Part III: The Verdict Is In

21 07 2011

Photo of microscopic pseudomonas bacteria, known for causing "Hot Tub Rash," courtesy of Wikipedia.

I recall once reading a fascinating story in Reader’s Digest about a detective who was hot on the trail of a serial killer, but somehow, every time he was about to close in on him, the serial killer guessed the detective’s next move and evaded capture. The long and short of it was that, in a fascinating series of twists and turns, the detective connected the dots and realized that the serial killer was none other than his best friend, with whom he’d been sharing the details of the case.

It was such a shocking example of “truth is stranger than fiction” that even though years have passed since that story was published, I’ve never forgotten it. How incredulous the detective — let alone the readers — was when he realized that the villain had been there all along, right under his nose.

The same can be said for the bacteria that caused the horrible infection that landed me in the hospital for nearly a week and puzzled teams of doctors. Today, the verdict — the final results of the cultures — came in. The villain in this mystery is a microscopic bacteria called Pseudomonas, more commonly known as “Hot Tub Rash.”

How shocking for Don and I to realize that the cause had not only been right in front of us, but from a source that had been bringing us such pleasure during a stressful time in our lives.

Don had always wanted a hot tub. But, they’re pricey and as the years passed, we never could quite justify adding this luxury item to our budget. Then my neighbor saw an ad on Craig’s List for a Free Hot Tub — You Move. We called. The owners were moving, the tub was in excellent condition, save the need for some new PVC tubing. No sweat for Don, who can fix, build and create anything.

So, Don and a friend drove to St. Clair Shores to pick the hot tub up, and brought it back to our house, where Don put it in our garage for a couple of weeks so he could run power to it as he tinkered with it. Somewhere near the end of June, it was ready. Friends helped Don move it to our back deck, where Don scrubbed it, filled it with water, shocked the water with chemicals, and heated it.

Waalah! We were in hot tub heaven! Don carefully checked the pH levels in the tub every day and used pool test strips to check the chlorine levels. He would often use the tub himself, late at night, long after Theo and I had fallen asleep. But on about four occasions, I joined him under the stars after putting our little munchkin to bed.

The last time was Thursday night, July 7 — two days before the first sores began appearing on my body. 48 hours, I’ve since learned, is the incubation period for this type of infection. I made a series of errors that Thursday night that, along with my compromised immune system, contributed to contracting the infection, such as:

Sitting in a wet bathing suit after getting out of the tub, instead of removing it immediately;
Not showering immediately after leaving the tub; and
Being in a hot tub in the first place, as an immuno-compromised person.

I did not have a clue until after my week in the hospital that hot tubs were off limits for chemo patients. Sigh. Once again, I’d missed something critical.

At the hospital, one of the doctors remarked that I was more knowledgeable about my condition than 99.9 percent of the patients he sees. That I didn’t know some of the basics — the information about fevers in chemo patients and that hot tubs are a no-no — is really scary. How is it that this information has somehow eluded me in the five years since I was first diagnosed with breast cancer? And what kind of a threat is it to other people going through chemo, who also somehow have missed this information along the way?

“Hot Tub Rash” is not a problem exclusive to hot tubs. It can also be contracted in pools and lakes. The Pseudomonas bacteria that causes it is not uncommon. It is actually found in both water and soil.

The good news is that, for most people, the rash that develops from exposure to this organism typically clears up on its own without medical treatment. Still, compromised immune system or not, I strong suggest you heed the tips I listed above. Change out of your swimsuit and shower immediately when you’re done swimming or hot tubbing.

I now have an entire skin protocol prescribed for me by the brilliant dermatologist who saw the infection for what it was immediately — when he was finally called in. And, of course, I have no interest whatsoever in our hot tub.

The end of this part of my story is a happy one, of course, because the culprit turned out to be perhaps the least dangerous and serious of the many possibilities the doctors threw out last week. Just as importantly, I’ve learned how to avoid it.

So many times, including last week, concerned friends and family members have gotten on my case, sure that a party we threw or attended, or an outing to a movie theatre was going to do me in. So many times, I’ve told them that, within reason, I’ve got to keep on living my life. And now we know that threats abound — even in our own private, well-kept hot tub in the back yard.

It’s also sad because I’ll miss sitting in the warm, bubbly water under the stars with Don and catching up on our days together. I was so excited after we got the hot tub that I ordered a floating checkerboard and a waterproof deck of cards, along with a special light that cycles through a rainbow of colors and patterns.

