Stepped on a Nasty after dark, no pain

[DADive]

Hi, this is my first post, I was on Kauai's South Shore on Oct. 7 (honeymoon). I had a one tank dive that afternoon (my first dive further South than Rhode Island, it was beautiful) and went swiming later that same day after dark. In knee deep water (while swimming bare foot after dark) I walked over something that I could tell was not sand, it held my foot approximately 2-3" off of the bottom. It did not hurt or sting so I thought nothing of it (the object was stationary) and I kept swimming. I walked around some that night with no issues. I was completely sober the entire time (I do not drink more than a beer a day).

The next AM I woke up and the bottom of my foot (this area would have been covered by the flipper while diving) in the arch area had a cresent moon shaped, itchy, red swollen area. I forget if there was puss right away or if it developed within a couple days. The rash was raised ~1/8" - 3/16". I have put an antiseptic Lanacane cream on it twice a day for a little more than a month and 75% of the area has healed thru skin sluffing. 25% of the area (3/4 in. X 3/4 in.) refuses to heal, I can not see it very well but it has at least 3 black dots in it amongst many pin head size red dots (1/16 th in. diameter half spheres). I do not know if this square area was present at the onset of symptoms. My first week and a half back at work I was not feeling well (~10/17 - 10/26), had a cold and possibly something else. I walk around at work very little (desk job) but more often than not the area is pretty itchy after wearing my shoes for 16 hours.

A good friend of mine has woken me up to the dangers of these types of injuries (i.e. bone loss in joints associated with some of the drugs used to treat bad cases, etc.) and I am wondering what I can do from Vermont to help solve this problem. Any thoughts on treatment and/or what I stepped on? Any names and numbers of good Doctors? I have been to my own Doctor, got a little bit of a blank stare and a tube of steroid cream. She is an excellent Doctor but this is not her specialty. I look fwd to reading what you have to say. - DADive

 

[gangrel441]

No idea what it could have been that you stepped on, but my first recommendation would be to call DAN. They are probably the best qualified folks within reach to either have an idea what got you, or recommend a doc to you that may.

Good luck, and please keep us posted!

 

[DADive]

Hi, DADive here, just called DAN, spoke with a really nice person in their diving medicine dept., the summation of the discussion goes like this: if it is not getting worse but getting better stick with the steroid cream, monitor the wound til it is better. If it gets worse get help. Possibly the nasty was a soft coral but it would be hard to guess at this point. (This does not make me any less curious as to what I stepped on though, any ideas?).

I looked at the wound again, I do not look at it every day (hard to see). I am down to 9 dots now, 6 are growing faint, like freckles, 3 are a burgundy color. I was initially worried the skin was growing over something that it was going to bite me later on but she said I need not worry (me talking: maybe if anything bad was going to happen it would have by now?). I am still happy to get as much input as I can get (on things besides the need to wear water shoes into the water and swimming after dark). Any thoughts?

 

[gangrel441]

Hi, DADive here, just called DAN, spoke with a really nice person in their diving medicine dept., the summation of the discussion goes like this: if it is not getting worse but getting better stick with the steroid cream, monitor the wound til it is better. If it gets worse get help. Possibly the nasty was a soft coral but it would be hard to guess at this point. (This does not make me any less curious as to what I stepped on though, any ideas?).

I looked at the wound again, I do not look at it every day (hard to see). I am down to 9 dots now, 6 are growing faint, like freckles, 3 are a burgundy color. I was initially worried the skin was growing over something that it was going to bite me later on but she said I need not worry (me talking: maybe if anything bad was going to happen it would have by now?). I am still happy to get as much input as I can get (on things besides the need to wear water shoes into the water and swimming after dark). Any thoughts?

From what you described before, I would say a soft coral is a pretty reasonable guess. I doubt you would get any more specific info than that without having a sample.

 

[babar]

From what you described before, I would say a soft coral is a pretty reasonable guess. I doubt you would get any more specific info than that without having a sample.

Or sea urchin. Although it should have hurt a little. SEa urchin spines can get impaled in a foot. Being organic matter, they have a very high infection rate. Keep a real close eye on it. Also, if it is organic foreign material in your foot, a steroid cream may make it worse.

Just keep a real close eye on it

Babar

 

[DADive]

Thank you Gangrel and Babar, I know what a sea urchin looks like. What I stepped on did not flex at all, it felt solid. Does soft coral look like regular coral? Any way to tell the venomous coral apart from the stuff that you can touch? I liked my first tropical diving experience but I am finding I need to read up more, can you suggest a good book title or two? Thanks, Don

 

[gangrel441]

First: Books

The only one I can think of to recommend off the top of my head is Reef Coral, by Paul Humann.

There are many types of soft corals. They are distinguished because they do not have the endoskeletons that hard corals do, and have a more fleshy appearance.

As for which ones can hurt you and which ones not, most corals are venomous to some degree. Some are capable of delivering that venom to humans, some aren't. What I can tell you for sure, though, is that humans touching corals is much more dangerous to the corals than it is to the humans. I would recommend making that all coral is venomous, and not touch or step on any of it, for the sake of the corals.