July 3, 2012

House of Pain

Not to sound macabre at all, but I hope one day I am fortunate enough to follow my mother-in-law's example and drop dead on the spot from a massive coronary or giant aneurysm or whatever it was she had, because if I get cancer (which seems highly probable after spending 18 years in a household full of smokers), I am screwed.  And not just because I have cancer.  The thing is, I hate needles.  Hate them.  As in "get the hell  away from me with that pointy metal spike, you MoFo!"  I always have.

I used to think it was just a "thing"; I mean, lots of people have needle phobia.  The grand irony is that I am a seamstress and play with needles and pins all the time, frequently stabbing myself with them as well.  Perhaps the difference is that I (theoretically) have control over my sharp pointy objects.  Also, they don't tend to penetrate as far into my flesh as when someone else is wielding them.  Regardless, I hate going to doctors and dentists because they inevitably hurt me (a lot), even when it's for my own good.  It wasn't till recently that I discovered this may be--in part--a side effect of spinning the genetic lottery and coming up with the MC1R recessive gene on chromosome 16.  In other words, red hair.  I've always heard that redheads tend to have increased pain sensitivity and certainly I do as well, though only for specific types of pain.  For example, while it still hurts me, I can generally handle blunt force (like walking into doorways, walls, people, lamp posts, etc) reasonably well.  I once walked around for weeks with an abscessed tooth and didn't know it until the dentist showed me the x-rays.  And that doesn't even count my walking around for 3-4 days with appendicitis, because it was only "a little distracting."  What I don't handle particularly well are instances in which my hull integrity is breached, such as by knives, needles, etc.  My skin has always reacted rather badly to such things, so I always assumed it was because I was so fair-skinned.  Recent studies like here and here explain that having not one but two copies of the MC1R gene not only gives us our red hair but, according to Pincott's article, causes receptors in our nervous system modulate pain more intensely.  At least that's the finding of one Edwin Liem of the University of Louisville, who further believes that the gene also affects hormones which then additionally stimulate pain receptors.  Also we bruise more easily (duh).
Cool.  Suddenly I'm finding my gingatude slightly less awesome.

Recent studies have also shown that redheads are more difficult to anesthetize, requiring 20-25% more general and local anesthesia than people of other hair colors, which may also contribute to why we are more than twice as likely as others to avoid dental care.  I know I am.  Going to the dentist when I was a kid was pretty freakin' traumatic.  At one point in my life I managed to avoid going to the dentist for 7 years.  I go regularly now, but it's still a stressful endeavor for me so I always have to find practitioners who claim to "cater to cowards."  Too bad all these studies weren't around when I was a kid and being tortured by brutal hygienists with little or no anesthesia; dental visits might have been much less horrific for me.  And I can definitely vouch for the "more anesthesia" thing as well; just before I got my epidural during labor I was told that I would only feel the first needle, which would numb the area so I didn't feel anything afterwards.  They were wrong.  I felt the first needle.  I felt the second.  I felt the third.  I felt them slide the last needle out of my back and off the tubing.  I had to be held down my both my husband and a nurse in order to keep me still enough to complete the procedure because I was sobbing so violently from the pain.  I'm starting to think that all redheads just need to come standard with medic-alert bracelets that read "Please jack me up with enough anesthesia to fell a rhino."

Anyway, all this is a precursor to explain the day of pain today which I've been dreading.  Last month I was supposed to go and have blood drawn for some routine labwork; some 5+ weeks later I finally forced myself back to the doctor's office.  I made every excuse I could to drag my feet, the most common being that since I slept too late (they suggested coming in at 8 am so I could break my fast sooner--I don't do early anymore) I was too hungry and it wasn't worth the bother.  I also told myself that if I got up and went at 8 am I could reward myself with breakfast at Panera's (because apparently I treat myself like a dog--"good, Ginger...GOOD Ginger!").  So naturally, if I couldn't get up and to the doctor's in time to be back at Panera's by 10:30 before they stopped serving breakfast, there was likewise no point in going if I was going to miss my lovely, lovely little power sandwich.  And of course the test was routine, so there was no rush.  Justification much, Ginger?

