Monday, May 3, 2010

A Really Bad Day: Update

For those of you who were kind enough to read the Tale of the Fingerstick (see “A Really Bad Day,” prior on this blog), an update on how it’s going. Last Wednesday I finally took off the fingertip dressing. I had kind of forgotten what skin looks like when it’s trapped under gauze for a week, especially when that dressing has gone through the wash-and-dry cycle umpteen times at work. (There are no sick days in the ED.) The cut was well healed, but the surrounding skin was all white, a real pale ghostly German tourist in an ill-fitting thong on Daytona Beach white, and wrinkly like you have hygiene OCD and never get out of the bathtub. I didn’t like how it looked, so I did what any enterprising physician would do. I put a new Band-Aid on it so I don’t have to look anymore.

I’m on Day 12 of the “expanded post-exposure prophylaxis” as I write. To put it mildly, the meds have been a mess. The first few days were okay. Didn’t feel like eating, and drinks tasted metallic, but tolerable. Last week the nausea kicked in, and with it a real psychological aversion to taking the next dose of pills. (I feel a very strong kinship with Pavlov’s dogs and Skinner’s rats.) White rice was about all I felt like eating, and the only way I could get the pills down was with thicker liquids like milk. (The local Wendy’s has already figured out I’ll show up every night about 10 looking for a vanilla frosty). Last Thursday I had a chance to go out for a really good meal at a local restaurant with a group of fellow physicians. I worked myself up an appetite, ate well, and then…well, let’s just say it was a sleepless night, and I’m glad I wasn’t paying for the meal because when I do, I’d like to keep some of my dollars within me. Now eating a piece of peanut butter bread each day since and that’s about it, although last night made it through a half order of biryani, which is an Indian dish consisting of mildly spiced dry rice. I consider this a moral victory. I’m also tired all the time; not sleepy, but just constantly fatigued. I understand exactly why those poor souls with HIV who need to take these meds up to five times a day are often non-compliant. I only have to take them twice, roughly twelve hours apart, and for only 28 days. Regardless, I’m ready to throw them into the trash and take my chances. (Note to insurance carrier: I won’t really do that.)

On the plus side, however, I have discovered that the generic fruit-flavored chewable antacid tablets I keep eating to keep the nausea at bay taste a lot like Sweet-Tarts. A bit of research turns up that this is likely because they share a lot of the same ingredients like dextrose, maltodextrin blue dye #1, red dye #40, and yellow dyes # 5 and #6. Of course, because the antacids are a health product and a serving of two tablets offers 43% of your recommended daily allowance of calcium, I am getting the added benefit of stockpiling calcium for years to come. (I take a lot more than one serving per day.) And the antacid tablets also contain talc, so I took one outside to the driveway to give it a spin. Turns out you can draw with them just like chalk. So if you have nausea but also need to play tic-tac-toe on the sidewalk, you can do so with a single product. Now isn’t that good to know.

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