By Sahara Cornwell and Dr. Jeffrey K. Brown
Thursday, April 22, 2010, started out like any other morning. It was 5:00 AM, and my eight-month-old daughter, Norah Willow, was letting me know that it was time for breakfast. I sat down on the couch with her, and as I was feeding her I felt the slightest sting on the back of my arm. Thinking I just had an itch, and not having a free hand to scratch, I rubbed the back of my arm against the couch. In that moment, I unknowingly killed a brown recluse spider that had just bit me. The baby and I fell back asleep on the couch.
A little less than an hour later, I woke up feeling not quite right. I found it odd that my fingers and most of my right and left hands were almost numb. They had that “pins and needles” feeling to them, like they had fallen asleep and were being awakened by me trying to move them. I put the baby back in her bed, and went to look at the back of my arm in a mirror. It was feeling really sore. I looked at it and thought to myself, “Hmm, that looks a little red and swollen. What an odd place for a pimple to come up.” I touched it and it felt extremely hot, almost on fire. I didn’t think anything else of it, and decided to go make myself some breakfast.
While making breakfast, I started feeling sick. It was as if suddenly someone had poured hot lava on me, then a bucket of ice water. I went from feeling extremely hot, to literally freezing to the point that my teeth were chattering. Quite literally, like I had stepped off a plane in Antarctica and forgot to wear clothes. Slight nausea set in. I decided to skip breakfast and go lay down awhile longer.
I crawled under the covers, but could not get warm. I put an extra blanket on the bed, still freezing. Maybe I was coming down with the flu? I’d only had the flu once before in my life, and it felt just like this.
It was now 7:00 AM. I decided to check my temp. I got out of bed to get the thermometer, and as I stood up I noticed how weak I really had become. I told my family I didn’t feel well at all, and I thought something might be wrong with me. I checked my temp, and it was 103.2 F. My average temp is usually around the 97 F range, so I knew then I should probably go to the hospital. I have severe allergies, so I drank some liquid Benadryl on my way out the door, thinking perhaps I was having the beginnings of an allergic reaction. Better safe than sorry. My family said they would watch the baby, so I got in my car and headed to the hospital, which luckily was only two miles from my home. I was thinking of driving to the much larger hospital 30 miles away, but by the time I was only one mile from my local hospital, I knew I would not make it if I continued. You know how people say when you’re close to death, your life flashes before your eyes? I can’t say that happened to me, but I did think to myself, “Gosh, I hope they bury me under an apple tree so someday people can pick and eat one and say, ‘MmMm, Sahara tastes good this year.’”
By the time I pulled into the local ER, I was finding it extremely hard to breathe, like a boa constrictor was wrapped around me, squeezing my lungs. Not that I’d ever had a boa constrictor hug me before, but I imagine their hugs are quite similar to what I was feeling at that moment.
I thought, “The flu doesn’t feel like this. Maybe I really am having an allergic reaction to something. My arm really hurts. Maybe something bit me?”
My Husband had been bitten by a brown recluse when I was three months pregnant. He had almost no reaction at all. He had a tiny spot the size of an eraser tip on his shin that turned brown and formed a little hole, and that was it. We had called an exterminator in at that time, and thought that had taken care of the recluses we’d been seeing in the house. Remembering this while walking into the ER, and my arm feeling sorer, I decided I would mention this to the doctor. When I walked up to the receptionist to sign in, I jokingly said in my best Forrest Gump voice, ”Somethin’ bit meee.”
The wait in the ER went from uncomfortable to downright unbearable. Not only did I feel like I had the flu, but also felt more and more like I couldn’t catch my breath. Then, extreme nausea set in. I couldn’t even get up to go to the bathroom. I vomited right there where I sat. Yes, something was terribly wrong. I hadn’t vomited since grade school. One of the docs walked through it and you could hear him squishing down the hall and slipping and almost knocking over a food tray.
I think this is when the staff at the hospital decided I shouldn’t wait any longer in the waiting room. I really was an emergency! I made the mistake of starting to panic. I didn’t know at the time that venom spreads even faster when you panic. I don’t remember the next few hours. The entire afternoon became a blur, besides waking up seeing an IV hooked to me and hearing “Her temp is still spiking, its 104.5 now. Let’s try more Tylenol.”
