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BROWN RECLUSE - THE ENTIRE STORY

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[Memorial Day Weekend] Friday, May 28th, 1993. An amusing side to this story is the fact that the reason I ever went into the basement closet was to find a book to use as reference material for an article I was going to post to another group on this network! Well, anyway, I knew it had to be in a box in a closet under the stairs we use for storage. There are also a bunch of old coats and clothes hanging on a rack. The boxes I was going through were underneath this rack of clothes and I moved them with my body as I bent over to look for this book. I can't remember, but I either had no shirt on at all, or a short sleaved shirt. It was warm here in Utah that weekend. We live in Bountiful, Utah, approximately 15 miles north of Salt Lake City, along the mountainside called the 'east bench.' Prior to this time, I had never heard of the brown recluse in my life. Growing up, we were only told of the black widow. You see them around once in a while, but generally they just stay in a corner by themself and y

Saturday, May 29th, 1993, 11:32 AM (Sounds like Dragnet don't it?) I had finished mowing the lawn and came in and took my shirt off to cool down. I was sitting in front of the TV and I was just rubbing my hands along my arms when I felt puffy skin on my right arm, near the shoulder. I looked and saw an area about the size of a quarter that appeared as though it was burned! It shocked me because I couldn't figure out what could have happened. My immediate thought was that I did it just minutes before while I was outside, but I couldn't possibly see how. The skin was wrinkled and thin. It appeared to have 'pus' under it so I grabbed a kleenex and just hardly touched it. The skin came awayeasily and a yellowish-brown fluid discharged. I'd never seen anything like this. At this point it looked harmless, like a blister or floor-burn. The area left after the skin came off was just light red or pink and seemed as though it would heal-up and be gone in a day or so. I didn't put anything on it or even give it much thought the rest of the day. By 8PM the area had increased to about the size of a half-dollar and looked bad. I had taken a shower and was getting ready to go out when I looked at it. It was weaping clear, light-yellow fluid and the skin had strange spots and was appearing to turn to a dark red color. I showed it to my Dad and he thought 'it looks like impetigo.' My mother didn't think so, she said then that 'it looks like you've been bit by something.' I decided to put 'Gentian Violet' on it.

(Now, this was a mistake in the fact that the dark violet color hinders diagnosis because color is an important part of identifying problems on the skin. Doing this did cause a slight delay in diagnosis. However, of all the things I tried, viz., Hydrogen Peroxide, Burn Cream, Hydrocortisone, and Neomycin, it was the Gentian Violet that seemed to work the best. If I were bitten again, and knew I was bitten, I would use Gentian Violet for at least the first 6-7 days. Anyway, back to the story...)

Sunday, May 30th, 1993, 7:45 AM. Get out of bed and --- YEECH! What have I got on my arm? It was weaping something fearce and there were 3 spots on the sheets where it had weaped yellow fluid but they were also stained blue from the damn Gentian Violet which drained out along with the fluid. Now, I had a thin piece of gauze taped over the wound, but it had drained to the point that it had become saturated and oozed through to the sheets. That's how much it was leaking. Gross. I shower and before I had put more stuff on it that day I noticed that our neighbor, a Pediatrician, was walking by the house. As I picked-up the morning paper I asked him to take a quick look at the ulcer on my arm to see if he had any idea what it was. (I'm sure doctor's are constantly asked about things by neighbors, but no more so I guess than I'm asked about computers). He looked at it and said, "You need to have this looked at, today if you can." Today? It's Sunday on Memorial Day Weekend - What's the sense of urgency? "That might be a brown recluse bite and I would really have it seen today." he said, and added, "Don't put any more of that violet crap on it." It kind of shook me up that he had a sense of 'do it now' to his voice. At 11 AM I went to the Bountiful "Instacare" (An 'always open' chain of medical clinics in the Salt Lake City area). The doctor said she was sending me to Salt Lake City LDS Hospital Emergency room right away. That she felt it was indeed a spider bite, but needed it confirmed and the clinic couldn't handle 'surgery' there if it was required. This really scared me to d the 'violet shit' I put on it. (Those are the words he used). So, I got a painful shot of antibiotics in the rear. (Don't know what or how much unfortunately. I usually ask about everything I'm getting but in this one case I forgot). I was started on Prednisone (20mg - 4/day for 4 days, 3/day for 4 days, 2/day for 4 days, then 1/day for 4 days), and basically told to see my personal physician on Tuesday. Topically, I was to put bacitracin on twice daily when I changed the 2 x 2 guaze.

Monday, May 31st, pain begins. I have diarrhea, stomach cramps, hot/cold flashes but didn't even once consider it was in any way related to my possible spider bite. I went to the store and bought several cans of Ortho Indoor Insecticide, making sure that the brown recluse was listed on the back of the can. Apparently, lindane is a necessary ingredient to kill them. I went to the basement and sprayed like crazy. We have no children nor pets so I really went wild. No one sleeps down there either. I had been asked the previous day by the doctors if I had been in any attics or dark closets,etc. At first I had said no. It didn't even hit me until sometime later when I remembered going into the closet for that book. That was the only 'dark unfrequented' room I had been in in the last several days. I gave the closet under the stairs a double-dose. Then I closed the doors to all of the basement rooms and made sure the windows were shut. I left it that way for hours, then went it and sprayed again. I wasn't messing around.

