Aby-a-Day: 24 & 25 August: Cat bites R srs bzns (Friday Flashback/Serious Saturday)

This post is very long, so I’ve made it a two-day post. Also, as a warning, some of the photos are fairly graphic. Blood, stitches, that sort of thing.

One year ago today, just after midnight on 24 August, Pyret bit my finger. We were having problems with giardia, so all the cats in the house needed to be dosed with Fenbendazole in pill form. I was giving everyone their last dose…and Pyret bit down on the first knuckle of my right middle finger.

This is how it looked 8 hours later.

And here it is 10 hours after bite.

Here is the finger 12 hours later, after going to my Vårdcentralen (basically, the medical clinic closest to where you live). Now, I already knew cat bites were serious business (not my first rodeo, people), but I had looked up a Mayo Clinic study on emergency room visits from cat bites to the hand, and tried to tell the doctor that this was serious. But she only spoke Spanish and some Swedish, and she had Googled up a treatment plan – the same treatment plan that I had already Googled whilst in class.

This doctor actually knew less about cat bites than I did! I tried to show her the Mayo Clinic study, but she just looked at my finger (not even taking off the bandage!) and wrote the prescription for just the oral antibiotics. No injection, no asking about a tetanus shot…she didn’t even tell me to take off my rings! That was the first thing my sister, a physician’s assistant, said when I texted her that photo. And I knew that wasn’t enough, but she was the one with the medical degree. Right?

This is 17 hours after bite. It was also really hurting. I know now I should have gone to the ER, but silly me, trusting the doctor and waiting for the pills to kick in.

Here is my Facebook post from that Thursday: Gather round, kids. Time for a cautionary tale. We have been dealing with Giardia in our home these past two weeks (which is how I discovered Virkon). Our house is now very clean, to say the least. But when one cat has Giardia, they all do, so everyone has to get the pill (Fenbendazole, which is available over the counter at the Apotek in Sweden) every night for four nights. I can handle the LunaTicks, but Björn has to help me with Pyret, because, well, I’ve been feeding her for 14 months but he bottle-fed her…so he calms her down.
Last night, Alfred had broken a lamp, which Björn was dealing with when it was time to dole out meds to the asylum patients. I wrangled the LunaTicks with relatively little trouble, and then I came to Pyret. Björn was still busy with the shards of broken bulb, and I didn’t want to bother him for just a pill, I shrugged and said, “Meh, I can handle her…”
Not so much. While pilling her, she bit me. Hard. Actually punctured both sides of my long finger. It bled a lot. So I washed it and put on a band aid and fed the cats. I’ve been bitten before, and as yet haven’t ever had a problem. This was around midnight.
I had SFI class at 8am and so I woke up at 6:45 or so. Finger is sore…but my hand has been hurting from a pinched nerve in my neck vertebrae, so I reckon it’s just that. Go to class and notice around 8:30 that my finger is swollen. I figure the band aid is just on too tight so I take it off and put on a new, looser bandage. Several minutes later, I notice my finger is REALLY swollen. Like twice the size as the same finger on the other side, swollen.
I mention it to my teacher. By 10 o’clock, I can barely hold my pen (where, just two hours earlier, I was doodling pictures of Logan), and it was throbbing. I say I’ll go to Vårdcentralen after class, but my teacher says I should ring them now. So I do; here you call the clinic and they give you a callback time; mine was 15 minutes (10:40). When I get my call, after hearing my description, they make me an appointment for 11:30.
And I am on antibiotics three times a day for 10 days. All in under 12 hours. Usually people wait a day or more…I’m here to tell you DON’T DO THAT. Cat bites are serious. Just do a Google image search for “Cat bite infection” and see for yourself (preferably without food). In comments I’ll post a link to a 3-year study of cat bites which found that 30-50% of all cat bites get infected and need at least antibiotics.
I’ve been lucky; this is my first infected cat bite. And I just got a tetanus booster on the 7th. But even an 18 year old cat can do serious damage. Ironically, I was trying to find a pillgun eariler that day, but neither DjurMagazinet or Apotek had one. I have now ordered one online.

That doctor was wrong. Dead wrong. This is the wound almost 24 hours later, after we cut the rings off that finger. The next morning, Friday, I woke up in screaming pain so bad that Björn almost called an ambulance. As it happened, he had an appointment at the Sjukhuset (hospital) that morning, so instead we took a cab together.

He got his CPAP machine adjusted. I got admitted to the infectious disease ward and had emergency surgery on my hand. This is the message I sent him when they decided I needed surgery.

It was quite lucky that I hadn’t had anything to eat, so I could go in straightaway.

