Thursday, April 16, 2009

Life Lessions In Lesions (Or, The Gross But Necessary Breast Post)

On Easter Sunday I had to take myself to the emergency room. It took me an hour & a half to convince myself it was necessary, even if I wasn't bleeding or otherwise looking like my life was in peril... Bad things had gone on long enough.

A few weeks ago, I was charmed (not!) to discover that I had a zit on the underside of my left breast. I know; what a complete "Eeeiiiwww!" But ladies, especially those ladies with large breasts, know that break-out on the bosom happens -- especially on the underside of the breast because, between bra cups & underwires, and, when you dare to go braless, the underside rests against your chest. The skin cannot breathe, and is often moist, perfect for bacteria etc.

Typically I slap a bit of Wayne's Whoop-Ass Healing Balm on the offending zit. (Seriously, that stuff is awesome!) Every now and then, when the zit is behaving stubbornly (and is twice as ugly), I apply the old hot water compress. Even in the worst case scenario, things come to a head and heal within a few days.

But not this sucker.

This zit was not your usual zit.

After sticking around over a week -- despite all my TLC -- it was only becoming more angry. After two weeks, on the Saturday before Easter, it was not only a zit with no head, but there was a hot, angry, red patch of skin surrounding it, working it's way towards my nipple...

I did just have my mammogram around the new year, and all was fine; surely if there was anything that was gonna burst out of my breast they would have seen it coming. But naturally such rational thinking did little when faced with such ugliness. So I probed, gently (which still pissed-off the zit and made 1/4 of my size E breast ache), lifting the skin to grab it to see if it was attached to my breast tissue. It felt like it was all "in my skin" only... There was a lumpier pocket where the zit was... But the red area wasn't just hot and sore -- the skin was thicker... Like a stale pancake or the hard top layer of Jello; bendable, but thick and sorta rigid too.

I gently washed it, applied a hot compress, then dried it and put on some of the healing balm before heading to bed.

The next morning I awoke to discover that nearly 1/2 of my breast was now red-hot angry. It hurt just awful. It was so bad, I refused sex with my husband.

"Let me see it," he says.

"No, you'll never want to have sex with me again -- at least not in the missionary position," I say.

But he does look at it; pronounces it an infection, as if that was "all" it was, and gave me the "let's continue" look. Uh, no, thanks.

Before dressing for Easter Sunday with family I applied more balm, popped some aspirin, and hoped it would just heal already.

When I returned home that evening, I was sore and tired. More washing & balm (was it bigger or was I imagining that?), more aspirin -- and a nap. I woke up feeling a bit better, but by the time dinner was over, I began thinking...

What if overnight it again doubled itself? Clearly this was no ordinary zit... What was it? The heat told me it was an infection, but what was that thing that, originally anyway, looked like a zit? With no other terminology, I called it a boil. Wasn't the treatment for a boil rather like a zit? But then it wasn't working and there was clearly an infection... But does one really go to the hospital for an emergency room boil lancing procedure? Not that I really wanted one. But it hurt. And it was ugly. Oh, gawd, if I went, not only would I be "the woman with the boil on her breast," but I'd have to say it out loud. In public. Oh ick. But after my son was hospitalized for three days because of an infection from a dog bite, I don't like to underestimate infections. In just a few hours, you couldn't find the nose on Hunter's face... What could this infection do, engulf my boob? Sounds funny, but it wasn't. Round & round I went with myself for 90 minutes until I decided that pride be damned, infections could be serious, and if it was worth an hour & a half of thinking, I should shut up and drive to the hospital.

There was the humiliating experience of announcing my problem to the registration staff person. There was the added humiliation of having to repeat it two more times -- to the intake nurse and then the doctor.

