Saturday, November 5, 2016

It's Over, Thank God or the Flying Spaghetti Monster!

I do not own this video. to whomever does, I readily acknowledge your supremacy. Please allow me to keep it here if even only for a short time.

My final post-exposure prophylaxis injection happened just under forty hours ago.  I could not possibly be much happier than I am right now. I should be sleeping as most normal people who live in my time zone and are not working a weird shift are doing, but I'm too happy to sleep. I don't have to work today, anyway. When I get tired, I'll sleep. Matthew's working tonight, so I've even been afforded the luxury of playing my musical instruments throughout the night. If I were Matthew, I'd play them anyway (Matthew plays whenever he is inspired to do so), but somewhere along the way, I acquired a few social graces that Matthew did not, and other than the one time I pounded out a bit of post-midnight Rachmaninoff in my parents' home just to make a point, I play my instruments during normal waking hours or when no one else is home.

I've complained a great deal about the indignity, inconvenience, and discomfort of this treatment I have recently undergone with the anti-HIV drugs. I do not claim to have suffered in silence. Joan of Arc I'm not. Still, some of the more demeaning aspects of the treatment I've kept to myself.  I'll touch lightly upon aspects of it now. WARNING: This is neither for the faint of heart nor for the weak of stomach! 

Imagine that you've gone ridiculously long, as in 36 hours,  without eating anything because you  know there's an excellent chance that, contrary to Sir Isaac Newton's theory, what goes down will very likely come back up. You finally force yourself to eat because the will to live is stronger than the sickness brought on by eating seemingly anything. You heat up a pan of chicken noodle soup, and finish most of a small bowl of it along with a small glass of 7-up. You stay upright for as long as you can, but eventually when you can no longer stand or even sit, you go to bed and fall asleep. After an indeterminate period of time (post-exposure prophylaxis invariably induces a time warp) you wake to the sensation of worms crawling out of your nose. You pull yourself out of bed and stagger to the nearest mirror, wondering what could be the genesis of this most recent and most bizarre symptom. The doctors warned you about many adverse effects of the drugs you have been given, but having worms crawl out of your nose was not one of those side effects about which you were forewarned. You pry your eyes open for a closer look even though you really don't want to see what it is that is causing the sensation. Upon closer inspection, you discover that the worms crawling out of your nose, two or three at a time making their way through each nostril, are Campbell's noodles. You pull the ones you can reach our of your nose and throw them into a wad of tissues. You lethargically make your way to the bathroom, toss the tissues full of Campells's noodles,  pull off your pajamas and leave them in a heap, and climb into the shower to rid your body of the consequences of this most recent repercussion of the medication, holding onto a railing in the shower. You silently express your gratitude to the people who designed and built the condo, who graciously put in features for senior citizens, such as grab bars in the combo shower/tubs. You toy with the idea of tossing your worm/noodle-covered pjs into the washing machine but instead leave them on the bathroom floor until you have the energy to carry them to the trash bin.  The same is true of the pillow on which you were resting your head when the phenomenon began. You know now that you will never, ever again eat Campbell's Chicken Noodle soup, nor, for that matter, likely any other brand of chicken noodle soup, for the rest of your life. (You, friendly reader, may not eat chicken noodle soup again after reading this account either. I apologize.)

What your doctor has warned you might happen has happened.  You've been stricken with the dreaded vomirrhea. Few things in life that aren't likely to kill you outrightly in short order are worse than vomirrhea. You must ensure that a receptacle for the oral aspect of the malady is constantly available. You have it with you at all times, and you have another receptacle waiting for you in the bathroom.  You could wear Depends, but that would force you to take a shower following each attack, and attacks may be frequent. Despite last year's el nino weather aberration, California is still in a drought pattern. You could single-handedly dry up a well or two by showering following each attach of vomirrhea.
This is far too much information, but the medicine you're being given changes the PH of  fecal output to the extent that it is extremely acidic. So even though you're trying not to single-handedly bring California's drought to more of a crisis level than it already is, you need to bathe in order to soak tender body parts after roughly ever third attack of vomirrhea. Sometimes another attack will strike while you're in the tub, so you'll need to hurriedly, whether or not you have the energy,  drag your self from the tub to the potty, while soaking and shivering and reaching for your barf receptacle. If you don't wish to undo what little good you've just accomplished by soaking in the tub, you will then need to climb back into the tub. You're feeling very weak, and you hope not to lose consciousness while in there, as Whitney Houston and her daughter Bobby Kristina Brown have more or less covered the recent quota for bathroom drowning deaths. You have to be really careful, as in using as little water as possible even though it causes your shivering to be worse, and being prepared to hit the "unplug" device at a nano-second's notice. As bad as all the other symptoms though which you are suffering are, and as benign as death may seem in the face of the symptoms,  you really don't want to drown in a bathtub.

