Tuesday, May 31, 2011

Two Toes and a Centipede

Written by Mike and Miranda

A few Fridays back, we decided to go out for a night on the town. Usually this just entails grabbing a bite to eat, or a trip to the video store to rent a movie to watch back at home. Neither of us can be described as social butterflies. Usually by the time Friday rolls around, we’d prefer just to lock the doors, unplug the phone, and relax for a few hours by the glow of the television.

On this occasion however, we went to the recently renamed Yap Pacific Dive Resort for dinner and some entertainment. This sprawling hotel and restaurant is on a hill above Chamorro Bay and downtown Colonia, and is the closest thing you’d find to a “Fantasy Island” style mansion in all of Micronesia. We hadn’t been to their establishment in a long while, and were pleasantly surprised at the greatly improved quality of the food and the reasonableness of the prices. We shared a sushi appetizer featuring freshly caught tuna, and each had an excellent chicken burrito entrĂ©e. The best part had to be the homemade salsa, made with a locally grown chili pepper. These peppers don’t have quite the same lingering heat as the roasted New Mexico chilies Mike is familiar with, but are still eye-wateringly spicy.

After dinner, we had what started out to be a thoroughly enjoyable evening. We met some of our expat friends to see some live music, and joining us as well was a group of students from a Georgia college, who were on-island to do some work study. Two of our expat friends had been getting together for awhile playing music and wanted to perform once before one of them moved to another Micronesian island for work.

Everything took a turn for the worse when at one point that night Miranda went with some friends to view the twinkling lights of Colonia from a wooden deck overlooking the Bay:

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Miranda recalls:

The path out to the wooden deck is one I had taken many times, though this was the first time that the overhead lights were not on to guide the way. I walked carefully along the gravel yet well manicured path. About half way to the deck, when I stepped down with my left foot I felt an immediate stabbing pain in my toe, similar to a bee or wasp sting. Since I was in complete darkness, I continued to the deck where I could sit down to examine my foot. In very dim light, aided by a cell phone’s built-in flashlight, a common and useful thing here, we began trying to figure out what happened to my foot. A local friend stated it couldn’t possibly be a centipede bite because the wound was bleeding, maybe I just split a callus on my toe. After cleaning it up a little it was noticed that there were three small bite-looking marks on the outside of my big left toe. One was bleeding, one was oozing a clear liquid, and the other just looked like a small puncture wound. After allowing a little poking and prodding, my toe, then foot, then ankle began to swell with impressive speed. I contemplated with my friends whether a hospital trip was necessary, but as time progressed the swelling and pain became unbearable.

As I went hobbling back towards the restaurant where Mike was, he found me half-way. I tried to compose myself a little as the pain made it difficult to walk, and told Mike that our first emergency trip to the hospital was in order. Something had bitten me, and I was in a lot of pain. I explained that I didn’t see what had done the damage, but it could have been a centipede.

Mike rushed to pay our tab as I sat down and looked at my toe for the first time in full light.  One young college student, who proudly asserted that she was “pre-med”, spent a few moments examining the wound, squeezing and poking it, before coming to the astute conclusion that I should probably go to the hospital. I ‘m not sure why I let this girl inflict even more pain on me, as the toe had already been thoroughly abused by my friends while on the deck, but at least I gave her a story to tell when she returned home.

So to the hospital we went. The entire place seemed deserted at the late hour on a Friday night, but we were able to find the on-call medical staff. The doctor brought us into an examination room and within seconds, nodded sagely and said, “Centipede bite.” He explained they see them fairly regularly at the hospital. The record being three bites in one night.

Since there is no antidote or cure for centipede venom, I was just given a couple of injections to help with the pain and one of Benadryl to keep the swelling down. The first shot to my toe did little to help the ever-increasing pain that was shooting through my toe and radiating up past my ankle. Honestly, it is the worst pain I have ever felt in my life so far. At one point I even joked about having them just cut the toe off to make the pain stop! Since the first shot of local anesthetic didn’t do the trick, a second shot, administered in two places was given. This shot blocked the nerves so that they could not feel the pain. Almost immediately half of my foot went numb, like I had been given a Novocain shot by a dentist with poor directional skills. my body instantly relaxed and I actually began to laugh at the absurdity of the entire ordeal. Who gets bit by centipedes? I DO!  Mike stayed by my side the entire time offering supportive words and a hand to squeeze through all the pain. The doctor prescribed some Tylenol with codeine and Benadryl to be taken every few hours, advised keeping my foot in nearly boiling water to help break down the venom, and said to come back for a consultation if the swelling didn’t go down within a week.

We had been told in the past by friends that a centipede bite was cause for a definite trip to the hospital. Luckily, we learned that night, it is only because of the incredible amount of pain, not because of the risk of dying or loosing a limb!

For the next several days I stayed off my feet and generally tried to get as much rest as possible, partly taking advantage of the sedative qualities of the medications. Even with frequent hot water foot-baths, my toe ballooned to almost twice its normal size by the next morning. Most of the pain came from the swelling, and the feeling that my “sausage toe” might burst from the pressure. Eventually, the pain lessened, and my toe deflated to near its usual size. After just getting my toe back to its normal size, and getting used to walking normally, I woke up the next Friday and noticed it had begun to swell again. This time, along with the swelling there was a new symptom, a burning and itching feeling beneath the skin.  It is like a really bad mosquito bite that has been scratched and become very large inside my toe, that constantly itches and hurts all at the same time.

Awhile back a friend of ours was bitten on the hand by one of these evil, evil creatures, and I remember about a week later his hand swelled and he complained of itching and pain all over again. So, with that in mind, I am hoping this is all a normal part of the healing process of centipede bites. If not, the hospital is well versed and can help us with this.

Once Miranda was over the worst of the pain, Mike decided it was high time to have his own foot-related injury. I just couldn’t let her have all the fun!

Mike remembers: 

Early one morning, I caught that constant trouble maker Peanut peeing on the floor. Instinctively jumping into action, I ran into the next room to grab a mop and bucket, and slammed my pinkie toe on the edge of some furniture. I doubled over in pain, while Peanut watched me closely, all the while still peeing on the floor. After cleaning up the mess, I didn’t think too much of my toe. It still throbbed, but I thought that would go away after a while. That is, until I tried to put on my shoes, and nearly passed out with the shock of it.

So, after a day or so trying to move as little as possible, with the pain not improving much, we returned to the hospital, pictured here.

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Another doctor was there, who gave my toe two pokes with his finger, and after two seconds declared, “Not broken.” I was given some Tylenol (without codeine), and sent on my way. We stopped at the pharmacy window, as seen below, to fill the prescription that was only $4! We enjoyed the “cover your cough” poster translated into Yapese.

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Thankfully, my toe has improved progressively on it's own since then, and I'm hobbling around with minimal effort. I'm sure I'll be back to running marathons shortly.

So, did we learn any lessons from our experiences? First, toes don't seem very important, until you're not able to use them properly, and then you realize that they're very important. Second, that neither of us like going to the doctors at all. Third, that we are so in tune with each other, that as soon as one of us is injured, the other inevitably joins in the misery, so we better watch each other’s back out here in the jungle.

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