Beda and Bites

Monday was hell. Actually it started last Sunday.

Mom went to visit one of our neighbors at their house. Our neighbor, Mr. Ed, was recovering from motorcycle accident. Mom went with a group of their neighborhood friends, all present or past members of the board of our homeowners association. Just my mom's luck that she got bitten on the knee by our neighbors' dachshund. Weird thing was she entered the house second. Ate Dee, who entered first, wasn't bitten. Six of the dog's fangs punctured her skin. Like I said, just her luck.

Mom was scared, who wouldn't be. Tita Edith, our next door neighbor, accompanied us to the emergency clinic. A few years back I accompanied Tita Edith and best friend Ian when Justine's son got bitten on the face. Thanks, Tita Edith!

Anyway, I found out that even if the dog that bites you is vaccinated, it is not enough. As a safety precaution, you still have to receive a lot of injections. Heck, better be safe than sorry. Anyways, at the emercency clinic which is also a dog and cat bite treatment center, E-med in phase 1, it was explained that mom would have to get injections of four types of medicine. I'm not much of a medical guy, but I'll try to reconstruct. These are:

1. Verorab (which had to be injected on different days based on a schedule)
   
2. Tetanus Toxoid
3. ATS or ERIG
4. Immunoglobulin

All of them are important in the anti-rabies / anti-tetanus process. Mom got the Verorab and Tetanus Toxoid at the clinic. ATS had to be skin tested since there is a chance of allergic reaction. Actually the skin tests hurt a lot. Mom had an allergic reaction to ATS so the hypoallergenic ERIG could have to be taken. Problem was, the clinic didn't have ERIG. Immunoglobulin, which had to be ordered from Mercury Drug, also wasn't in stock and costs way too much. The amount of medicine was computed based on body weight and Mom needed three vials. Each darn vial costs PhP6,000! That's already PhP18,000! Good thing Tita Millie would take care of the bill. But it's still too much. We had no choice but to go to either RITM (Research Institute for Tropical Medicine) in Filinvest, Alabang or San Lazaro in Manila, but this is more because of availability rather than cost. These two institutions are recommended for dog and cat bite treatment. So mom's ordeal had to continue yesterday, Monday.

We decided to go to RITM which is nearer our place. Had to take a leave of absence from work. I thought we'd be finished by noon, I was wrong. The lines and waiting period was so long that Mom was attended to at 3:00 pm. On the way home we nevertheless agreed that it was worth it since the doctors and nurses there were very experienced in this sort of thing.

Anyway, there were several choices involved. The inital Verorab given was intramuscular. Mom had the choice of continuing it or opting for the Verorab commonly prescribed by RITM which was intradermal. The intradermal option meant she'd have to start from zero which meant that the initial Verorab shots the day before nullified. She opted for the reset and was prescribed the intradermal.

ATS was tested again just to be sure, so was ERIG. Waiting time was 30 mins. She still had an allergic reaction to ATS, but she was okay with ERIG. So she was prescribed ERIG.

At the RITM there were a lot of patients, a lot were first bite patients, the others were follow up injection patients. The follow up line was so looooong! At about 4:45 pm Mom had her barrage of shots. I held her hand. I stopped counting the injections. There were about a couple for each arm, one near the butt, one on the hip, and a lot near the vicinity of the wound on her knee. The wound bled a little. Damn those have got to hurt. But Mom's one tough lady, which probably explains why she has a couple of tough kids (ooohhh, I'll be waiting for the side comments to that one).

Waiting time after the injections was 30 minutes for any adverse reactions. While we were waiting  we traded stories with the others still waiting in line. One mom was bringing her kid for the shots because she was afraid. She was a first-hand witness to the effect of rabies. Her brother was bitten and he relied on folk medicine, "pagpapasipsip sa bato", they called it. It didn't work. In about a month's time he had to be confined in San Lazaro, crazed, fopaming at the mouth, afraid of air and water. Despite being restrained to the bed with belts he was still able to run around with the bed along the corridors. The only thing which was able to stop him was when an orderly chased him back to his room with the air from an electric fan. My sister had a similar story. One of their students died a month after being bitten by their cat. The student didn't tell anyone.

Through the whole ordeal I found out that RITM and San Lazaro can offer the medicine cheaper. In private institutions, you have to buy the whole vial of medicine and they will have to inject the whole vial even if the dosage is less becasue if they don;t the medicine will go to waste. At the RITM and San Lazaro, the exact dosage can be extracted from the vials and the remainder used for other patients. I'm not sure but Marian, my officemate, told me that in San Lazaro you find a partner patient in some cases so things won't go to waste.

I also found out that Verorab has to be administered based on the type and on a strict schedule. It depends on the doctor and the institution. E-Med prescribed the intramuscular to be administered on day 0, 3, 7, 14 and 28. RITM prescribed the intradermal to be administered on day 0, 3, 7 and 21. After all the stories we were finally out by 5:10, just in time for the 3rd quarter of the NCAA Men's Basketball Finals between San Beda and PCU. We trodded home, I had a splitting super-headache because of the heat and of all the waiting and lining up.

By the way, San Beda won. So now they're 1-0. All they need is to win the game tomorrow and SAN BEDA WILL BE THE NEXT NCAA CHAMPIONS!!!

So tomorrow, I'll be wearing red. BECAUSE REAL MEN WEAR RED!



GO SAN BEDA FIGHT!
For San Beda, our country and God!
U.I.O.G.D.