My Facebook post from 25 August, after the surgery: So… I had surgery. It took about an hour and I was completely out. It was awesome. They flushed out the tendon sheath and stitched me up.
Do not take cat bites for granted! It hasn’t even been 48 hours since Pyret bit me, and I have had surgery, rings cut off, 4 different kinds of pain killers including morphine, and I think I’m going to need a cast…because a cat bit me.

But the best thing about today?…
You’re gonna love this. While I was in Recovery, I was talking to my nurse, a man named Göran. We were talking about my bite and the conversation turned to the other cats. At some point I said something about visiting hospitals with my Abyssinian…and he perked upon “Abessinier?”
So I explained that I have three Abys and a Singapura. He asked if I was a member of Billingebygdens Kattklubb. Okay, the guy knows the local Sverak club’s name…turns out, his fiancée has Cornish Rex. He asked if I show, and I said yes, bragging about Jacoby and then talking about Logan’s first show. Göran said his fiancée has a black and white Cornish from Arextocats named Sully who was “pretty high up in titles at shows.” Then he asked if we were going to the show in Västra Frölunda, which is our next show. I said that I’d have to look out for Sully, but that he wouldn’t be in my group since I was bring Logan and not Jake (Rexes and Abys are in Group 4, but Singapuras are in Group 3 with Burmese and British Shorthairs). Because of course I would find the one person in the hospital with purebred show cats…

That was the first day in hospital and the first surgery on Friday, 25 August. The next morning I posted this on Facebook: Day Two…Yes I am still here. They want to keep me another night and have an orthoped examine me tomorrow. I’m off the IV, but still am getting antibiotics pumped into me every six hours (I think it’s six. Losing track by now). I found another article about cat bites, written by a veterinarian, this time with an Aby!
Feeling okay, but tired. Really tired. Hand is just aching and slightly throbbing, but okay.
Cat bites R srs bizniz.

So this is cool. In Swedish hospitals (at least this one) instead of a gown, they give you a button-up polo shirt and sweat pants to wear. Also underpants. All emblazoned with the size (60-80 kg) and the Västra Götalands regionservice logo. I actually like this better.
I’m sleeping odd hours here. It’s weird. I’m also a little worried…someone came and asked me my choices for lunch and dinner on Monday…

It was particularly worrisome because this was the same weekend as the NEMO show back in Sturbridge, and I was meant to judge the costume contest (via FaceTime) at 19:00 Swedish time (1pm in Massachusetts). On Sunday afternoon, I posted this: Orthoped came to look at my hand. It’s not getting better as fast as he’d like – and this guy is familiar with cat bites! So I have surgery again tomorrow. Iris and Stephanie, looks like we’re doing the costume contest from here…I have wifi so we should be all right.

But it wasn’t. As luck would have it, I was rolled into my second surgery at the exact same time as the costume contest. But I will be able to judge this year’s contest tomorrow!

After surgery, I posted: Back from my second surgery. I’m in a cast. They let me keep the empty morphine syringe as a sort of trophy/talisman. I still have it, too.

Monday morning I posted this: For those keeping score: I was bitten around midnight Wednesday night/Thursday morning. Went to Vårdcentralen Thursday at 11:30 (12 hours post-bite), got antibiotics…and then went to the ER Friday around 8am, 32 hours after bite. That was Friday; now it’s Sunday/Monday, 96 hours post-bite, and I’ve had two surgeries and a lot of antibiotics and painkillers…That was a pretty fast reaction. Imagine if I had waited a day?

Björn came to visit me every evening after he got off work. This is me getting my evening dose of antibiotics (click on the video to view on Flickr).

Tuesday I posted this: Tuesday in hospital. Finally washed my hair with real shampoo and not dry shampoo! My orthoped is Dr. Jörgen Åstrand. Or Farmer Creekside, as he charmingly translated (I said I was Cat Flatstone-Twig and my husband was Bear). He’s somewhat famous and has worked with the Mayo Clinic. He wants me to spread the dangers of cat bites far and wide amongst the “cat people” (and he was very impressed when I said my friend Teresa wanted me to write an article for CatTalk*). He actually had a nurse take the photo of my hand.
I had blood drawn and I’m better than I was, but not better. But my wound seems better and I didn’t need another surgery, so there’s a chance I can go home tomorrow.
And it’s now been 144 hours since I was bitten. (The surgeries I had involved flushing out the tendon sheaths in my finger to remove all the bacteria.)

Here’s my post from Wednesday, 30 August: Coming up on one week since the bite. I had more bloodwork and an Xray done today and then Dr. Jörgen came by to take a look. I’m going to need another surgery to flush out the wound, at least at the joint. The infection isn’t spreading into my bloodstream, but it’s building up in the tendon/joint area. Not sure if it will be done tonight or tomorrow. I miss my husband and my kitties…

But the best part of the whole ordeal happened later that evening: I had a special visitor tonight – Logan!

