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Bite

17 Feb

Two weeks ago, a mama cat gave birth to four little kitties in my mom’s pocket garden. My mom’s not really a fan of cats, but my dad and I are both animal lovers. We convinced mom to let us “keep” the cat and her litter, saying that compared to dogs, cats are very low maintenance. I also said that since mama cat is a stray, she may poop or pee outside.

Hi, I heard they christened me “Sushi.” I can’t wait to nom on my hooman’s hand…oops, don’t tell her that!

So she was convinced, until our gardener watered the plants. He was not aware that the cats were there. Hence, mama cat had to move the kitties to another place. Until last Wednesday, she came back.

Hi! I’m back! Oooh kibbles! My hooman must love me a lot! Guess my kits will love this, what say you, hooman?

The first two days Sushi was still being her feral self–she won’t approach me until I put kibbles on her dish. Last Friday, she started approaching me and began rubbing her body against my leg or my arm. She even allowed me to touch her! That made me happy, because I thought that this begins our friendship.

Until today.

This morning, I went out and checked if Sushi was waiting for me to give her daily feed at the front door. She wasn’t there. I then went to see my sister and my niece whose house is within our compound. Halfway through Lilo and Stitch on Disney Channel AND Tangled 2 (yes, my niece and I love multitasking two movies at the same time!), my dad called us and announced that Sushi has arrived. So my sister, niece and I went out to see her. I went to the maids’ quarters to get her kibble and placed it on her dish. I noticed that some of the kibbles spilled in the box, so I poured it onto my right hand and started placing it on Sushi’s dish. Then, Sushi started rubbing herself against my arm and BIT ME! It wasn’t so hard but it was enough for my right hand to bleed.

Cleaned the bite with soap, VMV Id Sweat Acne and Overall Anti-Bacterial Monolaurin Gel; and Betadine.

My dad, my sister and my niece saw how I instinctively pulled my hand away from Sushi, and instructed me to wash my wounded hand immediately with soap, alcohol and Betadine; while my mom told me to pinch the wound so it would bleed. I was scared sh*t because I remember watching an i-Witness documentary about rabies and how fast it travels from the bite to my brain. Aside from that, I also recall how my ex-boss recounted the time when they visited a colleague in the hospital from her pet dog’s bite. The lady ignored the bite. Three days after, she was sent home from work because of high fever. My ex-boss visited the lady in the hospital and as she remembers, the lady knew when she was going to have her seizures as she politely asks her guests to leave the room whenever she feels like she’s going to have an episode. A day after the visit, the lady passed away, and so did the dog.

I digress.

I was mortified with the thought of me getting rabies, so I browsed the Interwebz quickly and look for the nearest Animal Bite Centre. My mom also called several of her doctor friends and she was told to go to either the three nearest public hospitals here in our place, or go to downtown Manila and have my bite checked at San Lazaro Hospital. I also texted a good friend of mine, Dr. B–who is currently an intern for one of the government hospitals here in Manila–to ask if the nearest hospital at home carried anti-rabies shots. Unfortunately, she told me that it is their SOP in that particular hospital to direct possible rabies patients to San Lazaro.

After lunch, my parents drove me to San Lazaro. It was near the old Manila where, as my dad recounts, my lolo (his father) plies his daily route as a jeepney driver. For awhile, we got lost at the old beauty of Manila, shattered by time and people who couldn’t care less about heritage. It took us an hour to get there from home.

2013-02-17 13.34.18

My mom was being funny when she pointed this out to me. “Anak, o. Cat’s Inn. Hahahahaha.”

As soon as we arrived at San Lazaro, the nurses checked my wound and was asked some questions at the triage. On normal days, the emergency room would not accept animal bite complaints unless it is a life-and-death situation. But since 1. It’s a Sunday; and 2. Sushi is a stray cat we just adopted to feed and still freely roams the road, I will have to be given some anti-rabies shots, plus vaccine against tetanus.