Consciousness is a good thing, especially while one is standing. If you are much like me, you tend to take consciousness for granted. No one has any guarantee of maintaining consciousness, and such is especially the case while undergoing a post-exposure prophylaxis regime. Losing consciousness while standing in an E.R. cubicle while talking with a patient often shakes the patient up just a bit and tends to cause the patient to lose what little faith he or she already had in you, the third-year med school student. Once in awhile, a loss of consciousness on the part of the med school student when talking to a patient can have an unexpected benefit. Not every patient taking up a bed in an emergency room truly belongs there. Some patients are there for reasons that could be managed quite effectively the following day in a doctor's office or in an urgent care center or clinic during normal business hours. Other patients are at the emergency room with the intent of obtaining narcotics. In either case, sometimes having a medical student fall into a cold faint right on the floor beneath their beds will cause the emergency room's frequent flyers and others who really don't belong there to re-think the issue. Sometimes they will tiptoe around the med student on the floor and the doctors and nurses attending to him or her and quietly leave, not certain whether the fallen med student is dead or alive. (At other times they'll shriek like banshees because THEY are the sick ones, not the unconscious med students on the floor beneath their beds.) Another especially important time at which to maintain consciousness is while operating a motor vehicle. Each time a person undergoing a treatment producing side effects including loss of consciousness makes the choice to get behind the wheel of a vehicle, he or she must be certain as much as it is humanly possible to be certain that he or she can do so without the loss of consciousness being a factor. While there's never any guarantee that any one of us is not going to have a heart attack, a stroke, a diabetic issue even if he or she has never been diagnosed with diabetes, or a simple loss-of-consciousness episode, undergoing post-exposure-prophylaxis predisposes a person to the condition of syncope, or fainting. I did almost no driving for the past four weeks. There were a few times when I felt perfectly safe behn]ind the wheel for short trips, but those times were the exception and not the rule. One cannot take chances with the well-being of others even if one does not care about himself or herself.

This final indignity of the experience may seem to be no major issue to many of you, but to me it was a huge ordeal. Because my arms are thin, arms were unusable as a site for my injections. That left thighs, hips, and buttocks (two of each) as injection sites. They needed to be rotated in order because the injections were damaging enough that even being rotated through one site each six days that the site was barely sufficiently recovered when it was time for the site to receive an injection again. Furthermore, where my body is concerned, I possess extreme modesty. Most of us are not extreme exhibitionists, but I may be at the other end of the spectrum. I blogged about my dad having to bribe me the tie my perverted classmate peeked over a restroom stall, saw the bead-shaped red bruises on my bottom and thighs as i was trying to pull up my overalls, and ran to the office yelling, "Alexis has got the shingles." instead of asking the girl why she was climbing to the tops of restroom stalls to peer at other children, the school called CPS. two cPS workers showed up at my home the following day to investigate. i admitted that the marks had happened as a result of my sitting on my brother's Mardi Gras beads for the duration of a long drive across the Tehachapis during a snowstorm in a deliberate attempt to hide the beads from my brother. i had to produce the mardi Gras beads, and the CPS workers insisted upon looking at the marks on my things and bottom in order to compare the size of the marks to determine that the bruises got there as I said and not as a result of abuse with a torturous device. my dad even had to convince them that, had I been struck with the beads, the marks would not have been so distinct and would have blurred a bit depending upon the angle at which I had been struck. The main point here was, though, that two cPS workers -- a male and a female -- insisted on looking at my nude bottom. My dad tried offering me money as a bribe in order to get me to cooperate with the social workers, but even $50 dollars (a large sum for a nine-year-old), wouldn't persuade me. The CPS workers tried to restrain and disrobe me themselves, but were unable to accomplish the feat. My dad had to help them to restrain me even though it was against their policy for some reason. (They questioned me away from his presence before, and could have done so again; it was a silly policy.) he felt so terrible about it that he gave me the fifty dollars even though I had ot cooperated.  

