Getting poked by a thorn has me out of the game 4 months and counting.

Edited: On November 1st I was bushwacking to a potential new crag and got caught in a big thicket of thorns. I probably got poked 80 times, but one in particular poked me in the middle finger at the crease. The thorn came out and I went on with my life. 2 weeks later there was a little bump. 2 weeks later the bump was a little bigger, still didnt hurt. 2 weeks after that, it started to hurt and i tried to cut into it to get out the suspected thorn debris, but instead of pus it was just more tissue and blood. An ER doctor tried to cut and burn the wound, but it grew back. I waited 5 weeks to see a dermatologist during which it continued to grow. She said it's a Pyogenic Granuloma, and because of the proximity to nerve and artery I need a hand surgeon. I went to the hand surgeon and he brought me to the operating room for a 45 minute surgery. It grew back again. I have to go back for surgery again later, or find a specialist who may be able to use a more rare technique for removal with a Lazer, if they are comfortable with its proximity to important anatomy of the finger. 

This is your friendly reminder to take it easy when something is wrong. All I had was a tiny thorn/bump, but its suspected that chronic low level irritation caused the tumor to start growing. This is bullshit. Good luck everyone. Also, fuck USA healthcare. 

Sorry this is happening to you. Good luck with your surgery, heal well and hope you are able to get back out there soon afterwards. 

Have heard similar stories, particularly one friend who had a thorn puncture turn into an antibiotic-resistant infection that nearly cost him his leg. Shit's a small deal until it isn't - sounds like a heap of bad luck. Heal up quick!

I had a piece of metal wire do similar, cable at work got me. Mine was palm located so dermatologist was able to do the cutting. If they sent you turn a hand surgeon I get that sucks, but they're gonna do a good job. You will feel better after and it'll heal quick. Hang in there

Good luck on your recovery! Rare weird shit does (rarely) happen.

I have heard of occasional small scrapes or pokes turning into a major, major PITA.

Lena chita wrote:

Good luck on your recovery! Rare weird shit does (rarely) happen.

I have heard of occasional small scrapes or pokes turning into a major, major PITA.

The relative of a friend of ours got a small scratch or poke on a hike in Montana. It caused a strep infection, resulting in quad amputation at the elbows and knees. He became the first limb transplant recipient.
https://www.wcvb.com/article/quadruple-amputee-reclaims-life-through-humor-transplanted-arms/14379862#

Sorry to hear what you are going through, OP, and thanks for the reminder. I'm curious, what could have been done better (besides not getting poked by thorns) in the very beginning? Would fully soaking the poke/scratch/puncture in rubbing alcohol or witch hazel be helpful? If we go to a doctor with a small bump in the skin due to a thorn poke, would they actually do anything about it? 

Mei pronounced as May wrote:

Sorry to hear what you are going through, OP, and thanks for the reminder. I'm curious, what could have been done better (besides not getting poked by thorns) in the very beginning? Would fully soaking the poke/scratch/puncture in rubbing alcohol or witch hazel be helpful? If we go to a doctor with a small bump in the skin due to a thorn poke, would they actually do anything about it? 

That’s the thing, they wouldn’t! I had a similar scenario once (minus the horribly unpleasant outcome of the OP). Got a small prickle under my skin in my thumb, pulled it out, cleaned the puncture, went on with my life. A week later, it still felt like there was a foreign object in there, no infection or anything, just felt like a cyst, or like a bit of the thorn was still in there, every time I pressed my finger against something.

I was about to leave on a 2-week trip, and thought it prudent to go to urgent care and have the little thorn removed, so I wouldn’t get an infection while I was in the middle of nowhere.

urgent care said they couldn’t do anything except make a hand surgeon appointment for me (6 weeks later), bc there was no piece sticking out that they could grab with tweezers, and they couldn’t just cut into my thumb. So I was sent home with a future appointment date, and instructions to go to ER if anything. It was rather unsatisfactory.

In my case, as for 99.9% of cases, the thing eventually worked itself out, and 6 weeks later I called to cancel the surgeon appointment. 

a related thought -- drug-resistant staph is no joke.  I think it is most prevalent in hospitals and clinics, and not at the crag......but generally, staph is everywhere.

bernard wolfe wrote:

a related thought -- drug-resistant staph is no joke.  I think it is most prevalent in hospitals and clinics, and not at the crag......but generally, staph is everywhere.

Strep, too. Seriously, read the article in the link I posted above. 

Hello Marc
I’m a retired ER doctor. No one can diagnose you via the internet, but here is one thing to consider. There exists a fungus called Sporothrix Schenkii, which can cause  an infection called “sporotrichosis.” It is sometimes caused by thorn punctures. The treatment would probably involve incision and drainage of any abscess, and possibly excision of infected tissue, plus a course of anti fungal medication, such as itraconazole. Standard antibiotics will not treat this problem. I am NOT diagnosing you with this infection, but because sporotrichosis is a somewhat unusual disease, it is possible your doctors have not considered this. Ask them. If in doubt, fungal cultures and a consultation with an Infectious Disease physician may be worthwhile. Best of luck to you.

Peter Lenz, MD

Peter Lenz wrote:

Hello Marc
I’m a retired ER doctor. No one can diagnose you via the internet, but here is one thing to consider. There exists a fungus called Sporothrix Schenkii, which can cause  an infection called “sporotrichosis.” It is sometimes caused by thorn punctures. The treatment would probably involve incision and drainage of any abscess, and possibly excision of infected tissue, plus a course of anti fungal medication, such as itraconazole. Standard antibiotics will not treat this problem. I am NOT diagnosing you with this infection, but because sporotrichosis is a somewhat unusual disease, it is possible your doctors have not considered this. Ask them. If in doubt, fungal cultures and a consultation with an Infectious Disease physician may be worthwhile. Best of luck to you.

Peter Lenz, MD

Good points.  I would have thought they did a wound culture already, however you never know. ID doc is a solid suggestion. 

Thanks for the replies. It is hard to say at what point my injury went from a simple wound to something that would become chronic and require treatment, and by the time it was something that any doctor would even look at, it was already complex. Even then, urgent care was 100% useless, not even a referral. One other thing I could have done was contacted the dermatologist earlier. With an injury like this, you can expect to play a lot of "wait and see". But it was unwise to only schedule after my wait and see phase. If they were gonna take 6 weeks to get me in, I could have scheduled early and just canceled later. 

This particular condition is thought to be sometimes caused by chronic low level irritation. So its possible that if I quit climbing when it was merely a strange little bump, it may not have progressed. It was sending season, and I was getting strong when this happened. I caution those reading not to underestimate their own tweaks and pains.