Jeffrey’s infection worsened. Before counting, he counted 200 citizens, and only those showed up. Most of the pain was in her rectum, which she told her doctor was “like a fiery rusty saw going off in my ass 24 hours a day.”
“I actually stuck my finger in to see what was going on,” Jeffrey said. “It felt like a bag of pearls, like a hard, round, very painful thing. I have never felt anything like it.’
To try to ease the severe pain in his anus, Jeffrey tried lidocaine gel, an over-the-counter local anesthetic found in some hemorrhoid creams, but it only made it worse.
“I tried it once and I was like, ‘Fuck it!’ I said,” he said. “Putting it on hurt more than it had any effect.”
(Remember that products containing lidocaine should be used with caution and only in relatively small amounts. Using too much can affect organs such as the brain or heart.)
Geoffrey was so relieved to be on his stomach, but he said it only worked for so long because he eventually had to sit up. He lives in an apartment with his partner, but they have been isolated. Her partner was tested twice, both times negative. Jeffrey hadn’t left his bedroom in weeks. He continues to work remotely while waiting for his final injuries to finally heal.
“Who knows all this?” he said. “The only thing that really works to make it go away is time.”
Time – and perhaps pharmaceuticals. Jeffrey’s doctor prescribed hydrocodone and an experimental antiviral drug, Tpoxx, to treat the illness. According to Jeffrey, the hydrocodone took his pain “8 out of 10.”
Other topicals include hydrogen peroxide and a Native American smallpox remedy called Sarracenia purpurea. None of the medical experts we spoke to knew anything about Sarracenia purpurea, but all cautioned against using hydrogen peroxide for monkeypox, especially Donald Nardelli, a registered nurse who has treated more than 45 cases at Pittsburgh’s Central Outreach Health Center.
“Using an abrasive solution like hydrogen peroxide can irritate these wounds and leave them open, and I don’t think that’s our best option,” Nardelli said. “If we allow the wound to dry out, we see healing from the inside.”
Most importantly, never, ever touch your eyes after touching your sores.
“You can actually get the virus into your eyes and have serious problems,” Cummins said.
Monkeypox ophthalmic infections can cause conjunctivitis, eyelid swelling, and in some cases blindness.
Warm sitz baths or cool cloth compresses may help
Liz, a 39-year-old Chicago gymnastics coach and married mother of five, believes she has monkeypox. One day he noticed that his lymph nodes were slightly swollen. He knew something was wrong, but he didn’t know what. Then, when he got a call from the health board, he came out and got it all together. At the last balance session, one of her students, a girl in her early 20s, had visible bumps.
Liz began to brace herself after receiving the news that she was diagnosed with monkeypox. He has an antibody deficiency and relies on plasma-derived immunoglobulins, or IVIG, to help fight any infection.
“I live on IVIG donations for my immune function,” she said. “So I was like, ‘Lovely!’ It’s going to be fun!”
As Liz’s infection progressed, her entire body ached. She says the thing that gives her the most relief is a very hot shower and bath.
“Did it distract me from the pain and provide me with another sensory input?” he said. “Of course it’s possible, but it seemed to help.”
Cummins agrees that Liz is misdirecting her pain with another type of pain, but she doesn’t think people should use extremely hot water to try to ease the pain.
“Someone can burn themselves in this way. “I don’t think it’s a good idea,” he said. “I think that person should go see a doctor instead.”
Still, most experts agree that warm baths are a good idea, especially for people who experience rectal pain. A sitz bath is a warm, shallow bath that is often used to treat hemorrhoids or birth pain. “If it’s skin that’s very abrasive and needs to be softened a little bit, heat can help with that,” Nardelli said.
Some people have also tried applying cold cloths to the sores, wrapping them in ice packs, and standing in front of a fan or air conditioner.
“During some painful periods, the cold is a little bit easier, and there are times when the itching is part of the healing process, so I’ll use the cold as well,” Nardelli said.
Liz’s infection had spread to her mouth and throat. The sores in the oropharynx became so severe that he finally became unable to swallow. Unable to eat, he called the doctor, who prescribed liquid oxycodone, a narcotic pain reliever. For over a week, he had to take a sip before every meal.
“I had five children, all natural, drug-free. I broke a lot of bones. I had kidney stones and my immune system was completely destroyed. I am a walking accident,” he said. “But it’s a pain… It’s a pain… It’s really, really scary.”
This helps to avoid friction and air out the sores
31-year-old Rahul is a gay man living in Luxembourg City. He doesn’t know how he got monkey disease. He had only recently had one sexual partner, but had traveled to Spain and attended several large parties in the weeks prior to the onset of his symptoms. Spain was the initial epicenter of the outbreak and has the second highest number of positive infections in the world with 5,719. In comparison, Luxembourg’s total is now just 43, and Rahul was one of the country’s first cases.
