Monday, June 3, 2019

Infested

Image result for scabie



I was trying to make sure everyone understood their assignment, crossing the room, leaning over shoulders, checking in and generally making a nuisance of myself, but my mind was on my back which has started to itch in this severe, crispy way that made me want to rake my fingers over it or, better yet, to pull off my shirt, lay down in the parking lot and ask someone to slowly drag me over the roughest patch of concrete. But, in front of the class, I could only give myself an occasional furtive pat which did nothing but send the itch signals stampeding through my mind.

“Yes, that’s it; can’t you see?” My mind was trying to communicate to my hands. “Scratch at this! Scratch at this for all you’re worth!” Must’ve been the new detergent. I ignored it and it subsided. It didn’t, however, go away.

When I got home, after scratching a bit on the bus, shimmying around in the seat—probably how I got this itch in the first place—I hiked up my shirt in front of the bathroom mirror. My lower back was an involuted mass of histamine swelling, like my body had decided to grow another brain just above my ass.

“Gina!” I yelled, hoping a second opinion would be less worrying, because, with my head turned around looking into the mirror everything looked worse, or so I hoped.

“Ohh that’s bad” she said, before she’d even gotten through the bathroom door. Together we marveled at how red and swollen it looked. “Something just irritated it.” Gina said and, to show her solidarity with my pain, she rubbed some lotion on the rash for me and, to stand by her point that the rash was some slight irritation and nothing more, she rubbed the leftover lotion onto her face, physically addressing the tacit question of whether this might not be something worse, something contagious and disgusting.

“Wait!” I started to yell, and then dropped my voice—Esme, our six month-old daughter, was asleep in the other room. “What if it’s contagious!” Gina waved away my concerns as unfounded. As usual, I was overreacting. She rubbed the leftover lotion vigorously into her face, smiling. Nothing to worry about.

...

Friday, I woke up, not itching, but still swollen, still red and with a ticklish feeling. I took a bike ride and picked up some hydrocortizone almost as an after thought—even that didn’t really seem necessary. I’d use it once or twice, like that Nyquil I bought the last time I had the ‘flu and then it’d get forgotten under the bathroom sink. I was surprised when I got home and put it on and it didn’t seem to do anything. “Hmm, still itches.” I said scratching the cream into the inflammation, hoping the intense contact with the cream would result in something.

Saturday, working for the bakery, out doing deliveries, I noticed I had a slightly different rash breaking out across the tops of my hands. Rather than being a single red plateau, these were islands, blistery islands, almost like zits, but less opaque, like a cyst. In one place there was something that looked like an inflamed scratch, a jagged line only, like everything else, it itched. I drove and scratched at the back of my hands. Muttering about the allergic reaction I was having. Clearly, the itch, the inflammation, the infection or whatever was spreading, but how the hell did it spread from my lower back to the top of my hands and the inside of my wrist? Was it poison oak? I hadn’t been near the woods in a week. Was it all the flour from work? Had a year of close contact with bread resulted in a gluten intolerance? I was grasping at straws, but I had nothing else. But even with this horrific rash breaking out all over, I figured I just needed to put some more cream on it and maybe get some rest.

Getting older brings so many maladies with it, I scarcely pay attention to the individual ones anymore. I had woken up at 3:30 to get to the bakery. I felt lousy all over. My eyelids were dried and felt jammed like rusted storefront shutters. My ears had a slight ringing that sounds like a distant alarm when you don’t get enough sleep and drink too much coffee and I was farting like crazy. I felt like an old scabrous dog: itching and farting. The itching, I reasoned on my way home from work, was just a specific symptom of a more generalized decay. I mentioned this to Gina by way of my usual Saturday afternoon ‘how do you stand me?’ monologue. Something about waking up too early on Saturday makes me feel particularly vile and hideous by the afternoon. As we talked, I scratched myself and whined piteously.

“It wouldn’t be so bad if I didn’t feel like a damn dog scratching like this.” Gina laughed at this and reminded me that I’d been scratching myself nearly since we’d met.

“Remember Argentina?” She laughed. “My boss when I was babysitting didn’t even want me coming in after I told her about your itching. She was convinced you had scabies or something.”