Triage: The gatekeeper to get treatment, stat

Triage: The gatekeeper to get treatment, stat

Guidelines for animal bite patients

For the bite to be given utmost attention at the San Lazaro ER on any day of the week except after outpatient clinic hours every Saturday, Sunday, and holidays, a patient will only be treated under the following conditions:

  • Children ages 0-2 years
  • Victims 60 years old and above
  • If your pet or the offending animal who bit you or the patient died
  • If the offending animal cannot be observed due to its being stray; or cannot be found
  • If you or the patient were/was bitten on a delicate part of your body
  • If the offending pet/animal bit the patient on his/her upper extremities (head, chest, back, hand, arm, etc.)
  • If the bites caused big, multiple, deep wounds
  • If the patient is a person with disability

If the patient do not fall under the various triage category, he/she will be asked to the Out-Patient Department of the hospital. If it falls on a Saturday after clinic hours, Sunday or holidays, the patient may be asked to return the following working days.

Going back…

San Lazaro only has one cashier on a Sunday. I don’t know how it goes on weekdays, but the queue can get pretty long especially when a huge influx of patients of different ailments arrive at the ER. When I had to pay for a P50 hospital card, it took me just five minutes.

Queue to pay for hospital card

Queue to pay for hospital card

After paying for the hospital card, I was brought to the far end of the ER to be interviewed by a foreign intern. He initially diagnosed my bite as Category 2, which prompted me to ask if it’s still considered that tier regardless to the shallowness of the bite. He said that for as long as it bled, it is Category 2. *insert okay face meme here*

The initial interview and examination with the foreign intern took us a good five minutes. After that, my parents and I had to wait for about fifteen minutes in a covered shed outside the ER until a young resident called me to be examined further. Stern and probably too harassed for the day (or for some personal speculations I’d rather not mention in this blog, unless I want to be the newest Internet sensation), the resident upgraded the bite wound into a Category 3, and prescribed me three shots for the day: two anti-rabies shots and an anti-tetanus shot. *insert okay face meme here*

Because San Lazaro is a public hospital, I had to be the one to purchase my three shots. I was given two options: to ask my dad to drive to the nearest Mercury Drug to buy my shots or to purchase it in the hospital pharmacy, where it’s 50% cheaper compared to commercial drugstores outside the compound. I opted for the hospital pharmacy, which gave me a total bill of P526 for a half dose of Verorab (One dose costs P948. I shared it with a five-year-old little girl who was bitten by her dad’s dog, hence the lower bill I split with the dad) and a vial of Tetanus Toxoid, which costs P52. From the pharmacy, I had to go back to the cashier to pay. The line was unbelievably long–well, not really that long, but it was longer compared to the queue I was in earlier, and it was a 15-minute wait to get to the girl behind the cash register. After paying, I walked back to the pharmacy where my mom was waiting for me, and collected my first two shots.

A good two hours after paying for my hospital card

A good two hours after paying for my hospital card

I went back to the ER alone because my mom offered to queue for me for my next anti-rabies dose. The nurse politely ushered me to the area where she was to administer the shots. Around me were kids bawling and screaming while getting inoculated. Well, I’ve had a few vaccines in my 25 years of existence. So this should be easy-peasy, I thought.

Prepping Verorab for my guns

Prepping Verorab for my guns

The pretty nurse warned me that the first shot (Verorab) she’s going to administer on both my arms might sting and cause pain. I quickly ran through my archive of painful vaccines and so far, the most painful but tolerable shot for me is the yearly flu vaccine. Okay, so I had my camera ready, her needle ready and pinched both my arms. Easy, I thought. She now tells me that the next one (Tetanus Toxoid) might also be painful and heavy on my left arm. Game on, I said. She preps me and pushed in the syringe, and HOLY MOTHER OF COWS IT WAS FRAKKIN PAINFUL! Seriously! Poor nurse had to hear my string of cusses escaped my mouth! Damn! No wonder those kids were crying so loud! After that painful anti-tetanus shot, the nurse had to put me into an allergy test to see if the next dose of anti-rabies would cause me to break out some nasty allergies. I obliged because I don’t want to risk dying of rabies AND allergies! So anyway, she took a small dose of ERIG and BLASTED SOME OF THE PAINFUL MOTHERF*@&#*$ ONTO MY SKIN!!! I was then asked to wait for thirty minutes to see if my skin reacts adversely to the skin test. Thankfully, I did not.