I told the doctor I might have been bitten by something on my arm. My arm hurt so badly. Every muscle in my body hurt. He looked at it and said he didn’t know much about bites, but thought maybe it was a black widow spider. He gave me Dilaudid for pain. I passed out again.
For 12 Hours I laid in the ER hooked to an IV of Levaquin antibiotic, Prednisone steroid, and Dilaudid for pain. None of this stopped the venom from spreading, and my arm became more and more painful and swollen. The doctor decided I needed to be transferred to a larger hospital where I would be given black widow anti-venom. I called my family to tell them what was happening, and that I had obviously been bitten by SOMETHING and was having a reaction. While on the phone, my husband started looking around the couch and right where I had been sitting that morning was a dead brown recluse. “EUREKA!”
I told him to please bring it to the hospital, because I was about to be transferred and given the wrong anti-venom! It needed to be confirmed that it was indeed a brown recluse that had been so generous as to donate its venom into my bloodstream. He put it in a jar, and brought it to the hospital. The doctors looked at it. The nurses looked at it. And then I got to look at it. Yes, there it was. The ominous tell-tale violin. The “devils fiddle.” It was in fact a brown recluse — a large female!
Since there is no anti-venom available in the United States for the brown recluse, and the Doctor didn’t have a clue what else could be done to help me, it was decided that there was nothing more to do for me but send me home. I found this strange, as I had just had a very bad systemic reaction — anaphylactic reaction even — and I was being sent home with a fever still at 103 F, my arm steadily turning purple, and feeling about as bad as I ever had. But I wasn’t going to argue. This ER was obviously ill-equipped and too ill-informed to treat me any further. So, home I went.
As the days went by, my arm and the pain at the bite site became worse. I went to four different ERs in a week’s time, with none of them knowing what to do for a brown recluse bite. My family physician took a look at it and immediately hospitalized me for another two days. Another IV of Levaquin, Prednisone, and Dilaudid. Although this helped with pain management, I don’t think it helped much otherwise. I started researching online, trying to find out what I could do myself. Knowing that venom is a toxin, I decided my last hope was to call Poison Control. Maybe someone there could at least tell me who to see for treatment, as my arm had started becoming extremely necrotic. I looked like I was ready for a cameo in a zombie movie. No special effects makeup needed.
I was an embalmer for a local funeral home after attending college and majoring in mortuary science, so I was very familiar with decomposing tissue and the smell that goes along with it. My bite site had started giving me that old familiar smell. I was ready to act like a wolf caught in a trap and gnaw the sucker off myself if it meant not having to watch and feel it slowly rot off. I started thinking of my time in that embalming room, and remembered, of all things, Maggots! Finding Maggots on remains and how they ate away at the decomp had me wondering if it would work on me. I had heard of maggot therapy and its benefits. Sadly, it was not available in my area. No way could I travel with an infant and my arm in such bad condition, so I had to look for another option.
Calling Poison Control was the best call I’ve ever made. They immediately transferred me to Dr. Jeffrey Brown, a medical entomologist with the the Mississippi State Department of Health, who not only knew about brown recluse spiders, but knew what I needed to do to treat the bite. I listened carefully to what he had to say and took down the numbers of infectious disease specialists who could treat me. But then another road block — I had to be referred to an infectious disease specialist. I went to yet another ER to see if they would refer me. I FINALLY received a tetanus shot there, two weeks after I was bitten. But no referral to Infectious Disease. Instead, I was referred to a surgeon. The surgeon was of no help. He simply said, “We’re going to wait another week and see how far the necrosis has spread, and we’ll start cutting from there.” Yeah, awesome, Doc. No thanks!
The necrosis had spread by this time to 18 cm long, 8 cm wide and 5 cm deep. My arm was literally rotting off, and no one would help me except for Dr. Jeffrey Brown, who was helping me exhaust all the options I had around here. It had been exactly four weeks since I’d been bitten. I was almost certain that if I couldn’t see someone who knew what they were looking at, I would lose my arm. I was lucky enough at this point to keep all infection out, but I was afraid if it kept rotting, infection would without a doubt set in. I decided that instead of looking for someone who dealt with spider bites, I would look for a place that simply dealt with wounds of all types.
It was then that I came across the Advanced Wound Care Center in Tupelo, MS. I immediately called the number and explained what had happened. I was able to be seen that afternoon. I was finally in the right place and being seen by the right people, who knew exactly how to treat my arm. They said that after I was debrided I would need a wound vac, but my insurance refused to pay for it. So all they could do was keep debriding, and keep it bandaged.
