Tuesday, June 10, 2014

Bat Shit Crazy



Highest on the list of things I never knew:

If you have a bat in your house, and it's there for more than a day or so, including while you and your child are sleeping, you need to get a full series of rabies shots.

I kind of gave away the surprise there, but again...who knew? Seriously, who the hell knew?

Our saga starts on Valentine's Day.  My first night alone in the house.  It's dark. Half the furniture is gone.  I'm physically and emotionally drained. I walk into the kitchen and snap on the overhead light.

Off to the left, I sense, rather than see, a flutter.  Moth, I think, and grab a soda.  Whatever. I leave the room.  A couple hours later, same thing.  Only this time, it has to be a bird.  It's too big to be a moth.  But it's way too quiet to be a bird.  Again, I shrug.  Bats aren't even on my radar.

My friend calls to see how my Love Day is going.  I tell her there's a creature in my kitchen  A long-time Astorian, she immediately knows it's a bat.  Over my protests, she sends her husband down the hill to help.  He arrives armed with a badminton racquet.  Because of course.

We do a room-to-room sweep with no success.  I open all the windows (brrr), turn on all the inside lights and turn off all the outdoor lights.  I assume it's flown out a window, and I go to sleep.

The next night, J is home with me.  It's hard to remember a Saturday night when she and I didn't watch our "Frozen" DVD, but we couldn't have, since it wasn't released until March.  Oh, wait, I remember!  We sold Girl Scout cookies for four hours in Cannon Beach amid a miserable storm.  The things I make my daughter do for my troop!  Anyway, I see the bat, again in the kitchen.  I sequester J in my room, which now has only a mattress and a nightstand so I know there's no bat in there.

And now it's in the upstairs hallway, and I finally discover the sole benefit of living in a 111-year-old Victorian crack house:  Doors.  Lots and lots of doors. I am able to seal the bat within the staircase and the foyer.  I do the lights again, then open the front door and hide behind it.  Just as I am about to go to give up and hope for the best, the bat flies out the door and I slam it hard.  J and I go to sleep.

That's where the story should have ended.  Instead, a couple of days later I recount the tale to my sister.  Who knows someone who happens to be a doctor who knows someone who had a bat and a sleeping child in their house at the same time and (suspenseful music here) they had to get rabies shots. The danger is that bats are sometimes rabid, and you may not be aware that they have bitten you.  Seriously--who knew?

I make a doctor's appointment for J and myself the next day.  Our regular doctor is not in the clinic, so we get a substitute.  I am convinced she will mark me down as having Munchhausen Syndrome, both by proxy and straight up.  But she takes our situation very seriously.  She appears more worried about me than about J, who, it seems, did not spend the night in the bat house.  She leaves us in the examination room and goes to consult the County Health Department.

J takes this opportunity to correct the history I have given the doctor.  She tells me that she saw the bat in the TV room, "the night we got the 'My Little Pony' book at Costco.  That was three or four nights before Valentine's Day.  "Why didn't you tell me then that you saw a bat?"  J shrugs.  "I don't know," she replies.  "I thought it was either a crow or your black underwear flying across the room."

For the record:

1.  Underwear does not routinely fly across rooms in our house.
2.  I breastfed that child.  For more than the recommended year.  Partly to          make her smarter.

The doctor returns, and I update her on our history.  She reports that the risk that we have rabies is low, but that rabies is always fatal, so it's a big risk to take.  She sends us home, promising that she will call us when she gets more information.

I get two calls from a nurse at the health department in Portland.  She says she has spoken to the State Vet and he thinks we're okay.  I am so tickled at the idea that Oregon has a state vet that I don't listen fully.  I wonder if it's real job or a sinecure like poet laureate.  Actually, I have no idea what a poet laureate does.  But that was an example my fifth-grade teacher gave when we had "sinecure" as a vocabulary word. Eventually, I tune back in to the nurse.  She is just saying that she will speak with the State Vet (!) again and get back to us.

She doesn't, but at her request our County Health Director does.  He tells me a long story about being in the Peace Corps, and one of his fellow volunteers died after being bitten by a rabid dog.  The upshot of his story is that the Peace Corps nurse made everyone get prophylactic rabies vaccines.  He says he couldn't make a recommendation as to what we do, but that he would get the shots if he were in our shoes.

Then he tells me that the only place in the state to get the shots is in Portland.  I'm still not sure if that's true, but it is definitely the closest place.  He has called OHSU and they have recommended that we come in the next day. 

So we do.  At OHSU, the only place they administer shots is in the ER.  Fortunately, they let both J and me go to Doernbecher, the pediatric OR, where the wait time is measured in minutes, not hours.  The ER doctor did not give us a choice:  If there is a bat in your living quarters and you were not awake for the entire time of its visit, you get the rabies shots.  Period.

On the upside, things are much improved in the rabies vaccine field.  No more giant needles in your stomach!




Depending on your weight, you start out with three (J) or more (me) shots.  J had hers in her thighs and arm, but I get some in my ass, to her endless amusement.  One is the vaccine and the others are the immunoglobulin. (Maybe?)  Then you get to drive to Portland three more times in the next two weeks to get one shot each time.  And no, they will not ship them to your city for convenient inoculation.  And yes, you do get to make an ER co-pay for each of your four visits.  Fortunately, Blue Cross paid.  And they paid A LOT.

Side note:  The pharmacy sends up the vaccine, and the nurse mixes it and injects it into your arm (or other places, the first day).  The solution is bright magenta.  One of the nurses asked if I were anti-vaccine.  I said no, but she said the way this stuff looked could turn anyone away from the science.

J was not happy.  But she was amazing.  Brave little bug, and I was so, so proud of her.  



The whole thing still seems strange to me.  I will always wonder if I did the right thing.  We were probably overtreated.  One doctor we saw at OHSU agreed that it was defensive medicine, but that (as noted) since rabies is inevitably fatal, you just can't take the chance.  What really bothers me, though, is what do other people do?  My employer provides amazing health insurance.  The whole thing cost me eight ER co-pays and two co-pays from our primary-care clinic.  Total:  $270 out of pocket, but of course covered by my flexible spending account.  So really maybe 2/3 of that. I recently was working with someone whose ER co-pay is $500.   That would have been $4,000 PLUS his insurance would have paid only a portion of the rest.  And let's not even think about people with no insurance.  I am so very grateful, and so very sad, all at the same time.

In fact, none of this really makes sense.  We live in a rural county.  Bats are ubiquitous.  Surely they must enter people's homes all the time.  But I have never heard of anyone (in real life; I'm not counting the internet) who has gone through this.  Are they just not asking their doctors?  Are they receiving different advice?  Is there really no risk?  Or do they have to balance the cost and the risk and ultimately decide they just can't afford the care?

So, people of Clatsop County, if you have a bat in your house, call J and me! We are now immune--at most we would need a booster if we got bitten. We like to do that Girl Scout good turn daily.

And, oh how I wish i had thought of this:



PSA time:  Turns out, you are NOT supposed to shoo the bat out of your house.  You are supposed to trap it so its brain can be tested for rabies.  If it's negative, you won't need to get shots.  I am sorry, but if any of these doctors or public-health professionals thought I was going to trap the bat, well, they're just bat shit crazy.