: Sep '16; Posts: 529; Likes: 1,588
Specialty: 23 year(s) of experience in ICU; Telephone Triage NurseOct 1, '17Ha! I thought the story was taking a wrong turn when you mentioned the waiting room being empty. So suspenseful!
On a more serious note, thanks for sharing this, sincerely.
Healing thoughts to you!Oct 2, '17Quote from 3ringnursingI'll skip over the immunoglobulin injections, which were horrible and made me cry like a big baby
I'm not sure why I lied about my pain level but I did. ER nurse: "How would you rate your pain?". Me: "Um ... a 1?"Oct 2, '17Okay, now that I've got my fix, I wish to seriously comment on your article, 3ringnursing. (BTW: may I call you 3ring? Thanks!)
Your article was interesting, informative, humorous, and my heart went out to you, 3ring. I greatly admire you for the tasks you have chosen to undertake and empathize with your situation.
Thank you for sharing your story!Oct 2, '17Great story and I'm glad you had a good experience under unfortunate circumstances. I'm glad you didn't choose to wait it out. I've heard the IVIG is horrible. I have always wondered why they can't use lidocaine.Oct 2, '17Quote from Davey DoLOL, that sums it upOct 2, '17Loved reading your article. As a cat lover, I've spent much time and money on helping with our feral/stray cat situation around my neighborhood. TNR programs are great! I've also seen a couple of cat bites that became very bad, very quickly. I'm glad you had the knowledge to get yours treated right way. Cat bites are like a syringe of bacteria being injected deep into the tissues. Sending good thoughts to you.Oct 2, '17Quote from dream'nLoved reading your article. As a cat lover, I've spent much time and money on helping with our feral/stray cat situation around my neighborhood. TNR programs are great! I've also seen a couple of cat bites that became very bad, very quickly. I'm glad you had the knowledge to get yours treated right way. Cat bites are like a syringe of bacteria being injected deep into the tissues. Sending good thoughts to you.
I'm glad I'm not the only one (sure feels like it).
When I got to the ER the PA asked, "Why do you do it?" (meaning why care for feral cats). I struggled for a bit, and thought, someone has to do it, or because they need help, and a variety of other answers paraded through my head, each being discarded one after the other. I finally settled on, "Because they're there?".
He seemed satisfied with that answer, but to be honest my brain had difficulty framing what my heart felt about it.
I guess because I do love animals, cats especially, and they would otherwise die with a helping hand.Oct 2, '17I hope you provided your praise directly to the hospital as well! It's always nice for the ER staff to hear positive feedback.Oct 2, '17Enjoyed your cat story details and your positive ER experience.
So much nicer than when someone posts how mean and awful the ER was to them.
Kudos to all ER staff out there (esp thinking of the ER and first responders in Las Vegas at this time).Oct 2, '17I wanted to come back and actually compliment your writing style - very enjoyable to read. I just read it again. I like how you interspersed some facts about feral cats and your care of them with your hilarious descriptions of your experiences, which you pulled off without using cliches.
Quote from 3ringnursingOkay, I admit to just a tiny split-second thought of "whaaat...come on..." when my eyes hit that sentence ^^I bet you didn't know the average domestic house cat has 7 rows of long, sharp, serrated teeth tipped in flesh eating poison? Well ... perhaps that is a bit of a stretch - but it sure feels like it when one is biting you!
Funny stuff.Oct 2, '17I also had to get rabies vaccines and antibiotics for a feral cat bite. There is ONE ER that does rabies vaccines out of the 12 hospitals in my area. And every shot had to be done through the ER.
All I can say is wait til you get that bill. Immunoglobulin is EXPENSIVE. My minivan, bought new, cost less than the total of this cat bite.
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