Man suffers from rare condition from spider bite
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BY CINDY-LANGE KUBICK / Lincoln Journal Star
The man lives on a farm. He's alone the day the spider bites him. His hand swells. He can't get to town for help. His fingers start to whither and turn black. He cuts them off.
Bud Zimmerman pecks the story out on his computer, one letter, then another, using the one finger remaining on his right hand. "It's part fantasy, part true," the 43-year-old Lincoln man says. "It takes my mind off the pain."
Two years and 21 surgeries after a poisonous spider bite on Sept.9, 2002, Zimmerman is hoping for relief. It's been a long stretch of bad luck for the wiry, blue-eyed former South Dakota farmer.
It began when he reached inside a tool sack and came out with a brown recluse spider clamped onto his right hand.
It got worse when he developed a rare syndrome called CRPS — complex regional pain syndrome.
It is that syndrome that will bring him to an operating table today to have a device implanted outside his spinal column. A device to block the pain signals from an out-of-whack nervous system.
At least that's his prayer.
"This is my best chance," said Zimmerman, who is no longer able to work because of constant pain.
His doctor, John Massey, an interventional pain specialist, agreed.
"This has been shown to be the most effective treatment."
The syndrome Zimmerman developed is rare. He didn't get it because he was bitten by a spider, but because the bite caused tissue damage and his nervous system — which transmits the pain signal — didn't shut down when the tissue healed. Instead, it went haywire.
When CRPS develops, it's as if the nervous system is "locked in the on position," doctor says. And Zimmerman will do anything to make it shut off.
The soft-spoken man grew up on a farm in South Dakota. Before he came to Lincoln four years ago, he'd never punched a time clock.
He had worked with his father raising corn and soybeans. After his parents died, there wasn't enough land to go around for the 13 siblings. He decided to get out before the bank forced him out. He met his wife, Angela, shortly after he arrived in Lincoln. He married the woman with two daughters and settled into a house with lacy curtains and gray carpeting in north Lincoln.
He found a job welding wood-burning stoves, but he missed being outside. So he took a job with Leach Camper Sales. He moved trailers and trained to become a technician.
One day a camper came in that needed some work. He set his tool bag on the floor. A few minutes later he reached inside for his meter and felt the pinch.
He pulled his hand out. A small brown spider was clamped to the side of his palm. Later he would find out the spider had bitten him three times. Those bites started the odyssey that has left him with just one finger and a thumb on his right hand.
"I can't even lift a cup of coffee."
The morning after the bite, his hand was as big as a baseball. Soon the venom began to eat away at his tissue. It's a trademark of the shy, brown spider with the fiddle-shaped marking on its back. Necrotic Arachnid. Flesh-eating spider.
Doctors cut away the decaying tissue. The wound would begin to heal. Then it would open again. Zimmerman made a videotape. Closeups of flesh eaten away, in some places to the bone.
He had a finger amputated. Then another. Last year the tissue healed. Then the unbearable pain began. It was the start of CRPS, but he didn't know that yet. Neither did his doctors. One doctor told him the pain was all in his head.
He saw nine physicians in all, he says, before he found Massey at Nebraska Pain Consultants. It's hard to describe that pain, Zimmerman says. But it's constant. Different than the pain of the spider bites.
Most medication doesn't touch it. He gets quiet when the worst starts, the feeling of boiling water poured on his arm, over and over.
He goes to the place his training in martial arts taught him. He closes his eyes. He tries to become the pain, to absorb it. It works. For a while.
When it gets too bad, Angela takes him to the emergency room for a shot to knock the pain down.
It's been a struggle. For a long time, workers compensation covered his medical bills. Not anymore.
His wife's insurance will cover some of Monday's surgery, but not all. They don't have the money to pay for the rest yet, but he has no choice, he says.
The syndrome is progressive. His doctor says that people with CRPS for less than six months have great success with the implant. The pain usually disappears.
For those with the syndrome longer than six months, the pain can often be reduced, made more manageable, but it rarely goes away.
It's been nearly a year since Zimmerman felt the pain change and intensify. He's ready for the surgery.
"At this point I'm pretty optimistic that it's going to help," he says. "This is my best shot and I'm looking forward to trying it."
The story Zimmerman is writing is 138 pages long. He's not finished.
"I'm not sure how it's going to end."
Reach Cindy Lange-Kubick at 473-7218 or clangekubick@journalstar.com.
Reaction to spider bite rare
A severe reaction to a spider bite — even the bite of a poisonous brown recluse — is rare.
The annual report of the American Association of Poison Control Centers listed just one fatality nationwide from a brown spider bite in 2003.
And of all the toxic exposures reported to the association, only 3.4 percent were from stings or bites.
"A handful a year are reported to us," said Steven Seifert, medical director of the Nebraska Regional Poison Center. "The vast majority result in a minimal amount of soft tissue damage."
Three spiders are listed as poisonous by the Centers for Disease Control and Prevention: the black widow; the hobo spider; and the brown recluse.
The venom of the recluse damages tissue. But the extent experienced by Bud Zimmerman is rare.
It is also rare to develop CRPS — complex regional pain syndrome — as Zimmerman has.
Seifert isn't familiar with Zimmerman's medical history, but he agreed his situation was unusual.
"Just bad luck, I guess, all around."
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