Thursday, September 21, 2017

Got the Stinkeye

It's been quiet. Too quiet. Until right now.

It has been 10 months since I definitively learned that I did not, in fact, have an exotic, aggressive tumor that would kill me within 2 years. Life has settled down to the ho-hum existence of your average northeastern US primary care doctor living in the End Times. What was I to do for excitement?

So, this summer, I had been getting a runny nose, a cough, sneezing, and a bit of bloody nose. It didn't seem like anything special, but it went on for several weeks and did not respond to allergy treatments. So I stuck a culture swab up my nose, sent it to the lab, and prescribed myself some antibiotics. *

The culture grew 'normal skin flora.' Generally, when they find this in a culture, they throw it out, and that's just what they did. And I didn't get better. I went to see Hygieia. It indeed looked infected. She cultured it again, and I spoke to JD of infectious disease (ID). He put me on two antibiotics.

Those two antibiotics did seem to help some, but they made me ill, and, three days in, I woke up in the middle of the night with a fire alarm in my ear (tinnitus from hell). That was minocycline. Not doing that again. So JD switched out one of the drugs for another. But the new combo didn't seem to work, and the other drug, rifampin, turns all one's body fluid orange, which can be a real downer.

Meanwhile, about a week ago, whenever I coughed or sneezed, it felt like my right eye and cheek were about to blow off my face. On Sunday night, it crossed my mind that this was not actually normal, even for me.

The next day, Hygieia squeezed me into her schedule. (I guess she found the idea of my face bursting apart disturbing too.) The inside of my face was not looking better.** So she got another culture and ordered a CT scan (also because that spot hasn't had enough radiation lately). And the CT scan showed...another trophy for my catalogue of experiential medicine! I have orbital cellulitis.

What's orbital cellulitis, you ask? Sounds like something Chris Hadfield (http://chrishadfield.ca) might get. But no. It's an infection in the tissues surrounding the eye. Usually, it's quite painful, because the tissues around the eye usually form a closed space that can build up pressure. Luckily (Heh!), in my case, the orbit is not a closed space. It's wide open to what should be bone and sinus, but what has, for the last 10 years, been my facehole.

Know what's even more special? That culture seems to be growing Enterococcus faecalis! To put it delicately, that's a bug that one more often finds in the hole on the other end of things. This is so special, that only two patients in all of medical literature have ever had such an infection! *** And I bet neither of them had a facehole like mine! I win!

So, last night, after all of this, I called up my parents, and I asked, "are you bored? . . ."




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* Before you give me the a hard time about my treating myself, I am in frequent contact about these things with my primary care doc and my ENT doc, Hygieia, the Greek goddess of otolaryngology. Dr. Bug, head of infectious diseases at Ben and Jerry's Hospital, is impressed that I have been able to keep the inside of my face from turning into a foul sewer of infection for the last 10 years given what cancer, surgery, and radiation have done to it. (I guess that 10 year streak is over.)

** Meanwhile, her lab had tossed the second culture, because it too grew 'normal skin flora.' This made Hygieia very mad, since normal skin flora do not belong on the inside of my face.

*** https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056554/




He's not bored.