stung, is there a better AB to ask for?

[jjs]

Hi,

9 days ago, i was pushing a boat that had gone aground in Mersing Harbour on route to Pulau Tioman.

Stupidly i did not put booties on before entering the water.

I stood on something that then stung me in the side of the foot, we think it was an "Inimicus Didactylus" - demon stinger which are common in the area and it was *in* not on the sand.

The foot swelled rapidly, i was in a lot of pain and certainly in shock.

Thanks goes to those that then carried and dragged me back to shore and to the hospital.

I had a series of injections around the wound which helped, we then awaited the return of the tide and i caught the same ferry as the people present when the incident occured.

Not moving on the ferry i got quite sun-burnt but the swelling continued to subside. On arrival at Tioman, we raised the foot and I got very drunk for the afternoon, by 2AM i awoke in agony took more pain killers and applied more cooling to the area which helped the swelling seemed to be the main issue which was over the front half and side of my foot.

After 48 hours the swelling and pain had mostly gone.

After another 48 hours i went to see a doctor as the wound was clearly infected, and he pescribed Dalacin C - clindamycin which seemed to help, and after a couple of days i could see stretch marks on my foot

However i have now finished the course and this morning awoke to a very itchy wound site and more swelling.

Any informed suggestions as to what AB i should ask for next would be very much appreciated!

Cheers,

Jon

 

[Rick Murchison]

Can't advise on antibiotics... but I can say that itching is not necessarily a bad sign - it is often normal in healing tissue.
Rick

 

[Web Monkey]

Hi,
However i have now finished the course and this morning awoke to a very itchy wound site and more swelling.

Any informed suggestions as to what AB i should ask for next would be very much appreciated!

I'm not a doctor, if it's bothering you and you think it's still infected, I suggest you see one.

Seriously, you could have pretty much anything, since there's no way to know what was in the water.

The only way to know what you have and what will fix it is to have a doctor look at it.

BTW, you might want to have it looked at immediately, since some infections progress very rapidly.

Also, if your doctor isn't aware of it, there's a free (registration required) antibiotic database at http://hopkins-abxguide.org that lists which antibiotics are preferred for particular infectious agents.

Terry

 

[redrover]

Aloha,

A physician is the best place for that opinion and local physicians will have experience with encounters such as yours. Call DAN.

From your account of events I feel compelled to offer some education which you may not need because I personally have better success following instruction when I know why, no intent to question your intelligence.

In general feet are bad places for infections.

Your blood carries the white cells (the good guys) that combat the germs. The germ warfare creates waste products that the blood has to carry back to deposit in the filtering organs. Feet are the furthest from the pump (heart) that provides all this circulation.

The reason feet swell on long plane trips as an example, is because the circulation is decreased. Walking uses muscles to assist the circulation. With decreased circulation ie; it hurts to walk so walking is limited and sitting down because it hurts to walk, the good guys have more work to do with less support.

The bad guys (germs and viruses) are frequently quite smart and become able to outwit the weapons. And/or in significant number that enough are able to survive, continue to breed and carry on the attack and after one course of antibiotics these guys are tuff little buggers. Sometimes there are several different enemy’s on the combat field and/or different ones prosper in different environments (aerobic and anaerobic). It is common to need additional antibiotics and/or changes.

Medicine, well a lot of it anyway, feels it is best to begin the campaign using the least firepower likely to be effective and move up to bigger guns or switch only if necessary. (Why kill a fly with thermonuclear weapons when a flyswatter works.)

It is common in an injury you are describing (rapid swelling and lot of pain, re-swelling post antibiotic course) that one or two band aids will not solve the problem, in fact this may be a serious problem needing close attention.

A physician would be best to advise you and I strongly urge you to see one ASAP. If there are red streaks from the wound area or any lymph glands are swollen or tender, go to emergency care ASAP.

Basic initial treatment includes RICE, Rest, Ice, Compression and Elevation.

Rest means the area is traumatized don’t keep beating it up.

Ice is a significant pain killer and if the tissues are leaking (swelling) it can reduce the flow.

Compression reduces the available space for swelling, swelling causes pain. Swelling also presses on blood vessels further reducing circulation.

Elevation allows the heart to provide improved circulation. Think of how much easier it is to walk the same distance on a flat surface vs up and down hill.

Considering the timeline, perhaps alternating Dry Heat with Ice would be more appropriate. Ask the physician if it is ok to use range of motion foot exercises to assist the circulation. Ask the physician exactly what you should and/or should not do about treatment, medication side effects and dietary concerns (alcohol, empty or full), dry or wet, heat or cold, work or not and everything I say here.

Pain killers are just that, they kill pain and not the cause. Avoid letting the pain medication encourage you to think you are better. Many also plug up the works and if you can, try to use them to sleep (Rest) or as needed vs ‘take 2 every 4 hours’. It sounds like you have a nasty infection, expect some discomfort.

I am curious about the initial injections around the wound; do you know what they were?

Best wishes with recovery! I’d be interested to hear of your progress.

Lisa

 

[jjs]

Been to see the Doc again, and we have come to an agreement....

There is no infection of the "wound" rather it seems to be the remainder of the toxin causing some grief after walking significant distance yesterday.

So anti-inflamatory and continue with AB.

>no intention to question your inteligence
lol....... you would have to find it to question it, good comments btw you should get that added to the DAN faq and made a sticky post.

>I am curious about the initial injections around the wound; do you know what they were?
No, I was in no state for making notes at the time, i had survived long enough that I was not going into anaphylactic shock.. so the best guess is that it was a steroid and AB mix... they were very calm in the hospital, in the right way to convince me that they had seen this many times and knew what to do about it, my Malay was good enough to say thanks and that was about it. The boat boys had said "one injection.. all better after a day"

Other things i read afterwards said it would be bad for 48 hours and that proved to be very true.

I will update you if i get to know anymore about it.

cheers,

Jon

 

[redrover]

I am so glad to hear that!
From what I could tell from checking up more on scorpion fish in particular, if you made it past 48 hours you were in good shape. I know I probably sounded over worried, I apologize. I’ve just seen people wanting to tuff things out and with tropical infections they’ve turned into life threatening infections. Very nasty stuff likes paradise too.
Did anybody suggest hot as you can stand it soaks to draw out the toxin?
Hopefully they did mention take anti-inflammatory with food, they’ll ride better. And same with the antibiotic. I suggest you look it up for possible side effects to be aware of. I’m not saying it’s bad, it’s good; just some people don’t tolerate it well. I am one; it didn’t show up quickly and took weeks to go away.
Drinking a boat load of water helps to flush.
I’m just guessing, the itchy part is part normal tissue healing and part toxin aggravation. In general scratching is an opportunity to introduce new bad guys. I’ve found the numbing of ice to really help keep itching tolerable.
Thank you for letting me know, I’ll sleep much better.
Aloha,
Lisa