Lots of Things to Think About
Friday: Trainee from Puerto Rico cut her hand with the same scalpel that she used to chop up pieces of cervical tissue. Yikes! Was the tissue infected with HIV or Hepatitis? Or some awful bacteria maybe? How to check? It was Friday evening and everything was closed.
I, being the only other person in lab at the time, vacillated between panicking myself and consoling the poor girl, who was in a full blown hysteria by this time. After washing out her hand and putting some anti-bacterial and anti-fungal cream on it, remembered to call the lab supervisor. We'd never had an incident like this at lab- ever. So, supervisor too was slightly undecided about what to do.
Firstly, it was a surface wound and it bled, so very likely any bug that got in there would have been washed out.
Secondly, HIV has a REALLY low transmission rate, believe it or not. Even less so when it is a surface wound like this.
Thirdly, this tissue is SUPPOSED to be HIV negative, otherwise we wouldn't be getting it into the lab (because we need to infect it externally with HIV, see?). But, we wouldn't know for sure unless it was possible to check the records, which couldn't be done till Monday.
On the other hand, if she had been infected, the sooner prophylactic anti-retrovirals were started, the better.
In the meantime, the girl called up her husband in Puerto Rico, who got even more hysterical.
So all things considered, we decided to go to the ER. Uggghhh.... I hate the ER. But I went along anyway. Fully expected a four hour wait before we could see a doctor, but the room was surprisingly empty of sick people (mental note: in future, when having to go to ER on a Friday, must remember to go between 4 and 7pm. That way, the "I'm so drunk I'll die" crowd hasn't yet begun to trickle in). For the first time ever, got to see what the inside of an emergency department looks like- not at ALL like in the show ER, which was slightly disappointing. Where were the screaming people and where was the splattered blood? Everything was quiet and boring.
To cut a long story short , she decided to take anti HIV prophylactic drugs. You know, weirdly enough, this was the first time either she or I, despite being PhD students working on HIV, had ever seen these anti-retrovirals. Weird because we learn so much about these drugs- their design, drawbacks, resistance mutations and stuff. The other novel thing about this trip was that I had to serve as interpreter. It's surprising that Puerto Ricans do not speak English very well.
Looking at the labels on the tablets- Zidovudine, Lopinavir etc.- suddenly brought home to me the gravity of the situation, which till then I'd been thinking of as a bit of a lark. If she were really infected, she'd have to take those drugs forEVER. Or at least until the virus became resistant to them, then she'd have to take worse ones. How terrible. Prophylaxis or not, those drugs made her sick to her stomach- a few hours after taking the first dose, she was throwing up all over the place.
Anyway. It's Monday. We still don't know the status of that piece of tissue. Throughout the weekend, I was thinking: what would I have done if it had been me? Would I have decided to take a calculated risk and not take the drugs, or would I have continued to take them, feel terribly sick all the time, just to be on the safer side? She said she had taken them only at her husband's insistence. Would I take those tablets if mine were to insist?
All in all, I'm SO glad I don't have to work with tissue or sharp scalpels around tissues!
I, being the only other person in lab at the time, vacillated between panicking myself and consoling the poor girl, who was in a full blown hysteria by this time. After washing out her hand and putting some anti-bacterial and anti-fungal cream on it, remembered to call the lab supervisor. We'd never had an incident like this at lab- ever. So, supervisor too was slightly undecided about what to do.
Firstly, it was a surface wound and it bled, so very likely any bug that got in there would have been washed out.
Secondly, HIV has a REALLY low transmission rate, believe it or not. Even less so when it is a surface wound like this.
Thirdly, this tissue is SUPPOSED to be HIV negative, otherwise we wouldn't be getting it into the lab (because we need to infect it externally with HIV, see?). But, we wouldn't know for sure unless it was possible to check the records, which couldn't be done till Monday.
On the other hand, if she had been infected, the sooner prophylactic anti-retrovirals were started, the better.
In the meantime, the girl called up her husband in Puerto Rico, who got even more hysterical.
So all things considered, we decided to go to the ER. Uggghhh.... I hate the ER. But I went along anyway. Fully expected a four hour wait before we could see a doctor, but the room was surprisingly empty of sick people (mental note: in future, when having to go to ER on a Friday, must remember to go between 4 and 7pm. That way, the "I'm so drunk I'll die" crowd hasn't yet begun to trickle in). For the first time ever, got to see what the inside of an emergency department looks like- not at ALL like in the show ER, which was slightly disappointing. Where were the screaming people and where was the splattered blood? Everything was quiet and boring.
To cut a long story short , she decided to take anti HIV prophylactic drugs. You know, weirdly enough, this was the first time either she or I, despite being PhD students working on HIV, had ever seen these anti-retrovirals. Weird because we learn so much about these drugs- their design, drawbacks, resistance mutations and stuff. The other novel thing about this trip was that I had to serve as interpreter. It's surprising that Puerto Ricans do not speak English very well.
Looking at the labels on the tablets- Zidovudine, Lopinavir etc.- suddenly brought home to me the gravity of the situation, which till then I'd been thinking of as a bit of a lark. If she were really infected, she'd have to take those drugs forEVER. Or at least until the virus became resistant to them, then she'd have to take worse ones. How terrible. Prophylaxis or not, those drugs made her sick to her stomach- a few hours after taking the first dose, she was throwing up all over the place.
Anyway. It's Monday. We still don't know the status of that piece of tissue. Throughout the weekend, I was thinking: what would I have done if it had been me? Would I have decided to take a calculated risk and not take the drugs, or would I have continued to take them, feel terribly sick all the time, just to be on the safer side? She said she had taken them only at her husband's insistence. Would I take those tablets if mine were to insist?
All in all, I'm SO glad I don't have to work with tissue or sharp scalpels around tissues!