There are always risks, but only some of them are anticipated--especially if you don't know enough. One reason I pile one ink project on after another is that with each effort I learn something new. Even with 200+ hours of getting needled, plus my experience as a dermatologist, I still don't think I know enough about tattooing. But the more I learn, the better I'll be able to share useful ideas with other tattoo enthusiasts. That's a major reason for pushing myself towards a full body-suit of ink.
So with a good deal of forethought and experience risk can be mitigated, but of course not eliminated. In my case I've tried hard--maybe too hard--to lessen the risks associated with inking. One risk is of over-preparing--easy, in my case, since I have access to a wide range of medical supplies and treatments. Easy then to make things harder for myself than they really need to be, I thought, as I hunched over vomiting out a cocktail of antibiotics into the electronic toilet in our Shinjuku Airbnb a few days after Xmas. I should have taken the tablets with a few more soy chips, perhaps, or maybe not taken them at all.
One potentially risky intervention can start a cascade. In this case, two weeks after my November Tokyo session I noticed a tender, warm and swollen plaque develop on my freshly-inked ankle--despite fairly continuous doxycycline to prevent common infections. Was this an uncommon one? Probably, though I didn't want to remove a chunk of the artwork to do special testing and prove it. I stopped the doxy and began two other antibiotics: heavy-hitters for less common infections such as nontuberculous mycobacteria. These critters hang out in tap water globally. It's standard practice in Japan to rinse needles with plain water; while quite likely not a problem for a healthy, young, tough Yakuza, for a flabby dermatologist pushing sixty it could be, especially with a mild to moderate amount of fresh immunosuppression via the intramuscular cortisone I routinely self-administer before each inking trip.
The antibiotics suck: nausea, diarrhea, and a real risk of torching the good gut bacteria and causing clostridium difficile colitis. I added on probiotics and toughed it out for a little over two weeks. The lesion regressed in a couple of days, and since I may have caught it really early I discontinued the antibiotics well-short of the standard, three-month course. More shooting from the hip, yes, but I've survived that so far...
So I skipped the steroids this time and instead we lugged twelve liters of sterile water with us all the way to Tokyo. Certainly that must have looked suspicious to security screeners, but nobody got arrested in Haneda Airport, and we and our water made it in one piece all the way from Las Cruces to Shinjuku.
I decided to take a pulse of these antibiotics, along with my usual doxycycline, the morning of the first of three days of inking. The puking later on made me wonder if I'd even gotten any of the drugs in where it counts; the next day's explosive diarrhea made me confident I'd succeeded. But succeeded at what? Was I really doing myself any favors here? I gave myself the benefit of the doubt and headed for Machida City and round three, hunched under a twenty-five pound backpack laden with water. At the studio stood a case of purified water (not the same as sterile), a gift from Sensei. I felt bad even bringing up the whole (unproven) infection issue, and I did stress that whatever it was it was my fault alone. I hope he took it all with a large grain of sea salt.
Minus the steroids and other analgesics, the work was rough. After four hours of needling my shin and ankle were on fire, with hours still to go. I wondered, what with the pain and upset stomach and burning butthole, whether I might be just a little too old for this shit: a youngster's game, not to be taken lightly, let alone done in a concentrated set of long and consecutive days on a jerk my age. But then I thought of an osteoporotic, hunched-over old woman slowly but determinedly walking her bicycle just outside of Naruse station in Machida City. A bunch of youngsters passed her, as did I, but she kept on going. As the needles bit into my swollen skin I thought: if she could do it, so could I.
I couldn't help thinking as well of the Angelina Jolie movie 'Unbroken,' with the American olympic athlete POW getting raked over the coals again and again by a sadistic Japanese commandant in WWII. An interesting comparison, maybe, apt save for minor details like I wasn't a prisoner, was there at my own request, and though he's a tough fellow, Sensei is no sadistic commandant--though it was tempting for me to feel exactly that, what with the lower half of my leg ablaze and hours more to go. Perhaps I might have mutinied were the work not so damned terrific. Fire away, Sensei!
So what did I learn on this phase of the adventure? First, consider context when thinking about a steroid injection prior to inking. They’ve done me well over the years, but aren’t a one-size-fits-all solution for lessening inflammation and speeding healing. There are situation-specific risks that require attention. Second, if inking a leg is part of a family trip, consider doing your sightseeing first, and not after the inking is done, so you can keep your leg elevated and not have to wonder if your ankle is going to explode. Finally, along those lines I’d recommend wearing compression socks, or at least an ace wrap, after extensive leg work involving distant travel—your won‘t be able to elevate your extremity much in a car or plane and the swelling will be greatly lessened. (Probably DVT risk will drop as well.)
As alluded I brought my entire family this time, promising them fun and amazement in one of the safest cities in the world. The twilight zone that Tokyo presents to Americans--at once so similar, and yet so completely different--was relished by them all from start to finish.
While I did deliver for them, who would have known we'd dodge not one, but two bullets on the trip. We were at a Shinto shrine on New Year's Day when several friends from back home texted and asked if we were OK. Little did we know that moments before a 7.6 earthquake hit the west coast, about two hundred miles from where we watched Buddhists pray for good luck in the new year. While perhaps a hundred or more Japanese were losing their lives not far away, we were buying beautiful little charm bags for our dogs' health, and felt not a tremor.
The next morning, while I hemmed and hawed trying to get decent wifi reception to listen to a big game on our flight home, a Japanese Coast Guard plane back at Haneda was readying to take supplies and personnel to help the injured in areas hard-hit by the quake. For unclear reasons the plane crossed a runway and was struck by a landing passenger jet bringing holiday travelers home from Sapporo. At least five were killed in the fiery crash, though in an impressive testament to Japanese communality all passengers from the commercial plane quickly and orderly got off only moments before it, too, was engulfed in flames.
Back home safely it struck me how much luck matters. Hard as I may try to keep my skin and family safe, in the end you still need luck on your side. I don't begrudge the Japanese their omamori prayer bags for a second.