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Wednesday, March 11, 2009

 

paging Z in Richmond

Hey, I'm thinking of you and wondering how your nursing school journey is playing out! Update me when you have a chance. Hope you & yours are well.

 

eyeball

Okay, okay, I've been promising this post forever. Consider it a cautionary tale. (If you don't like gross stories, don't read this one, ok?)

I took care of a patient a while ago who was a young woman who had decided to leave her boring suburban life and plans for college to hang out with the wrong crowd. She was using heroin and while her claim was that the massive necrotizing infection in her face started when she just picked at a scab on her forehead... it seems more likely to me that she had either injected or dripped a solution of heroin into her eye. That's right, her eye was the center of the infection. And man was it gross. The eye was swollen shut and continually oozed bloody drainage... when we cleaned it, it drained more, so that it looked like she was was weeping blood. Amazingly, she didn't lose the eye, although she is blind on that side now.

The good news is that she stopped using heroin and got into a methadone maintenance program. The bad news is that she came back to us a couple monthes later with abcesses in her thighs... apparently she decided to change things up by injecting cocaine into her femorals. I didn't ask her this, but I wanted to ask why she would risk infection by injecting when she had a perfectly good cocaine nozzle right on the front of her face... I suppose that would be a less-than-therapeutic message?

So, the takeaway lessons here are:
1. If you use heroin, keep it the hell away from your face and eyes.
2. If you want to use cocaine instead, I really can't recommend injecting it.
3. Srsly, college is not that bad. At least give it a try before you turn to drugs & whoring yourself out. Kthx.

And finally, heroin factoid of the day: dealers apparently cut black tar heroin with many things including fecal matter. Yes, poop. Which then users inject. And get nasty infected abcesses, big surprise. Could it get any grosser?

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