Gross medical question

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jcliff
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Gross medical question

Post by jcliff » Fri Aug 16, 2013 8:02 pm

Well, either you are reading this because you actually have some expertise in this area, or you just like gross stuff. Either way, happy to have you.

The long of the short is, I have very slow healing wounds on both ankles. They are from a nerve biopsy I had done on June 12, but these suckers just refuse to heal. Right now I have been leaving them uncovered, keeping them clean, and putting on antibiotic ointment. Even still, I have had off and on minor infections in both. There's currently a deep scab in both, but they also still weep a little bit. I have not brought my doctor into this discussion because I'm worried he will tell me not to go.

I really don't want to make these worse. I had a tiny cut on the tip of my finger last year that ended up being a serious pain in the ass.

I would appreciate some input on the best course of action for my gross open ankles. By the way, the wounds are now about an inch and a half long and maybe 3/4 of an inch wide. Thanks!

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danibel
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Re: Gross medical question

Post by danibel » Fri Aug 16, 2013 8:07 pm

I don't like gross things, but I was intrigued by the subject line anyway.

I am not an expert either but I will pose a suggestion. Liquid skin? Perhaps it would be best to run it past your doctor to see if they feel it is safe to use on your particular wound, but I think the stuff would seal quite well. Of course all the other precautions, like keeping it clean and covered.

Hopefully someone with some actual medical knowledge will chime in and offer other potential solutions. Good luck.
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Re: Gross medical question

Post by TT120 » Fri Aug 16, 2013 8:11 pm

Well, I think you already know what you should do since you know what the doctor is going to say.

However, if you did happen to go, you would probably be alright if you stuck around camp and took VERY good care of the wounds. The alkaline Playa dust out there will not be good for them. Infection is quite possible from the dust.

You'll also want to find out where the med tents are.
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some seeing eye
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Re: Gross medical question

Post by some seeing eye » Fri Aug 16, 2013 8:12 pm

I am not a doctor. As you know from experience, playa dust is not sterile and is also an irritant because of the pH. And you don't want those brine shrimp eggs getting into you and going all Alien. Also sounds like your skin doesn't heal easily and you might be having a lot of flexing as you walk. If you are selling your ticket you might want to do it ASAP.
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jcliff
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Re: Gross medical question

Post by jcliff » Fri Aug 16, 2013 8:15 pm

Not not going, but thanks! More looking for advice along the line of the best type of wrap or covering, etc. Maybe a good cleaning plan or product to use? Nu-skin might be a possibility?

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Re: Gross medical question

Post by FIGJAM » Fri Aug 16, 2013 8:25 pm

I've had a lot of experience with wounds that I need to heal quickly.

usually with no scarring.

Get some 100% aloe vera gel.

Put a glob on the wound and wrap in plastic wrap, then an ace bandage to hold it in place.

Do this every morning and evening, and sleep with these dressings in place.

I would be very suprised if those wounds weren't completely closed up and covered in new skin by next friday.

Bring "New skin" to the playa if the area is still sensitive. 8)
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Re: Gross medical question

Post by stew » Fri Aug 16, 2013 8:41 pm

Tell your doctor that you will go no matter what and ask him what you should do to minimize harm. Don't take medical advice from a net forum full of laymen.
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Re: Gross medical question

Post by theCryptofishist » Fri Aug 16, 2013 8:42 pm

How deep are they. You don't want the skin to close if there's some sort of infection in there.

*doesn't tell hospital wound story*
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Re: Gross medical question

Post by jcliff » Fri Aug 16, 2013 8:48 pm

Thanks everybody! Will try the aloe and plastic wrap ( not infected now). Hopefully I'll have new skin by next Friday. If not maybe I should put bread bags on my feet and tape them down with duct tape. :D

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Re: Gross medical question

Post by lemur » Fri Aug 16, 2013 8:53 pm

thats what i was gonna jokingly suggest.

just like momma used to do when going out in the snow.


plus, youd be ready for the mud!
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Re: Gross medical question

