Hidradenitis Is Not Your Friend

Hidradenitis Is Not Your Friend

Warning: I’m probably sharing too much on this post.  If you think that infection is gross, then you’re a normal human being and can stop reading right here.  Hell, I’m not even sure why I’m writing this post.  I’ll post about other stuff soon. If you don’t mind a few mentions of disgustingness, keep on going.

I’m nearing three weeks out from my surgery.  I didn’t die.  Here’s the details.

I have myself a nice little case of hidradenitis suppurativa, which I forget if I’ve talked about in the past or not.  I probably have.  To wit, it’s an orphan disease that involves a susceptibility to infection under your arms, in the crotchal area, and the underboob area for ladies and really fat dudes.  Lucky me, it’s far more common in ladies than in guys.  I have again hit the genetic jackpot.  Mine (fingers crossed) only was in a few spots under my left armpit. It’s painful, embarassing, and a big pain in the ass.  Studies say it might be linked to other autoimmune diseases, like… you guessed it, psoriasis.

Also, I can never properly pronounce the name, so I call it Hidradenitis Superlatina. I’m the only person who finds the slightest iota of humor in this.

Dealing with it basically consisted of using Hibiclens (a common pre-surgical prep cleaning agent… not really soap) in problem areas and potential problem areas, the suggestion of bleach baths every so often (I don’t remember the ratio, I think I blogged it back in the day), and hoping that the side effects of my psoriasis meds helped.

They didn’t.  The spot (there was only one at first) would come back, cause me pain, explode at the least opportune times, leave me with an abcess that would eventually fill in and… get infected again. Lather, rinse, repeat.  I became adept at washing the area, slapping a gauze pad on and taping it to my shoulder area to form a MacGyver bandage, and carrying on.  My dermatologist honestly didn’t seem overly concerned with it, other than occasional checks and wanting to know if it was getting better or not.  Problem is, it was getting worse.  The time between recurrence was less and less… and then Spot 2 formed.  Lower on the armpit.  Spot 2 didn’t burst at first… it was just painful, and I thought maybe it’d go away.  It actually receded a few times.  Then it didn’t.  It turned a color showing it was under pressure.  I treated it gingerly, hoping I could get in to see the Derm. Maybe they could take care of the particulars  The spot didn’t cooperate.  Instead, it decided to kersplode at work… and it didn’t want to stop bleeding. I asked my boss if she could get a promotional T-shirt or something from HR or Sales, but she had a towel she was willing to sacrifice for the cause.  (The first aid kit, of course, didn’t have any gauze I could use.  But they did have like seven foil shock blankets.)

As this was happening, I was hightailing it to my doctor’s office (the Derm was closed, so I went to my GP).  The GP took a look at it, agreed with the diagnosis of hidradenitis, and told me that he used to be a surgeon.  He and his surgical partner had done many surgeries to eliminate the problem. He gave me a referral to his old partner and I got an appointment with him.  The Surgeon and I talked about my Scandinavian ancestry as he looked at the spots.  I was told that I was lucky because there are two forms that he’s seen… one where the spots pop up randomly, one where they tend to stay localized.  Mine were the latter, and he told me that he felt 100% confident that removing the cyst area and part of the surrounding area would solve the problem.  I agreed, and surgery was set for next week. I was also surprised to find that the surgery is something that would require general anesthesia.

Let me sidebar for a moment… I tend to have a LOT of dreams where shitty things happen to me. Getting murdered?  Old hat.  Chased by animals and then eaten?  Been there.  Horrible things happening to those I love due to actions (or lack thereof) that I did?  Yarp.  I’m a helluvalot more likely to remember nightmares.  About a month ago, I had one EXTREMELY vivid nightmare… I was going to be operated on for some reason or another.  I went under anesthesia… and stayed under.  I don’t know if I died or if (worse than that) I was aware but paralyzed.  Yeesh.

I had pre-admission stuff at the hospital the Monday before.  It was your basic “are you who you say you are?” kind of questions, but I was asked if I had an advance directive.  I know that it’s mandated, but that’s NOT the kind of thing you want to hear if you’re irrationally freaked out about anesthesia.  The rest of the pre-admission stuff was standard… height, weight, fill a page or so of medications, supplements, and related that you’re taking, list your maladies, and give a vial or so of blood.

