I need advice .. got stuck by sea urchin

[DocVikingo]

Got stuck by sea urchin - UPDATE

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Saw the Doc., armed with D.A.N. article, reccommending steroid treatment. He gave me a tetnus shot, then wrote a scrip for Prednisone. The steroids worked .. until scrip ran out; swelling returned. The GP punted, sending me to a Ortho/hang specialist .. who sent me in for an MRI. MRI confirmed ... that my finger hand significant swelling (duh!), and nothing else. The Ortho recommended surgery as next step, under a general anesthetic to slice the finger open along the length, clean & inspect nerve sheath, and culture the infection to find out what it is.

This seemed a bit extreme, so I checked with D.A.N. The good news: D.A.N. insurance covers what my insurance doesn't. The bad news: D.A.N. agrees with the surgery as next step. Had the surgery yesterday, so here I sit, with one arm wrapped from from fingers to wrist, a great Vicodin buzz, one-finger typing. The "half hour" surgery took 2.5 hours because he didn't find anything more than the MRI did. I'll be out of the water for 2 weeks, which is depressing, especially because I'll miss this weekend's "Lover's Cove" cleanup dive ... doesn't happen often and, after a summer of low-vis beach diving with students, I was really looking forward to it (sniff ... obvious plea for support!)

The tally so far:
2 Visits to Gen. Practioner
1 tetnus shot
1 Scrip for Prednisone
3 Visits to Ortho (1 in 10 days to remove stitches)
1 MRI
1 surgery ($1600!!)
1 Scrip for Vicodin
Opportunity to coach 1 soccer team & 2 bball teams as "Forrest Gimp"
2 weeks of missed diving during best vis of the year

After all this, no one can tell me that Sharks are the most dangerous marine life! Arrrrrggggghhhh!

 

[Hank49]

healed over completely.

Does anyone have advice on what to do next? Has it happened to anyone else?

I can't imagine that a doctor would do much except start cutting, which seems a bit radical for something so minor. If it continues to worsen do I go to a dermatologist or just a regular MD?

I got poked by a black urchin paddling across a shallow part of Crouching Lion reef in Ka'a'awa, HI. It was just as you described with swelling and a feeling like I had sprained the two fingers. I didn't do anything. The pain was gone after a few days...the swelling and the little black dots were there for a about a month.

 

[archman]

The Ortho recommended surgery as next step, under a general anesthetic to slice the finger open along the length, clean & inspect nerve sheath, and culture the infection to find out what it is.

Ewww! I might just annotate this to my field lectures, to scare away the students that like to touch things.

"Getting poked by urchins may entail a hospital visit, where your finger will be sliced open, and the nerves cleaned out."

Think that's intimidating enough?

 

[Scubakevdm]

The tally so far:
2 Visits to Gen. Practioner
1 tetnus shot
1 Scrip for Prednisone
3 Visits to Ortho (1 in 10 days to remove stitches)
1 MRI
1 surgery ($1600!!)
1 Scrip for Vicodin
Opportunity to coach 1 soccer team & 2 bball teams as "Forrest Gimp"
2 weeks of missed diving during best vis of the year

Seeing the look on that urchin's face when I slapped him... priceless.

MASTERCARD​

 

[milkathecow]

I know this thread is almost 3 years old now... bu there is a little thing that works amazingly to get sea urchin splints out... olive oil.

Always have a little amount in a little plastic canister... useful for ears ... and for sea urchins. just put some on the finger (don't be mean) and rub gently... you'll see them pop out... it's just incredible. then vinigar etc... and the normal checks...

 

[DocVikingo]

... olive oil. then vinigar (sic) etc...

And voilà, dressed garden salad ; )

Regards,

DocVikingo

 

[fisherdvm]

I know this thread is almost 3 years old now... bu there is a little thing that works amazingly to get sea urchin splints out... olive oil.

Always have a little amount in a little plastic canister... useful for ears ... and for sea urchins. just put some on the finger (don't be mean) and rub gently... you'll see them pop out... it's just incredible. then vinigar etc... and the normal checks...

Never heard of that before. I know this old chemist who insists that vinegar will dissolve the spine. But anatomically, I can't imagine that. The seal by the skin is too tight to allow the vinegar to penetrate. Even if it partially dissolve the spine, it makes it harder for a real doctor to pull it out.

My advise is - go to the nearest ER or a physician with good sharp splinter forceps. He might be able to pull out the spines without anesthetic.

The worry is, if the spine penetrate one of the flexor tendons of the digits, a very nasty infection can occur and cause you to have surgical drainage and iv antibiotic.

I'd leave it to the professionals (dermatologist, family doctor, or ER doctor) and not mess with it yourself.

 

[sea nmf]

I'd leave it to the professionals (dermatologist, family doctor, or ER doctor) and not mess with it yourself.

Ha! I called my doctor when I got stuck a few years ago. No pain after awhile but a black spine in my finger.

Anyway, living in Hawaii, you would have thought they would have heard of it before. The nurse asked around, called me back, and said "well, the ancient Hawaiian's used to suck it out with their mouths". Just what we need, saliva in the wound . . . .

Anyway, after about a month, it disolved on it's own.

 

[fisherdvm]

There is a plant in hawaii called the bougainville - real pretty, but nastier than heck. Folks would prune the plant, and get stabbed with the thorn. When in it penetrate the tendons - it can get infected, and can not be treated with antibiotic.

I remember taking care of a patient who need to have to tendon surgically opened and drained with iv antibiotic for almost a week.

The same could happen to sea urchin spine... I think it is nearly malpractice to tell someone to "suck out the spine". If you are not infected with the marine bacteria in the spine, you will certainly get infected with a worse bacteria from your own mouth.

Not to say it can't be done... I just wouldn't recommend it. I have very good luck with a dermatologist's dermatoscope plus custom made splinter forceps.... If needed, I'd do a digital block and get anything that is deeper out.

 

[k4man]

Got stuck by sea urchin - UPDATE

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...The tally so far:
2 Visits to Gen. Practioner
1 tetnus shot
1 Scrip for Prednisone
3 Visits to Ortho (1 in 10 days to remove stitches)
1 MRI
1 surgery ($1600!!)
1 Scrip for Vicodin
Opportunity to coach 1 soccer team & 2 bball teams as "Forrest Gimp"
2 weeks of missed diving during best vis of the year

After all this, no one can tell me that Sharks are the most dangerous marine life! Arrrrrggggghhhh!

instead of a MasterCard advertisement, it sounds like a GREAT endorsement for DAN DIVER INSURANCE!!