The dirty shot and the bone-eating bacteria

Matthew has a big scar, with an even bigger story. He says it’s the “what not to do” tale that completely changed the way he injects. The battle to get doctors to take his pain seriously taught him some lessons around stepping up for himself. The whole incident also made him realise that it takes more than a near-death experience to achieve abstinence.

Image: A photo of one of Matthew’s scars from the surgery.

I’ve been an opioid user for most of my life. A few years ago, I was regularly injecting a fair bit of heroin and street methadone - my usual MO.

One Sunday morning, I woke up with a sore stiff neck. I didn’t think much of it. I thought it was just from sleeping on it funny.

It slowly got worse over a few days, so I went to the doctor’s.

The first doctor literally walked around in circles, repeatedly saying, “I don’t know what it is!”

He just gave me some strong paracetamol & codeine pills to numb the pain. But that didn’t work - the codeine didn't touch the sides because I was already dependent on opioids. I had told him I was dependent - so when he showed no understanding through his choice of prescription, I should have taken that as a big hint that he wasn’t a good doctor!

Then the pain got worse. I had a fulltime job as a gardener and couldn’t work. I went back to the same medical centre a week later and saw a different doctor. But he wasn’t any more interested than the first one. He just said, “You look stressed, your shoulders are hunched up, take some Valium to relax”. And I said, “Sure, whatever you reckon”. I mean, we’re taught to trust doctors. But the Valium didn’t help.

I was upfront with the doctors. I told them I was an opioid injector. What they gave back was a pretty poor effort. They could have done more and taken it more seriously.

It was getting worse, so a couple days later I went back again. I saw a lady doctor I’d seen once before. I knew she was a bit more switched on.

She had a good look at me and we got some x-rays done straight away. She showed me the x-rays and said, “It looks like you’ve had a big accident, or something has fallen on your neck?”

I told her, “Neither of those things have happened.”

She said, “Weird. Go to the hospital ASAP because you have a significant injury. You need urgent attention.”

Being a typical Aussie bloke, I was scared of hospital – I’d never been before. I put off going, but after a few more days of pain, I decided to go in. I remember driving down the road on my way and I was finding it hard to drive because I couldn’t twist my head around to check the lanes. Driving over a speed bump felt like my head was going to fall off.

At the hospital, they took a blood sample and did a CT scan straight away. They said, “You better stay the night.”

The next morning, a doctor showed me the scans on his phone. He said “You’ve got a really nasty thing going on here. According to your blood sample, you have a lot of bacteria that is floating around, and it has landed on your spinal cord. As you can see from these scans, it is eating your backbone vertebrae.”

I was gobsmacked.

My vertebrae looked like rotten teeth. Like a bone with a big piece eaten out of it. Like a hungry little puppy dog was in there munching away. I had pain shooting up and down my arms and neck.

I told him I was a person who injected drugs, and he said, “You probably got this bacteria into you from a dirty shot.”

I said “Yeah, that is probably what happened... What now?”

“We have to give you an operation and rebuild your spine.”

They tested a sample of the bacteria and told me it was “Burkholderia cepacia complex” which is apparently found in soil and plants.

I’m a gardener, and I used to score after work. I’d shoot up in my hands and my hands would be filthy, because I work with soil!

I also remember that a few weeks before the neck pain started, I had one of the worst dirty hits I’d ever had. I felt so sick, I thought I was going to die. I was spewing and pissing. I guess my hands were dirty when I did that shot. But I had also recently bought and injected a bottle of methadone that the owner had used from – it had her blood in it – and I had a bad feeling about that too.

I think I was still in denial about how bad it was. I was itching to get out of the hospital right up until he said, “You’re going in first thing tomorrow morning.” Then I realised how serious it was.

After an 8-hour operation, I woke up in a neck brace with a steel cage around my spinal cord and they had fused together several sections of my neck bone (C3 vertebrae down to C7).

It really freaked me out. I had to stay in hospital for a month on heavy duty antibiotics.

Everyone in the hospital treated me well, except for a comment from one of the surgeons. When he found out it was from a dirty shot, he looked at me with disdain and said “What did you use? Toilet water.” I thought it was unprofessional, but I just replied with a plain “No.” It was a nasty comment and it really hurt at the time. I felt a lot of shame.

