Hit by a Crown of Thorn - Ouch!

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ulrikakroon

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Scuba Instructor
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Location
Dumaguete, Philippines
Hi!
I'm not sure if this is the relevant Forum but I'll give it a try.
Three weeks ago, I was diving on the reef and a Crown of Thorn (nasty venomous starfish) fell on my hand. Long story, but about 6 of its venomous spikes hit my finger - very painful, lots of bleeding and swelling.
I soaked it in hot water and then just started waiting for it to go away. Within a week it was all red and infected and I got antibiotics and finally after two weeks the infection was gone. Yihaaaa I thought.
Not quite. I can't use my finger! The joints are extremely painful and I can't bend it and there is no improvement there since 3 weeks. I feel like i have arthritis or something and it seems to be in the joints, not the muscles.
I have tried to look on the internet but found nothing useful - WILL IT GO AWAY?
(I live on a small Philippino island so going to the hospital is a big project)
Cheers!
Ulrika
 
Some stuff I uncovered.


Starfish, Crown of Thorns, and Sea Star Punctures Treatment



* Immerse the affected area in water as hot as the victim can tolerate for 30-90 minutes. Repeat as necessary to control pain.

* Use tweezers to remove any spines in the wound. Symptoms may not go away until all spines have been removed.

* Scrub the wound with soap and water followed by extensive flushing with fresh water.

* Do not close the wound with tape.

* Hydrocortisone cream may be applied 2-3 times daily for itching. Discontinue immediately if any signs of infection appear.

* If signs of infection occur, such as pus, redness, or heat, apply topical antibiotic ointment (Bacitracin) 3 times per day.

* Oral antibiotics are usually recommended for infection. Continue antibiotics for at least 5 days after all signs of infection have cleared. Check for drug allergy prior to starting any antibiotic. Some antibiotics cause sensitivity to the sun. Use a sunscreen.

* Pain may be relieved with 1-2 acetaminophen (Tylenol) every 4 hours and/or 1-2 ibuprofen (Advil, Motrin) every 6-8 hours.
http://www.emedicinehealth.com/articles/26867-3.asp



First Aid for
CROWN-OF-THORN SEASTAR (STARFISH) PUNCTURES:


Remove any obvious broken spines protruding from the wound. Unless a victim is allergic, these wounds are not a medical emergency and can be treated at home. Soaking the wound in hot water for pain control is unproven. Some authors believe soaking the sting in hot, nonscalding water for 30 to 90 minutes may reduce pain caused by this venom. Others feel heat application has no benefit in crown-of-thorns injuries, and should not be used. Follow First Aid in Staph, Strep and General Wound Care. Infections from these wounds are rare. If you cannot remove broken spines, or develop hives, breathing difficulty, numbness or weakness, go to an emergency room. These symptoms usually disappear after spines are removed.
http://www.aloha.com/~lifeguards/alsting1.html#crownofthorn


Thoughts - did you remove all the spines?
 
ulrikakroon:
Hi!
I'm not sure if this is the relevant Forum but I'll give it a try.
Three weeks ago, I was diving on the reef and a Crown of Thorn (nasty venomous starfish) fell on my hand. Long story, but about 6 of its venomous spikes hit my finger - very painful, lots of bleeding and swelling.
I soaked it in hot water and then just started waiting for it to go away. Within a week it was all red and infected and I got antibiotics and finally after two weeks the infection was gone. Yihaaaa I thought.
Not quite. I can't use my finger! The joints are extremely painful and I can't bend it and there is no improvement there since 3 weeks. I feel like i have arthritis or something and it seems to be in the joints, not the muscles.
I have tried to look on the internet but found nothing useful - WILL IT GO AWAY?
(I live on a small Philippino island so going to the hospital is a big project)
Cheers!
Ulrika

I was poked in the tip of my thumb on Boracay and it was painful to the touch for about 3 months. It finally went away. Nasty buggers those...I also got poked in the thin skin over my ankle bone but it bled a lot and heeled as fast as any small cut. I think you're just going to have to tough it out for a while.
 
I’m told that if you get a bit of spine broken off inside the joint, it usually won’t go away without minor surgery. Could this be your problem?
 
Hi and thanks for yr answers!
I finally gave up and took the ferry to The Hospital where I had my finger x-rayed. Oh and apparantly there's a piece of starfish stuck in there. Great.
Doc claims it's hard to get it out so I should just wait until it comes out by itself and deal with the pain.
He also gave me 2 "painkillers" that I checked on the net - one was good for "anaemia, and treatment of peripheral nervous system disorders such as Parkinson but also good for male infertility". The other one was good for "musculoskeletal spasm".
I think I'll skip it and stick with anti inflammatory and see what happens :nurse:
/ulrika
 
Hi,

I also got my fair share on one of my fingers while I tried to show my students not to touch them. I accidentally got 3 punture wound from the COT spine and my palm swell by the next day. I tried to recover all visible foreign object from the wound immediately after the dive but couldn't find any. I also submerged my finger into hot water after that. I was given some anti-inflamation pills and pain killers by the local hospital.

I was told by dive medicine physician when I visit him on the 3rd day after I start to develop a mild fever that I should not immerse the infected area in hot water as it will cause the blood vessel to dilate and the venom to spread. The swell on my palm subsided after a week but the joint on my finger where 2 of the puncture wound still swell. I guess it will need a few more weeks to fully recover.

Try to refrain from eating shell fishes(crabs, prawns etc) as it does cause the swell to get worse (I have tried)...

Dive Safe,
EZ
 
Next time you see a COT an interesting trick is to reach down inside the thorns with a boltsnap or other object and touch it. There will be very interesting color changes in response to the touch.

I did this once while on a DM-led dive in Maui. The DM didn't see the boltsnap in my hand and totally freaked out, thinking that I was petting the COT with my bare hand. :)


That DM had brushed a COT and gotten a painful injury. He says that it healed completely, but it took about 6 months to go away completely.
 
These things suck. Even if you get the spine out, it's a fair bet that you're still going to have swelling and pain for a good long while after. Weeks to months. That brand of venom is quite nasty. Keep us informed if you or your docs come up with a good treatment, and best of luck on your recovery.
 
https://www.shearwater.com/products/swift/

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