At this, a dull lightbulb flared, not the strong incandescent kind that come with a good idea but a naked bulb hanging in a basement, illuminating something awful lurking in the shadows. Scabies, that was something I’d hadn’t considered. By this point in my itching, I’d Googled all kinds of word combinations that seemed to encompass my symptoms. I’d played Scrabble on the internet with words like ‘rash, inflammation, hands, causes, treatments, blisters, swelling, redness, allergy, psoriasis and dermatitis’ all of which yielded those ‘top ten’ lists of common skin aliments, common treatments, common causes, etc. They had names like:

  • 7 Worst Rashes!
  • 4 Things You Don’t Want to Infect You!
  • 5 Reasons you Itch like a Damn Dog!
  • 6 and ¾ Symptoms of Psoriasis!

Comparing my rash to the pictures on the internet was profoundly depressing. I was beginning to resemble the inflamed bastards with their expressions of quiet sufferng, but no matter what diagnosis I gave myself, the problem persisted. The itch defied categorization. It only looked vaguely like anything I’d seen on the internet and usually only had about 3/4ths of the associated symptoms. After Gina mentioned it, I decided to type in ‘scabies’. It was going out on a limb, but it was something else I hoped I could rule out.

The images of scabies looked slightly worse that what I had. Inhabitants of the ninth circle of hell stared back at me from the screen, covered with oozing pustules and rouged and swollen burrows, like wiggly track marks. Just looking at the poor bastards made me itch, but this time there was something sympathetic about the reaction. As I read about the symptoms, I felt myself becoming more and more desperate, which was a sure indication that I had what I was looking at. When previously reading about the symptoms of psoriasis and eczema, I found myself overextending to try and make my symptoms match what I was reading, with the scabies this wasn’t necessary. I had everything it said I would have, everything, that is that indicated a ‘highly contagious infestation’ for which Web MD recommended cleaning every kind of fabric the afflicted had come into contact with. As I read I looked around the room. The carpet floor, my daughter’s blanket, the rugs, the clothes, the fabric of the couch. It was impossible not to imagine the scabrous bastards crawling all over everything. If it was scabies. I was screwed, worse yet, my family was screwed.

Gina was still laughing remembering how her former employer thought I had scabies when I motioned her over to show her the picture I’d found of them that looked very much like what was on my wrist. As she looked at it, I raised my wrist alongside the monitor, in an awful display of similarity. She stopped laughing and, she too started looking around the room, in particular at where our daughter was playing, surrounded as she was by the potentially infested fabric of her baby blanket.

“Oh my God,” she said, showing dismay for the first time, “after I touched your back that time, I rubbed my face!”

“Wait,” I said, interrupting her and my own thoughts which were racing ahead to all kinds of awful quarantine scenarios. I began to read the screen. “There’s a test, rub a marker…. alcohol.” I didn’t bother reading it, but left the details to Gina and ran off to get the makeshift scabies test components.

When I came back, she told me what to do. Rub the marker over the sores and then use rubbing alcohol to wipe it away. If there’s a dot of ink that won’t be wiped away, you’ve got scabies. We conducted the test twice, but each time, the result wasn’t clear. Some ink remained, but it didn’t seem like enough to be of consequence. “Besides,” I argued. “That’s just where the skin is broken from scratching. Of course it’ll leave a mark there.

Don’t ask me how we did it, but despite all the evidence to the contrary, we mutually convinced ourselves, I didn’t have scabies and went for a walk! Not just a little stroll but a rollicking Saturday afternoon walk, downtown and back. And worse still, I carried our daughter in the carrier, where her tender skin would be pressed right up against mine for hours! Looking back now, I want to scream at this lunacy, but my protests go unheeded and that foolhardy couple goes walking out the door, wanting to think themselves safe so badly did they ignored even that most faithful of Cassandras, the internet.

...