I used humor to diffuse my embarrassment. I was cracking jokes my whole time there. See, I have an anxiety condition (PTSD from domestic violence) and the whole thing made me nervous as hell. Which not only means I'm seconds away from crying, but my blood pressure goes up and then I have to explain that it's just nervousness & have them take it again... Which reminds me that the new-fangled automatic computerized blood pressure cuffs hurt -- actually leaves me bruised. And so I hate having to have them take it again -- nearly as much as I hate to tell people I'm an emotional mess. So it's make jokes and have a (possible) reason to cackle, or risk having them consider admitting me to the psych ward for emitting too much maniacal laughter -- while tears stream down my face.

But I digress.

There was the nearly comical reaction of the doctor's assistant who had to touch my breast and the affected area -- twice. Each time with a sourpuss look on her face followed by a dash to the wall dispenser of hand sanitizer and a furious scrubbing of her hands.

I know it's gross, lady, but I bet at some point in your career you've been wrist-deep in a cadaver and experienced human excrement; how's a breast boil so much worse?

(Note: The doctor wasn't so reactionary, but I guess that's 'cuz he doesn't have a breast to imagine that on.)

Anyway, after a brief Q & A (how long have you had it, me describing my treatment of it, assurance that I just had a mammogram, etc.) and several words ending in "itis" etc., the determination was "an infection." Antibiotics would be the remedy. (Initial relief at no lancing; but then, "Oh, joy, a yeast infection will be here soon!") But because the doc couldn't feel a "puss sack" he wanted an ultrasound just to be sure...

Sure of what? My nervous brain wanted to know. Looking for a "puss sack" was the answer. Oh, so if chapter one was "The Breast Boil Lady", chapter two was "Looking For A Puss Sack". What an utterly charming story this was becoming.

While awaiting escort to the ultrasound, a very cool nurse tried to get an iv with an antibiotic started. I politely warned her that I'm a hard stick & that my veins blow too; she shouldn't take it personally. Of good cheer, she proceeded, confident in her ability -- greatly underestimating my non-cooperative blood vessels. Bless her, she both tried and was kind.

While she waited, gently slapping my arms to get a vessel to sit up & take notice, I regaled her with amusing stories of other iv experiences. Like when I was giving birth to my son, how the young nurse couldn't stick me either. And I told her that it was because I was royalty; that's where the expression "blue bloods" came from, our delicate thin, blue veins. It was a joke -- but she didn't get it. She was amazed -- on her way out she repeated it to another nurse, in all seriousness. *eyeball roll*

(Whenever I tell that story, I have to include the part about how during very painful labor I rhythmically chanted, "I would not, could not, in a boat..." To which the amazed & impressionable young nurse cooed in reply, "Oh, how beautiful, I've never had a laboring mom quote poetry before!" Dr. Seuss is poetry? I mean come on. That's when I ordered my mom to get that girl away from me.)

But I digress. Again.

While I babbled on the emergency room nurse laughed -- which probably helped her mood as she grappled with my non-compliant arm veins. But even she of positive attitude had to give up on my arms. I suggested my wrists; the veins are very visible there. "Oh no, that's really really painful," she warned. She gave my hand a try -- very painfully in, & then the damn disrespectful vein blew.

I asked what would happen next... Since I was going to get a script for antibiotics, couldn't they just increase them & skip the iv antibiotic? She looked at me and seriously shook her head and then quickly said, "Oh don't worry, I've only got two tries and then I pass you onto another nurse." To which I blurted, "But what if she can't either?" She continued on, "There are only 9 of us working tonight," oblivious to my horror. "So I'm looking at 18 stab-sticks before we move onto option B?!"

She went to get another nurse. A not so nice nurse. A gruff by comparison nurse. Ah, but the ultrasound tech is here and I have to go!

A momentary reprieve before I remember we're looking for a "puss sack" and start to sweat away at least the bottom half of the magic marker dotted lines Nurse Sourpuss-Wash-My-Hands-Too-Vigorously had made to monitor the size of the infection area.

Embarrassed & literally sweating out what was to happen next, I ask her -- to ease my tension, you know -- if my boil was a boy or a girl. Ba-dum-dum!