Post by VultureChow » Fri Aug 16, 2013 9:15 pm

I like the new stuff they have out now. The advanced healing bandages that stay on for a few days. They seal everything out. The bandage absorbs the fluids from the wound and keeps a nice moist sterile environment. Way faster healing than letting a wound dry out and they provide some cushioning.
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Re: Gross medical question

Post by ygmir » Fri Aug 16, 2013 9:16 pm

real honey is great on wounds, too.
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Re: Gross medical question

Post by Canoe » Fri Aug 16, 2013 9:16 pm

It commonly believed that small cuts one gets on the playa will not heal until you leave the playa. This is attributed to the alkaline playa dust. I don't know if this is "true", but anecdotal observation and accounts support this.

Even if the wounds as you describe them heal closed by the start of Burn, being on the ankle, and possible injury on-playa, could easily reopen them and now you are on-playa with an open wound. I doubt the plastic/rubber wound sealing membranes would even work to keep this sealed on an ankle, but you should seek medical advice on this.

There are the shrimp and other aquatic organisms that are dormant in the playa soil, that get bashed up and blow around in the wind, along with the various bacteria that they feed on, and the feces of the birds that come to feed on them - we've just had a recent rain spread on the playa too so you'd have recently fresh remains adding to the various biologicals.

In addition, you should consider the following very carefully.
lemur wrote:
Canoe wrote:...As long as you don't learn why the food permit people worry about the playa dust. As in, downwind from the porta potties where everyone walks out of them...
5,507 Pounds: The estimated weight of E. Coli bacteria spread by the water trucks which use water pumped out of a nearby (non-potable) water source.
mmm that dust sure is tasty
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Re: Gross medical question

Post by 9ah » Fri Aug 16, 2013 10:56 pm

Cliff talk to harry in the FB group, he might have a fix. You can't not be at the house on Friday!
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Re: Gross medical question

Post by maladroit » Fri Aug 16, 2013 11:02 pm

This is what you want. Find an appropriate size Tegaderm dressing and apply them before hitting the playa. Wrap gently with sport tape and check every day, change the Tegaderm as needed.

Who knows, those suckers might actually heal on the playa.

Tegaderm stuff: http://www.amazon.com/b/ref=sr_1_5_acs_ ... sr=8-5-acs

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Re: Gross medical question

Post by BirthChazz » Fri Aug 16, 2013 11:34 pm

I am an advice nurse- BSN, RN, PHN, IBCLC

Please please please please- talk to your Doctor, open wounds of that size, that are refusing to heal are a problem. Even without heat and dust. Go now. Even if s/he does not agree with your decision to go, they will guide you so as to reduce harm. If you go Monday, if needed the wounds can be cultured, and systemic antibiotics could be prescribed for you before you go (either to treat them now, or to have in case they seem to be getting infected while you are trying to have fun).

I deal with open wounds in a dirty environment (open wounds on the nipple face, that are put into another person's mouth). They can very quickly turn into systemic infection.

You need to talk to a Doctor.


At a minimum I would expect care to include-
Two saline soaks/irrigation a day (ratio, 1/4 tsp of SEA SALT not table salt, in a cup of warm water)

if they are weepy you need to gently wash with mild antibacterial soap 1x-2x per day (just a little goopy, 1x is fine, really goopy 2x) pat dry. If they are _not_ in the early stages of infection- (weepy, goopy, red, swollen, hot to touch) then the saline will be enough.

and you will need a prescription antibacterial ointment- not OTC, something like mupirocin (bactroban) ointment.


If it needs to be covered from the elements- I would ask about- (rather than sealing with a plastic bag, super glue) a hydrogel dressing (it is what is used for burn victims), it provides moist wound healing. Most of them are medical use only- but they sell them at walgreens for Moms with open wounds on the nipples (note- you cannot use them if you are not willing to clean the wounds with saline and abx soap everyday, it will increase your risk of infection. Moist plus dirty is a bad combination)

CALL YOUR DOCTOR! DO IT MONDAY!
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Re: Gross medical question

Post by jcliff » Sat Aug 17, 2013 7:52 am

Ok, you guys are great. Calling doctor on Monday. Thanks for all the advice.

