I stepped on a stingray and my foot looks like a red grapefruit

[SchralphMacchio]

It's been 9 days and my foot is more swollen now than it was a week ago!

Doc says there's nothing much to do besides IBU. There are no signs of infection and she thinks everything are just residual effects of the envenomation. Anyone else ever have long-term effects from stingray venom?

The first day was interesting ... the pain is manageable for the first 20-30 minutes, and then it turns into "please punch me in the face right now" kind of pain. Not the worst pain I've ever had (I've had lung surgery, crashed into a tree, had shingles ...) but some of the most annoying ever. It felt like my foot was mangled under the treads of a tank or in the gears of a giant machine, plus being lit up on fire from the inside. Then after 2 hours it hurts a lot less, and after 3 hours it was "fine." Fine, minus the left side of my foot and big toe that were mostly numb - I still had sensitivity, circulation, and muscle control, but only partial feeling.

The next day I played disc golf with manageable soreness, and went (gym) rock climbing the next 2 days after that and it was tolerable.

Then, on Day 4, walking started becoming actually harder than it had been. The part of my foot that was numb slowly started becoming less numb ... with the numbness gradually being replaced by throbbing pain.

I'm on Day 9 and my foot is swole - I can't climb or bike. Each day I've gotten back a little more range of motion and slightly more feeling in my big toe ... but the swelling and pain hasn't really subsided. That's some fucked up venom!!!

[splat]

That sounds like a real stinger. Soak a sock in piss, put it on, tie a plastic bag (or two, or three) around it and sleep with it overnight and see if it helps. Beyond that, the new treatment for bee stings is to put a penny on it. Might give that a try, too.

[Orthoski]

I'll admit up front that I can't say I've ever dealt with sting ray venom. The pattern of improving symptoms followed by severe worsening of pain/swelling a few days later, however, would force me to really rule out a deep infection (i.e., the outside puncture hole may have started to heal, but the deep spaces of yoru foot may create an anaerobic env't perfect for an abscess). I would definitely rule that out before attributing it to overuse, or any other benign cause. As is frequently the advice inherent to forums, consider being seen again ASAP.

Best of luck.

[systemoverblow'd]

I have no history with anything other than man o war. But something doesn't sound right.

On an aside... There were no signs of infection when my shoulder surgery got fucked. One night I woke up 4 or so weeks later to my shoulder being the size of an orange, I was smoking hot and disoriented. They had to immediately open my up and let my shit heal from the inside out meaning a gauze stuffed shoulder to the bone pulled and replaced every few hours. I'd get a second opinion.

[Sinecure]

I only clicked this for the gruesome photos. Fail.

[old goat]

I'll admit up front that I can't say I've ever dealt with sting ray venom. The pattern of improving symptoms followed by severe worsening of pain/swelling a few days later, however, would force me to really rule out a deep infection (i.e., the outside puncture hole may have started to heal, but the deep spaces of yoru foot may create an anaerobic env't perfect for an abscess). I would definitely rule that out before attributing it to overuse, or any other benign cause. As is frequently the advice inherent to forums, consider being seen again ASAP.

Best of luck.

I agree. What kind of doc are you seeing? Might be good to see an orthopedist or podiatrist. The barb may need to be removed. You should be doing better now, according to my comprehensive medical reference (wikipedia).

[splat]

Interwebz advice:

Treat the pain by immersing the injured area in water as hot (but not burning) as the person is able to tolerate (113°F or 45°C) for 30-90 minutes. This neutralizes the painful effects of the venom because the venom is inactivated by heat.

[DAFTC]

FYI, neither the piss (as an ammonia delivery system) nor boiling water helped with the sea urchin spines stuck in my foot (nor drinking saltwater, etc.), despite multiple locals' insistence...

It just took a couple of weeks until they started working their own way out. But the swelling was mostly gone by day 3-4. Go make sure you don't have an abscess.

[SchralphMacchio]

Good advice y'all.

Saw the doctor this morning, with foot still swollen but better than it was looking over the weekend. The first thing she said, before I said anything was, "it's a good thing you came back because your foot did not look like that on Thursday morning."

Started on antibiotics today.

