They did not debride it? In this case, medical treatment after initial injury was delayed which required surgical treatment and prolonged hospitalization. Stingrays generally do not attack aggressively or even actively defend themselves. There is still swelling but it subsides if I elevate it. Only a lite jog. the wound is still open and draining but looks so much better than when it happened. The barb had cut an artery and blood was going every place. One more point I forgot to mention. It would have however made me more cautious of my surroundings. Kelly – The streaks could be a sign of infection. There was no bleeding for a few hrs. he applied a turnaket compress.. then soakd emediately hot hot water over and over for abot 2 hours… extremly painful ..hard to discribe..i had been enjoying some drinks so i was bleeding alot …left foot just under the toe… its the second day and im AFRAID to go see anyone who claims to be a doctor,or medical advisor in this very small town in the high desert .. my inquiry is has anyone tryed to find out what our native americans did for this..? Meade, J.L. It continually is in proving each day. Proof that chocalate can definaltley heal! St. Petersburg Times [Online news wire], October, 2006. Following cleaning a radiograph is helpful to confirm removal of all the fragments. He has to take the wound vac home for an undetermined amount of time and have a PICC line put in so they can continue IV antibiotics (vancomycin) on an out patient basis. I live in NE Florida and the PA at urgent care knew far less about stingray venom than myself. Figure 2Â Â The Australian bull ray or Southern eagle ray (Myliobatis australis). 1. Pain subsided immediately. Hello…. The area around the puncture is a very hard and becomes swollen after I’ve been on my feet for over an hour or so. ( Log Out / How long should a wound go before it needs hyperbarics/advanced treatment? Yo Al- Rocca, A.F. I’m amazed how doctors on the coast here don’t know about Stingray injury. i have some very tender streaks going up my shin and from the swollen ankle, but the ankle itself is not red or painful. In his case, a 2 Â½ inch barb penetrated his left lung and migrated into his heart crossing both the left and right ventricle. The penetration mark is on the interior portion of my left heel (actually between my heel and ankle). It was not cleaned at all in the er, I was put on doxycycline and given a tetanus shot. Any ideas? Sometimes these deep, muscular injuries require a secondary operation to remove additional necrotic tissue. In a sense this is a case report, except Iâm the patient. Also went for a second visit and was told I was fine. hopes this helps some one from going through what im going through. I had no idea it would take this long and am shocked to see everyone’s stories!! It was obviously infected. Hello, There was black slime still in there and dead tissue. Figure 3Â Â A small puncture wound is see to the dorsolateral aspect of the foot consistent with a stingray envenomation.Â The central puncture wound will have signs of tissue necrosis. Not seeing a doctor, you could even lose your foot. I got stung by a ray in the left foot just below the inside ankle bone last Saturday July 9, 2011, on the beach below Cardiff-by-the-Sea, CA. He continued local wound care and within 2 weeks of his injury, the wound closed. Meade, J.L. People @ the beach called 911. Dr decided not to operate but do a bed side procedure which essentialy was picking at my tiny puncture scab…again taking samples to lab. 3) There was increased soft tissue swelling with slight tissue crepitus. The affected area, which was black and blue for about a week or more, is no longer discolored, but it is still swollen. Skin looked like it was going to explode, it was red, purple and black, started forming lots of pus bubbles and it was oozing clots of blood. Yea! Then my foot went numb, after a week there is still about a 2 inch area still numb. I was in so much pain it was unbelievable. Tomorrow I will see if anything is wrong and they said maybe I will need an ultrasound on it as well. Any issues since? Walking is painful and difficult due to both the crps and the mechanical damage (loss of tendon). i got hit in venice beach ca in july & still have pain in my foot. I will need a skin graft as well. My biggest thin today is that I can no longer run. My life is so different from how it was. Needless to say, it’s pretty obvious that the following should have happened: 1. People, be proactive! I called an urgent care center and they said if gets worse I may want to have it checked out! It has been 3 weeks today and it is almost closed up, for 1 ” gash to a 1/4″ . He drove back to Birmingham the following morning but swelling and redness increased and sooght treatment at ER. It is important to treat these injuries promptly. The swilling is going away. Routine radiographic evaluation showed an area of gas in the region of the puncture wound, but no sign of barb. by Al Kline, DPM1 The Foot & Ankle Journal 1 (6): 4 Stingrays are docile marine animals that only strike their victim when provoked or startled. If anyone has any advice please let me know. The effects of envenomation are not clearly understood as to reported systemic effects. That was the only thing that controlled my pain when I was barbed and seemed to stop the spasms in my foot. Only a lite jog. At the same time, if you are having trouble breathing or with glands, find a doctor immediately. The time between my husband stopping the hot water treatments on the beach and my brother’s bathtub was the toughest time of the ordeal! They said from April for at least 5 months they have at least 6 people coming in from sting ray attacks and there is no warnings on the beach. There was no bleeding for a few hrs. stay tuned……. Change ), You are commenting using your Twitter account. it never showed real signs of infection or anything, but it did swell right at the injection site. sorry about the misprint…the dressing is called “wet to dry” Hope you have a speedy recovery in the New Year…. It is 5 years since then and the top of my foot still hurts, it feels very stiff sometimes and at night I have to keep it sideways to keep the pressure off. They took him to the OR 45 minutes later opened his foot and cleaned it out, apparently the bleeding and drainage wouldn’t stop so they had to put in a wound vac (drainage system that has suction)! The anti-biotic (triple) ointment will help keep out infection, you need to soak it twice a day. I have seen this type of behavior when rays are in groups. ANYWAYS….it’s been almost 2 months now and it’s pretty painless in normal walking (even jogging), but hurts like crazy to try to bend my ankle sideways like