Sliceoftheocean
New member
happy to see you are doing better
Visit to the ER..."ON Topic"
- Thread starter Jacwil
- Start date
jeremyjoslin
New member
My regards to the OP: hope you're doing better, and always hate to post more than once in someone else's thread like this. My intent is that there may be a shred of info in here that is helpful to others.
My fullest apologies if this was offensive. It was meant (and commonly used) as a figure of speech and not a direct address. It is commonly used as a light-hearted defense when someone is being slightly offensive in their own right (please refer to your discourse on ER physicians). Perhaps it is the tone of this forum to be casual, or simply a breach of my manners, that allowed me to use the vernacular. Either way, I hope you would forgive me and that there be no hard feelings. This forum is a small place, and although I don't know you, per se, you are already respected.
It's fair to share your opinion. I hope that my counter-opinion is alright with you also. We both know that doctors come in all degrees of experience and training.
Although we agree on the principle of stewardship, the wholesale advise of being seen by an ID specialist is firstly impractical in the ED, and secondly inappropriate for the wider spectrum of marine problems. My advise was purposefully more generic to encompass other commonly encountered problems such as envenomations and injury. Knowledge of which might be extremely limited to an ID specialist whereas someone with training in wilderness or dive medicine would immediately understand the multi-disciplinary complexity of the problem.
With full deference to the OP, I think that 99.9% of the time these medical issues can be, and are, dealt with by a single EM trained ED physician (there are other types out there, yes) without the need for ANY consultation at all. Certainly, there are cases where the ED provider may not connect the dots when we talk about our tanks in terms or descriptions that don't trigger the cognitive process needed by that provider ("Wait, did they say reef tank... that's saltwater, right? I wonder if the same organisms grow in there as they do in the ocean... that's a special concern and management might be different than routine for upstate NY...")
I tried to be a bit more careful and articulate in this post than in my previous post, which runs me the risk of sounding pedantic. Please know that my intent here is sincere... I want to get along and humbly pass along some information.
Justin, I hope you continue to recover.
My fullest apologies if this was offensive. It was meant (and commonly used) as a figure of speech and not a direct address. It is commonly used as a light-hearted defense when someone is being slightly offensive in their own right (please refer to your discourse on ER physicians). Perhaps it is the tone of this forum to be casual, or simply a breach of my manners, that allowed me to use the vernacular. Either way, I hope you would forgive me and that there be no hard feelings. This forum is a small place, and although I don't know you, per se, you are already respected.
It's fair to share your opinion. I hope that my counter-opinion is alright with you also. We both know that doctors come in all degrees of experience and training.
Although we agree on the principle of stewardship, the wholesale advise of being seen by an ID specialist is firstly impractical in the ED, and secondly inappropriate for the wider spectrum of marine problems. My advise was purposefully more generic to encompass other commonly encountered problems such as envenomations and injury. Knowledge of which might be extremely limited to an ID specialist whereas someone with training in wilderness or dive medicine would immediately understand the multi-disciplinary complexity of the problem.
With full deference to the OP, I think that 99.9% of the time these medical issues can be, and are, dealt with by a single EM trained ED physician (there are other types out there, yes) without the need for ANY consultation at all. Certainly, there are cases where the ED provider may not connect the dots when we talk about our tanks in terms or descriptions that don't trigger the cognitive process needed by that provider ("Wait, did they say reef tank... that's saltwater, right? I wonder if the same organisms grow in there as they do in the ocean... that's a special concern and management might be different than routine for upstate NY...")
I tried to be a bit more careful and articulate in this post than in my previous post, which runs me the risk of sounding pedantic. Please know that my intent here is sincere... I want to get along and humbly pass along some information.
Justin, I hope you continue to recover.
Capt_Cully
Active member
First of all, I had to look up pedantic.
Second, my experiences are my own, as are my opinions. Every hospital I work at and have worked at, has an available ID specialist. Is that the best choice for all marine related injuries? I'd agree, no. Toxicologists are fewer in number and availability. Still rarer, are wilderness trained and or dive related injury specialists. Particularly in this area. Therefore, the suggestion to seek attention for unusual injuries at SUNY Upstate, is likely the best option in our area.
The message I would like to convey is that you need to be aware of the fact, that in this hobby, our muse is potentially harmful. Providing an accurate history, when seeking medical attention, is of paramount importance. It is the history which provides a health care provider with their most powerful clues. As a patient, you should be sure that the person you are seeking medical attention from, acknowledges that they understand the unusual nature of your insult. If you feel slighted, or that the attention you are receiving is incomplete or inadequate, IT IS YOUR RIGHT to request further consultation or evaluation.
I maintain that Justin's injury was botched, and cost him a few days in the hospital, instead of merely an afternoon or an overnight stay.
