Jacuzzi Exposure

I have never really liked jacuzzis. At the end of a long day of skiing, a favorite winter sport of choice in Montana was to get a bunch of people together to soak in the hot tub, jump into a snowbank, and then hop back into the tub. There are a lot of reasons why this didn't appeal to me, not the least of which is that I find jacuzzis, well, disgusting. Add freezing my ass off before jumping into a pool of germs - no thank you.

Thursday of this week I had a patient who had "bumped his shin", developed cellulitis which abscessed and subsequently turned into a stage III wound needing debridment, packing, possible plastic surgery. The medical interpretation of the cause of his abscess was "lower extremity trauma followed by jacuzzi exposure". Wondering if this is a common medical problem*, I did a little research and discovered another ailment known as hot tub rash (pseudomonis folliculitis), a bacterial infection of the hair follicles.

So, the next time you're thinking about your relaxing afternoon at the spa, think again.

It is a fairly common medical problem. Typically, people with compromised immune systems or poor circulation, or healthy people with an open sore, can be exposed to staph and other strange things in that large, steaming petri dish of relaxation. Professional athletes, fearful of MRSA, have began to take extra precautions around shared jacuzzis.

Sick

I watched this documentary about Bob Flanagan about ten years ago, but The Partner had never seen it, so this afternoon we headed out and got our hands on a copy from Le Video. The whole experience of the film, for me, has been totally recontexualized. What's different now than then? I now believe it should be requisite viewing for all nursing students. Not into S&M? Can't really deal with someone driving a nail through his penis? Tough. Sit through this movie if you want to know what it is like to have a chronic illness and if you want to know what it's like to die. As a nurse or future nurse, it's important. Allied with some of Flanagan's pain journals, it can really provide a window. We just have to be willing to peer through it.

As for my mom, who I think reads this blog from time to time, you definitely don't need to see it.

No Hugging.

A young patient was admitted to our floor today with hepatic dysfunction. A liver transplant recipient who has had some bouts of rejection, his medical team determined that he will need to be re-transplanted. When asked if he'd noticed anything in particular that may have caused his latest symptoms, he simply reported, "A couple of weeks ago my buddy hugged me real hard and ever since then I've had this terrible pain in my side."

Pretty much cinches for me why the whole hugging thing has got to go.