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How I Spent My Government Economic Stimulus Check at the Hospital on the Fourth of July

July 5, 2008
No, this isn’t a crazy I-Tried-to-Launch-Fireworks-with-My-Bare-Hands story. It is, however, a story about karma. About love. About cats. And about pus.

Just to warn you, the latter parts of this story are not for the faint of heart. Even if you’re made of steel, you’ll still probably be disgusted. I’m not going to sugar-coat any of this for you. And it’s long. I’m not mincing words with a tale this epic.

Let’s start with karma. Things you say, things you do—they come back to get you. Karma’s been building a portfolio on me in regards to certain things, and it looks like two karma police combined their cases and came up with a special treat for me this week. Let’s start with Karma Situation One.

Four years ago, I was spending my first full summer at the publishing project management company where I’d would eventually working until last September. I was spending 80-hour weeks huddled over a massive, four-volume otolaryngology book (that part’s important; “otolaryngology” means “pompous way of saying ear-nose-throat [ENT]”). I had created an elaborate tracking system for the book that went on to be the backbone of our company’s project tracking system, so I knew the exact stage of each chapter. That was the good news. The bad news was that the author corrections were overwhelming me—they filled the margins of already-tight, two-column pages—and many figures were incorrect or in the wrong place. I had no experience with books of that complexity, size, or magnitude, so I placed most of my trust in the authors and proofreaders (of which there were several at all times). I was also struggling with incredibly late typesetters and an incompetent, lazy client. Needless to say, I was in way over my head.

I like a good challenge, and I was determined to finish the project on time. I worked my butt off, and in the end, I accomplished that goal (I think I sent several volumes to the printer on time; the final volume, containing the index, was a week late). However, in striving to complete the project on time, I made one crucial error.

I didn’t check the front matter at the back-end of the project.

I had checked it much earlier, at the manuscript stage. But in publishing, the front matter is the first thing that people see, and it’s the first place that authors flip to see their name in print. There were hundreds of chapters in this book, many of which were multi-contributed, so I’m guessing there were at least 300 authors keen at the idea of being published in such a prestigious volume. These things change over the course of getting a book ready to print, so you absolutely must check the front matter right before you send it to the printer.

Due to my negligence, many names were misspelled. Some were on the wrong chapter, and some were missing completely. Chapter titles were no better. It was a disaster. And none of this was discovered until after the book had been printed.

Although I still made front-matter mistakes in the future (I’m extremely efficient but lacking perfect attention to detail), I always at least checked the front matter at the end of the project. I learned my lesson. But the karma police weren’t satisfied.

Karma Situation Number Two: I love fried chicken. I’m not really sure why; I’m from the south but didn’t actually eat fried chicken that much as a kid. The only time I got it was on summer days—even July 4ths (karma!)—just like this one, sitting outside at Dogwood Dell. That was when my parents would treat us kids to a big bucket of Ukrop’s chicken. Try it if you’re ever in Richmond. That’s one grocery store that knows how to make a mean bird.

Given the health problems associated with fried chicken, I only eat it about once a month, usually Popeye’s. I bring the leftovers to work and eat them there. So far, so good.

My manager at the old publishing job one day revealed to the other coworkers over lunch that she didn’t eat fried chicken. I was eating Popeye’s that day. My manager said that she had once read that someone was eating a piece of fried chicken (it may have been a McNugget) when they bit into a huge pocket of pus contained by the fried skin. She didn’t even know if the story was true, but the very idea, the possibility of the existence of pus pockets, deterred her from ever eating fried chicken again (we later checked Snopes.com to learn that the story wasn’t actually true. If pus was somehow trapped under the skin, it would be released when dipped in the scalding oil).

One day at lunch not long after that, another female coworker brought ham and cheese Hot Pockets to the table. Now, it should be known that the smell of that variety of Hot Pockets makes me nauseas, so I probably should have changed seats or eaten part of my meal in my office. Instead, I stayed and sung the tune of the Hot Pockets commercial, replacing “Hot” with “Pus.”

“Pus Pockets, Pus Pockets….”

Big mistake. Of course my coworker wasn’t keen on the parallels drawn between her lunch and giant pockets of pus. That’s not appetizing, and I’m an inconsiderate idiot. I think she may have already been having a tough day, because she stormed out of the lunch room (I later apologized).

