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With my hands exposed I wanted those spines as far away
from me as possible. I manipulated the spear to slide the lion-
fish away and in doing so triggered a twitch that drove a dor-
sal spine deep into the tip of my thumb near the nail bed. My
initial reaction was one of shock and then dread at the realiza-
tion that this was going to be far worse than a simple needle
prick. I’m sure I yelled in my regulator to get Sean’s attention.
He looked over at me and then down at my hands, my thumb
gripped tightly in my fist. He gave me a questioning “OK,” to
which I shook my head and gave him the sign for “up.”
I remained calm, and we made our ascent. Once on the
boat I submerged my hand in hot water, which felt scalding to
the affected hand but just shy of “hot” to the other (caregivers
should always test water temperature for exactly this reason); it
was almost unbearable to put the stung hand in the water. The
sting site looked bluish green, which I initially took to be bruis-
ing rather than a result of the venom. Sean continually replen-
ished the hot water during the short ride back to the dock.
About 15 minutes after being stung, I took an over-the-
counter pain reliever. I continued to soak my hand in hot
water for the next few hours, hoping for the relief I had seen
this treatment bring to others. Swelling occurred within
minutes of the sting and extended just beyond my wrist. The
pain reached up to my shoulder and could be described as
a dull ache punctuated by nearly unbearable searing sensa-
tions. I felt sleepy, and I couldn’t stand the feeling of any-
thing against my skin all the way up to my elbow. The joints
of my thumb and wrist felt stiff, and I even felt some stiffness
in my shoulder. After three hours, I took a Benadryl, and
within minutes I felt a marked improvement — my whole
body felt less distressed.
During the whole ordeal I wrestled with whether or not to
go to the hospital. The tip of my thumb remained discolored,
but after soaking it for so long it was difficult to assess the
severity of the reaction. I took a bath to warm up and relax,
and I felt much better afterward. I put the idea of the hos-
pital out of my mind. My hand was swollen, stiff and numb
but not really in pain at this point. I went about my evening,
had dinner and watched TV. As I was getting ready for bed,
I realized the swelling in my hand was not present in the
immediate vicinity of the sting site. Now dry and no longer
wrinkly from soaking, I could see that the pad of my thumb
was purple, flatter than the surrounding skin, cold and
even recessed. Part of my nail bed was purple as well. Still
not convinced a trip to the hospital was necessary, I called
friends who had been stung and compared stories to help
discern the severity of my wound.
It did not immediately occur to me to contact DAN®. I
had already treated the injury using the first aid practices
DAN teaches; I knew DAN could provide emergency assis-
tance if I needed it, but I was confident in my skills. Friends
and coworkers who had been stung, including Sean, had
managed their symptoms using the same first aid I had and
showed marked improvement in their conditions without
professional care. But I did not appear to be following the
same progression. The term “tissue necrosis” kept creep-
ing into my head as I examined the cold, purple pad of my
thumb, so I went to the hospital. After a short wait, the doc-
tor came in and with brilliant bedside manner took one look
at my thumb and said, “Oh, we’re going to need to cut that
off.” Luckily, he meant just the skin of the affected area.
I was given local lidocaine injections, and the doctor cut
away the skin that was no longer viable. I was told leav-
ing the dead skin would make me susceptible to secondary
infection, and removing the skin would ensure any residual
venom was gone. An area about the size of a nickel was
removed. My wound was then treated similarly to a full-
thickness burn: covered in lidocaine gel and wrapped in
gauze. I was given an IV antibiotic as well as another IV
drug for inflammation and pain. I went back to the hospital
the next evening for a dressing change, and the doctor said
everything looked good. I was sent home with a prescription
for an oral anti-inflammatory, a seven-day course of Cipro
and a large open wound that would require dressing changes
every other day for about three weeks.
I decided to call DAN, and no sooner had the phone
started to ring than Dan and Betty Orr walked into our dive
shop. Talk about service! I called DAN, and the president
himself arrived in person within seconds. It was purely coin-
cidence, of course, but Dan and Betty were very reassuring
that DAN would be there for me. In all my dealings with
DAN I experienced prompt service both by phone and via
email. All my associated medical bills were covered, includ-
ing reimbursement for out-of-pocket expenses. The claims
process was straightforward and simple, and the full reim-
bursement came as a great relief; it was a nice silver lining to
an accident that kept me out of the water and away from my
underwater photography for a seemingly endless five weeks.
I continue to cull lionfish — with an elevated respect for
the inherent risks involved. I’ve also invested in a pair of
hospital-grade needle-proof gloves. You won’t catch me on
a lionfish hunt without them. I learned the hard way that
when it comes to envenomation everyone reacts differently.
A sting that might be very painful but hold only short-lived
discomfort for one person can result in a severe reaction and
tissue necrosis in another. The amount of venom delivered
in a sting may vary as well, and no two stings should be
expected to follow exactly the same progression of symp-
toms. It’s best to administer the appropriate first aid, seek
medical attention, and call DAN.
AD
36
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SUMMER 2012
RESEARCH, EDUCATION & MEDICINE
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D A N WA S T H E R E F O R M E