Wednesday, May 31, 2006

Here's What It's Like to Get Rabies Shots

Jennifer, the nurse from the health department, called Monday evening to see if we had found the bat that had woken us up the other night. We hadn’t. She wanted to know if either of us had been awake, or even half awake, when the bat flew into the room. We both had been sound asleep.

Unfortunately if you want a public health nurse to tell you don’t need rabies shots, those were the wrong answers. She had wanted to know whether we could say with any assurance that we had been aware of the bat’s whereabouts and that those whereabouts didn’t include our skin. But we couldn’t say that.

She told us that a doctor from the health department would call by about 9:30 today, with more questions and instructions, but that we’d have to start treatment. Where do we do that? One of us could pick up the vaccine and the immunoglobulin at the health department office in New Rochelle, she said, and bring it to our doctors. We’d need a vaccination and immunoglobulin on the first day, and then more vaccine on the third, seventh, fourteenth and twenty-eighth days.

Someone from the health department finally called at around 11 the next morning. Her instructions weren’t quite the same as Jennifer’s, or quite as simple. Your doctor has to order the vaccine and the immunoglobulin, she said. Then it’ll be sent via overnight courier.

I called my doctor and at 2 p.m. he got back to me. He’s a good doctor, always sympathetic, and I like him because about seven years ago he saved my life; but he and his colleagues run the New Canaan Medical Group like a business and if something is inefficient or gets in the way of their practice, they don’t tolerate it.

Such is the case with rabies shots. They gave up administering them about five years ago, he told me, mainly because it was too much trouble. He said we’d have to go to the emergency room at Norwalk Hospital, and they’d make an appointment for us to get the shots at a place called Express Care.

Express Care turned out to be the part of the Norwalk Emergency room where they treat people who don’t quite have real emergencies. It also turned out that the word “Express” was something of an overstatement.

We got there at 5 and checked in with the emergency room nurses, who were happy to make jokes about the numerous shots we’d be getting. Rabies immunoglobulin is administered based on weight. The more you weigh, the more you need. A smaller person will need fewer shots than a larger person, the nurse told us, and she looked at me with her eyebrows raised and a little smile on her lips, as if to say, “You’re in trouble, buddy.”

She said that when she was a kid, she and her friends caught bats, and no one worried about rabies. To me that emphasized the one undeniable truth of this episode: if a bat flies into your room, you don’t really need rabies shots, but no public health official or doctor or nurse is willing to tell you that.

We were sent to the waiting room. After a few minutes, a woman emerged from an office and called my wife’s name and then another woman emerged and called my name. They were ready to register us. Each went back into her office and had us sit in a chair separated from her by a thick plastic ticket booth-type window. My registrar, whose name was Colleen, told me bats had been living in the attic of her house and found their way into her son’s room three times. He got the shots the first time, she said. The second and third times he didn’t bother.

We went back to the waiting room. Soon a nurse came out of the Express Care doors and called our names. She had orange hair and wore blue scrubs – the Mets colors, I noted irrelevantly. She led us into a small room set up for eye exams.

“Wait here and someone will be in to talk to you, to figure out if you need the shots.”

“You mean we might not need the shots? That’s not what everyone has been saying.”

“Were you bitten?” she said, and she smiled as if she knew something we didn’t.

She shut the door and we waited. We read. We chatted. We looked at the eye charts on the wall. After half-an-hour a doctor came in. He told us that rabies treatment was effective but that it wasn’t really based on science: there’s no evidence that you’ve been exposed and there’s no evidence that you can get rabies from a bat being in your room. But we’ll treat you anyway, he said.

“The truth is,” I said, “no one is willing to say we don’t need the shots.”

“I’m not saying you do and I’m not saying you don’t,” he said. “It’s your decision.”

He told us he had ordered the immunoglobulin and the vaccine and that it would be up soon. Gina was particularly worried that the immunoglobulin shots would make her muscles sore over the next couple of days.

“How much of it do we need?” she asked.

“One shot,” the doctor said. “For you, one teaspoon full. For you [he looked at me], two teaspoons.”

He left. Outside at the desk the staff was talking about the immunoglobulin and the vaccine, and about the schedule for future shots. A nurse was trying to write down on a form when we’d need to return – day three, day seven, day 14, day 28 – and was having an extremely difficult time figuring out when those days would be.

After about 10 minutes, two nurses – a man and a woman – approached bearing hypodermic needles. The woman told us we’d get the vaccine in the arm and the immunoglobulin in “the heiney,” as she put it.

“Two for you,” she said to Gina, “and four for you.”

Although my courage has improved in recent years, I’m still an enormous baby when it comes to getting injections. I don’t like to see other people getting a needle, I don’t even like to look at the needle. The nurses’ plan was to administer the immunoglobulin and the vaccine to me and Gina at the same time, in the eye-exam room. But I didn’t want to have to see and hear her getting her shots, so I asked if we could do it separately. The nurses were surprised but happy to accommodate us. I stepped out into the area near the main desk and as I waited, my nurse decided she might as well at least administer the vaccine and so with surprising quickness, she wiped my upper arm with an alcohol pad, jabbed the needle into me, wiped it clean, and we were done with that part.