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Re: Gross medical question

Post by Elliot » Sat Aug 17, 2013 8:03 am

Always listen to a lady pointing a pistol at you. And Stew had it right too.

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Re: Gross medical question

Post by some seeing eye » Sat Aug 17, 2013 8:18 am

Occasionally eP kicks out good advice. And so if on the advice of a real medical professional you end up on playa with a week worth of daily cleaning and dressing supplies, you might make the acquaintance of medical when you arrive. Although you absolutely need the supplies capability to care for you wound in your camp, they might also play a role in the daily care.
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Re: Gross medical question

Post by jcliff » Sat Aug 17, 2013 5:31 pm

Well, you offered some good advice! I talked with a nurse practitioner at my hospital's wound center. She advised, follow up with my doctor with pics of my wounds on Monday...will do. She gave me the following advice: Do a sea salt/water solution soak once a day until I leave. No more petroleum antibiotic ointment. Apparently they do well with preventing infection for the first couple days, but after that they form a barrier for bacteria to work under. Until I leave she said to keep them uncovered and dry. On playa, I am to clean each day with an antiseptic cleaning solution that she recommended. Then cover with a 2x2 gauze pad, and then a sheet of Thermaderm over the gauze. The Thermaderm will seal them from the dust. She assured me that my doctor will probably write me a script for a round of antibiotics to take on playa. Hopefully that will help out with possible Ecoli or STD infections as well! :D

Thank you for the concern and advice. I will follow the advice to the letter. See you in the dust!

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Re: Gross medical question

Post by Savannah » Sat Aug 17, 2013 6:14 pm

Thank goodness you spoke to a professional, and will have antibiotics with you! Jesus. We don't want to worry about you. :)

Emergency Services has a certain quantity of the milder, less exotic medications but they can't have everything, or sometimes they run out. You cannot count on a specific medication being there. They can write a prescription at the main medical area (5:15 and Esplanade) but a roadtrip to Reno for something as simple as antibiotics would suck away 5 or 6 hours of your Burn at minimum.
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Re: Gross medical question

Post by Eric » Sat Aug 17, 2013 6:55 pm

May I make one last, worst-case-scenario suggestion? Pay for the helicopter evacuation insurance - I think it's $59 bucks for a whole year, and it will save you $25,000 if, for some awful reason, they get worse. Info is in one of the recent JRS's.

Thank you for getting doctors advice.
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Re: Gross medical question

Post by some seeing eye » Sat Aug 17, 2013 7:29 pm

Medical is likely to have a less dusty environment, checks vital signs, sterile irrigation, good lighting, dressing disposal, iodine and the like. So for your first dressing change if you wander over at a lesser busy time and explain "I have this", "this history", "my dr said I should", "I brought these supplies", "can you help me", you might have a wondrous story to relate of your experience. Also suggest asking, "I need to do this on this schedule, can you help, when is the best time to come, what's best, center or 9/3, what should I watch out for?". Keep in mind though they also may be dealing at any time with serious unpreplanned life threatening emergencies. As mentioned you do not want sepsis, so you might want to bring a medical body temperature thermometer and know how and when to use it and what indications require an immediate visit to medical and potential evacuation. Preplan with your campmates for the worst. What Eric said.

All said, you may just have a boring adventure in the desert!
Last edited by some seeing eye on Sat Aug 17, 2013 7:41 pm, edited 1 time in total.
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Re: Gross medical question

Post by lemur » Sat Aug 17, 2013 7:39 pm

i bring a regular old household 'mommie am i sick?' thermometer every year.

if ya need it.. i can totally take your temp every day and decide if you get to stay home from school or not
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Re: Gross medical question

Post by Savannah » Sat Aug 17, 2013 7:44 pm

some seeing eye wrote:Medical is likely to have a less dusty environment, checks vital signs, sterile irrigation, good lighting, dressing disposal, iodine and the like. So for your first dressing change you might wander over at a lesser busy time and explain "I have this", "this history", "my dr said I should", "I brought these supplies", "can you help me", you might have a wondrous story to relate of your experience. Also suggest asking, "I need to do this on this schedule, can you help, when is the best time to come, what's best center or 9/3, what should I watch out for?". Keep in mind though they also may be dealing at any time with serious unpreplanned life threatening emergencies. As mentioned you do not want sepsis, so you might want to bring a medical body temperature thermometer and know how and when to use it and what indications require an immediate visit to medical and evacuation. Preplan with your campmates for the worst. What Eric said.