I think it possible that the news was just too overwhelming. The diagnosis too severe. Scabies? Who gets scabies? Sure I was not the cleanest of individuals, but it’s not like I was sleeping on couches found discarded in alleys with suspicious stains and faint noisome odors. It’s not like I’d been staying in an abandoned house, sleeping on a pile of mattresses found in the basement. I hadn’t been in any dumpsters lately. What made the scabies so impossible was that I’d never gotten them before when I’d been doing all the things I’ve listed. I used to eat from the trash, spend excessive amount of time in squalid settings and go for days, even weeks without bathing while wearing the same clothes I slept in. When I was in 8th grade. I wore my Operation Ivy shirt every day of the school year and I don’t think I ever washed it. In 9th grade, because I had to get up early, I took to sleeping in my clothes. In college, the trend continued, but now so far from my mom’s free laundry service, I eschewed the entire practice of washing. In short, I used to be filthy and I’d never gotten scabies. Now I woke up and showered almost every day. I changed my clothes. I wore shirts with collars. How the hell was it that only now I got scabies? Had they lain dormant, waiting until I’d had a family they could infest as well? All the websites said they were usually transmitted through skin-to-skin contact. Whose skin had I contacted? Show me where and when. It just wasn’t possible, but the more I thought about it, it was.

It’s not the most common scenario, but scabies can be transmitted in fabric, especially in institutions where infestations might not be noticed or treated right away like prisons and rest homes. While I hadn’t been in any such place recently, I’d been on a close approximation: The Redwood Transit Bus.

Because I’d braved all kinds of dirty scenarios and never had any ill effects, I’m not squeamish about germs or dirt or unwashed hands. The one aspect of filth that I try to avoid, and not because I’m afraid of it, is stink. Even in my unwashed years, I made an effort to avoid any kind of noxious odor: that awful mattress that got left in the flooded basement, the armpit infection a friend developed, people’s feet, vinegar in any of its putrid forms, halitosis and the incontinent. The latter I’d been increasingly encountering on the RTS bus. Probably twice a month, riding back and forth to work, I’d find myself seated too near someone who’d crapped or pissed themselves who didn’t have the energy or the wherewithal to do anything about it. Each time this happened, I noticed something awful. The offender would get off somewhere along the line and, within the next few stops, someone else, usually a fairly clean and nice-looking person would sit right where the incontinent had been, as if they were sinking into their own couch at home. I always wanted to say something, but how do you word that?

“Excuse me, ma’am, but you’re sitting in a seat that, well, the guy who just vacated it, well, I’m pretty sure he’d recently shit himself. The smell might not be too obvious anymore, but if you do some olfactory casting about, I’m sure you’ll soon discover all the evidence you need. You might want to take my seat. I’m about to get off anyway.”

A few times, I myself had sat down in a seat that had a lingering cloacal quality. But, because my experience had led me to believe such interactions were unpleasant, but ultimately benign, I didn’t think much of it. Now, it seemed, I had my answer. If I’d gotten the scabies from anywhere, it was from the bus, not necessarily from someone incontinent, but someone who had such a bad infestation the mites had been raining off of them onto the seat, waiting for me to get on and, so trustingly, take the open seat.

“Damn those padded upholstered seats!” I shouted, after returning from the walk and reading how scabies is difficult to transmit through hard or smooth surfaces, preferring fabric or hair the way lice do. “Why did they ever switch over from those hard plastic seats buses used to have?”

It was like we just needed the walk to process things and by the time we got home, both Gina and I were convinced what I had was scabies. Gina bathed Esme and put her to bed, hoping such preemptive measures could stop the dread mites from spreading. I sat in front of the computer, scratching and obsessing.

The internet suggested all kinds of things to combat my infestation, but, unfortunately, I’d have to go to the doctor to get a prescription if I wanted to be sure to get rid of them. I rubbed tea tree oil all over myself while Gina started striping the rugs off the floor and the covers off the chairs. She took all the pillows and blankets and made me sleep on the couch. I closed all the self-diagnosis windows on the computer and opened Youtube, searched, Choking Victim’s song “Infested”. I hadn’t listened to it in years, but I remembered the words. I sat back and listened, scratching and smiling with complicity.

I’m sure I hate ‘em, there ain’t no maybe/ body lice and crabs, headlice and scabies.

