MARK'S ABSCESS STORY: PAINFUL GAINFUL
Last year I was in hospital for almost 3 months with pain in my lower back. The agony was so intense, I was an atheist in prayer.
Fortunately for me, I ended up in Sutherland Hospital, which is one of the few hospitals that doesn't push a moralistic view about illicit drug use. I have a long history as an opiate user but the doctors who treated me did not punish me for that. They accepted my pain was real and recognised my tolerance to opiates meant I needed more pain relief, not less.
While the doctors established early on that I had golden staph and a resilient blood poisoning, it took a long time to put their finger on why the pain I had was so intense in my lower back. I had X-rays, CTs, MRIs and all sorts of other nuclear and you-name-it tests with no real diagnosis for some weeks. One doctor even suggested a bit of physio. I had some dental problems so there was a theory that I had an infection that started from my teeth. I was prioritised for dental treatment while I was in hospital. It was fantastic to get my teeth fixed, but they were eventually excluded as the reason for my painful infection.
A second CT was organised at another hospital with a more sophisticated scanner. I only managed to cope with the claustrophobic tunnelling machine because I had a lot of opiates in my system. There, the technician let slip that he spotted a problem with my spine.
When I got back to Sutherland, I hunted down my formal results and there it was: I had an abscess within my spinal cord.
This meant another 6 weeks on intravenous antibiotics. Operating was on the cards but rejected as an option in the end. When I was discharged I was still in pain, but it was at least manageable.
So, wht was it all about?
The most likely cause of the infection was injecting methadone in 1mL fits, undiluted and filtered with only a bit of cotton. It was a stupid thing to do, especially because each time I have done it I have had a miserable result, but I have persisted.
This wasn’t the first infection I have had from shooting methadone, but it is the most serious and I am determined that it will be the last! On one occasion, a “dirty hit” resulted in a level 9 migraine with a hospitalisation. Unfortunately, I ended up at WHICH hospital where the staff would not administer analgesia. They saw pain relief as rewarding me for doing something that they judged to be wrong.
Six months later I have a new GP who I am really happy with. I am also getting outpatient support from the Infectious Diseases Registrar at Sutherland Hospital. The localised pain has greatly dissipated. I have remained on a high amount of pain killers but this has gradually been consolidated into my methadone dose.
Importantly, I have changed my behaviour because of my hospitalisation. I am super clean when it comes to injecting anything these days -- something which was also reinforced by the NUAA PeerLink training days that I attended recently. I have learned to use a wheel filter, I wash my hands and swab scrupulously and always make sure all equipment is new and as hygienic as possible.
I can’t believe it took me this long to have a long hard look at my injecting technique, even though I had been getting “dirty hits” and abscesses on my skin as well as vein damage. Perhaps the change was motivated by realising that my behaviour could have a long term and serious impact on my health. Once you get this kind of infection, you are prone to getting them again and again. Apart from the pain, spinal infection can result in changes in sensation that at worst can mean paralysis, but can also cause the loss of bladder and bowel control.
From one peer to another, my message is this: learn to use cleanly, to filter out bacteria and to plan. It’s no good telling yourself you’ll never use again -- then ending up in the same space because you do it without having all the equipment you need at hand. Get the knowledge, get the equipment. If you don’t ever do it again, great, but if you do…. well at least you won’t end up in a hospital for months in serious pain -- or in a wheelchair.