Allergy Test for ERIG

Allergy Test for ERIG

Amidst the pain I had to go through the first phase, of course I had to ask the nurse if there are some things I should not do after the shots, or what to expect after. Drinking liquor within the treatment is a NO-NO as it may decrease the effectivity of the vaccine, and one is not allowed to eat greasy foods. Well, I’ve been sober (meaning, I haven’t been nasty wasted and knocked out by alcohol) for a year already, and I plan to stay the same till forever. Greasy food? Oh, but we’re going on an outing this Saturday! *insert okay face meme here*

I was given clearance by the same resident who saw me earlier to proceed with the last phase of my agony–the ERIG shot. Since my mom was already on queue to pay, I only have to get an assessment form from the pharmacy guy and went back on queue with my mom. You see, the ERIG shot depends on how heavy a patient weighs. Let’s say you weigh as much as me, you get four doses of it. Each dose costs P1272.

ERIG vials

After paying for the last vials, I collected the shots, went straight to the ER and waited until someone attended to me. At 4pm, there were a lot of people having their bites and whatnots checked, so I had to wait a bit. When it was my turn, yet another pretty nurse (are ALL government hospital nurses pretty?) prepared my shots and ushered me to a gurney and closed the curtains–she was going to push in the meds into my buttcheeks! Good thing I need not worry about wearing the wrong underwear because I was wearing my best boxer-cut panties! She then tells me to stand up and prepare for the first of the last vaccine to be administered in my right glutes…AND GOOD MOTHERF@*#(^% SHIZ!!! I squeezed the IV pole beside me for support because it was THAT.PAINFUL! How could I not remember the pain I had to go through when the ERIG was first tested on my skin?! And for the last one, I turned my other cheek (pun intended) to get my last for the day. Ohhhhh pain!!!

These needles had to go through both my buttcheeks

These syringes had to go through both my buttcheeks

I already expected that I was in for an adventure on my way to get treated, because I was too used to the luxury of having to wait comfortably in an airconditioned private hospital, where medical staff ran around to get things done for you. Another thing is, the shots were unbelievably and incredibly painful! To get to the bottom of it all, I must say that it’s too hassle to travel from our place to downtown Manila. Before going to San Lazaro, I googled Animal Bite Centers nearest my place and sadly, no positive search results turned up. The first website on the list–which probably have the whole list of specialised centres in the country, at least online–is down; and to get treated at a private hospital means coughing up a great amount of hard-earned cash! That explains my option to go to San Lazaro not because of the cheap bill I was to get as soon as they’re finished treating me, but because I know that they are an experienced bunch over there with regards to treating animal bite cases.

Sadly, the influx of animal bite victims hailing from everywhere in the Metro (the kid I shared a vial with is from Antipolo!) is just insane! While every city have their own general hospitals; and every barangay have their own health centres, why can’t every locality have their own animal bite centers because frankly, bites from a beloved pet, whether it’s yours or a neighbours; a stray cat you had just started to fall in love with, or just an obnoxious animal lurking in the streets are a daily occurrence! You just don’t tell people to take care and not touch every animals they see, because some of them tend to attack even without provocation. I just hope that someone heeds this call and take action not for me or some people looking for cheap but effective anti-rabies shots, but for the people who leave the comforts of their districts to seek medical attention they can afford.

I exactly don’t know what lesson I learned from this incident, because I will never stop being an animal lover. Well for now, my parents have decided to give Sushi the boot by putting away her dish and water, and I now call her “The Bastard Cat” for nomming my hand and for the inconvenience it caused. Heh.