In the morning, first thing, we headed over to the walk-in clinic, one of those places that exist solely for people who are convinced they don’t need insurance and that any rash, cough or shooting pain will eventually go away on its own. To see such a place through the gloom of Sunday morning is really a powerful argument for finding a family practice but, of course, who has the money for that?

The clinic opened at 8, and we did the thing we always do which was that we got there just early enough to be at the back of the line of desperation before the place opened. Anything that was going to bring people out early on a foggy Sunday morning to stand around a parking lot in Eureka was surely going to be bad. One lady coughed like she had TB, an old lady chatted with someone else about her bladder infection. There were various symptoms passing between these people like witticisms at a 19th century dinner party. We stayed by the car.

When the doors opened and everyone ran to claim their place, I found myself predictably near the end of the line, between the old lady with the bladder and the woman who couldn’t stop coughing. A guy with a clipboard was moving down the line, asking everyone, in a way as to completely dispel any lingering illusions of privacy, what we were there for. I didn’t bother to beat around the bush. When he came up to me, I told him, ‘scabies’ and almost enjoyed watching everyone, including him, shrink slightly away from me.

I was told there’d be an hour wait. Gina and Esme were waiting in the car, not wanting to risk exposure to the miasma of germs and bacteria swirling around that waiting room. There was a cafe nearby and I went over to get a coffee to calm my nerves. Gina made me get decaf—probably for the best.

After an hour of hanging around the walk-in clinic parking lot, they called us in. When we were all ensconced our little examination room, a girl, no more than 20, peaked her head in, she was observing the doctor today and would we mind if she observed my case. “Sure, join the party,” I waned to tell her. As little as I was concerned with my image, I understand why people don’t want to tell everyone they have scabies. For one thing, it’s contagious. If you told me you had scabies a few months ago, I might still consciously move a few feet away from you and go wash my hands at the first opportunity. Furthermore, well, it’s got that association with filth. I was surprised to find all these things online telling me that it wasn’t only the lowest of the low that got scabies and to not take the diagnosis too hard. It seemed the biggest blow for most people is psychological. Not only do they feel dirty, there’s the knowledge that they’ve got bugs burrowing through their skin. But really, we’ve always got bugs burrowing through our skin, it’ just that certain varieties are a little more pernicious. I didn’t mind the observation, but I wasn’t about to tell all my friends I’d recently seen that I had scabies. It just makes you sort of untrustworthy in a way, like you’ve allowed yourself to be colonized by bugs.

I had tried not to harbor any illusions, but when the doctor came into the room, I couldn’t help but to hope that maybe she’d tell me that, as much as it might look like scabies, I’d just had an allergic reaction to something. But when I told her I had scabies, she just nodded and began showing the intern—or whatever she was—the telltale signs, making me strip down so that they could both marvel at this thorough example of an infestation.

The doctor prescribed the Permethrin I needed, but when I asked about my family, she told me that she’d have to see them, too in order to prescribe more. The cost of ‘seeing them’ would be 100 bucks a person. I considered protesting, but Gina told me she’d call the open door clinic and see what she could do—they’d probably be willing to help a breast-feeding mother by just sending in the prescription. The doctor even told me, sotto voce, that she was prescribing the largest size and including instructions for female and well as male application, wink wink.

Next it was time to worry about the insurance covering the medication. I’d read on the walk-in clinic’s website that they accepted Medi-Cal, but when I got there, I had to sign a waiver saying that I acknowledged that they didn’t accept Medi-Cal and would have to pay out of pocket. I’d been told my insurance would probably cover the Permethrin, but, I was expecting the same thing to happen again. This is usually what happens with insurance. They do all they can to avoid paying for anything. At least, for once, I wasn’t paying for the insurance anyway, so if it gave me nothing, it wasn’t like I’d put anything into it.

I was so happy to find that the Permethrin was free, I didn’t worry much about the size of the tube that didn’t look like it would be enough for three people even if one of them was a baby. When I got home, as usual, Gina took the disappointment in stride. After all, I was the one who actively had the bugs, shouldn’t I be the priority here? She agreed, but I understood her reluctance. I’d read somewhere that an infestation could take a few weeks to display symptoms and she had rubbed the lotion from my rash onto her face and then there was Esme who, as a breast-feeding baby, was still attached to her most of the time. If Gina had it, it was certain Esme would get it too. I tried not to picture the wriggly bastards flocking eagerly to my daughter’s soft and probably much more vulnerable skin.

