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Friday, February 19, 2010

What's That Smell?

The world is full of odoriferous emanations. Not all of them are pleasant but hey, how else are you gonna find a meth lab or a body dump? I was consulted by a walk-in about her friend's wound that she was too embarrassed to come in and ask about.

I LOVE wound inquiries because many times they have a good story attached. Any time I get a patient in from the ER with a bandaged finger, hand or arm I will ask them "Did you try to cut it off or just break it?" Many times I will get a laugh and a story because they are already full of pain killers and need a little something to forget about the sh*t sandwich life has given them to eat today.

So her friend had a boil under her breast that popped. So she just slapped a Band-Aid over it and went about her life. Several days later it is a big stinky hole and she still just keeps it covered with a Band-Aid because she is too embarrassed to ask a medical professional about it.

This leads me to think to myself, "Self? What holes on the human body normally stink?"

The nasal openings don't stink unless there is an infection in them.

The mouth stinks when you haven't brushed in a while because it is a cesspool of bacterial activity.

Skin pores don't normally stink unless you sweat a lot and/or don't bathe on a regular basis.

The anal opening will smell a little like poop no matter what you do because it is a sewer opening.

The vagina under normal operating conditions is pretty much odorless unless Aunt Flo is visiting or you have a swarm of yeast or bacteria hijacking your pleasure pool.

The urethra will generally have a pee smell but will smell worse when infection in the urinary tract is present or you eat asparagus.

So the prevailing answer is infection! DING DING DING, WE HAVE A WINNER!!! Bacteria find our subdermal soft tissue delicious! We are the walking talking microbial equivalent of a Las Vegas buffet: open 24/7 and a nice comfortably warm place that tempts you to stay f-o-r-e-v-e-r.

So I tell her to relay this very important message to her friend: Clean the stinky hole out with hydrogen peroxide, cover with Band-Aid and call her primary care physician as soon as the office opens in the morning or go to urgent care to get some oral antibiotics. She is well beyond the point where Neosporin and a Band-Aid will fix it. It will get much much worse if not treated now.

This also leads me to wonder how people can let something fester like that and not even think about seeing a medical provider. Hey Captain Obvious, it is getting bigger and it stinks. Get some antibiotics, for f*ck's sake!


Drive Thru Wench said...

I had a patient come in and show me a fungal infection that was so bad her skin was raw pink. Wha... you have Medicaid, why in the world would you let that go on to that point? And it was between her breasts so she of course, pulled down her top and let me view her saggy Aggies in front of our drop off.

Tanya said...

eeww-don't they have basic health classes in schools any more? Isn't this kind of stuff pretty basic common sense??

Allison said...

Right before Christmas we had a Mom come in to our pharmacy for her son, said he had slammed his hand in the car door a while back. The finger had now turned black and smelled funny and bubbled when you put it in epsom salts/water. She honestly wanted to know what she could do for her adult son that was over the counter. We directed him to the nearest ER facility....

Big 'N Tasty RPH said...

I wonder how long it took that finger to go from smashed to gangrenous (why do I suddenly crave an Almond Joy) and what was the final tip off that made them come in to the pharmacy: the bubbling in epsom salt water, the smell, or the color?.....**baffled**