As for the four shots of immunoglobulin, I’m afraid I have to report that they weren’t so bad. The nurse was quick and reasonably skilled – the first shot didn’t hurt at all, the second hurt a fair amount, and the other two were in between. By 6:50 we were done and on our way home.

We have to return to Express Care four times over the next month for more vaccine. Unfortunately they do not make appointments and we were told that each time, we’ll have to register anew, and so there’s no telling how long it will take for what should be a five minute procedure.

But do we need it? I don’t know. All I know is that no one was willing to say we didn’t.

22 Comments:

Anonymous Rob Carlson said...

Wouldn't an absence of puncture wounds be sufficient?

3:07 PM  
Anonymous Anonymous said...

sexy

9:07 PM  
Anonymous Haley said...

How long was the needle? Oh man that must have hurt.

7:21 PM  
Blogger Joanie said...

I was glad to find your rabies story which so closely parallels my own frustrating experience with public health/emergency. I was bitten by a dog in Peru- other than hungry it seemed okay and my puncture wound was immediately scrubbed with soap and running water- no infection occurred. It's now a month later besides. Still trying to decide whether to go ahead with the treatment (left emergency in disgust as the nurse's confusion and waffling drained any confidence I had in her competence to properly administer the vaccine and immunoglobulin).

8:44 AM  
Blogger Dago de Madera said...

Yeah, I just got the day 0 post exposure rabies treatment 2day - 3 shots of immune globulin and 1 vaccination. I too am a baby when it comes to injections, and it took me more than a week to get up the courage to go do it.

I may have been bitten by a bat on Sept. 22 - 13 days ago. I was riding my motor bike right at dark, heard a squeak and felt something land on my neck - felt like and insect with sticky feet. I forgot about it until 3 days later and when I looked at my neck, there was a scab. Then I started reading all the horror stories on the internet. Basically, people have died who woke up with bats in there room. I also read where people said the shots really hurt. I actually chickened out twice and left ER without getting the shots.

Today, I had my dad go with me which helped a lot. And the shots did not live up to the horror stories. Like I said, I got 3 globulins and the first vaccine. I bit a wad of gauze and carried on a bit, but it was all just in case and not necessary. The shots weren't half as bad as I was afraid they would be, certainly not as bad as I remember Penicillin shots being.

The moral of the story - the shots aren't worth sweating. If you need 'em, just go get over with and don't wait 'til tomorrow.

Don't mess with rabies for even as long as I did (I hope it did it in time). Its a very deadly virus that only few have survived. I should've had the first on the night of Sept. 22. I spent the last 7 days in fear and dread of dying and getting nasty shots. It was all for naught.

Again, as already said, THEY DON'T HURT THAT MUCH

12:26 AM  
Anonymous Anonymous said...

I was bit by a rabid fox early this month while just taking out the trash. Getting bit definately means you get the shots. They hurt. I was sick after several of them like I had the flu. Very bad muscle aches and pains all over and dizziness. I guess it depends on the severity of your bite and exposure. They give you shots in each wound when you get bitten as well as the immugoglobin. Like the person who posted this story I was told my regular doctor couldn't administer. I had to go to express care to get them.

8:26 AM  
Blogger Rick said...

It's like the nurse told me in a similar situation, only 1 percent of bats have rabies, but 100 percent of people who get bit die. Do you want the shots? I got the shots.

11:43 AM  
Anonymous Anonymous said...

Sorry post is ancient, but here are the 'non-bite' means the rabies virus might transfer.

http://rabies.emedtv.com/rabies/rabies-transmission.html

It is extremely unlikely that you were in danger, but the docs didn't know 100%. That's why they wouldn't say you didn't need the shots.

1:56 PM  
Anonymous Anonymous said...

Thanks 4 all the info my son was bit and i have heard bad storys but this makes me fell alittle better for him still upset about the whole thing

3:36 PM  
Anonymous Anonymous said...

I am in same situation. Was going to bed one night and suddenly a bat flew out of my bedroom. I have reason to think it had been in my room a few days earlier as well, since i had heard strange flapping sounds. As with you, since i couldn't say with assurance, the Health Dept. is now calling me every day to come and get post-exposure shots. I am terrified of the toxic effects of the shots and am nearly certain i wasn't bitten anyways -- but like the stories go, it's apparently possible to be bitten without seeing any marks or waking up from your sleep. I still don't know what to do, and i am close approaching their "10-day limit"...

9:27 PM  
Blogger Buddhalicious said...

Wow, I'm so happy to have arrived at this page from google! I actually handled a compost bin that was chewed by raccoons last week, still wet with what I assume was saliva. I'm pretty sure I wiped my eyes too. I've spent the past days sorely regretting that I didn't immediately get the shot. I'm getting it today after work and I hope all will be fine. I'm actually also headed to Norwalk Hospital, and glad to hear it's the right place to go, as an EMT I'm didn't want to be one of those patients who goes to the ER for no reason. Thanks so much for sharing your story, it really put my nail-biting at ease. Also, bats are very dangerous as far as rabies go. A few years ago a girl down in Greenwich died of rabies from a bat she didn't even know had bitten her. Most US rabies deaths are from bats. Good to hear you erred on the safe side and got the vx anyway!

