(Semi) Medical Question

[Lemur]

So I cut my left hand up something dramatic while working with a tree-trimmer. A stupid accident, but aren't they all? Finger mobility is fine, nerves appear to be fine, just a neat gash on the index finger and a spectacular one on the middle.

Let me stipulate that our health insurance is junk. Worse than junk. Our insurer appears to spend most of their time figuring out new and creative ways to deny claims or stick you with a crazy bill. So we pretty much act as though we had no insurance, since that's the practical effect. For instance, when my son had breathing problems, we got stuck with a multi-thousand dollar bill, even though every procedure was supposedly covered. (If you really want to know how they pulled that I will explain, but it's long and tedious, and the upshot is that when you play poker with an opponent who can declare what any card is worth as the game is played, you lose.)

I only bring this up so you will understand why I am reluctant to go to the doctor. If I can avoid spending several hundred dollars, I'd like to skip it.

So. As an old ex-lifeguard, I have all of my first aid and CPR training, and it isn't completely gone. I cleaned and dressed both wounds, smearing plenty of Neosporin in each gash.

Both fingers appear to be healing just fine, but on the middle one there are two strips of white (dead?) flesh, about 4 mm in width, on both sides of the wound. What I cannot remember is whether you should trim dead flesh or wait it out. The Neosporin and twice-daily dressing changes are doing wonders, but I cannot for the life of me remember what you're supposed to do with a small amount of potentially necrotic tissue.

Advice appreciated.

[Whacker]

Go. To. The. Doctor.


You are asking the INTERNET for advice.

[Lemur]

Fine, be that way. I'll go ask the RN next door. That will involve walking, you insensitive clod.

As for going to the doctor, I think I explained why I'd rather not. If I'm going to be financially violated, I'd like it to involve two blondes and a bottle of champagne.

[Tratorix]

Go. To. The. Doctor.


You are asking the INTERNET for advice.

Oh, come now, the internet is a perfectly acceptable place to get medical advice. Now, in my professional opinion as a member of the internet, you are suffering from bonus eruptus, a terrible disease where the skeleton tries to leap out the mouth and escape the body. I'll need a golf cart motor and a thousand volt capacimator, stat!

[Lemur]

I think I have monkeypox, and that's the final word on the matter.

I'll see how it's doing tomorrow. If anything falls off, I'll let y'all know.

[drone]

Somewhere up north, Beirut is chuckling...

Are we talking a mini-chainsaw here, or something a little less lethal to the zombies? What sort of blade (and potential tetanus host) is involved here?

I don't know if the white flesh should be removed or not. I generally trim this off on my smaller wounds, but I'm not sure if this is medically correct or not. I go by the rule "if it hurts, don't remove it". So I take a snip, if it stings, I stop. But I had a recent one where the cut was deep enough that the edges (which were white) successfully grew back together and covered the gash. But I was very worried about an infection growing underneath. Any way to get oral antibiotics without getting reamed by the medical industrial complex?

[Lemur]

It was a folding handsaw, about two feet long, very sharp, very clean. No motorized saws involved, thank goodness. Just trimming the pine so's the kids can run under it more easily.

I think I'm a prime candidate for larval debridement therapy. Where can I get sterilized maggots at eleven p.m. in rural Wisconsin?

[FactionHeir]

While it certainly could harbour bacteria in some shape or form, you probably want to let the flesh be as it heals up. Natural process and all. Never hurt me anyway.

[A Very Super Market]

The wound probably isn't deep enough for the maggots to really stick around. You would need to attach a rig to your finger to support them as they feed or something.

[Aemilius Paulus]

Lemur, there are plenty of medical forums out on the Internet. Why are you asking in a video-game forum? I mean, come one, we are most certainly the least-life-experienced group of people in the entire collection of tubes teh Internets are. Paper and kitchen-knife cuts are likely the worst we had...

[miotas]

How long have you had the cut? What I usually do is that, after a few days, if the skin is still hanging free and hasn't "attached" to anything then I cut it off. But don't get too hasty sometimes it will take a few days to "attach".

Oh, and betadine is you friend.

[miotas]

Lemur, there are plenty of medical forums out on the Internet. Why are you asking in a video-game forum? I mean, come one, we are most certainly the least-life-experienced group of people in the entire collection of tubes teh Internets are. Paper and kitchen-knife cuts are likely the worst we had...

Hey, speak for yourself. In my family a scar is a badge of pride. Plus I'm rather clumsy LOL.

[A Very Super Market]

Australians are exempt from that rule. I think it's a law there to have at least once conspicious scar.

[drone]

It was a folding handsaw, about two feet long, very sharp, very clean. No motorized saws involved, thank goodness. Just trimming the pine so's the kids can run under it more easily.

I think I'm a prime candidate for larval debridement therapy. Where can I get sterilized maggots at eleven p.m. in rural Wisconsin?

Cool, no oil or other contaminants. I was going to suggest the maggots, but as AVSM says, probably not enough food for them to do their job. Fingers are tough, you need the mobility and flexibility, and this prolongs the healing process and increases the chance of infection. Hopefully you are right handed. My aforementioned deep cut was on my main hand. At this point I would highly recommend everyone practice wiping their butt with their off hand, just in case.

[rasoforos]

Lemur, there are plenty of medical forums out on the Internet.

Lemur,

If you heal level is not high enough you can always use a healing potion or a stimpak.

[Iskander 3.1]

Lemur: what part of Wisco are you from? I spent the first 25 or so years of my life there.

[Alexandros_III]

Move to Canada. Its all free and covered here. Really, they spent 20 thousand once.

[Evil_Maniac From Mars]

Move to Canada. Its all free and covered here.

Backroom topic, but nonetheless I heartily disagree. Switch your insurance company instead.