My original post was misleading - the doctor told me there was nothing to do about the pain and venom, but my foot was not yet swollen at that point. It started swelling up right after I saw her. Like I said, parts of my foot were partially numb for a while so it's been hard to determine by feeling alone things were getting better or worse ... but yes, mostly worse.

[systemoverblow'd]

Whew glad you got it checked out!!!

[splat]

FYI, neither the piss (as an ammonia delivery system) nor boiling water helped with the sea urchin spines stuck in my foot (nor drinking saltwater, etc.), despite multiple locals' insistence...

It just took a couple of weeks until they started working their own way out. But the swelling was mostly gone by day 3-4. Go make sure you don't have an abscess.

Yeah, but don't mention that to hot surfer chicks who ask for someone to piss on them when they get out of the water. Hawaiians and locals swear by piss for wana. I never got hit by one but, goddam, when I was on the reef at low tide with my skag in the coral, I sure had the piss scared out of me by how many there were in the reef. Not sure the ray sting is the same as wana - the heat breaks down the protein that is the ray venom, whereas sea urchin is more like getting a shard of glass stuck in your foot that someone then hits with a hammer and shatters. So I've heard...

[TahoeJ]

Hawaiians and locals swear by piss for wana.

The Hawaiian locals I've met swear by meat tenderizer followed by white vinegar in a spray bottle - for both wana and jellys. That's what they did when my wife's leg got wrapped up by a man o war.

Not sure if the sting ray issue should be getting worse this long after the incident, but I do remember my friend who stepped on one was hurting for several days afterwards.

[crackboy]

meat tenderizer works, as does sticking the tagged spot in water as hot as you can stand

i was kayaking down in baja a few years ago and a guy who was with us got hit by one. boiled up some water, and stuck the foot in, and he turned out ok.

the science behind this is that it breaks down the proteins in the venom

[summit]

Pee, Heat, Meat Tenderizer, Vinegar....

OP If I were you, I would NOT stick your foot in very hot water, sleep in a pee soaked sock, nor pour food products in the wound at this point!

Many of these are good treatments for certain problems immediately envenomation, not a week+ later.

What works for cnidarians (man-o-war, jellies, fire coral) isn't necessarily what works for other marine envenomations. With cnidarians, you want to activate "unfired" nematocysts (stinging cells) still on your skin without having them touch your skin, activate, and deliver more poison. Acid works well for this, specifically vinegar (acetic acid). You can use rubbing alcohol. Meat tenderizers are usually acidic (often lemon juice, vinegar, etc) so they work. Urine is very mildly acidic and probably helps, not the first choice, but often all one has at the moment.

I have seen the pee trick used for echinoderm spine punctures (urchin), but the warmth and placebo is probably what helps. That venom is best treated by heat (heat inactivates by denaturing and breaking down the poison, this also works for lion-fish and some other marine envenomations).

I'm not a stingray expert, but stingray woudns I remember we were taught to the heat treatment, but that is only effective early on, like immediately after, and mostly for pain relief.

I'll admit up front that I can't say I've ever dealt with sting ray venom. The pattern of improving symptoms followed by severe worsening of pain/swelling a few days later, however, would force me to really rule out a deep infection (i.e., the outside puncture hole may have started to heal, but the deep spaces of yoru foot may create an anaerobic env't perfect for an abscess). I would definitely rule that out before attributing it to overuse, or any other benign cause. As is frequently the advice inherent to forums, consider being seen again ASAP.

Best of luck.

OP What this guy said was what immediately came to my mind as I read your story.

Never be afraid to get a second opinion.

I do remember that it is pretty much standard to treat for gram-negative infections with stingray punctures if there is much of a delay to seeing a doc and cleaning the wound. Were you given doxycycline or TMP-SMZ or cipro?

[SchralphMacchio]

Bactrim / sulfamethasomethingzole

[Art Shirk]

The Hawaiian locals I've met swear by meat tenderizer followed by white vinegar in a spray bottle - for both wana and jellys. That's what they did when my wife's leg got wrapped up by a man o war.

Not sure if the sting ray issue should be getting worse this long after the incident, but I do remember my friend who stepped on one was hurting for several days afterwards.

My family is kama-aina and while piss would get bandied about, we always used something else.