Rahul didn’t understand what was happening when he started having severe pain in his rectum. He didn’t suspect monkey disease at first, and neither did his doctors. They misdiagnosed her with hemorrhoids and then an anal fissure. In the process, they prescribed a bunch of medications that helped. It was only when Rahul went to the emergency room that he was diagnosed with monkeypox. Even then, the infectious disease specialist on duty only prescribed a moderate dose of ibuprofen—not your average ailment.
“People who’ve had surgeries, people who’ve been in car accidents, they say it’s the worst of them all,” Rahul said. “I haven’t experienced these things, but I can guarantee that this is the worst pain I’ve ever felt in my life.”
Surprisingly, the ibuprofen did not ease Rahul’s discomfort. He found the greatest relief lying perfectly still in a certain position.
“It’s very embarrassing, maybe not embarrassing, maybe traumatic. “I lay there for hours trying to keep my hips from squeezing my jaws, because if they did, I’d be gone,” she said. “There was a couple of days like that.”
Nardelli advocates a comfortable physical position for the patient, encouraging them to ventilate their injuries and avoid friction.
“Think about it physiologically. If the two lesions touch each other, it can cause pain. We recommend that our patients, if alone, have as much air exposure to their wounds as possible. It helps dry them out and that helps a little,” he said. “But they might get a little relief from this, but I don’t know if I can stay in this position for a long time.”
There is one intervention that people are discussing on the Internet that you absolutely should not do. Because these are fluid-filled sores similar to pimples or boils, some people try to remove the fluid with forceps or a needle. It was the remedy most strongly opposed by both medical experts.
“Then! Don’t do that. It’s like doing surgery on yourself. You may contaminate your wounds with bacteria. After that, you’ll need an antibiotic,” Cummins said.
“Also, the fluid contains the most virus, so you’re exposing it to other areas of the skin where there’s no wound,” Nardelli said. “A terrible idea.”
You can use mouthwashes for mouth ulcers
Before going to the hospital, Marco tried several times to soothe the pain under his tongue with an over-the-counter chloraseptic spray designed to relieve other sore throats and mouth sores. The product contains phenol and is not recommended for use on deep wounds or serious burns.
For Marco, it seemed to irritate the area. “It took me a few times to connect the two, but I realized that every time I sprayed it, I was getting a weird sensation in my salivary glands or lymph nodes,” she said. “My lymph node under my jaw is so swollen you can see it.”
Cummins advises anyone with symptoms of monkeypox to check product labels for ingredients that may aggravate the sores.
“Oral products may contain alcohol or something else that you don’t want on an open wound,” Cummins said. “Look at the solution. Take a look at the ingredients. Anything like alcohol can sting!”
According to Nardelli, patients at his clinic have found relief with a definitive solution that could be tested by doctors for people with oral thrush, hand-foot-mouth disease or tonsillectomy.
This is called a magic rinse or magic mouthwash—the mixture can vary, but usually contains an antacid such as Maalox; Antihistamines such as Benadryl; and an anti-inflammatory agent such as liquid lidocaine. This is usually formulated by a pharmacy with a doctor’s prescription and you use it to rinse your mouth before spitting it out.
“We have several patients with serious oropharyngeal injuries, and they really get relief,” he said.
The best antidote to stigma is indifference or community or both
When we spoke with Marco in early June, he didn’t want to use his last name for fear of some stigma. But this move of his anonymity didn’t stop his friends from putting the two together.
“They were like Marco, a gay man from Edmonton. It’s you, isn’t it?”, he said. “But I really didn’t care. There wasn’t much stigma. I’m glad I could help get the message out sooner.”
At first, Jeffrey also kept his diagnosis close to his vest, but then he had an epiphany.
“Everyone is always talking about COVID and posting test results on social media and stuff. Why should it be any different? Because it can be transmitted through sexual intercourse? “Sex is already stigmatized for the gay community,” he said. “Something clicked and I was like, ‘Fuck the stigma.’ Shame shame. If I want to talk about it, I will.'”
He has now told all his friends and even colleagues. One of them flew in from Indiana to cover the event because he couldn’t be there.
“They were all very kind,” she said.
And Rahul is open with his community right from the start. She lives alone and cannot leave her apartment, so she relies on the support of others to get through this time.
“I have to be isolated and of course I can’t meet anyone or get anything,” she said. “But you know, the best part of it was seeing that I had a good circle of friends. They helped me with food, food, everything.” ●