I’ve been asking Björn to “smuggle” him in for a few days now (because he’s the smallest and easiest to conceal)… although it’s not really smuggling because I’m in the infection ward (that’s where a bed was, and I came through the infection department, even though I’m not contagious), and these rooms all have “air locks” on the internal and external doors – and there is a door that goes straight to the outside, bypassing the hospital corridors. So Björn was able to bring Logan in without “contaminating” anything but just my room.

A nurse came in before we could hide him, but she said it was okay.

For an almost six month old kitten, Logan was remarkably calm. He didn’t really need to explore the room much; he just sat on me or let me hold him and just purred.
I never I’d be on the patient side of a therapy cat visit!

Also, I don’t know if therapy animals are a thing in Sweden, but it looks like Logan might be a natural!

When Björn got home, he sent me a photo of Logan with Jake and Pyret.

I ended up having a third surgery on the 31st. Later that evening, Björn came by with Logan again. I wrote: More kitten therapy tonight! Björn brought Logan after my surgery.

At one point, a nurse came in and I hid him under my nightshirt..! He meowed and walked around, but somehow she didn’t notice him.

Later I found an EKG sticker still stuck to my back so it became a little hat…Hoping to go home tomorrow, but nothing is certain until Dr. Jörgen looks at the wound again.

I did end up going home the next day, 1 September.

I was prescribed antibiotics for six more weeks. And my hand was in an actual cast. On 7 September, I posted this: Cat bite update… 2 weeks and one day since Bite Day. Been wearing a cast since Friday. Which has been clumsy and annoying. I had a check-up today and I got my cast taken off!

Now I have a nice bandage on my finger…with full use of all the other fingers! I’ve even managed to put some rings back on that hand. Next Monday, I get my stitches out. But I’m still on antibiotics for five more weeks.

But that wasn’t the end of it. I went and got the cast off, and the stitches out. I was still recovering, but life started to return to normal. We even took Logan to a cat show in Västra Frölunda (outside Göteborg). I was getting regular wound checks at the Vårdcentralen and, on 20 September, I had what was supposed to be my last exam.

This was also the day that Freddy got neutered, so I had dropped him off at the Skultorp, and on the way back I stopped at the clinic.

But the nurse who I saw noticed my finger was a bit red and swollen, and it felt warm. But the next thing I knew, I was back at Sjukhuset with Dr. Jörgen. The bite had become reinfected, despite me being on powerful antibiotics, and the nurse had picked up on it (quite arguably, this nurse knew more about cat bite injuries than the first doctor I saw)! He wanted me to have surgery at 16:30 that afternoon, but I had to go back to collect Freddy (they called me while I was at the hospital to tell me he was ready to go). Dr. Jörgen didn’t want to let me leave, but there was nobody else who could get him; Kalle couldn’t have paid the bill, and Björn was working until 18:00, after the vet’s office was closed. So I took the bus straight from the hospital to the vet and back to Resecentrum (Skövde’s central station, where all the local and regional buses and the trains stop). The time between buses was an insane 12 minutes, so I actually took a cab home. Even so, the trip took about 90 minutes. I dropped Freddy off, took off all my jewelry and nail polish (that’s something they don’t tell you about surgery on TV: you have to take off every bit of jewelry and nail polish. Not just the rings on the hand that’s being operated on, but every single thing. Even earrings and anklets. And you have to take a pre-op shower, too, with special soap and special sponges), and quickly packed a bag with my laptop and every other thing I could think of that I needed…but even rushing as quickly as I could, I couldn’t get back to the hospital until almost 17:00.

Since I had gotten there late, they weren’t sure if they could still do the surgery that evening. I had my shower, and wasn’t allowed to eat or drink anything for several hours while they tried to see if the surgery could be rescheduled. I was a cranky, hungry, exhausted patient. Finally, at around 21:00, a nurse came in and told me I’d be having the surgery in the morning.

Of course, the kitchen was closed, so I couldn’t have a proper meal, but they brought me a snack. That was a frustrating day.

I was also a bit sad I wasn’t there with Freddy after his surgery. However, Björn sent me this photo, and he seemed fine.

He also sent me this photo of Logan and Jake. Logan wanted to be friends with Jake so much…

The next afternoon around 15:00, I posted this: Surgery done and back in my room. Long one this time. Went in at 10, came back after 1. Some pain, but I have morphine and oxycontin to combat it. Best part was my Swedish anesthesiologist who’d lived in Australia. My first Swedish with an Aussie accent.

Taken about an hour ago, when I got back to my room.

Taken just now. It’s bleeding more than any of the other surgeries.

Björn wasn’t able to visit me the 22nd, but he did send me this photo of Logan in bed with him. Jake was there, too, behind Björn’s knees.

They actually let me go home the next day, Friday. That was a nice surprise; I had resigned myself to spending the weekend there.