Second, my experiences are my own, as are my opinions. Every hospital I work at and have worked at, has an available ID specialist. Is that the best choice for all marine related injuries? I'd agree, no. Toxicologists are fewer in number and availability. Still rarer, are wilderness trained and or dive related injury specialists. Particularly in this area. Therefore, the suggestion to seek attention for unusual injuries at SUNY Upstate, is likely the best option in our area.
The message I would like to convey is that you need to be aware of the fact, that in this hobby, our muse is potentially harmful. Providing an accurate history, when seeking medical attention, is of paramount importance. It is the history which provides a health care provider with their most powerful clues. As a patient, you should be sure that the person you are seeking medical attention from, acknowledges that they understand the unusual nature of your insult. If you feel slighted, or that the attention you are receiving is incomplete or inadequate, IT IS YOUR RIGHT to request further consultation or evaluation.
I maintain that Justin's injury was botched, and cost him a few days in the hospital, instead of merely an afternoon or an overnight stay.
Cully, you could be right that Justin's injury was botched. If he had the same thing that I had (which it sounds like it could have been), then a stay in the hospital of more than a night was pretty much guaranteed.
I was on 4 different IV antibiotics for over 72 hours. Even if I was admitted, given a bag or to of antibiotics, stayed a night, and then released, I would have been back. They were never able to determine what the exact cause was because the cultures never grew.
Justin. I'm glad you are better. Did they ever open it up and do a culture? I've got bad news though... Your pinky is probably going to hurt for a while. I still experience pain in my thumb joint and have decreased range of motion and strength.
I was on 4 different IV antibiotics for over 72 hours. Even if I was admitted, given a bag or to of antibiotics, stayed a night, and then released, I would have been back. They were never able to determine what the exact cause was because the cultures never grew.
Justin. I'm glad you are better. Did they ever open it up and do a culture? I've got bad news though... Your pinky is probably going to hurt for a while. I still experience pain in my thumb joint and have decreased range of motion and strength.
Jacwil
New member
It's hard telling and hindsight is always 20/20 as Mark said, re: my hospital experience.
They got cultures from blood samples from my left wrist, x2, and my right arm, x2. They did not open my wound up. They didn't grow anything.
Doc said that he MAY discuss matters with an ID specialist but if that happened I didn't hear about it.
I also thought it was odd that during my stint in the hosp, the nurses and staff never really checked my finger or arm streak. They just asked if I needed anymore pain meds and swapped out my IV antib's. I however, did remove my splint/ace wrap numerous times to see if the streak had progressed. The last night a nurse came in while I was inspecting 'things" and asked what I was doing..I told her, "monitoring the streak", she said "oh, we're just treating you for cellulitis."
The thing that seemed to concern the team the most was if the infection were to get into the tendon channels in my palm. The ortho said that antib's wont help if that were to happen, and that they would have to "go in" if the range of motion became more restricted. It never came to that however.
It's still quite sore and I'm fighting the urge to go in there myself with a new blade and see if I can extrude whatever may still be in there causing all the inflammation...I tend to be not too patient a patient
They got cultures from blood samples from my left wrist, x2, and my right arm, x2. They did not open my wound up. They didn't grow anything.
Doc said that he MAY discuss matters with an ID specialist but if that happened I didn't hear about it.
I also thought it was odd that during my stint in the hosp, the nurses and staff never really checked my finger or arm streak. They just asked if I needed anymore pain meds and swapped out my IV antib's. I however, did remove my splint/ace wrap numerous times to see if the streak had progressed. The last night a nurse came in while I was inspecting 'things" and asked what I was doing..I told her, "monitoring the streak", she said "oh, we're just treating you for cellulitis."
The thing that seemed to concern the team the most was if the infection were to get into the tendon channels in my palm. The ortho said that antib's wont help if that were to happen, and that they would have to "go in" if the range of motion became more restricted. It never came to that however.
It's still quite sore and I'm fighting the urge to go in there myself with a new blade and see if I can extrude whatever may still be in there causing all the inflammation...I tend to be not too patient a patient
It's still quite sore and I'm fighting the urge to go in there myself with a new blade and see if I can extrude whatever may still be in there causing all the inflammation...I tend to be not too patient a patient
Dude, if you do that, you need to take video and post it! I'm always down to watch someone cut themselves open!
It's not easy being a patient. I think the two things that are really common in exotic aquatic injuries that sets them apart from little scrapes that can be dealt with neosporin is (1) pain and (2) restricted motion. The time frame as noted earlier is also really important especially in the first 12hrs these symptoms are not good signs.
It's going to hurt for a while. I'm not surprised they just treated you for cellulitis. The only people that checked the streak on my arm were the infectious disease doctors and the ortho people once or twice.
Be glad they didn't open you up. It is probably one of the worst pains I have felt. But... Chicks do dig scars.
Be glad they didn't open you up. It is probably one of the worst pains I have felt. But... Chicks do dig scars.
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