S-Day came.  I got up early and my brother drove my ass to the hospital at too-damn-early in the morning.  I was already thirsty and hungry from the mandated no food after midnight and trepidatious as a Commie at a HUAC hearing. They let me in at 6:30ish, gave me a hospital gown, sat me down in a comfy chair, gave me a thin-yet-warm blanket, and asked me about a thousand questions, verifying that I was me, that I was there for them to take chunks out of my armpit, that I have no religious preferences, basically the same kind of stuff asked during pre-admission.  They plonked an IV into my arm (never had one before that I was aware of, feels weird, man) and I asked for a cold washcloth, ’cause I was sweating like a pig and felt uncomfortably warm.  The surgeon came in, said “hi” and put a star on my shoulder of the arm that was getting operated on, Then the anesthesiologist came in, assuaged my fears (kinda), and left.  Another five minutes of getting hydration via IV, it was go time.  I thought that I’d have to hoist my fat ass onto a gurney, but (to my great surprise), the nurse stepped on a hidden lever and my seat reclined to a flat surface… yup.  SECRET GURNEY.

I met the nurses who would be helping with the surgery, had an O2 mask put on, and was led to not a stainless-steel operating table, but a cushioned table with flexible arms and legs.  I gingerly rested my bulk on the table, and moved my arm into a position that was agreeable to the surgical staff.  I had to give my full name (and one of the nurses said “that sounds like the name of a high-priced lawyer!”), took a hit of the oxygen, was told that the thing that they were about to slap onto my side was a grounding pad ’cause there was about to be some electrocautery up in this joint, and… I didn’t even get a countdown to 10.  I was out.

I woke up at some indeterminate point later in the Recovery… area, chilling out on another one of those recline-a-gurneys.  I was still masked and kept fading in and out of consciousness.  Eventually, I could discern a conversation and (me being me) attempted to add my $0.02.  I had the mask removed a few minutes later, asked for a blanket ’cause I was chilly, and then was wheeled into Recovery II.  I was provided with a sumptuous bounty of a package of Lance Captain’s Wafers (the Peanut Butter Cracker kind, for those keeping score) and a Sprite.  I wolfed the crackers down and drank the Lymon-flavored beverage (sidebar: do they still even mention Lymon in the advertising?), and was provided with more.  I guess ’cause I’m a big boy or some scheisse like that.  My little brother came in later while I sat, still under the effects of narcotics and relaxing.  I had a big-ass series of bandages on my pit and a removable icepack strapped to it.  We talked, he recounted the visit from the surgeon once I was done having bits hacked out of me (“he was weird, but said that it went OK”) and I was given the go-ahead to be driven home, but not before I made a trip to the bathroom.  Once that business was attended to, I had to take the policy-mandated trip out the doors in a wheelchair, climbed into my brother’s Jeep, and… headed straight to the pharmacy to pick up some narcotics.  As those of you who are reading this who have actually gone through surgery know, the rest of the day was spent resting, stumbling down the stairs to change out my icepack, and trying not to think of too much.

KLynne and I visited the surgeon’s office the next morning for instruction on wound care.  The doc took the fancy hospital tape off of the wounds, and removed the gauze packing them.  Since this is a situation that involved infection and the excised areas were of a pretty decent size,  I had to have the wounds packed twice daily.  Each one was about the diameter of a quarter (a little bigger on one, about that size on the other) and somewhere between 3/4 and one inch deep.  Weird as hell.  My long-suffering wife was told that it would be her job to throw on some surgical gloves, take out the old surgical sponge (we were to use the non-sterile open-weave gauze ones), wet part of a new sponge, and snake the moistened gauze into the holes in me.  I got a few more sponges thrown on top of that for cushioning, and then the whole shebang was taped to my shoulder and side.  I had that day and the next off of work, but I quickly found out that that arm was damn near useless for anything major.  Camping, disc golf, or bowling were out.  KLynne spontaneously (because the universe has a sick sense of humor) wanted to do activities that necessitated two healthy arms.  It was not great.

The next few days were more resting, more showering (I had to irrigate the wounds with the shower and use Hibiclens on the surrounding area, which hurt like a sonofabitch), more taking pain meds (I tapered off within a few days to nothing) and more wishing I wasn’t useless.  Plus the packed wounds felt really odd.  Eventually, though, they felt… comfortable?  I know it’s weird, but it felt better with the packing in than with it out… unless the sponges dried up.  Then it decidedly did NOT.

A week and a half ago I went to my first follow-up visit.  The surgeon said that my wounds were lookin’ good and that a wet gauze was not necessary.  Dry was fine.  The holes had filled up significantly in that time.  The dry was rough at first but eventually felt pretty good.  Within this last week, I’ve since switched to extra-wide bandages.  The top hole is mostly filled in and the skin is starting to grow over the top of it, the bottom one not as much.  They itch like any healing wound will, but sooner rather than later they’ll be done… and I can finally, FINALLY wear deodorant on BOTH of my armpits again.  You don’t miss it until it’s gone.  One arm fine, the other arm… I keep down.  Bleah.

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