I decided to go ahead and force myself to go to the doctor's office today since I already had an appointment to see a podiatrist so I could have my big toe chopped off.  Okay, not really, but that's how it's going to feel.  My poor, pitiful big toe has suffered much in the past year.  The day before I went to Orlando with my friend, I stopped by a nail salon for a much-needed mani-pedi.  Fatal mistake.  On the plus side, the technician trimmed off the very last bit of damaged toenail that was originally traumatized by last year's break.  So finally, I have a relatively smooth, flat toenail of a normal width and not a mutant thickened one.  Only took a year...go me.  Of course, the sliver of toenail that the FMD removed in January because of my epic hangnail and infection is still only halfway grown out, but at least it's been making progress, or it was till last week.  After I got back from Orlando, I discovered that the corner or my toe was again getting red and irritated.  Because I'm an idiot who has apparently learned nothing, I attempted to "fix" it.  Big mistake.  In spite of attempted trims and repeated salt soaks, it continued to get worse and more infected.  I'd hoped to get it taken care of over the weekend with FMD because I'll be leaving Thursday to visit the girlie in NY and I wasn't particularly thrilled with the idea of hobbling all over the Atlanta-freakin'-airport, which is roughly the size of a small country.  Unfortunately, the FMD was inconveniently unavailable before today.  And, knowing that there was a fair chance of his referring me to a podiatrist anyway, I went ahead and sucked it up and made an appointment.  As it turned out, I could only get an appointment for today anyway because the podiatrist "does not see patients on Mondays and Fridays."  I almost canceled so I could go back to the FMD, but I am attempting (moderately successfully) to behave like a grownup.

Except I'm not a grownup, not really, and certainly not when it comes to medical procedures.  Nevertheless, this morning I dragged myself out of bed and drove to Dr. Earnest's office for the labwork, berating myself for going late because I was, yet again, going to miss my precious Panera's breakfast.  I sat waiting for 10-15 minutes to be called back, though the blood draw itself only took about 5 minutes.  I was greeted at the door by some random nurse, for which I was grateful since it meant that I would not be sitting and glaring balefully at Nurse Stupid while waiting for her to stab me with her syringe.  Not that it mattered, because the nurse I got still managed to give me one of the most painful sap taps I've ever had and for me, that's saying something.  Mercifully she did it in one stick, but it took her a while to find a vein; when she did, it was near the bottom of my elbow pit in the soft, vulnerable flesh most likely to rub up against things for the rest of the day, rather than in the traditional center of the elbow pit or even on the top side where I'd gotten my IV for my appendectomy.  I liked it there...much less jostling about.  Once she'd found the vein in question and plumped it up to her satisfaction, she tightened the elastic strap on my bicep and then jabbed me violently with the needle as thought it were a tiny little epee she and was trying to win a gold medal in the Olympic fencing finals.  I managed to keep the punctured arm still, but the rest of my body writhed in pain while tears stung my eyes.  "Are you okay?"  Yeah.  I'm peachy, thanks for asking.  Eventually she removed the little vampire fang and had me hold a gauze pad in place while she tore off a bit of (thankfully) paper tape.  Yay!  No contact blisters from the tape!!  She said the worst was over (she lied) and to remove the tape in five minutes, then I was free to go.  At 10:30.  When Panera ruthlessly starts refusing to serve sandwiches with eggs in them.  I cried like a little girl all the way home because the injection site was still burning like a mofo.  When I got home I removed the gauze, which was soaked in blood, presumably because of her somewhat inept assault on my arm.  The wound started bruising in less than 15 minutes.  Two hours from now I'm gonna look like a junkie.

O+, anyone?

After my non-Panera lunch, I headed over to the podiatrist to let him lop off my nail.  Since the man is  not FMD and since I've never met him I was understandably tense, my nerves already frayed from the earlier assault on my person, which only served to make me dread additional hypodermics in the extreme.  The pleasant young man I spoke to yesterday checked me in and took me back to a room where he and the nurse were ecstatic to learn that I have never smoked.  Doesn't mean I'm still not gonna die of lung cancer, because that's just how my life seems to operate.  I reiterated that I am a colossol pansy/wuss/coward regarding needles and asked them if they knew that redheads required an average of 20% more anesthetic to be sufficiently numbed, etc.  They did not know this and were fascinated with the possibility.  This did not bode well.