The karma police don’t file apologies.

All of this brings us to last Sunday, June 29. I went to church in the morning feeling completely normal, minus the smallest of sores in the back of my throat that felt like I bit my tongue in an unreachable place. No problem. I come home, fire up the grill for the Euro 2008 Championship BBQ, and greet the guests as they arrived. The grill was a little slow, so we paused the game at kickoff (sweet glorious TiVo), but things were soon underway.

Over the course of the game, I noticed that my throat starting to hurt more and more. Hoping numb it a little bit, I grabbed a beer (I bought German beer and Spanish wine for the event). That didn’t work. In fact, it probably hurt me in the long run (karma!). By the end of the game, every swallow—even just saliva—was a painful ordeal. I ushered the guests out, avoided shaking hands, and crawled into bed.

Yep. I had strep.

I had it once before during a two-week trek across France, so I knew the feeling. I didn’t have to go to the doctor to diagnose me. I did, however, need him to prescribe antibiotics to me. So after a fitful, feverish night of very little sleep, I checked in at an urgent care center.

The doctor, bless his heart, didn’t swab the back of my throat (as painful as strep is, even worse is that scraping, gag-reflex-inducing swab. Blech.) He confirmed that I had strep, gave me some pain relievers and amoxicillin, and told me that there was the off chance that I might need to see an ENT after a few days if the swollen area wasn’t draining naturally. Something about a pus pocket.

Those words stuck with me after I got home (in truth, after I got home and napped. I spent most of Monday and Tuesday of this week asleep). After Nap 1, I got on WebMD and looked up “pus pocket.” There were a few hits, and one of them jumped out: peritonsillar abscess.

Peritonsillar Abscess: A peritonsillar abscess forms in the tissues of the throat next to one of the tonsils. An abscess is a collection of pus that forms near an area of infected skin or other soft tissue. The abscess can cause pain, swelling, and, if severe, blockage of the throat. If the throat is blocked, swallowing, speaking, and even breathing become difficult.

After a little Google Imaging, I found what one looked like. My throat looked exactly the same, minus the labels.

This wasn’t the strep that danced with me through the streets of France. That strep just involved swollen tonsils, which is still pretty painful. You can see the swollen tonsils in this photo just behind the uvula. The huge inflamed mass on the right could be a peritonsillar abscess. Sometimes it’s just an inflammation—you have to wait a while to see if it doesn’t go away, since the pus, unless lanced, will just stay in there.

So I had my suspicions early on that something wasn’t normal, but only time would tell. Monday and Tuesday were awful—I stayed home, of course, and fought a nasty fever both days and nights. I was constantly sweating through my clothes and sheets, and since I was sleeping all the time, I went through a lot of clothes and sheets. I’d wake up after an hour-long nap that had begun with me shivering with cold and find my clothes soaking wet. An imprint of my body would remain on my bed after I got up, like chalked outline on crime-scene asphalt. I remember getting up to greet Caroline when she came home the first night. After I gave her a hug, I looked back down the wood hallway to find my wet footprints imprinted on the floor. I’m a night sweater, but this was ridiculous.

Finally the fever broke on Tuesday evening. My body responds really well to antibiotics, so I took this as a turn for the better. Swallowing still hurt just as much before, and I could only eat very soft foods, but I thought I’d wake up the next day (Thursday) feeling like a million bucks.

Wrong. Wednesday night sucked again. Perhaps due to a combination of the overabundance of sleep the two previous days and an overlap of a pain reliever that wasn’t working and ibuprofen, which generally works for me, I spent most of the night crazy eyed and uncontrollably replaying Mad Men scenes in my head (I had watched two episodes that evening. Pretty good show).

I had even called the doctor Wednesday night, asked him if he thought I should come in to see about that peritonsillar abscess. But he said I was probably overreacting, and that I should wait until I completed the antibiotics (10 days total) before I took any action. He reiterated that such abscesses are uncommon, and that there is minor surgery involved, so taking such steps might be a bit drastic. He said I should only go to the doctor if I could no longer physically eat anything.

The lesson here: Doctors know their stuff, sure, and many people have hypochondriac tendencies. However, no doctor knows your body as well as you do. I think sometimes you need to think about your history, especially if you’ve had similar issues/diseases in the past, and trust your gut if it tells you that something’s wrong.