Tuesday, Jun 1st, I see my doctor in the morning. I was lucky to get in - there had just been a cancelation and apparently he was booked solid from the long weekend. By now, most of the violet stain had disappeared. It was the size of a dollar and looked terrible. I hurt terribly and didn't feel well. He didn't know what it was but wanted me to see a dermatologist in the same building. He set up the appointment himself as he didn't want me waiting more than a day at most to get in to someone. The appt. was for Wednesday. He told me to stop putting ANYTHING on it. Just leave it completely alone except for the guaze to soak up the drainage. He wanted the dermatologist to be able to see it without it having been affected by anything. At this point, the pain wasn't bad enough that I needed anything and I didn't even ask. When I got home that night, my Dad and I carefully removed everything from the closet under the stairs. We found 2 dead spiders. One was a small common black house spider, the other was strange. We had never quite seen a spider like this in Utah. It's legs were smooth and light brown. It's body was definitely brownand the fangs on its head were huge. On the cephalothorax was a little brown 'line' that on inspection with a magnifying glass looked like a small upsidedown violin. Bingo. The violin spider. It was so damn tiny! "Oh, come on.", my Dad said, "How could this little thing do that to your arm?" I doubted that it did also. My Dad thought about it, then said, "Hmmmm. It's so small it makes me wonder if there isn't others around here. Maybe this is just a baby one." The entire breadth of it was no more than the size of a nickel.



I saw the dermatologist and my regular physician each Wednesday for the next 3 weeks. I watched with dismay as the wound increased in size and swelling began in my right arm. After about 2 weeks, it began to 'separate' into 2 circles. At first they were hooked together like a figure eight (8), but gradually they separated into 2 distinct circles (OO) about the size of a half-dollar each.

Pain would wax and wain. The wound looked awful, after 2 1/2 weeks it turned a honey-brown color and looked disgusting. The purple part came off and I had 2 nice 'holes' in my arm, the pieces that came off were almost 'corroded' looking, not like a scab or skin or anything else, but like tissue that was destroyed. It was kind of scary. Each day you think, "This has got to be as bad as it's going to get, I'll be improving soon." But it goes on and on. And you can't hardly believe that it's expanding. I took good care of the wound and changed the bandages and took my medication religiously. Finally, the color of it concerned the dematologist. The honey/color suggested to her that staph might be in it. On Tuesday, June 22nd, she had me go in for a biopsy and possible surgery. Here's the posting I made to the news when I returned to work 2 days later:

GAK! I'm back!

Well, for those interested, here's what happened...

Biopsy confirmed presence of staph infection and deep areas of necrosis so they laid-on surgery for 11:30 AM.

Went in and stripped. Was given Valsed (not sure how much) and 150 mg Demerol. 20 minutes later I felt wonderful and scared to death. They put iodine on the arm (felt cold), then told me the numbing injection would be painful. Boy they weren't kidding. One nurse actually held me down on the table with both hands on my chest. Apparently it is an involuntary reaction to 'jump' and I did. The doc said, "OK you're going to feel the needle." And I certainly did, but it didn't hurt anything like the Xylocaine (or was it Marcaine?) going in. Good Grief that hurt like nobody's business.

Well after just a few seconds the pain went away. They used a 'burning needle' to cut away and I remember seeing smoke drift up towards the ceiling. I was starting to enter la-la land and my memory gets foggy here. I do remember a LOT of honey-colored crap being taken out. I felt them 'tugging' and heard 'noises' but felt nothing. Anyway, the doc told my Dad that he was 'suprised' at how much tissue was involved and just 'mascerated.'Dad said I had a 'hole' in my arm that was pretty deep. Approximately 6-inches long roughly the shape of a banana or diamond. It was sewn up and it HURTS. I don't even use my arm to try to open a door as it invokes pain. I drive with my left hand. To sit here and use the computer - I push the keyboard to the back of the desk and rest my arms on the desk so that no muscles are needed to support my arm.

The docs say, "Now, if we were to remove tissue from your left arm it would heal nicely. But this area here in your right arm is *not normal tissue* and it also has staph in it. Therefore, I'm on Cephalexin (250mg 4/day), Prednisone again (same dosage regimen as before), Dapsone (which required blood tests and crap), and my old friend that has helped me combat the pain: Mepergan Fortis.

Ladies and Gentlemen, if you have these things in your area I implore you to call Orkin. We spent $125 for inside and outside spraying by them and they found 2 more down behind a deep freezer we have in a darkened room not frequented. I don't know how much all of this is going to cost me but I'm sure it won't be cheap. The surgery I had will probably reach $2000.00.

Well, Today is June 28, 1993, 32 days since I was bitten and 6 days after surgery. Finally, finally on Sunday I could tell I was not only feeling better, but my arm is getting better. I can see absolute signs of healing going on. I'm sure now, that this thing will be healed up soon. I'll have a scar, but it will be a long thin one, instead of 2 huge round ones. The skins is red around the scar and there is a kind of scab there but I'm not worried about it anymore. I'm getting good use now out of my arm (it doesn't hurt nearly as bad - I can even open a door now) and I'm well on my way to recovery. I've only taken 1 pain pill all day and I wonder if I'll need one tonight. Thanks for all of your concern and thoughtful letters. If anything else happens - except for normal healing - I'll let you know!