During one of his more sophisticated moments (Click to Enlarge)
Meet Oliver, our big orange kitty. At 16 pounds, he’s large and in charge – the complete opposite of the scrawny kitten we brought home from the shelter 5 1/2 years ago. He’s the perfect mix of predator and sweet lap cat, but for all that he hypes his hunting skills, he’s never been outside and is afraid of his own shadow. Though not totally his fault, he’s made life around our house much more interesting since the beginning of the year.
Monday 31 December, 6:00pm As has become tradition in recent years, we have some guests over for New Year’s Eve. Oliver tends to get stressed out around people he doesn’t know, so we set him up in a bedroom with his food, toys, and litter box.
7:00pm One of our guests goes upstairs to see Oliver, accompanied by my wife Michelle. They were trying to pet Oliver and play with him, but Oliver got scared and was backing away. Eventually finding himself cornered, Oliver went into self-defense mode and tried to bite our guest in order to get away. Michelle intervened and ended up getting bit on her middle finger. She was bleeding a little bit and cleaned it up immediately with soap, water, and rubbing alcohol, finishing with a bandage. I saw that she got bit, but didn’t think much of it. We’ve both been bitten hundreds of times before so no big deal, right?
Unbenkownst to me as the evening went on, Michelle’s bandage kept on getting tighter and tighter. She changed it at one point, thinking she had put it on too tight. She also thought maybe her finger was broken. It continued to swell and throb with pain.
Tuesday 1 January, 1:00am Our guests leave and Michelle tells me that her finger has been swelling the entire evening and is now to the point that she can no longer move it. Since that’s clearly not a good sign, we head to the emergency room. Thankfully it’s still slow there as most bars haven’t closed yet. We are seen right away.
2:30am After a thorough cleaning and x-ray, we head home with a prescription for large antibiotic pills. The doctor says it may take a day or two for the drugs to kick in, but we should return if Michelle gets a fever. It’s a crappy way to start 2013, but we figure the worst is behind us.
After 6 Hours
12:00pm Her finger definitely doesn’t look any better yet, in fact it looks like it might be swelling even more. Since she’s been on the drugs for less than 12 hours, we decide to give them some time to work, rather than being those people that run right back to the ER.
9:00pm It’s definitely swelling more and oozing some pus as well. Comparing to photos we took earlier, it looks like her adjacent fingers are also swelling a little bit. We still aren’t at the 24 hour mark though, so Michelle opts to sleep on it and return to the hospital in the morning if things don’t appear better. I am told to go work like usual and she will keep me posted with what’s going on.
Wednesday 2 January 7:00am Michelle sends me a photo of her hand and it’s looking worse yet. The adjacent fingers are definitely swollen, and the swelling and redness is starting to spread down the back of her hand. I forward the photo to one of my closest friends who happens to be a clinical pharmacist. She shows it to some doctors she works with and their replies are along the lines of “What hospital is she at and what are they treating her with?” She advises me to have Michelle go back to the hospital immediately.
8:00am Workaholic that she is, Michelle goes to work to make sure all her things are in order. Despite the fact that her body is battling a major infection, she’d rather make sure her preschoolers have their juice ordered before checking into the hospital.
9:30am Michelle heads back to the emergency department, and is started on IV antibiotics and painkillers. They decide to admit her soon after. I catch the first available train out of Chicago, but that’s not until the early afternoon.
4:00pm I join Michelle at the hospital. She’s seen by a few doctors. They tell her that a hand surgeon will be coming to see her, but they probably won’t be doing anything until tomorrow.
After 45 Hours
5:30pm Michelle is seen by an orthopedic hand surgeon. He takes one look at it and says he’s going to do emergency surgery immediately.
Virtually No Hands!
8:30pm Michelle is out of surgery. Her doctor tells me they were able to remove all of the infection, but some of it had spread to inside her knuckle joint. He had to open the joint to get everything out, which means a longer recovery. She’s very hungry when we get back to her room, but the hospital cafeteria is closed for the night. Her nurse gets us a sandwich and some apple sauce. Since Michelle’s right hand is wrapped up the size of a football and the other is tethered by an IV, I hand feed her after a few vomiting sessions (great practice for when we have kids, right?)
Thursday 3 January 7:00am Surgeon comes to see us but says he’s not taking the dressings off her hand until tomorrow. He invites us to “watch a lot of TV and have a boring day.”
10:00am Infectious disease doc comes in and says that whenever Michelle is discharged, she will be on IV antibiotics at home for a month. She doesn’t explain this very well, and leads us to believe we’ll have to use needles and give her an IV once a day. This does not sound pleasant.
10:15am Our nurse sees Michelle freaking out at the thought of having to deal with needles every day, and explains that she will be getting a PICC line and there are no needles involved. Crisis averted.
12:30pm PICC nurse comes to give Michelle her PICC line. It’s a sterile procedure so I have to leave the room.
We spend the rest of the day watching TV, taking a couple of laps around the floor, and talking with Michelle’s sister who came to visit us. I also learn how to put her hair in a ponytail. I learned a lot of knots in Boy Scouts, but they all have nothing on a good ponytail!
Friday 4 January 6:30am Orthopedic surgeon comes in and removes the dressing. Her finger looks pretty good considering everything it’s been through. The doctor left the wound open (no stitches) so that it would drain itself if necessary. He says as far as he’s concerned Michelle should be going home today, though the infectious disease doc will have to agree.
2:00pm Infectious disease doc stops by and says we will be going home today. He explains the drug Michelle will be on at home and wants her to have one dose at the hospital just in case she has any adverse reactions to it. He orders the new drug and says we’ll be able to leave as soon as she gets it. “It should be coming up from the pharmacy in about 15 minutes.”
What a PICC line looks like
4:00pm Drug finally arrives from pharmacy. Over the time we’ve spent in the hospital I’ve crafted Pusateri’s Law™: Pretty much every time the hospital gives you a timeline for something, it will really take at least four times as long as they claim.
4:30pm After a crash-course in PICC line maintenance from our nurse, including a stern warning not to do any drugs through it (and I bought all that heroin for nothing…) we are done and Michelle is discharged! We head to the pharmacy to pick up her prescription for painkillers, and then go home so I can wash her hair. My parents show up a little later with dinner in tow (thanks Mom & Dad!)
Since then we’ve gotten into the routine of doing Michelle’s medication infusion every evening. With the drugs and various flushes it comes to 6 syringes per day. She also gets weekly visits from a home care nurse who comes to change the dressing on her PICC. Two weeks ago she had to have her PICC removed and re-placed on her other arm due to a blood clot forming near it (this is not typical.) Her finger is healing nicely but she has yet to regain full motion in it and will be starting occupational therapy soon.
Moral of the story
A fun night of doing drugs at the Pusateri house
Cats are not evil, but when you corner them (or any other animal) they will of course protect themselves. If you find yourself bit by one and the area starts swelling, get to an emergency room immediately. We were told that over 80% of cat bites result in an infection, way more than dogs. This is because cat teeth are long and skinny and create puncture wounds that can deposit bacteria very deeply beneath the skin.
Update: Several people have asked if we got rid of Oliver. Absolutely not!! He’s not a mean cat at all – he’s our baby and he was just reacting like any other scared animal would. Neither of us can imagine life around our house without him.