How deep is the cut?

[Strike For The South]

Cut the hand off.

[InsaneApache]

Joking aside it's probably a good idea to get a tetanus shot at the the very least. It all depends when you had your last one. Anti-biotics might be a good idea as well.

As an (ex) first aider myself, it sounds like you did all the right things in the first place but as you're well aware in most cases it's not the wound per-se that the potential problem, it's infection.

Now if it becomes hot and red etc. You know the signs, then you must see a doctor.

By the way as a lifeguard myself in a previous life, what qualifications did you need?

Here in the UK, the minimum just to get an interview was the R.L.S.S. Bronze medallion. Then when on the job we had to qualify annually for the Pool Bronze medallion, which take it from me is a real ball-breaker. A lot harder than the supposed superior Award of Merit. I also got the Award of Merit because I was considering doing the open water bronze and silver cross. I saw sense in the end though and applied for management. :o)

[Hosakawa Tito]

Dead skin is dead skin. I'd trim it off to avoid catching it on something and having it tear off and reopen the wound. As long as there is no infection and you have feeling & movement you should be fine. If not we'll be calling you Lefty Lemur....

[pevergreen]

Australians are exempt from that rule. I think it's a law there to have at least once conspicious scar.

That be a secret rule mate.

Lemur,

If you heal level is not high enough you can always use a healing potion or a stimpak.

Cast Mordeheims faithful healer.

Cut the hand off.

The real mans solution.

[Husar]

My aforementioned deep cut was on my main hand. At this point I would highly recommend everyone practice wiping their butt with their off hand, just in case.

I've had my left hand in a cast twice, I know what you mean...

I'm not sure about the wound, as a euroweenie with semi-free healthcare I'd go to a doctor and pay the ten bucks...

[KukriKhan]

Well, he's typing with wounded paws, so he obviously has function and intact nerve endings, etc. Just loose, white (from the cleaning process) skin remaining.

I wouldn't assume it (the skin) is "dead". Keep it clean and covered; change dressing 3 times a day. If it doesn't re-attach in 3 days, you might need a stitch or two, which your nurse friend can tend to.

Like IA said: "red & swollen" = professional medic... an ER at minimum.

----------------------------
I took the Am Red Cross lifeguard test at age 15, then Senior LG at 17, to qualify for my pool-guard part-time job. First Aid, CPR, rescue techniques, etc. When I first arrived here in San Diego, unemployed, I looked into becoming a lifeguard. Wow. Those guys train and qualify in ocean, white-water, surfer, flash-flood, SCUBA, and any other kinda water rescue - way beyond my experience and training. I admire them, but needed work quicker than their training would allow.

[Lemur]

Lemur: what part of Wisco are you from? I spent the first 25 or so years of my life there.

In in SE WI, Elkhorn to be exact. As a native informed me, we're the part of Wisconsin with the money and the jobs.

Backroom topic, but nonetheless I heartily disagree. Switch your insurance company instead.

Not a realistic option, nor would it be for most Americans. You're stuck with what you've got unless you're independently wealthy.

Now if it becomes hot and red etc. You know the signs, then you must see a doctor.

Right, obviously if it shows signs of infection I'll take steps.

By the way as a lifeguard myself in a previous life, what qualifications did you need?

It's been years and years, but it was something like this: Massive swimming qualifications. Don't remember all of the details, but you had to qualify in crawl, breaststroke and backstroke in timed trials, and you had to swim something like ten miles in a set time (not all at once, though, and I think you had a week or two to put in the miles). First aid, CPR, boat safety, a bunch of that sort of stuff, all of which required tests and certification.

And let's not forget the lifeguarding test, where you get presented with various situations and have to respond appropriately. They would always pick the biggest, meanest guy to be the panicking swimmer, and he would see if he could pummel you into submission. Exciting times.

I'm not sure about the wound, as a euroweenie with semi-free healthcare I'd go to a doctor and pay the ten bucks...

If it were ten bucks I would have gone that day to have it looked at. Unfortunately, I have the health insurer from Hell, so not only will I get stiffed for the bill, I won't even know what the true cost is for months. It's agony dealing with these Satanic imps.

[Evil_Maniac From Mars]

Not a realistic option, nor would it be for most Americans. You're stuck with what you've got unless you're independently wealthy.

That would appear to be what needs reform then.

[InsaneApache]

Lemur, there are plenty of medical forums out on the Internet. Why are you asking in a video-game forum? I mean, come one, we are most certainly the least-life-experienced group of people in the entire collection of tubes teh Internets are. Paper and kitchen-knife cuts are likely the worst we had...

He's not seeking medical advice. He's asking for advice from his interwebs mates. Nowt wrong with that.

[Reverend Joe]

Dead skin is perfectly harmless as far as I know; try applying neosporin (what is that ****, anyway?) again tonight or tomorrow just to be safe, and as soon as the skin hardens and/or begins to change color (even slightly) start cutting it off. Don't cut it all off, as the skin underneath is undoubtedly tender, just enough so you feel safe.

I do have to criticize you, though, for not immediately applying iodine or peroxide, as these both purify wounds with extreme effectiveness. It's like bleach that you can clean your wounds with.

[Lemur]

I do have to criticize you, though, for not immediately applying iodine or peroxide, as these both purify wounds with extreme effectiveness. It's like bleach that you can clean your wounds with.

None handy, and none in either of my two first-aid kits. Silly, I know. I made do with hot water and detergent, which is oodles of fun to squirt on an open wound.

Index finger's looking really good today, middle finger a little more leprous. But it's been 48 hours, and if an infection were to show up, I'd be seeing signs of it by now.

Neosporin is magic, isn't it?

[Evil_Maniac From Mars]

Hydrogen peroxide is phenomenal. Terminates with extreme prejudice.