We spent the rest of the afternoon cleaning the house. We bagged up everything that could be bagged and sprayed Clorox on anything that couldn’t. I wiped down the floors with bleach water while Gina took Esme for a walk, but as I cleaned, I couldn’t shake the notion that I was undoing my own work. I hadn’t put the medication on yet so I was still crawling with scabies. I’d thought about putting the Permethrin on first, but then I would’ve been touching all the things that potentially had scabies on them, as well. Despite this concern, when I finished the cleaning and the whole house seethed with bleach and Clorox fumes, I felt better. It was hard to imagine anything, no matter how tenacious living through the disinfectant—even I had to open the windows and go outside.

That night, I put the Permethrin on, taking care to rub it into every pore beneath my chin. I’d hoped it would tingle or at least smell like an insecticide, but it was about as sensational as an application of Jergens. I went back to the couch to sleep for the night. As I lay there, still itching, I couldn’t help but to wonder if I’d gotten a defective tube.

After the application of the Permethrin I was safe to go back to work. It was for the best, if I had to stay home, I would’ve done nothing but sit around and worry. I woke up and took a shower after leaving the Permethrin on for the maximum time of 12 hours. I couldn’t even tell if I was washing it all off. There was no residue or any hint otherwise that I’d gone to sleep slathered in toxic goop.

Even though I wasn’t contagious, I stayed as far away from everyone at work as possible. Not only to avoid an outbreak but also because I was beginning to look scabrous. The pimples on my wrist had swollen to pustules. I had an inflamed and sweaty plateaus on the back of either hand. Despite the medicine, I could swear the bastards were spreading.

I was relieved to get a call from Gina in the afternoon telling me, after much finageling and calling around, she’d managed to get another tube of Permethrin for her and Esme. When she’d called the local open-door clinic they told her they’d have to see her before prescribing—the same runaround we’d gotten before. She tried to explain that she had no symptoms, but the receptionist wouldn’t accept this. When Gina relented and asked for an appointment, they told her it would be more than a month before they could see her. No wonder people are clogging up the emergency rooms. There’s no where else to go. I could see how something like this, though not necessarily an emergency, would make anyone frustrated enough to just risk the expense and go to the hospital—even with no symptoms. After everything we’d read said everyone who’d been in contact with the afflicted needed to use Permethrin.

By the afternoon, I’d begun to itch like crazy and I felt guilty as hell just being at work, sitting in chair that other people sat in. Using a computer that other people used. Touching things. Would the mites crawl into the mouse pad and wait for another wrist to infest? Was that how I got the bastards in the first place? Maybe I’d been wrong to accuse the bus, maybe I’d gotten scabies from a much more benign place, like the college. My mind went into hypochondriac overdrive. Everything around me could’ve been infested. I started thinking of all the other associate faculty. Who knew where they’d been. I was freaking myself out and I decided to go home.

Over the next week, I continued to have small outbreaks I was convinced were indicative of the Permethrin’s ineffectiveness. I still itched and nothing looked to be receding. If anything, it was swelling and growing more red and involuted as the days went on. I started putting on aloe and tea tree twice a day and showering like a madman. Every time I’d feel itchy, I’d point to it as evidence that nothing was working, but, gradually, the itching and the swelling started to go down. By the time a week had gone by and we were to reapply the Permethrin, I was nearly back to my normal appearance. Other than a few red bumps on Esme that we obsessed over, but turned out to be pimples, nothing developed in anyone else.

It’s now been almost two weeks; today is my last day of class for the semester and it’s looking like infestation has subsided, except for this strange collection of small red bumps on the side of my nose...oh well, it’s probably just another symptom of the larger, more generalized infestation of time, one that, unfortunately no cream can combat which continues to ravage my body. I guess it’s just something I’ll have to get used to—time that is.


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