Jungle medicine.

12 years ago

Sunday night (9 days ago) I was in Josemite Park, California trying to sign up my grand daughter for a hose back ride the next day. At their sign up stand, I slipped and fell down about 2 feet or so. I braced my fall with my outstretched hand and suffered a blunt avulsion laceration of my palm. Not a clean cut but a ragged tear across the entire palm, 2 1/2" long, full thickness so you could look into the hand and see the tendons moving as I wiggled my fingers. All the fingers moved normally, there were no areas of numbness.

It reminded my of the Terminator laying open his forearm to fix something. The horse people freaked out and were ready to call an ambulance or at least drive me into Fresno to an ER. It's Sunday evening and it would have taken 2 to 3 hours to get to Fresno, I elected to go to my daughter's camp instead after wrapping the hand up.

When I arrived there, it was the same, my daughter, a family MD who is used to doing things straight wanted me to go to Fresno to an ER. My son in law, an orthopedic surgeon and his campsite neighbor, also an orthopedic surgeon had a different take on it. Like Apollo 14 , they assembled what we had which included the following:

Beer

Whiskey

Bottled water

First aid kit with some gauze, ace wrap, H2O2 and tape.

Since they were way ahead of me with the consumption of alcohol, I started by downing a couple of shots of Jack Daniel and a couple of beers in rapid succession. While the alcohol was putting me in a 'Feeling no pain' state, they had a humorous discussion how this would be treated in Zimbabwe or Haiti.

The alcohol had now worked it's miracle on my pain receptors so they flushed the wound out with bottled water, trimmed of the ragged parts with a pair of nail clippers, poured some Hydrogen Peroxide on the area and then wrapped it all up with my hand closed in a semi fist.

It stayed like that for several days, dressing changes twice a day, while I went river rafting, horseback riding and hot air ballooning with 2 of my grand kids. None to minimal discomfort experienced.

It is now 9 days since the incident, the wound is totally closed and I'm beginning to use the hand carefully in a near normal way. The alternative to what we did would have been a 3 hour ride to Fresno, then 10 hours plus in an emergency room. Since tendon's were exposed, most ER physicians would have called for a ortho or hand surgeon consult not willing to accept the liability to fix this themselves.

16 hours and $6,000 or more later, the edges would have been approximated by carefully placed sutures and I would have been on my way. By putting the hand in a semi closed fist position,we accomplished the same thing. It's healing very nicely.

I think we have a tremendous need to over do things at tremendous costs. Being in the middle of a park with a couple of orthopedic types who were letting it all hang out let to a wonderful experience. I am up to date with my tetanus and would have started heavy duty antibiotics if redness, swelling and fever occurred, but that did not happen. I love to go back to a simpler way of life and avoid all the modern poppy cock that we feel obligated to heap upon ourselves.

Nick

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Comments (5)

sambac
12 years ago
last modified: 9 years ago
Oh boy!! I would have freaked the hell out. Good that you don't need your hands to make a living- right away.... Have to say 'daring you'. BTW, how was the white water rafting- long time desire- but need some disney kind to get started, kind of fearful of water...
orchidnick
Original Author
12 years ago
last modified: 9 years ago
Not really all that daring. First off all, I do appreciate the use of my hands and was not willing to gamble away one of them. Even though this was the left on and I'm not a lefty, I used it today without any protection repotting and some construction, no problem, total healing has taken place.

My point really is that our bodies are quite capable of healing them selves given half a chance. I'm a retired physician, my son in law and the neighbor at the campsite both are orthopedic surgeons so we had enough talent there, just no instruments like sutures and needles etc. The Jack Daniels and the beer made up for that deficit.

My daughter, also a physician represents the opposite end of the spectrum. She freaked out and would have me admitted to an ICU and the wound sutured in an OR, damn the expense. Their 4 little boys are the most protected yuppie larva you can imagine. Them eating an apple is an experience worth watching. First the apple is washed, then sprayed with Veggie Spray, rubbed in this and then washed again. Then it is polished with a paper towel and cored with a gadget she has that eliminates the center and makes little apple wedges. These go on a plate which is carried to the table where they are eaten. To just grab an apple and start munching on it is unheard off.

She had nightmares about my hand and wanted me to start heavy duty antibiotics. As long as there was no pain, no red swelling and no fever, these were absolutely unnecessary. She is amazed at the results and can't believe that modern medicine is not really needed to get good results.

Nick
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orchidnick
Original Author
12 years ago
last modified: 9 years ago
Forgot about your white water question. These trips are rated from 2 to 5. 2 is a float down a river with little waves reserved for families with very small children, 3 gets you soaked and into a few real rapids. 3 is what you start with, do it twice and then move on if you like it. 4 is for experienced rafters only, 5 is considered unraftable. Forget about Disneyland, do a class 3 in West Virginia which has some of the best river rafting in America. If you like it let the 3rd trip be a class 4, you won't regret it.

It's like any other tourist activity. It has to be thrilling, other wise why would people do it and they can't kill too many tourists so it won't get a bad reputation. If you go with a reputable rafting company, you will be totally safe and have an experience you will never forget.

Go for it, Nick
sambac
12 years ago
last modified: 9 years ago
Thnaks for the rafting tip. Almost tried at Costa Rica and back peddled the last minute. I thought the waters looked a little rough.
I am a germ freak like your daughter- not as intense though, but I do take 'cut' bodyparts serioulsy. Now that you have gotten over your wound- how bout necrotizing fasciits aka flesh eating bacteria and all that good stuff...
orchidnick
Original Author
12 years ago
last modified: 9 years ago
You missed the experience of a life time. The best river rafting adventure in my life was in Costa Rica. We had 23 back to back class 4 rapids, at one point my entire family and myself got catapulted out leaving the guide as the only occupant of the boat. None of us will ever forget that trip.

Flesh eating bacteria or necrotizing fasciitis as some people call it, is about as rare as being abducted into a UFO. It is not really related to the extend of the injury or the level of contamination of the wound but probably has more to do with the immune resistance of the host. Anybody can get it from the smallest scratches on up but it is most commonly seen in immune-compromised individuals. We thoroughly irrigated the wound with bottled water and then flushed it out with Hydrogen Peroxide, about all one can do. Whether the skin is nicely closed with sutures or held together by positioning the edges so they touch each other will have no bearing on the incidence of necrotizing fasciitis.

I'm still waiting for little green men to abduct me into a space ship for reproductive experimentation. I'm ready, but that hasn't happened either. I'll just sit tight and water my orchids, prepared for the worst but expecting the best.

Nick.