The most embarrassing thing and a VERY itchy head

Offspring is at that age where he is obsessed with what makes people embarrassed, and all of the what-ifs scenarios. What if you barfed in front of the President? What if you peed your pants because you laughed so hard? What if you tripped and fell right on your face in front of everyone at your work? And so on. He's clearly in that stage, the one where he's starting to be self conscious. So yesterday when he asked the same question he'd asked 1000 times already, I was pretty sure I knew how the conversation would go.

Mom? What would be THE most embarrassing thing EVER to happen to you?
Ummmm, I dunno.

Well, *I* know what would be the most embarrassing thing ever for you.
Ummm. Ok. What would that be?
If you were a college professor, and you were up in front of hundreds - no a thousand! - students, and they were all looking at you, just staring at you, and it was just you up there .....
(inwardly groaning here, knowing what he was going to say)

.... and you opened your mouth to talk and you used poor grammar!!! Mom, you would totally die of embarrassment!
Ahhhh, my son does know me well. Poor grammar (as opposed to bad grammar) is a huge pet peeve of mine. I am constantly correcting him on verbal and written uses of words, especially adverbs versus adjectives. One doesn't run slow, but slowly (this reminds me of the entry about Offspring's grammar gun). I do find it interesting though that he said something about being a college professor - my mind must be projecting my desires to switch back to academics.

On another note entirely, Wheeler has a completely bald head now. On Sunday, after we got back from dinner, he asked me to look at his head and scratch it, because it was making him absolutely bonkers, itchy - super itchy all the time. I put him directly from his chair into the shower chair, which makes it much easier to have a panoramic view of his entire head. I could see lots of fiery red bumps and I was shocked at how many there were. As we've learned from the past, where there's smoke there's fire, so I suggested that we shave his head completely so that I could get a truly clear view and then treat it with my variety of potions and lotions. He agreed, so I shaved him completely.


Oh. My. God.

I was so incredibly horrified. His ENTIRE head was a fiery mass of angry red bumps, scattered absolutely everywhere, all over his head. The bumps I could see were maybe 10% of the ones that were there. I cringed inwardly thinking how much this much this must have been hurting him, and that he'd been suffering in silence. I still just can't imagine how horrible it must have been for him. I couldn't even bring myself to take a picture of his head to show him, which I normally do for all manner of things - pressure sores, infections, whatever, since he is physically unable to see most of his body (ask QuadCat, I photographed his pressure sore every day to track its progress). I - mistress of never being bothered by anything - couldn't even take a photo to show him, it was that bad.

First, I scratched the everlovinshit out of his head - after which I nearly had to hand him a cigarette because he kept saying ahhhhhhhh ahhhhhh ohhhhhhh ooooooooohhhh with a scandalous look of bliss on his face. Then I used Nizoral (ketoconazole based) shampoo on his head. I scrubbed it in really well, massaging it into his scalp, over and over and over again. I left him out of the shower, washed him up without the water running so that the shampoo could work its magic for longer. After I let it sit for about 10 mins, I washed it off, finished up his shower, and dried him.

At that point I was torn on what to put on next. Hydrocortisone would quiet down the incredible itching and inflammation, but this rash (based on experience) was almost certainly a fungal infection on his scalp. Hydrocortisone is a steroid, and fungal infections feed on steroids. If you aren't careful, putting a powerful steroid on a fungal infection can light it absolutely on fire. But, if I put on just an anti-fungal without a steroid, it would take at least a day for the itching to decline - and after seeing the angry rash, I couldn't deal with the thought of him being that itchy any longer. I gambled and put on a hearty layer of Rx strength hydrocortisone and then for good measure, smeared lidocaine all over the scalp.


Lidocaine deadens sensation - just like novacaine for dental work. In topical form, its used for cathing and all sorts of other applications, so we always have lots of it on hand. It has handy for intense itching because it just physically blocks the sensation. Unfortunately the effect is short lived and you can't put on more than about a quarter size dollop over the skin in any 4-5 hour period because high doses of absorbed lidocaine can cause seizures and even death. But, I could at least deaden the itching for 20-30 minutes after the shower and by then the hydrocortisone should start to quell the inflammation.

After putting on the hydrocortisone and lidocaine on, I put him in bed, babied him to death because I felt soooo badly for him, and then gave him oral fluconazole to try to fight the fungal infection from the inside out to balance against the topical hydrocortisone. A few years ago we battled fungal infections from hell on his head, his crotch, in the webbing of his toes and fingers, his armpits, anywhere it was dark and most - and the strains he had became resistant to absolutely everything Rx. It has been quite a long time since he had a serious infection though, so I hoped the fluconazole would be effective.

Well, whichever worked, I don't care because it worked. By Monday morning, his head was significantly better. I could see where the rash had been, but all of the pustules were gone, and the skin was basically just mottled from where the rash had been, but wasn't now. Since then I've been watching it like a hawk, and I've transitioned off of using hydrocortisone during the first 12 hours to using topical antifungals. So far, so good. And no matter how long I live next to a spinal cord injury, I will never, ever have a clue what it means to have one. Poor Wheeler. My ant bites seem rather inconsequential now ... perspective is important.

Clanging doors

Today I visited the Federal Medical Center (FMC) with our dog Dog. The FMC is hospital into which ill, mainly desperately ill, federal prisoners from all over the country are sent. FMCs take in all level of prisoners from low level non-violent offenders to supermax level felons. As a result, the security at the FMC is the maximum possible.

