Thursday, May 10, 2012

Gross Photo Essay: Tick Bite & Burn

If you're easily grossed out, I'd recommend skipping this post.

A few days before May Day, I went for a walk through my favorite meadow, barefoot and wearing jeans. I've done it hundreds of times before, but this time I picked up a tick. That's also happened a hundred times before, but I usually catch them before they burrow in.

Not this time. He got deeply embedded in my leg in about 20 minutes. I gently but nonchalantly pulled it out and checked to make sure that his head was attached to his body before I crushed him. (Why is the tick male? I don't know.)

The bite hurt immediately. Actually, that's how I found it so quickly. By morning it had swelled up and started to look a little infected. By the following morning it had developed a wide necrotic center with a 1" ring of infection. Time to go to the Urgent Care clinic!

They did a 6 mm punch biopsy to remove most of the necrotic flesh and be sure that all the tick parts were removed. They cauterized it with silver nitrate, put a bandaid on it and sent me home with a 10-day course of antibiotics to prevent systemic infection, including Lyme disease.

And here's where the photos begin. This is what it looked like after removing the silver nitrate soaked bandaid. The black is from the chemical. The smear is from me wiping it off with gauze before realizing I should photograph it.

And here's where it gets interesting, in a Darwin Awards kind of way. A couple of days later, the center looked and felt infected so I thought that it would be a good idea to use hot epsom salt to draw out the infection. The idea was simple: I'd put the hot liquid in a cup and seal it over the wound. As it cooled, the suction would pull out some of the infection.

What happened instead was that the top layer of skin peeled off. I was kind of mystified as to why this happened because the water didn't seem that hot. Well, I've since recalled some basic chemistry stuff and realized that Epsom salt can hold five times as much heat energy as water. (At least, I think that's what the numbers from WolframAlpha mean...) While hot water would cool down before it burned you, hot epsom salt water might not. And in this case, indeed it didn't.

But see? It doesn't look that bad. It's just one layer of skin, right?

Now I don't know that much about healing burns so I thought that the right thing to do would be to keep it clean and let it get plenty of air to dry it out. Remember, I'm on antibiotics that should keep it from getting too infected. These next photos were taken one each day so that I could keep track of the thing.

Here's an angle with sunlight showing just how deep it's getting.

And then the pain kicked in. I mean, it had hurt all along, but yesterday the pain just kept climbing until I could hardly see straight. This last development just took a few hours. The level of pain and the rate at which it was increasing sent me back to Urgent Care.

The doctor said I had a slow-developing deep second degree burn with secondary cellulitis. This means that the burn was bad and that the infection was spreading through the fat layer deep under the skin.

Here's the last I saw of it before the nurse fixed it up. Notice the pink that extends about 2" in every direction. I hadn't noticed it before, but it's actually really important. It's what told the doctor that the infection was spreading.

The nurse smeared it in silver sulfadiazine cream, covered it in petrolatum-soaked gauze, then about 10 sheets of dry gauze, wrapped it with 2 rolls of gauze, and a held it all together with a layer of self-adhesive rubber bandage. I'm told that this is standard dressing for large burns, and I took notes on the order and amount of dressings because I need to clean and redress it myself twice a day for a while.

The doctor noted that a burn like this must be causing a lot of pain so he prescribed Tramadol. I'm not a big pill popper, but let me just say that it's kind of amazing how good these drugs are. The pain is greatly lessened, sleep comes easily, and there are no other noticeable side effects. [Update: I just had my first daytime dose. "Sleep comes easily" is an understatement. It should read "This stuff drags you under the surface of consciousness like the kraken latching onto a dinghy."]

When I opened up the dressing this morning, I was a little surprised at how disintegrated it is. There's really no structure at all, just a deep, soupy mass. I gently cleaned it with Hibiclens, being careful to only rinse away the truly liquid parts of the wound. If some part of this is going to become skin, I don't want to jeopardize its integrity. The water evaporated quickly because this thing is HOT, and I immediately covered it up with fresh burn dressing.

So, what does this mean for business? Well, first off it delays the introduction of black cloth by about a week. I learned from the blue beam that I should not make the complex decisions that it takes to wind a beam while my mental capacity is compromised. I spent three days plying black threads so I'm ready to start winding as soon as I get back from this weekend's show. And, even if I have to spend most of the time sitting, I need to go and do this show. All this doctor stuff is super expensive.

Instead of weaving, I'm spending the next couple of days doing things that I can while sitting at a desk: price tags, signage, branding bags, etc.

And this is why the retail price is twice the wholesale price. The markup has to cover the time and materials that it takes to present items to customers in a professional manner. Wholesale pays for production, retail pays for getting it to customers.


eldri said...

that looks nasty!
Glad you are getting it looked at!

Epsom salts and 'cupping' are to separate cures, my dear, next-time you cup, just put a Small piece of burning paper in the cup, to make the partial vacuum...
Love, blessings, wishes for fast healing...

are you going to check out the eclipse?
(probably not, I know..)

Blossom Merz said...

Hi, Eldri!

Well, I know that now! And the latest theory explains things a little better. Apparently, I have a sulfa allergy. That would include magnesium sulfate (Epsom salt) as well as the silver sulfadiazine cream. So, maybe I didn't burn it. I mean, the water really wasn't that hot! Maybe the application of an intense allergen with a little heat was enough to slough off the skin.

The good side of all this is the Ultram. It works on the mu-opioid receptors and acts as a serotonin reuptake inhibitor. It's like mixing opium and Prozac. Yay! No pain and a happy outlook despite all the unpleasantness. Too bad I've only got a few days' supply...

And, of course I'm going out to see the sky! What sort of nature-loving double air sign would I be if I let that opportunity pass? :)

Anonymous said...

Blossom, that is an impressive wound... I cringed when I saw the telltale signs of cellulitis. Heal well & have a good show! -Sarah (nurse, sister-weaver, blog- follower, nature-lover and tick-annihilater)