On 25 September, I posted this: Finger update, one month, two days post-bite, and four days after the last surgery. It’s much more bleedy than after the other surgeries, and I’m not sure what that means. Also not sure when the stitches should come out. And it hurts. A lot. I did get a refill of both slow – and fast-acting painkillers, which helps.

Funny thing about me and oxycodone…it doesn’t make me “high” or buzzed or even sleepy. It just makes pain go away. I guess that’s a good thing. I’ll be glad to stop the antibiotics, though. I hate the smell of them. The first two photos (green) are yesterday afternoon; the second two are this morning.

The last surgery was definitely the most painful, especially the incision on the palm of my hand. A week later, on 6 October, I had the stitches out and wrote: I haven’t done a finger update lately. I’ve been wiped out all week from the antibiotics.

And the stitches have really been killing me. I got the stitches out today and it HURT. A lot. So much so that I had to get my hand numbed up with that giant needle you can see in the background of the first photo.

I was injected in several places on both sides of my hand. And you know how when the dentist numbs up your gums and it’s just a tiny little stab you barely feel? This was NOT that. It hurt more than all my tattoos put together. But once it was in, my hand was REALLY numb.

After the stitches were out, I had to see the rehab specialist. She was bending my hand and fingers to show me how the exercises should go, and I literally could not feel her hand touching mine. It was surreal. I’m still on painkillers, and the rehab therapist actually told me to take them if it hurts, because she said if it hurts, I won’t exercise it, and if I don’t exercise it, it will get stiff. Makes sense to me.

I did ask the guy who took out the stitches the story of my original visit to Vårdcentralen and how the first doctor mismanaged the bite, and I asked him if my experience would have been “better” (i.e., fewer surgeries, fewer nights in hospital, perhaps not having the re-infection) had that first doctor send me straight to the Sjukhuset as soon as she saw it (as the nurse had done) instead of just sending me home to take antibiotics. Of course, he didn’t want to say anything against another doctor, but he did say that it was very probable. So, lesson learned.

Then on 8 October, I wrote: Took the bandages off today. Also did some hand exercises. Look how bruised I am from the numbing injections, and look how swollen that finger is compared to the long finger on my left hand. (Please excuse the FU fingers.)

The next day I got the bill for the second hospital stay. The bill for the first stay, a week in a private room, including emergency care, three surgeries, unlimited medication and other care, was 700 SEK…about $87.75 USD. The second bill was for two more nights, an additional 200kr. Which makes the grand total for my week and a half in a private hospital room, four surgeries, endless amounts of antibiotics and painkillers, follow up visits, wound checks, physical therapy…900 SEK. Which today is about $110.92 USD.

Coincidentally, I was still dealing with one old doctor bill from April 2016 and a dispute whether my doctor was in or out of network. I did a post about that on Facebook, and wrote: Talking to a insurance person in Cincinnati, I happened to mention my cat bite and Swedish healthcare experience in relation to the year and a half never-ending battle to correct a $169 incorrect bill. She was curious to hear a story from a person who had experience first hand what it was like to live in a country with socialised medicine and find out what it was really like. Which with her working with health insurance claims and hearing all the propaganda these days on the news about Obamacare and inflated hospital charges, she was really interested in. Turns out, she does a local talk show on cable about health insurance issues…

But at one point in that conversation, we wondered aloud how much that cat bite would have cost me had I lived in the States. So, of course I Googled: “what would a bad cat bite cost in the us” (that is exactly what I typed). And look what the first link was! Funny how everything comes together…(This is the first article he wrote about his bite, before he got the bill).

David Lazarus is a columnist for the LA Times, writing consumer-oriented articles. But…$55,000 USD for a cat bite! And even after his insurance paid part of it, and the hospital wrote off the rest, it still cost him $1,500 USD out of pocket (deductible or co-payment, not sure which). He was only in hospital six days compared to my nine, and I had four surgeries to his one, but he had an MRI which I did not. But I never got an itemized bill showing what each procedure cost. I only got a simple bill for 100kr for each night I was in the hospital bed. I actually wrote to him because we had almost identical injuries (except his was his left hand, the lucky bastard), and I thought he might be interested to hear how the same sort of injury was treated in Sweden…but, sadly, he never responded. It would have been interesting.

But that’s the whole story of the cat bite I got a year ago and part of why my blog was on hiatus for so long. I had the rehabilitation therapy for another six months (my last visit was in April). My hand is still not “normal,” and probably never will be. But here is what it looks like today.

Moral of the story: if you are ever bitten by a cat in your hand, GO TO THE EMERGENCY ROOM ASAP!. Don’t waste your time at your regular doctor, or at an urgent care clinic. Four surgeries and a year later, I am here as your example.

*Which I still need to write…