The young man left the room and the nurse told me to get in the chair and then promptly plonked down the loaded hypodermic on the table right in front of me.  Now call me cynical, but it seems to me that if my patient were already twitchy and had just professed both vehemently and volubly to having a fear of needles,
I might consider it a very bad idea to present the object of said phobia in living technicolor inches from the patient's face where it could scream things like "Look at me!!  I'm sharp!!  I'm going to cleave your flesh in two!!  Stabby, stabby, stabby!!  Pointy, pointy, pointy!!!  And I'm NOT going into anything soft and fleshy which might absorb the shock!  Instead, I'm going to jam into muscles and tendons just because I CAN.  Sucks to be YOU right now, doesn't it?!?!?!?"  Stupid needles.  Never know when to shut the hell up.  I told her I wanted the freeze spray like the FMD had used.  She tried to talk me out of it, saying it hurt more than the shots.  Liar.  She gave up, leaving me alone to contemplate the harbinger of pain sitting before me with my highly overactive imagination.  For 15 minutes.  Also a very bad idea. 

By the time the doctor came in, I had tears rolling down my eyes and was jumpy and scared shitless.  The doctor came in, too one look at me and said, "You look scared, Mary."  Incidentally, I find the doctor's name endlessly entertainting; he appears to be of Middle Eastern descent and every time I see his name I want to pronounce it "Knick-knacks," so that's what we're gonna call him today.  Anyway, Dr. KnickKnacks says "Mary" in a very interesting way.  Seems not only is he from whatever Middle Eastern country, he studied medicine in Cardiff, Wales and then spent many years working in New York.  So his accent is quite unique, and when he says "Mary," there is an almost audible pause between the a and the r, making is sound sort of like "Mehrhie."  No doubt I would have enjoyed this more (language and dialect nerd that I am) had I not been ready to rocket past him and out of the room.

I informed him that I was indeed scared and started babbling incoherently about hating needles and how I didn't know him and he was going to hurt me and how no one ever gave me enough anesthetic at first and how I hate needles (again), etc.  He asked me what had happened to give me such a bad experience and I babbled some more.  Then he asked what had happened and I explained the whole broken toe and jacked nail and infection in January, etc.  He asked if FMD had hurt me and that's why I was so upset.  I told him "No, I love FMD--he's my hero because he didn't hurt me."  I told him that FMD had taken it slow and that any time I felt pain, he'd jacked up the anesthetic.  To his credit, Dr. Knickknacks actually paid attention--mostly--telling me he would never hurt me "on purpose."  He did use the freeze spray on me and then inserted the first needle.  This went fine until the medicine started to burn like fire ants inside my skin.  Next he did the second shot, just like FMD had done, again using the freeze spray first.  Then he left to tend other patients while I got sufficiently numbed up, but not before asking me first if I wanted a magazine or my phone "to play with" while I waited.

Fifteen or so minutes later he came back to start the procedure.  He scrubbed down my toe with betadine (my first two toes are still yellow) and then started started squeezing out all the trapped pus (tasty, right?). Which I felt.  There wasn't as much pain as there would have been with no anesthetic, but I still felt significant discomfort and when he started to cut, I kept jerking my foot away.  So he asked if I needed more anesthetic.  I tried to say no, but he replied, "It's okay if you need more...we aren't cheap here."  That made me laugh a little, so I said yes and he left to get more anesthetic.

After shooting me up again, he got back to work, asking me questions all the while in a blatant attempt to distract me.  He asked all the usual small talk sorts of questions:  Are you from here?  Where do you work?  Why do you live here if you aren't from here?  And of course he asked about my daughter, and how old she was, affecting surprise that I had a kid that old and commented that I'd clearly "started early."  I don't call "27" early, but whatever, dude.  Then he asked if I had more kids.  I told him no.  "Why did you stop?  Did you not want more??"  Thanks, dude.  Appreciate that.  Thanks for reminding me of our secondary infertility.  "I didn't 'stop.'"  "OH.  So you do like kids then?  That's good."  WTF, dude? 

Aside from that little bit of  "mind your own effing business," he seemed like a nice enough guy; more importantly, he didn't seem at all put out by my enormous wussery.  Afterwards, he asked if I wanted to take the hangnail home.  "Not particularly."  Then he asked if I wanted to see it, so I answered "Sure."  What the heck, right?  He'd already told me that when the nail root is damaged, such as when one stupidly drops nightstands on one's toe, the nail eventually starts growing back, but it doesn't grow back straight like you'd expect.  Instead, it grows back up AND out sideways.  Even so, I was surprised to see how wide the sliver of nail was.  It was easily twice as wide as the visible nail growing out from the last hangnail-ectomy, half of which had been imbedded in my skin.   So it seems FMD was right.  Even though he would likely have been a little gentler or perhaps less scary since I already knew him, ultimately I'd have ended up at a podiatrist anyway because this would continue happening every time my nail tried to grow out after the break.  At least this way I cut out the middle man, so to speak.  Dr. Knickknacks flushed out the infection and killed off that corner of my nail root so that sliver of nail can't grow anymore.  I was told that as the toe healed, my skin would fold over the damaged area and "hug" my nail.  I looked at him dubiously.  He said "That's what we call that."  Presumably this will make my nail perfectly normal again, if a little narrower than previously.  Whatever.  At this point, I'm just freaking over it all.