There are only 6 FMCs in the country, one being in Butner, NC which close to where we live. When locals here think of the prison in Butner, they think of the minimum security prison where among others, ‘white collar’ criminals such as Bernie Madoff are sequestered from humanity for 150+ years. The staff at the FMC call these local low security prison inmates campers, which for some reasons struck me as sort of funny in a sort of not-funny way. Perhaps like day camp, only free. And less fun. And you don’t get to go home on Friday. But this isn’t where I went; I was at the FMC, a nearby but totally separate place.

I am affiliated with a local professional therapy dog program run by a person who is truly kind soul with a pragmatic approach to life. In addition to the typical therapy dog program stuff, like visiting sick kids in the hospital and visiting nursing homes, he has been trying diligently to develop a ‘cell dog’ program whereby inmates raise and train shelter dogs to become more adoptable, and perhaps to even become service dogs. Search the internet for examples of these programs. They are truly in all ways a win-win proposition. However, the paperwork to develop this – and gaining the trust of the warden on down – is a long process. In the meantime, I have repeatedly expressed a high level of interest in taking Dog to do pet therapy at a prison. It must be the do-gooder in me, but I truly believe that there is no one so terrible that they shouldn’t get the pleasure of petting a dog. I’m sure that some would disagree with me, but of those I would ask them to follow me metaphorically through my journey today.

To get in, I could only bring a single car key and a form of photo ID, all else had to be left in the car. I filled out a number of forms and log books while Dog sat patiently and happily, being petted by the social worker who coordinated my visit. I went through a metal detector, noting that the X-ray screener type device was used even for a single sheet of paper to pass through into the prison. After I cleared the initial security, we visited a number of the administrative staff on the 1st floor. Perhaps this was to let me get used to the idea of being in a maximum security prison facility. Or perhaps they just really did want to meet Dog. Either way, everyone was smitten with Dog.

There were several more layers of security to get in, and yes, the doors clang. Loudly. We went to the hospital floors after we got through all of the clanging doors. Right off the bat, there were a number of inmates in the hallways, mostly in wheelchairs. We visited the men in the hallways and went individually to the rooms of patients too ill to be upright in a chair. Dog is what we call a ‘nudger’ – he will push his head up against you to signal his overwhelming desire to be petted. He nudged nearly everyone, and won over even those who initially expressed no interest in petting him. In one room, Dog – bless his heart – carefully jumped up, unprompted, and put his paws ever so gently on the edge of the bed of one inmate so that he could at least see him and perhaps reach over him to pet him. I do not know how, but honestly, Dog just knows who needs him. He really, truly does. I wouldn’t believe it if I didn’t see it over and over again with my very own eyes. He laid his head down on this man’s bed so that he could reach him, and the inmate reached over with obvious effort to try to touch Dog and could just barely reach the top of his head. I have no doubt that Dog sensed a deep need within this man, and Dog didn’t know what he had done before coming to be in that bed. He just wanted to give him a small piece of happiness, a tiny ray of sun, in an otherwise sad existence made all the worse for being near death alone in prison. I fervently hope that no matter what he did in the past that one of his last memories is of a beautiful gentle dog with his head on his lap.

Some inmates appeared to be very healthy, which confused me until I learned that they were low security inmates who became helpers to those most ill. From what I understood, these inmate helpers essentially perform nursing care and live on the floor with the patients for whom they care. These inmates particularly touched my heart because although there must be benefits to being on the hospital floors, perhaps a bigger room or more freedom to roam about – I don’t know – it was clear that regardless, they really cared for ‘their’ patients. One inmate helper propped up ‘his’ very ill inmate who was on a ventilator, holding him very gently, placing his hand gently on Dog so as to pat him on the head. The inmate, who is very near death, smiled every so slightly which caused me to fight off tears.

One of these helper inmates was so lonely and needy that it practically radiated out of every pore. He volunteered to keep Dog in his room if we needed to eat lunch or take a break, which is of course against the rules. If there were any possible way I could leave Dog there with him for an hour, a day, a few days, I would do it in a heartbeat. His hunger for the affection of dog was palpable and make my heart ache in concert with his loneliness.

Throughout my visit I was struck by the level of respect given to the inmates by the staff. All men were called by their last names preceded by “Mr.”. Based on what I saw – albeit a short time period – I believe that the people at the FMC see themselves as in the business of healing and rehabilitation, not necessarily in the business of punishment. All told, I spent about an hour on the floors all total and about an hour talking about logistics, meeting the administrative staff and clearing security.

It was an emotional visit. It was immensely satisfying to see my dog help so many people, even those that some deem unworthy. I am so proud that I trained him so well, that he is well behaved enough to do these things. But the credit isn't due only to me, we are so lucky that we found a dog with an innately gentle spirit who sees and loves the good in all of us, he somehow sees the part that makes us human. Dog recognizes need by instinct and responds to that need the best way that he knows how, by looking up with those giant brown eyes and by burying that soft poofy white head into a lap.

The day’s visit was also tremendously sad. Whatever these men had done, they were dying or were ill, more or less alone, in prison. Many of them will die there. At least a few will have died by the time I return next*. Some may have absolutely no one who cares if they live or die, and in fact, some may have those who fervently await their death as reparation for the bad things they did during life. This set of conflicting emotions were intense as I drove home and are spilling over as I type this.

No matter what anyone would say, no matter what it would seem, life is not black and white. There isn’t a bad person and a good person. Life is grayscale, a continium. Today Dog brought some white to the black and white scale that exists in these mens’ souls. For that, I am proud, sad, and happy. And because of that, I will be back every Monday. Count on it.

*update since I wrote this, about 1/2 of the inmates I saw the first time had died by the time I returned the next week. The social worker said to expect that, but it still was a shock.