Thursday was no better. I tried to eat better, strengthen my body, give myself some much-needed energy. But by the end of dinner, I couldn’t take it anymore. I couldn’t swallow another bite due to the pain. I dreaded every upcoming swallow like a public speaking appearance. Looking in the mirror with a flashlight, I could see that the mass on the right side of my throat was now pushing my uvula over to the other side—I could barely see the dark of the back of my throat. And my right ear had started throbbing as well.

I told myself I’d give it one more night, and if it hadn’t started improving by morning, I’d go to the hospital.

10:00 the next morning, Caroline drove me to the emergency room and dumped me on the curb.

(I actually just got out. But it would have been much funnier if, in front of the four cop cars waiting there, she had pushed my intentionally slack body out the door and sped away. Next time.)

I wanted to get to the emergency room in the morning to avoid crowds, and I got there just in time. They called my name after no more than 10 minutes. I did find it a bit odd that the tone in people’s voice throughout the day was that they didn’t expect me to have health insurance. Not me in particular, but anyone. When did it become the norm that people aren’t responsible enough to get health insurance? (That being said, I’m coming around to the idea of universal health care.)

The first doctor that saw me said that I might be there for a few hours, so I told Caroline that she didn’t need to stay, but she was so kind to stay anyway. Although my Kindle could have kept me company, it doesn’t have the calming affect that she does. I think I dealt with what happened there pretty well, but I was weak and tired and a bit scared. Caroline definitely helped.

There were a lot of residents around, and a number of them came in to see me. One who just wanted to see my throat came in and announced that I had a peritonsillar abscess, and Caroline, surprised that I had actually correctly diagnosed myself, proclaimed, “Jamey got it right!”
The doctor turned to me. “Oh, are you a med student?”

Me (with a smile): “No, I have web access.”

Another doctor came in with her assistant and took a few photos of my throat for a publication she was working on. I guess my large mass made quite an impression on her. She was using a regular digital camera, so the first picture she took wasn’t very clear.

“What do you think?” she said, showing it to me.

“I don’t know,” I said. “It’s missing a certain…je ne sais quoi.”

So she took a few more photos, none all that good, so I don’t know if I’ll get my throat published anywhere. But I was pleased by the attention.

Finally an ENT specialist came in with his assistant and took a look. He said that he couldn’t tell by looking at the abscess if it was filled with pus, so there were two scenarios: One, he could lance the area, and if there was a pus pocket, he could drain it and I’d feel much better. Two, he could lance the area, and if there wasn’t a pus pocket, no harm done, and I still might actually feel better. So either way, I was going under the knife.

We asked that doctor if he expected to see a lot of fireworks-related injuries later in the evening. He nodded, saying that it’s one of the worst nights of the year. Too many people drinking and playing with explosives. I told him he wouldn’t have to worry about me drinking tonight, but I suggested he slip some beer into my IV while I was at the hospital. I wonder how fast my BAC would have risen.

As the surgery loomed on the horizon, I asked the doctor if I was getting local or general anesthesia. I’m a local guy—I like to know what people are doing to me. Plus, general knocks you out for a few days. However, in this case I was concerned about the gag reflex involved with my mouth filling with pus. The doctor said that I would indeed have local anesthesia, but there would be a siphon in my mouth to suck out all the pus. I crossed my fingers and hoped for the best.

Finally, the senior ENT on hand came in and looked at my throat. One poke into my abscess was all he needed to declare, “Do it.” He was kind enough to explain the steps of what they’d do next. Again, I like to know what they’re doing.

Step 1: Spray the back of my throat with numbing/anti-gag spray that’s supposed to taste like banana but actually tastes like rotten banana. My tongue went numb anyway, so the taste didn’t really matter.

Step 2: Inject the local anesthesia into the back of my throat in several locations. This, they said, is the worst part. I’ve had these shots before…there’s something about a needle poked into your gum that’s so much worse than having it in your arm.

Step 3: Lance the abscess and suck out the pus.

Step 4: Open the lanced area and push around the tonsils with little pliers to make sure that all the pus came out.

