People have asked me why they didn’t have the Crofab ready for me when I was wheeled into the emergency ward.My answer is: This is what I know about Crofab.
Crofab is an antivenin that is made from immunoglobulin fragments from healthy sheep that have been immunized with one of four types of North American snake venom.
Crofab comes in little vials. Each vial is reconstituted with 10ml of sterile water and must be mixed by hand. The mixing is done very slowly. The vial is rolled back and forth in the palm of some medical staffers hand.
It takes up to 45 minutes to reconstitute. In the meantime your tissue disintegrates into porridge.
The reason Crofab is reconstituted so slowly is this: If it is mixed too fast it will foam, causing the proteins to break apart and rendering it useless. There is, of course, some debate about the foaming issue.
Several reconstituted vials are then mixed into a bag of saline solution and given intravenously to the patient, in this case —me.
The number of vials per bag of saline varies. They used six vials per bag of saline in my case.
Back to the story:
My sleepy EMT guys had just wheeled me through the doors of the ER, through the curtains of my treatment room, and then scampered off to get double caramel macchiatos.
Now it might have been the elephant sitting on my chest, or the bees buzzing under my skin, but there sure did seem to be a lot of people sharing the room with me.
There were not only people in the room with me.
There were people peeking through the curtains as well.
I couldn’t shake the feeling that people were staring at me. Did snake venom make you paranoid also? Every time the curtain opened, would there be a new person staring in?
I looked up at the curtain again and I recognized a face, it was my neighbor, Jill. Jill is a firefighter. She had heard through the firefighter grapevine that someone in her neighborhood had been bitten by a rattlesnake and she figured out it was me. It was one of those perfect moments, when you are never so happy to see someone in your entire life.
Jill sat down beside me. I showed her the wound and she started snapping pictures. What are friends for if they can’t take embarrassing pictures of your giant sausage leg and post them on the internet?
After the pictures came the happy words, “We’re going to give you something for the pain.”
Oh Joy! Hello Morphine. Good-bye pain, or caring about the pain anyways.
My leg was now swollen up to my knee and the swelling was showing no signs of stopping.
There was more scribbling on my leg—where they had located a pulse (very important) swelling measurement lines and swelling progression lines.
At one point, I think I even saw one of the busy nurses jotting down her grocery list.
Several random ER staff members approached me through the curtains saying things like, “I’ve never seen a rattlesnake bite before.” I realized that all these people were just curious. They just wanted to see my leg.
They wanted a bit of an envenomation education.
I was the freak in the tent that everyone just paid a buck and a half to see. I liked being a freak. I figured, why not, as long as I’m just lying here swelling, I might as well let the staff learn something. So with every new person who peeked through my freak show curtains I would lift up my leg and say, “Do you want to see my snake bite?”
This was, of course, after Mr. Morphine came to visit.
I probably would have felt a little more assured if the hospital staff had had a bit more experience with snakebites. Most had never seen a rattlesnake—let alone a rattlesnake envenomation.
I kept having that feeling when you’re on a plane and the there’s a lot of turbulence, but everything is O.K. because your flight attendant is still walking around looking serene—and serving drinks.
Then all of a sudden that unruffled flight attendant of yours gets a panicked looked on her face, she sits in her jump seat, and buckles herself in.
The staff was a little nervous and tense, understandably so.
As I’ve learned, every single snakebite is different. There are a million variables involved and the outcome is never, never certain.
The throngs of curious hospital staff parted.
A slim Ukrainian ICU Doctor entered.
She walked in with a cane, and came up to my bedside, introduced herself, looked at me ominously and said in a thick Russian accent “Arrrrrre you bleetingk frugm your vfagina?”
I stared at her and shifted on my bed, looking back at Jill, she too was staring at me.
I looked back at the doctor and said ”What?” She said, “Arrrrrre you bleetingk frugm your vfagina?”
I answered weakly. “I don’t think so.” She said, “Are you bleetingk form your mouth?”
I licked my lips and then said, “No?”
“Not that I know of.”
She stared at me another moment and said, “Well, you probably will be.” With that she turned and hobbled away and out through the curtains.
Jill and I counted at least seven people in my room at all times.
My Freak Show curtain room was no bigger than 12 x 12.
The next doc to enter the room was a surgeon. I was told to consult a surgeon in case my condition worsened and an ugly surgery called a fasciotomy had to be preformed, or the worst-case surgery—amputation.
I had three different administrative people come in to see me while I was transforming from a human into a blimp. Two asked me about my “advanced directives.”
“Would you like us to resuscitate?”