So the other day we had a little old lady in for CT with a history of basal cell carcinoma of the face. She had apparently declined to be treated for the last 12 years, and it had been eating away at her face. Her family brought her in because it had suddenly started to bleed copiously. Emerg debrided her face, then sent her for CT. We CT’d her, I helped because I have a strong stomach, and weak sense of smell. Even to me, it smelled unholy, and she had blood all over her clothing.
After the CT was done, the nurse was adjusting things and took off the bandage, and I saw the great hole where her right eye socket had been, completely eroded away through the cheekbone, the stump of her destroyed eye, all in a pool of blood and red meat. The nurse, very kindly, pointed out the moving maggots still within her eye socket, even after emerg had cleaned it up.
Fortunately, the horror movies have totally desensitized me.
Later that evening a bat flew into the old, spooky house where I am staying, initially presenting itself by swooping right past my right ear and scaring the hell out of me. I spent 20 minutes girlishly chasing it, yelling at it and batting at it, trying to direct it to a window. Whenever it went the wrong way, it went via a route that attempted to intersect my head, and I would drop to the ground. Eventually if flew out the door.
Taken together, I figure that these events would be appropriate for the beginning of a teen slasher flick. I think I may spend the weekend at the old cabin by the lake and wander around half naked in the dark. Or not.
Not to make things worse, but did the bat touch you at all? Apparently, you can be bitten and not feel it. So it might be a good idea to follow up in case it was rabid:
I was extremely careful with respect to the bat, for exactly this reason. It went by, and in some cases at, but at no time did I think it was close to me or my bits.
Thanks for the article. Fortunately, the bat I was not bitten by was likely not on the most wanted list noted in the article, as I am still in Newfoundland, home of the Little Brown Bat, the Northern Long-eared Bat and the Hoary Bat.
I will be seriously re-thinking my aversion to medical treatment. I hate going to the doctor and the dentist, but should I be losing my face, I think I would certainly overcome my nervousness toward the medical field. Good god almighty.
Your story is very grisly but it’s sadly lacking in details.
So, how was the lady with the maggoty face? I mean, I’m not a medical professional of any time, but that sounds pretty bad.
Did she agree to get some treatment? Did they remove the maggots? Did YOU remove the maggots? Or leave them in to clean the, erm…wound. Order a prostetic eye?
Basal cell carcinomas are slow growing and not particularly aggressive (at least, until they eat your eye out :eek: ).
My 24 y.o. stepson has just had one diagnosed on his scalp. The doctor has scheduled him for surgery (Mohs, where they keep taking more tissue using a microscope until the removed tissue is all normal, very slow and not widely available in the UK) in 6 months time. No urgency there. If he had been much older, he probably would not have been treated - by the time the carcinoma got to a point where it might kill him, he’ll probably be dead or dying from something else.
But it sounds like the old lady had a real problem - management of the illness should have prevented what happened.
Now, see, the whole ‘bat flying around the house’ thing doesn’t bug me at all. OTOH, the whole ‘eye missing and maggots crawling around in the socket’ thing, that was pretty impressively horrifying, and I don’t horrify easily. Yeesh.
Basal cell carcinoma (BCC) is, as mentioned elsewhere in the thread, very slow growing and essentially doesn’t metastasize. It does erode locally, and is sometimes called the ‘Rat Bite Cancer’, since it makes a person look like they’ve been chewed on. In this case, the woman was living with her family and had refused treatment some 12 years ago, and had not been seen since. Her family made her come in when a blood vessel burst and she started bleeding. The BCC had gotten into her eye socket and her eye was gone, that is to say there was a central stump, but no actual functional globe.
The consensus was that the maggots had probably been a mixed blessing, since they would have kept the wound clean, keeping her from getting an infection in the soft tissues of the face - potentially leading to bad stuff like brain abscess. On the other hand, they probably didn’t help social life. We were scanning her head to figure the extent of the BCC as well as to look for abscesses and suchlike. The ER had washed out the seething bulk of eye socket maggots, I only saw the hardy survivors of the deluge.
Treatment-wise, the only option would be radiation therapy, to try to slow down the advancement of the BCC and keep it from eventually hitting something vital. And keeping the wound clean would be good. But she’d have to come in to the hospital for treatment, which was the start of the problem. I don’t know if she’s been referred to social work.
With regards to the bat - I realized that my attempts to chase it out the window - while yelling “use your damn sonar, for Christ’s sake” - were not helping, and were eventually going to get me bitten, or it injured. I walked out of the room and stood by the door, and eventually it flew past.
However, it gave me new purpose in life, and now I’m writing this from my secret lair, taking a break from sewing lycra after a punishing workout in the danger room. Can’t say anything more, or DC’s lawyers will get me.
When I was in nursing school, going through my least favorite rotation (Ambulatory care) We saw lots of basal cell carcinoma. Most on the tops of ears. It was know as Farmer’s ear. Attack from the 3rd dimension, I could make you cry. I’ve been very careful to not tell over the top stories. I’ve made the mistake IRL. I’m not always welcome at dinner parties.
sigh
I can handle the gore in movies and books/stories, but not IRL, which is one reason I did not finish nursing school. Bless all the nurses, doctors, paramedics, and anyone else who has to deal with this kind of stuff first hand!
In that case, start a “What’s your favourite gory true story” thread in IMHO. You start, I’ll contribute, we’ll get the veterans in, and soon it’ll be so cathartic we’ll have government funding.
I’ve seen what used to be a breast when a woman is in denial about CA and just doesn’t look at the suppurating rock which is leaking mucusy, green and grey foul smelling drainage, and uses a maxi pad to keep it “contained”.
But I think I’d blench at the eye socket.
I’ve been very careful to not tell over the top stories. I’ve made the mistake IRL. I’m not always welcome at dinner parties.