The Caper Continues

This dog bite thing has become very frustrating. I went to Canadian Blood Services today to donate plasma. Now, when you donate plasma, part of the deal is that you need to get a basic physical from their in-house doctor every year. It was my time to have a physical before donating today.

So he asks me some questions, listens to my heart and breathing, looks in my eyes and ears, taps me on the knees, and I’m good. But I figured I should at least inform him about the dog bite thing – it’s the kind of thing they need to know about. It turns out that he doesn’t really know if it’s a problem, so he phones some other doctor. After talking about their holiday travel plans for a few minutes, the doctor turns to me and says I can’t donate until they get a letter from my family doc saying I am rabies free.

Makes sense, for sure. You can’t be too careful with Blood Services. I asked him if there was some kind of test for rabies, but he had no idea. He assumed there was some kind of blood test. As it turned out later, he was wrong.

I figured I should deal with this issue today, so I went to the drop-in clinic in Dartmouth (I don’t have a family doc). After waiting for about an hour, I got in there and told my story. The doctor sighed and told me that this was going to be way more complicated than I was going to like. His instinct was simply to send me home and tell me not to worry about it because rabies is so rare in Nova Scotia, especially among domesticated dogs. But the problem is that because I didn’t get the owner’s information, nobody can be 100% sure that I wasn’t exposed to the rabies virus. If I had the owner’s information, all we’d have to do is wait 10 days and see if the dog was still alive. Apparently, once rabies sets in, it works very quickly.

In the end, the doctor decided that even though I would have a better chance of winning the lottery than getting rabies, he was still going to call Public Health to let them make the final call. The problem is that rabies is fatal if you don’t get it before it blossoms in your brain – so there is a bit too much at stake to be cavalier.

By the time I got home from the walk-in, I already had a message from Public Health, and just as I was about to call them, they called me again. Yikes. The lady from Public Health was very nice and assured me that her eagerness was only because it was Friday afternoon and they like to tidy things up at the end of the week. Phew.

Anyway… the woman was very nice and asked me for my story – I’m not sure so many people have ever heard a story of mine! She took down the info and asked some questions about things like the dog’s behaviour and so on and so forth. Then she told me to keep the line clear while she talked to the head doctor to assess my risk. It all seemed a bit dramatic to me, but rabies is no joke.

In only a few minutes she called back and told me what the doctor had said. Apparently, there hasn’t been a single case of rabies in Nova Scotia in years and years. And my case is especially low risk because it was a domestic dog that didn’t seem to be showing signs of ill-health.

But…

Because I don’t have any information on the dog besides the owner’s word, they can’t say that I’m 100% risk free. Sigh.

So what the doctor decided was that I didn’t have to have the series of vaccine shots, but I could get them if I wanted them. After all these expert opinions, it comes down to my choice.

Now I have to oh-so-enviable task of weighing pros and cons in this little game of rabies roulette. The very fact that Public Health didn’t descend on my condo with helicopters and men in toxic spill suits means that I’m probably okay. The chances are that I was not exposed to the virus, but the niggling little chance is still there.

The other factor for me to consider is my career as a blood donor. Without the vaccine, I assume I would be too much of a risk – the doctor at the walk-in clinic looked up the incubation period for the virus and (incredibly) it was anywhere from 20 days to 19 years! 90% of cases bloom after a month or two… but again, there is that rare chance that has to be accounted for. I haven’t talked to Blood Services about this end of things yet, but I’m pretty sure they wouldn’t take me again without the vaccine. However, the deferral for rabies vaccination post-exposure is one year after the last shot.

Speaking of shots… rabies vaccination is notorious for being painful and dangerous… or so I thought. A bit of Web searching turned up a few testimonials that described the modern process as not much more painful than any other vaccination with the same small risks of side effects. The days of 50 deep injections into the abdomen are over (except in remote Indian villages).

But there’s yet another twist. The vaccine needs to be administered on precise days. After the first couple of shots (day 0), I need to go back on days 3, 7, 14, and 28. Not only does this sound not fun, it also coincides with our trip home to Ontario for Christmas! The woman at Public Health assured me that they could organize a shot with Public Health in Brampton or Kingston, but if I had decided to start the shots today, I would have needed one on Christmas! I can only imagine what kind of administrative nightmare it would be for them to organize all of this.

So I’ve decided to take the weekend to mull this over and gather information. I have no real concept of the risks of vaccination. My sources of information so far have been less than scholarly – and none of the government public health sites commented on the risk of pain and side effects from the post-exposure regimen of shots. Are the shots worth it?

All I had to do was to get the dog owner’s freaking phone number – but I didn’t know. Nobody ever said, “If you get bitten by a dog, get the owner’s information or else you’ll get stuck full of needles.” If this had been a car accident, I would have known to get the information – that’s drilled into everyone practically from birth. But this was new, and I mucked it up, and now I have to make this silly decision.

There is a moral to this story for every runner: if you get bitten, if your skin is broken at all, after you're done cursing at the owner, get his or her information – you’ll save yourself a lot of frustration.