But, I’ve figured out a compromise. No one said I couldn’t pull up a chair next to the hot tub and talk to Don while he’s soaking. So, that’s exactly what I’ll do, all the while praising God that I’m home sweet home and getting better every day.

Photo Credit: The Pseudomonas bacteria, under extreme magnification, courtesy of Wikipedia.

Copyright 2011, Amy Rauch Neilson



17 responses

21 07 2011

Then when you are all better and able to do the hot tub again please remind me why you bother with a bathing suit.

23 07 2011
Amy Rauch Neilson

The neighbors, Ken, the neighbors! I don’t want to give them a heart attack! 🙂

21 07 2011

Amy, thank you for sharing your story. I have primary lymphedema (most likely was hereditary) and hot tubs/saunas are off-limits for me too…. I knew that heat contributes to a higher possibility of swelling, but the germ thing is something I didn’t think about either…… But I love your idea of sharing time with him next to the tub, even if you can’t get in it right now. Keep fighting the fight!

21 07 2011
Jennifer L.W. Fink

I’m glad you have an answer — and glad you’re sharing this info w/ the rest of us. Who knew?

23 07 2011
Amy Rauch Neilson

Really, Jennifer — I keep telling Don that certainly we could have made it successfully through life without having to know all this information. Sigh.

21 07 2011

Having MS also hinders me from enjoying a long relaxing time in a hot tub. I sneak in a quick minute or two every now and then when I am at a hotel with a tub. A MS patient needs to keep their body temps down. The warm water could allow the MS symptoms to increase.
I am so glad to hear that the verdict is in though,and you now know what the problem actually was. You go right on and live your life girl. You know your body, and when it needs rest. Other than that you have fun……but do try to stay cool. My goodness is does sound dreadful there right now. Those kind of temps are just not safe.xoxoxo

22 07 2011

I am so glad that is what the rash ended up being. Hot tubs are nice but they are too hot for this 99+ weather we’re having anyway (I don’t think it was this hot when the rash started, but I’m just sayin ;o)

22 07 2011


22 07 2011
Karen J. H.

Praise God that they found the answer. Now you know, and have one other way to keep yourself safe. I’m sure your story here, in this format, can and will, help someone else. Keep fighting! Be strong!
I’ll keep praying that God will continue to help you each and every day.

22 07 2011
Marsha McAuley

What a story Amy.

22 07 2011

Who would have thought a nice bubbling hot tub could potentially be a killer! Just like the Readers Digest story….one never knows! So glad that was all it was and you’ve taught us all another good lesson. God bless.

23 07 2011
Bob Adams

Once again your information has probably saved someone out there discomfort at the least and possibly their life. And, you’ve added another chapter to your story. You are truly amazing!

23 07 2011
Amy Rauch Neilson

Bob, you are too kind! But thank you thank you thank you! Hope to see you and Cris in Arizona late September/October — yes, an overlap would be terrific! If I could stay out of the hospital and away from the doctors long enough, I could actually communicate with you re: The Plan! 🙂

26 07 2011
margaret jarose

another lesson learned, but at least your still 99.9, ahead of the learning curve…. aunt margaret here to say hello to all, and enjoy reading your comments, keep us posted Amy, Rauch family, & Jarose family all here to support you, Theo, & Donnie… hope your being juris prudent in the heat of july….. Ps: Uncle Bob Rauch, Jack, were here in Michigan for short visit one week, they spent time up at our Forest Lake, Cottages…. xoxo to all of you.

4 08 2011
Sunny Stripes-O'Connor

Amy, Another thought…Did you perhaps shave just prior to the hot tub episode? I learned recently that I should not shave just prior to having a pedicure because shaving causes micro-abrasions in the skin allowing access to opportunistic microorganisms. I’m thinking the same may apply to hot tubs and the like.

5 08 2011
Amy Rauch Neilson

Sunny, You are indeed on the right track. I didn’t shave just prior — but had shaved earlier that day as I shave every a.m. The doctor mentioned that it gives mircoorganisms an “in” — so you are spot-on! All chemo patients need to know this info!

5 08 2011
Rita O'Connor

Wouldn’t it be funny if everyone typed out their complaints? What a list it would make! ME FIRST…ME FIRST! I have SHINGLES! And not the ones on the roof. its called itch itch itch….but don’t scratch. This too will pass.

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