7:46 AM  
Anonymous Anonymous said...

I'm a science teacher who touched the back of a bat a student found on the ground on campus. I was trying to determine if it was alive or dead. Long story, short - The Health Dept. told me that bats clean their fur like cats and dogs do - by licking - therefore their fur could harbor the rabies virus from their saliva. Insisted I should get the series of vaccine shots. I felt like that was over-reacting, but when she said "It's either take a few shots, or if you do happen to get it it's too late - it's 100% fatal," I decided I could handle a few shots. I had 3 of the immunoglobulin in my butt cheeks, and have so far had 3 of the 4 shots in the arm. No problem, no pain, no side effects - but now, no worries.

9:39 PM  
Blogger Kathy's Cupcakes said...

So my animal lover self saw 2 dogs walking on the side of a very busy hwy today; I stopped wanting to see if they had collars, etc. They approached me and were very friendly; I pet them a bit, they weren't very skiddish. One had a collar the other didn't.

Well, my stupid self decided to try and pick the one up that had the collar on and put him in my car to save him (and the other) so they wouldn't get hit by a car....well, he nipped/bit my finger and did break skin, I washed it with soap and water when I got to work, about 30 minutes later, and ran some rubbing alcohol over it.

Thoughts? Suggestions?? Do I need to get the shots....? (ugg-scared to do so)

11:41 AM  
Blogger Kathy's Cupcakes said...

So my animal lover self saw 2 dogs walking on the side of a very busy hwy today; I stopped wanting to see if they had collars, etc. They approached me and were very friendly; I pet them a bit, they weren't very skiddish. One had a collar the other didn't.

Well, my stupid self decided to try and pick the one up that had the collar on and put him in my car to save him (and the other) so they wouldn't get hit by a car....well, he nipped/bit my finger and did break skin, I washed it with soap and water when I got to work, about 30 minutes later, and ran some rubbing alcohol over it.

Thoughts? Suggestions?? Do I need to get the shots....? (ugg-scared to do so)

11:41 AM  
Anonymous Anonymous said...

rabies shots hurt! had 4

10:59 PM  
Blogger Christine Oliveira said...

No because bat teeth are so small you don't even feel the bite, nevermind see it

7:09 PM  
Anonymous Anonymous said...

A litle late,see the doctor,inmediately.

8:46 AM  
Anonymous Anonymous said...

Hi, I am a senior at Indiana University. Last year a bat flew through the dorm building and bit 2 girls. One girl died of rabies. The bat was caught and tested positive, but the girl did not receive treatment soon enough, she didn't know she'd been bit. The other girl knew shed been bit and received vaccinations, lucky her. If your not sure if you've been bit or not just get the shot. A shot is nothing compaired to death.

10:35 PM  
Anonymous Anonymous said...

Personally, I read about what happens when humans get rabies, and even a .001% chance was enough to get my ass into the hospital for those shots.

2:30 PM  
Anonymous Anonymous said...

I went to the hospital twice for possible bat exposure at 5:30 am in Las Vegas while walking dogs. At the hospital they wouldn't give me the shots. They didn't think it was likely because I didn't actually see a bat or bird or whatever fluttered by my ear. I showed then where I was scratching but they said they didn't look like puncture wounds. I can't understand the lack of knowledge or care amongst clinicians. It's now 28 days later. I pray I'll be ok.

6:14 AM  
Blogger Mic John said...

My daughter was either bitten or nicked by a dog. The dog was with it's owners and had a collar so I'm 99.9% the dog did not have rabies because the owners wouldn't walking the dog at the park. However Urgent Care decided to call CDC and told the doc that if she was bitten that she should take the shots. I think this is a bit out of hand but since I no longer know where the owner of the dog is or lives I decided to do the shots. Today was the first day and she took it like a champ. They put some type of creme like novacane to numb the wound. She got 4-6 shots to the wound and one on each leg, which hurt her more than the ones on the wound which she didn't even cry from. My daughter is 5 years old. So I think the shots are over dramatized by people who are really afraid of needles.

Now she has to go back in day 3 and day 7 then day 14 and day 20 or something like that. I would like to mention the staff seemed clueless and inexperienced. I'm worried that the vaccine may cause an affect on my daughter now more than the shots. Well that is my story. Good luck to those who have to deal with the same as my daughter did. So far it is the time waiting that has been the worse part. Good Luck.

10:13 PM  
Blogger Mendi Davis said...

I received my final shot today. Shots were not so bad except the one at the site (my pinky finger- the swelling for the amount of immune globins injected made the finger swell to a painful size). But I have been incredibly sick after each shot for several days- nausea, , vomiting, flu like symptoms, low grade fever, swollen lymph nodes, etc. Doc said the vaccine can cause this reaction in some people. I am just thankful it is over. No more - oh look at the cute raccoon for me!!! Not my smartest moment.

12:38 AM  

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