All said, you may just have a boring adventure in the desert!
Yes indeed. If you cannot get your hands clean enough to safely change your dressings, go to Medical at 9:00 & C, 3:00 and C, or 5:15 and Esplanade and ask them to change 'em for you. It's totally fine. Bring your supplies, in case they're more specialized than what ESD has.

Signs of infection: Increased pain, swelling, redness, or warmth at the site, red streaks extending from the affected area, drainage of pus, or fever.
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Re: Gross medical question

Post by theCryptofishist » Sat Aug 17, 2013 7:48 pm

You forgot Spontaneous detaching of feet...
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Re: Gross medical question

Post by Savannah » Sat Aug 17, 2013 7:50 pm

theCryptofishist wrote:You forgot Spontaneous detaching of feet...
:oops: :lol:

. . . I hope he would notice that one. But I do know a person who fractured his leg on the playa, & stayed a few more days. :shock: It is by far the weirdest thing I know about him.
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Re: Gross medical question

Post by chiefdanfox » Mon Aug 19, 2013 12:51 pm

I am not a doctor. I know a few who go out there and volunteer at medical. Most agree that the playa dust itself is fairly sterile, but its alkaline nature makes it irritating. There is a wee bit of solar UV radiation sterilizing the ground out there. The last two years, I and my fellow carpenters got some nasty "playa finger", wherein the natural creases in the fingers turn into gooey open splits because of this alkaline dust. They looked like little gummy mouths. The Lion of Anubis, Jake, did little puppet shows with his.

Last year, I received a deep gash in my soft white fleshy forearm that needed 8, EIGHT COUNT 'EM staples, done at medical, by a hottie doc in a tutu. It is actually hard to see the scar. It healed fine, and I worked with the staples all week. Medical put them in and pulled them out a week later. No lollipop. I did not cry. Changed my bandage every day. I was a good boy.

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Re: Gross medical question

Post by jcliff » Mon Aug 19, 2013 1:21 pm

I think as long as I stick to the prescribed routine, this is a workable situation. I loved the suggestion of getting transport insurance. When the suggestion was made I went back and looked, and I am covered on my students' Costa Rica trip emergency evacuation insurance that we purchased for a June trip. It's a 6 month policy, and it covers me anywhere in the world. I called them today, and even Black Rock City is covered. So, I got that going for me.

Thank you for the personal messages, and this thread's suggestion of going to a Med Tent for a dressing change each day. I've already purchased the needed materials (2x2 gauze pads, big gauze pads for cleaning, Thermaderm patches, and the antiseptic cleaning solution.) I have all my supplies packaged in individual Ziplocs, and they all fit neatly in a gallon Ziploc. I will present myself on my first day with an explanation of my situation, and I'll let them tell me what time of day and location will be best. I'm sure if I go at an off-peak time, with my own supplies...the Med Tent folks will be happy to lend me a sterile place to change dressings under a professional's careful eye.

I hope you know how grateful I am for the support and guidance from my eplaya community. Over the years your help and advice has been so helpful and needed. It makes my heart warm that you all (especially the long-term consistent contributors) take the time to help a Burner out. You perform such a vital role for us that benefit from it. I'm taking your positive thoughts and energy into this Burn, and I send mine back to you. I love you guys.

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Re: Gross medical question

Post by maryanimal » Mon Aug 19, 2013 1:44 pm

I was looking into the helicopter insurance and you can apply for it only if you already have medical insurance. I was thinking about getting it but I don't have medical insurance.
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