if you roll your ankle on it’s side basically….not sure if I should go back to the doc for this??? I just saw a girl in my office who read my article on the internet. Stingrays belong the the class Chondrichthyes meaning cartilaginous fishes. Got a pair of large side cutters and finally got the barb cut. I’ve been to 3 docs, the 2nd one removed a barb after it had gone undetected for 2 weeks. I do have to say that I am a little worried about this tissue necrosis. mented in a healthy patient as a result of stingray injury . He felt a sharp pain to the top of his foot. It sounds like your wound is a lot larger than mine. Ideally, medical treatment will consist of radiographs to eliminate the possibility of a barb that may remain in the wound. There I was stung by a sting ray in the inside if my left ankle. The stingray tail has a sharp, serrated barb along the proximal third of the tail that is usually hidden and encased in an integumentary sheath and can deliver painful enzymes causing tissue necrosis. X-ray evaluation of stingray wounds is an unnecessarily misunderstood diagnostic concept. I’m on 2000 mg amoxicillin daily and they told me not to walk on it unnecessarily. we went back to the doctor/surgeon and have found out that her ankle or grwoth plates are injured and so are the tendons and ligaments surounding her ankle and now is in a cast and awaiting blood test results for internal infection of the bone. Sorry to hear about your encounter. The tail will lash upward like a scorpion and penetrate a sharp bard in the lower extremity or foot. Thanks to all my friends and the phone calls that I made to have the knowledge to get him out of the first Hospital and get the second opinion, if not I’m afraid of what might have happened to my husbands leg. Unless you like a ton of wildlife in the water then it’s pretty cool (Solana Beach was the site of a fairly recent (great white?) His laboratory data revealed a 16,000 white count with a left shift. the swelling in my calf has gone down quite a bit, but i am concerned about the pain that i am having in my leg. These Centers are available in many larger cities and provide the best medical expertise in wound management. He delayed initial treatment, continued to fish and developed cellulitis with a painful foot which required hospitalization and surgical treatment. another thing: does the venom get into your bloodstream or stay localized? The patient had undergone multiple medical evaluations before an X-ray was obtained. 4 days for cleaning and repackaging. By that time I was in agony, soaked in hot water for 90 mins then no pain. Med Journal Australia: 163: 665. My Mom is a nurse and I am an aesthetician so we know how to take care of skin that is for sure!! I took their advice and sumberged my ankle in hot water for about 30 mts the pain subsided as long as it was in scalding water. told the ray today was his lucky day and decided to pull in the boat which i did and laid him on his back so he could not strike. I was put on bactrim ds. His laboratory data revealed a 16,000 white count with a left shift. Now he has about a 6 inch insession in his leg. It is important to initially submerge the foot into hot water after the incident. Taking care of yourself right now will really assist in the healing process. She looked at his very small slit of a wound and gave him a hot pack saying he needed to soak it in the hottest water you can stand. I have never experienced such excruciating pain, and it unfortunately lasted about 7 hours. Post was not sent - check your email addresses! Here is is December 23rd for me and mine still looks pretty much the same. Because that ankle will not push off to run. Thanks. SO ready to get back to work. Water-borne pathogens of concern include Vibrios vulnificans in salt water and Aeromonas species in fresh water. Interestingly, one month later in October 2006, James Bertikas from Florida was stung by a ray as the barb also pierced his heart. The serrated stingray barb.Â The barb is encased in an integumentary sheath.Â The serrated spines are directed proximally and can cause extensive tissue damage when pulled from a wound. I soaked in the tub for about an hour and a half, and by then the pain was virtually gone. I only do that if Iâm keeping a stingray for shark bait. additional unpleasant incident. The boy was relatively asymptomatic and initially treated for a puncture wound to the chest and knee, but he died six days later from sequestered venom and myocardial necrosis causing right ventricular rupture and fatal cardiac tamponade. Placed on IV antibiotics for 7 days. She was hit on the back of the left heel while on a school trip at the beach. (Fig. I kept thinking of Steve Irwin and I guess it could have been much worse!! took a few seconds to realize what had happened to me. I was shuffling my feet but still got hit on the inside lower portion of my foot. Last time I drank about 5 beers and 600 mg ibuprofen over 2.5 hours as a painkiller, starting about an hour after the initial puncture, and it did not seem to reduce the pain. Clinical evaluation revealed a small puncture wound to the dorsolateral aspect of the right foot. , Of course, antibiotic treatment can be tailored to the results of deep tissue samples taken at time of surgery to determine the infective organism. Stingray. The wound was then irrigated with 3 L of gentamicin- they also recommended i get a tetanus shot, but i have not done so yet. I have just leaded to adjust and live with what it is. This means, that as the barb penetrates, the barb can rip tissue or even lacerate tendons, ligaments and other soft tissue as it pulls away from the puncture site. When i got back to my room i looked online and found out about the hot water. I had no pain until he got to the nerves that were damaged. ( Log Out / first tried to pull my foot off of the barb, which i couldn’t do. You don't want to pull them out or tear them off. Water-borne pathogens of concern include Vibrios vulnificans in salt water and Aeromonas species in fresh water. I also received a tetanus shot that day. The pain was instant and almost unbearable! Went to the emergency room in St. Petersburg. After reading all of these posts I am worried they may not have done enough at the ER. Rapid application of heat will denature the enzymes causing the pain and limit the effects of tissue necrosis. I haven’t found much online on the long term treatment of this.  The wound should always be cleansed thoroughly with an antibacterial wound cleanser immediately after injury. By September there was no more scab.  Serotonin is responsible for the intense pain associated with the sting and the 5-nucleotidase and phosphodiesterase enzymes cause intense tissue necrosis.