Last time I was stung, I came out of the water and told my cousin that it was pretty bad. He told me to rub sand in it and wait while he went to the truck to get the antidote. He came back with a 12'er and none of it ended up on my burning leg.

[old goat]

Hopefully the antibiotics will do the trick. If there is still barb in there you may continue to have problems. Apparently the barb will sometimes show up on xray and sometimes requires ultrasound to see. If it's in there will need to be removed (unlike bullets which are generally sterile). More expertise from the Journal of Wikipedia.

[SchralphMacchio]

very little tiny bits of barb have actually been coming out of the cut for the last 2-3 days!

[SchralphMacchio]

Man, I feel like San Diego lifeguards could use a little better training. They were pretty casual about the injury and made it seem like not a big deal. Fuckers didn't even betadine my wound before they wrapped it and sent me off, let alone recommending I check out the hospital or doctor immediately after. Now I'm dealing with antibiotics 2 weeks out, the wound is barely closed, and my big toe (several inches from where I got stung) is still not fully sensitive.

Oh, well, I didn't have it as bad as the little kid, stung 10 minutes after me, who got cut deeply and it wouldn't stop bleeding, and the venom made him nauseous and he had a 7 on the pain scale - ambulanced out of there.

This stingray shit is too legit to quit!

barb example - the venom flows along the grooves in the bone:


http://faoj.org/2008/06/01/stingray-...a-case-report/

[Ripzalot]

curious - what type of stingray? that sounds like some nasty shit.

i got tagged by one in FL once, fortunately my wetsuit blocked most of the barb, just the tip pierced the wetsuit right on my ankle bone. was like the worst bee sting imaginable. swelled up like a golf ball. but then again it was only half as painful as having a man-o-war wrapped around my bare leg.

[Orthoski]

very little tiny bits of barb have actually been coming out of the cut for the last 2-3 days!

Make sure your treating physician knows that little bits of barb are coming out. Your clinical description is concerning for abscess, which often requires surgical debridement/drainage in addition to antibiotics (an abscess is an area where blood, and ergo the antibiotics, can't reach). I would be concerned that antibiotics may mask the symptoms of infection, but if you still have foreign, marine bodies imbedded in your foot, you're unlikely to be cured until the foreign body is surgically removed.

Again, best of luck.

[Piggity]

Splat, I might be wrong but I think your pee remedy is actually for sea urchins. Hot water is for Stingrays. The hospital will turn away 99.9% of stingray victims and tell them to go soak it in hot water to counteract the enzymes and further necrosis. Unless it becomes infected, the person goes into shock, or if it's a gigantic gash (No formal knowledge, just going by countless stories of friends being stung)

Shralph's is an extremely rare case. Hundreds of people are stung in SD every summer, 41 people stung at 1 beach in 1 day a couple days ago. Remember to shuffle your feet when walking in the water, the best remedy is not getting stung in the first place. Also keep in mind they can swim in about 2" of water and often are 2-3' from the shoreline. Most people aren't expecting them that close in. Hope you heal up soon Shralph

[old goat]

Foreign material like barbs will often work it's way out if it's close enough to the skin and the wound is open. You might try to get an xray, and if it's negative an ultrasound to see if there's any barb left--otherwise infection is likely to come back after the antibiotics are stopped, and like orthoski says given the amount of swelling you had there is still concern for an abscess in a deep space. I'd feel better if you were seen by an orthopedist or podiatrist (if you're a Kaiser patient podiatrist.) And make sure they consult the medical literature (wikipedia)--not a lot of sting rays in the 510.

[splat]

Splat, I might be wrong but I think your pee remedy is actually for sea urchins....Shralph's is an extremely rare case. Hundreds of people are stung in SD every summer, 41 people stung at 1 beach in 1 day a couple days ago.

Yeah, Hawaiian word for urchins is wana. I don't think Schalphs sting sounds all that rare if 41 people a day are getting stung at one beach.
Unless you meant in terms of severity.

Sounds like it's time for a good old-fashioned poultice to pull the rest of that shit out and close 'er up, Schralph.

[single]

Ice pick, a little gumption and maybe rye whiskey for courage. Open 'er up.