As I write this, it has now been 66 days since the itsy-bitsy spider crawled up and bit me. I’m still going once a week to The Advanced Wound Care Center for debridement. My bite site has diminished to 12.4 cm long, 4 cm wide and 2 cm deep. I still have a ways to go before I’m completely healed, but they say I’m progressing nicely and should make a full recovery.
I’m writing this not only to get my story out there, but in hopes that it doesn’t happen to someone else. Though I sought treatment as soon as major symptoms came about, the doctors really had no training on what to do to treat it. This is simply unacceptable. I’m also aware that the reaction I had to the brown recluse venom was rare. If it happened to me, though, it can happen to anyone. Even if you have been bitten before and didn’t have a major reaction, the second bite can still be fatal.
I was sent a new product from Mr. Roger Williams from Applied Science Labs in California called VX88 to use on the “Spider house.” No products we had tried previously worked. We needed a strong insectide to eradicate the recluse infestation, but one that would be safe enough so that my baby could come in contact with it with no ill effects. So far we’ve killed over 100 recluses by combining the VX88 with sticky traps.
I used to see dead bugs on their backs, but with VX88 they died with their ventral side down, sort of like they were stopped in their tracks. I asked Mr. Williams why this happens and he told me that the product is a paradigm shift in the mode of action and does not affect their nervous systems. Instead, it emulsifies their outer waxy layers. He told me that Applied Science Labs has modified a complex polypeptide protein molecule — OK, Roger, I eat protein all the time and the darn thing still bit me, so I guess I’m eating the wrong polypeptides — that is harmless to human beings but deadly to the spider and to insects.
I sprayed all over the house, especially on the furniture. I loved it because it was so safe around my baby and had no odor and did not stain anything. Most people think the bite from a recluse will simply leave a little, black, pinky-nail size spot. I ask those people to look at my arm. When I run into people in town and they ask what happened to my arm, they say things like, “Well, my great Uncle Charlie’s cousin’s momma got bit, and it barely did a thing to her. Looked like a ‘skeeter bite.’”
Good for her. I doubt it was a recluse then. It probably WAS a mosquito bite. If you are bitten by a true brown recluse spider, you will certainly know.
I have total respect for the itsy-bitsy spider with the fiddle on its back now, but it’d be just fine with me if I never saw one again. Especially since I went through all of this and never even got my Spidey-senses.
As of September, 2013, after six surgeries and debridements, I am fully recovered. My four-year-old daughter and I are now living in a new home and are taking precautions to make sure it is free of brown recluse spiders and other “itsy-bitsy spiders.”
I sent an email to Dr. Jeffrey Brown, the one who had helped me when I called Poison Control, that read, “I can’t believe how my arm looks with a scar that is seven inches long and two inches wide, but I am lucky to have my arm at all. I now cherish it as a “war wound” from my battle with an arachnid, one that caused me pain both physically and emotionally. But I won in the end thanks to the help and care of an entomologist. I have never even known an entomologist before, let alone a medical entomologist, and I have still never met you personally. Thanks, Doc, for staying with me and never giving up. I hope to meet you someday.”
Sahara Cornwell is a 38-year-old mother to four-year-old Norah Willow, and is married to her husband Edward. She is a former mortician who retired to become a full time mommy and 24-7 caretaker of her husband, who has Alzheimer’s. In her spare time she likes to read, write comedy, and step on spiders.
Dr. Jeffrey K. Brown is the Bureau Director and State Medical Entomologist for Public Health for the State of Mississippi, and he holds the position of Director General at the American Academy of Entomological Sciences, a private contract insect research firm.
EDITOR’S NOTE: While Sahara obviously had a terrible experience, her reaction is NOT TYPICAL. According to brown recluse expert Dr. Rick Vetter, most people do not show symptoms until six hours after being bitten, and numbness is usually not a symptom. Also, there are many spiders that resemble the brown recluse, and it is very easy to misidentify them. Finally, sometimes people get nasty wounds from other conditions, like necrotizing bacteria and pyoderma gangrenosum, but they believe the wounds were caused by insects or a spiders. “Ninety percent of brown recluse bites are not medically significant and heal very nicely, often without medical intervention,” according to Dr. Vetter. Click here to learn more about the brown recluse spider.