If you have the stomach for a visual of this process, check out the 15-second video here. It’s a little less than halfway down. Watch ‘til the end for the payoff.

The whole thing went off without a hitch. Indeed, Step 2 was the worse, and I had to focus everything I had to ignore the pain and not gag. Step 3 was remarkably easy, and there was a satisfying “pop” when the pus pocket was released. Even Caroline heard it. The senior ENT did that part, so his nimble fingers caught almost all of the pus in a syringe before it was released into my mouth. I sucked up the rest with a manual suction device.

Step 4 was a little weird, but it was over quickly, and then I was done. Immediately I could open my mouth wider than I had in days.

But wait, there’s more.

We waited for my IV to finish, and then Caroline and I headed out. The doctors put me on a different antibiotic and told me to come back in a few days. I came home and ate a liquid meal—my throat already felt so much better (the pain was reduced from level 8 on the little scale on the wall in the emergency room [“bear attack”] to a 2 [“firm hug”]), but I didn’t want to risk having little bits of food get caught in the incision. I was drained but not sleepy, so Caroline and I went to see Hancock (pretty cool, definitely entertaining, fun to see a superhero movie not based on a comic book).

We were driving to the pharmacy after the movie when I felt a slight pop in my mouth, followed by a foul taste. Yep, more pus had come out. I quickly rinsed it out with some soda. It was pretty gross, but also somewhat satisfying, knowing that my body had just been purged of even more evil.

By evening, I felt great, and now I’m talking normally, eating normally, and getting closer to eating normal foods. It’s been quite an ordeal, and I’m glad to have it over with. Who knew that what started with poorly edited book on otolaryngology and a “Pus Pocket” melody would eventually result in strep, a giant pus pocket in my mouth (and not one attached to a piece of fried chicken), and a trip to the emergency room?

That, my friends, is how I spent my government economic stimulus check at the hospital on the Fourth of July.

Damn those karma police.

(P.S. I mentioned cats in the first paragraph. What do cats have to do with any of this? My kitten has had a problem with his paw for which he went on antibiotics a few days ago. So for part of this week, he and I were taking different doses of the same medicine. Kind of like E.T. and Elliot.)

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6 Comments leave one →
  1. Anonymous permalink
    July 6, 2008 9:50 am

    Wow. That’s quite a story. First of all, thanks for my first blog shout-out, Jamey. And you should know that 5 years later, I still can’t eat a Hot Pocket without hearing your off-tone voice singing that tune. But, I would never wish that kind of karma on anyone. My dad had the exact same thing happen to him in May (lancing and all), and his doctor suggested he have his tonsils out. Apparently it’s something, in his case anyway, that would keep coming back if he didn’t. Needless to say, Dad’s tonsils belong to Barnes-Jewish Hospital now, and he’s recovering quite nicely.

    Glad to hear you’re feeling better!

    ~Tracy

  2. carlos permalink
    August 2, 2009 1:35 pm

    Your story is very similar to mine except I didnt have pus. It’s funny how I also watched hancock while sick.
    I first thought it was strep, or mononucleosis, but when I saw this article I related; the pcture looked a lot like my throat.
    One of the many interested doctors would swear it was peritonsillar abscess, but then the ENT, just in case, pintched me with a gigantic needle: no pus.
    I smoke, and somehow I think this is the karma police’s way to keep me away from those cancerigenic cylinders.. I will remember the terrible pain I had everytime I feel like smoking.
    Good Luck, and good health!

    • August 2, 2009 9:41 pm

      Hey, thanks for sharing your similar story. I think it starts off as strep and then blossoms into this.

      I’m not a smoker, and I don’t know if strep and smoking are related, but it would make sense. Best of health to you too!

  3. Amy permalink
    September 15, 2009 8:57 am

    I recently went thru the same situation. The only difference: no anesthesia when the ENT stuck the needle in the back of my throat to drain it.Fun. He was able to drain approximately 50cc’s of pus at that time. Later that evening, I started coughing and, like you, POP! I must have spit up at least another 100cc of pus. Ewwww!!! The doctor is requiring that i have my tonsils removed next month.

    • September 15, 2009 1:14 pm

      No anesthesia! That sucks. Sorry to hear you had to go through this too. And then get your tonsils out. I’ve heard that’s not fun to go through as an adult.

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