Another time, when I was twelve, I was spending a few eeks with my pseudo-relatives in /utah when I developed a case of croup that caused my breathing to become sufficiently labored that I had to be taken to the local emergency room. When the physician in charge of my case sent a nurse into my cubicle with a syringe and hypodermic needle and she announce that the injection needed to be given yo me in my bottom, I bolted out of the cubicle barefoot and in a hospital gown, holding the ends together, and had to be chased down a hospital corridor, brought back to the cubicle, and restrained in order for the nurse to give me the shot. Had my breathing not been so severely impaired, I'm not sure I would ever have been caught. Nine years later, I might very well still be hiding on the edges of the forests of Utah County still wearing a hospital gown and sustaining myself from the fruit I managed to steal  from residents' trees. that's just how serious I was about protecting my right not to display private body parts.

I was forcibly disrobed in the restroom assault situation. That probably did little to turn me into more of an exhibitionist than I otherwise might have been, but the truth of the matter is that something in my nature, with or without the restroom attack, made me unlikely ever to apply for the position of a Playboy centerfold, which is probably just as well considering my build or lack thereof. 

As my disdain for nudity pertains to my post-exposure prophylaxis routine and the need for injections to occur in places normally covered by clothing, when I worked and was able to stay until the end or near the end of my shift, co-workers took care of the injections for me.  On nights when I had to come home hours early because I exceeded the three-barf-session-per-shift rule or when i was off, I had to receive the injections at home. A few of those times my dad was there. If those times I needed injections at home happened to be when it wasn't a day for a thigh injection, it wasn't a huge deal. My dad has provided medical care for me for my entire life, or, for that matter, I could have given the thigh injections to myself. While I'd just as soon not receive a Pap smear or any similarly sensitive and invasive procedure from him, having my hip or butt injected by him isn't the end of the world. He's good at it and gets through it as quickly and painlessly as possible. 

It was a different case when it involved my brother. Hip injections weren't such a big deal -- I just needed to pull my scrubs or pj bottoms down about an inch, and not a whole lot of nudity was involved. Butt injections were different. Think about it. Who wants her brother swabbing it and injecting a needle into her nude bottom? May I remind you that I live in California and not in some remote section of the Ozarks. I would groan at the prospect each of the four times it came up. Matthew would ask if I would prefer that he call ****** (Cool Guy), ****** (Handsome Hunk), ****** (Raptor Jesus), or any one of a number of guys to give me the injection in his place. I would say that such would only make things worse and, besides, we didn't have time for that. The injection really needed to be given within no more than a ten-minute window, and ideally almost to the minute. Matthew would remind me that he wasn't getting any more pleasure from the experience that  was. In the end, he'd just give me the stupid shot. I can tell you from personal experience, though, that getting an injection in one's bottom from one's brother is the very epitome of awkward.

Thank God it's all in my past. That which doesn't kill a person theoretically makes him or her stronger, though looking at myself in the mirror, I'm not so sure abut that. I'll gain the weight back, though, and life will go on. And I wouldn't have done anything differently in the situation even if I had do overs, which we never do in real life. 

This is the last time I intend ever even to look at the stuff in any form.


  1. Yikes! That sounds like a horrible ordeal. I'm glad it's behind you now!

    1. If there's one good thing about going through it, which I'm still not sure there is, it e=could have to be the idea of how great a normally boring life is.

  2. Appreciating boring and normal is a good thing. Having been a very sick person may also help with empathy for your future patients which is a good thing. As Matthew pointed out, he was a very logical candidate and good choice to poke you in the butt. Glad you're better.

    1. Everything is so great right now that it's almost scary.