"'Cuz maybe after all this fuss, I should name it..." I babble on.

Inside to myself I'm screaming, "Shut up already!" but it's babble jokingly or cry, so I say, "I suppose I shouldn't say that; you'll admit me to a different floor..."

"No, we don't do that here. We'd kick you to the curb," she says. Images of homeless mentally ill people flood my mind. It's a sobering thought & mercifully I shut up for a bit.

Then I ask, "What are we looking for here..." I don't expect her to reply with anything other than, "The doctor will tell you that," but the tech shows me the infected area, the skin line, that the infection was not in my breast tissue, and that there was no abscess to drain (back to that lancing option, were we?).

Just as I started to relax she told me she had been called from home to come in and do my ultrasound. I didn't have any jokes for that. I apologized and just thought to myself... Umm, what didn't I know about me, my boob, and my boil sorry, my infection that required a person to get out of bed at night on a holiday? I've seen that on ER, and that's not ever good.

Oh, but the gruff nurse was waiting for me; I had more attacks at sticking me to distract me for the time being.

She tied that rubber thing on my arm so tight that all but the tails of the knot disappeared in the flesh of my arm. I complained and got the gruff tough love explanation of how a tourniquet works. Uh, yeah, I know that; but sheesh when I came in here tonight my pain was a 2 or a 3 and now it was at a 5... Could we be a little nicer?

Oh, and can't we just give me a larger script for oral antibiotics and skip this iv mess?

"Oh, no then you'd need the shot."

"Fine, the shot can't be any worse than all this painful sticking."

"No, this shot hurts."

I don't think she understood the pain I was experiencing.

Anyway, this nurse fares no better -- in fact, she doesn't even try to stab me but instead, after minutes of none-to-gently slapping my arms, she says she's going to go get this lady EMT who "can stick anyone in a vehicle bouncing down the road." Awesome, I'll go anywhere to get this stabbing over with -- take me to the bouncing rescue vehicle!

But I didn't have to leave; she came to me.

She assess my multiple stab wounds & frowns; suggests my wrist.

"That's what I said, but the first nurse said it hurts a lot."

"I think it hurts worse on the hand than the wrist," she says matter-of-factly.

What the hell, let's try it.

It worked. It hurt a lot (about the same as the hand, I'd say), but it was done.

Now for the iv antibiotic. Twenty minutes of sitting and reading from the book I'd brought for the waiting area. But then, in calling hubby (so he doesn't worry about how long this is all taking), it occurs to me that I've never had this much fuss ever. Forget about the problems sticking me (I'm trying to), emergency room ultrasounds from staff that had to be called from home? Intravenous antibiotics? In addition to multiple scripts for simultaneous antibiotics? And I have to return to the urgent care center tomorrow to have it looked at again? Just what the hell did I have?

Well, as it turns out, the check-out slip says I have cellulitis. So it was a good thing I went in. Even if it was all so bizarre.

I went home and have followed all instructions -- except the "keep the area raised on pillows" because the whole area is a pillow. The directive to "rest until healed" is easy to do because cellulitis knocks you on your ass.

Days later, I've still got an ugly breast. See?

I'd apologize for this photo's grossness, but felt it was important to show women what it looks like -- so that those who recognize something like this on their own breast know to get medical attention. Got this thing or one like it? Get thee to a doctor.

I apologize for the photo's blurriness. I had to take it myself because hubby now doesn't want to see my icky boob. When I hinted at sex he was looking at my (fully covered) breast with that "Eeeiwww" expression.

"What, now that it's getting better, you don't want to see it?"

"I didn't know how gross it was; now that I do, no thank you."


But I can wait him out. *wink*

Oh, and should you ever need to know, I was told by the doctor who gave me my follow-up exam the next day, that increased redness at the infection site for the 36 hours following antibiotics is normal. It seems contrary, but give it a few days and it will start to clear up.

And that concludes today's life lessons in lesions.

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