"Yello?  You called??"
(Infected feet are puffy feet.  Though that bag of popcorn I had at the
movie theater last night probably didn't help much...)

Surprisingly, he didn't give me any antibiotics.  He didn't seem to think I'd need them provided I follow the take home instructions exactly, which involve soaking my foot in a magic solution of epsom salts and betadine, torturing the open wound with peroxide, and keeping it wrapped and dry for two weeks.  Because that's gonna happen when I'm in New York for 4 days.  I can only imagine the looks TSA will give me when I try to carry a little brown bottle of suspect fluid and a bag of salt onto the plane.  Clearly, I'm gonna have to check a bag, which means there's a good chance all my clothes will end up stained yellow.

Oh, well.  It could be worse, I suppose.  I'm alive.  It isn't cancer.  It's just me behaving like Cardinal Wussington over some very minor surgery.  In fact, when I went the office to provide my copay, both the nurse and the nice young man said I'd done very well because "we couldn't hear you at all."  I found this rather disconcerting, but they informed me that they routinely had big, burly men in there screaming at the tops of their lungs like six-year-olds.  Suddenly blubbering doesn't seem so horrible.  Also?  Best part?  The first line of the instruction sheet reads "Okay, you've had enough excitement for one day.  Go home and stay off your feet."

I left, intending to acquire my betadine and additional salts at CVS and then lunch at Outback since I'd missed Panera's.  Except I forgot that Outback doesn't start serving till 4 pm.  Sigh.  This is why I doubled up the appointments...I knew it was going to be a sucky day all 'round.  On the way home my car's thermometer read 104 degrees, but as I neared my house, I saw a storm coming; by the time I was home the temperature outside had dropped nearly 20 degrees and I pulled into my garage just before rain started thundering down.  Thank heavens for small favors.  And now I sit typing this, with my arm burning from the puncture site and the scratch next to it (apparently the nurse earlier doesn't know how to do smooth jabs), as well as from a point a couple of inches past the wound where the needle would have stopped inside the vein.  Because yeah, I am THAT sensitive.  My toe is still blissfully numb, though I felt a couple of twinges a moment ago, so that's not gonna last much longer.  Hopefully it will at least hold out till I can do a quick solo practice for my choral group's show and get back home where I can sit snug in my jammies while my various body parts shoot little jolts of stinging pain at regular intervals and sulk over this one significant drawback to being a ginger.

EDITED TO ADD:

Finally got blood test results back from Dr. Earnest's office (after they lost them for a while)--turns out my cholesterol is actually good and my blood sugar, though high, is in normal range.  Yay!

This is my arm maybe 36 hours after the blood draw.  Yay, crappy needle sticks!
(Three weeks later, there was still the faint shadow of a bruise.)

4 comments:

  1. I have always had reddish hair, and have learned a lot of these things along the way too. I am definitely difficult to anesthetize, and when I gave birth to my son, my midwife called to the nurses: "I need help over here! She's bleeding like a redhead!".

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    1. Hahahaha--that sounds about par for the course! I trust you were appropriately tended after that?

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  2. 1. Welcome to the Genetic Lottery. I call it the cesspool. I live there.
    2. Anesthetic? Yeah. Doesn't work for me. AT. ALL. This sucks. Rather a lot.
    3. Put the betadine in a ziplock.
    4. This was toetally sucky.

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    1. 1. Indeed you do, though I wish you didn't. Personally, I think all lotteries should involve Ed McMahon showing up at my door with a big fat check. Or maybe someone else; I'm guessing Ed doesn't look so good these days. On the other hand, a zombie check give would be memorable...
      2. I'm less than thrilled about the half-working myself, so I can only imagine.
      3. That's the plan, Stan.
      4. Indeed. Makes it much harder to pun(t).

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