When I woke up after the surgery, a nurse asked me about the experience. I told her what the surgeon had said and that I was feeling really low about it. She said “He shouldn’t have said that. Don’t feel ashamed. We’re not here to judge you, we’re just here to treat you.”

I was so close to becoming a quadriplegic, but they fixed me pretty good. I still have a lump of steel screwed into my spinal cord, and some massive scars on my front and back. But it is 95% as good as what it ever was.

I now see how important it is to take your health into your own hands and press your doctor for better answers. If you think they’re being shit, or they are disrespecting you, get a 2nd (or 3rd!) opinion. Don’t let them push you around because you are a drug user. Give them all the information they need to fix you up without shame. It's our health and we deserve the best care there is.

I used to be really afraid of hospitals. I saw them as places of pain and sickness. I have a different view of hospitals now. I see them as places of care. It has given me more compassion for nurses and doctors, to see the stuff they deal with daily.

For anyone who is scared of going to hospital, please don’t be, just go for it. Going to hospital is better than the alternative (like a wheelchair for the rest of my life).

Later on, I visited the good doctor who got me the x-ray, and I took her a bunch of flowers to thank her for saving my life. I had got to her just in time. If she had been as woeful as the first two, I’d probably be dead.

The whole experience made me want to try harder to be healthy and to find other ways to enjoy life. It made me a lot more careful with how I use. I mean I could name at least 2 occasions off the top of my head that could have started the ball rolling.

I have changed the way I mix up and inject. Before this experience, I was never the cleanest user in town. Because we do it every day, we forget injecting can be risky business. I was well and truly due for a review of the way I did things.

Nowadays, before I use, I always wash my hands really well, as well as any other injecting site, with soap and water then with antiseptic hand sanitiser or swabs. I've learnt that the way to clean an injection site with swabs is to just wipe once with the swab in one direction - not to keep rubbing it about because that just pushes the germs around.

I haven’t shared a fit for a long time – not since living through hep C and thankfully getting treated with the incredible new treatments around now. But I did reuse my own fits, partly to save money and partly from laziness. Now I use sterile injecting equipment every time.

I even get NUAA’s free home delivery – because around here you either pick your fits up free from the health centre opposite the police station – no way I’m doing that – or buy them from the chemist and I don’t always have the means. You can order from NUAA a box of fits in whatever brand you want, plus water, cotton, swabs, tournies – even 2 kinds of wheel filters for methadone or pills plus naloxone for reversing overdose. You can’t tell what it is when it comes – it's just a box and it could have anything in it – just another order from the internet – and it comes to your door within a few days. I’m telling everyone about it – partly so they stop knocking on my door thinking I’m the new local NSP.

Another thing is that I’m very careful who I buy my drugs from, so I’m not buying cut or contaminated gear and I use filters every time, even for ice.

All this stuff doesn’t take much thought or time, and it’s worth paying attention to the details for my health. After my near-miss experience, as well as getting older, I no longer believe I’m 10 foot tall and bulletproof. An extra couple of minutes is nothing when it means your life.

The episode also gave me an experience of abstinence. I realised there was a lot more work involved in that than I thought but I found out that I do want to do that work.

I stopped using while I was in hospital. My methadone clinic found out I was in hospital, and they came to dose me. I thought “I’m stuck here for a while, I can’t get any drugs, and I don’t want to be on methadone, I may as well hang out while I’m here – it is just like a nice holiday”. So I told them that. Once they knew I was determined, they respected my decision. It wasn't fun but I was really proud of myself.

I went ok not using for a few weeks after I got out… until my flatmate came home with a pack of heroin and a fit and said, “Here‘s your breakfast”. Maybe he wasn’t happy that I was abstinent and he wasn’t. Maybe he missed his shooting buddy. Or maybe he was jealous. I’m not sure. I do know that I was really annoyed at him for doing it – but I used anyway. And in hindsight I can see that living with someone who used was never going to work if I was serious about not using. Instead of blaming him, I could have taken it into my own hands and moved out.

I really regret using again. I very much wanted to be abstinent. I still do, but it’s hard once you start again to find the exit ramp. But at least I’m not waiting around for another near-death experience to give me the motivation to change. I know it’s a lot more complex than that. There are big changes I need to make, and I need to find the right sort of support to do that. It’s like I’m preparing the garden bed now, doing the weeding and fertilising. Pardon the gardening metaphor but I know this for sure - you can’t grow anything if you don't have the basics sorted.