Friday, December 08, 2006

Of Zippers Bloopers and Fish Hooks Mishap

It's December, the clammy monsoon season in our part of the world. I was waiting for the typical torrential rain to pour , to set me in the right mood to write on the wet and gloomy weather, like last year (read here). But apparently, the weather is a bit fickle this year and so far, the heaviest rain only lasted a few brief hours, followed by a bright sun which was quick to nullify the rain effects to the weather. A real monsoon weather would mean continuous, relentless rain that would pour unapologetically for days on end, causing our homes to be damp and musty even on the inside! Well, at least you can save on the electric bills as you utilize less of the fans and air-cons.

As for now, I'd like to relate several cases I get at the clinic. Yesterday I finished late as I had to attend to a small boy who got his ***** stuck into his zippers! Blimey, he must have been in a damn great haste to have pulled up the zippers deep into his groin and not realizing it soon enough! So far, all similar cases that I got before were easily reversible. Usually I only had to disengage the zipper's teeth and once removed, I could easily slide the foreskin out the zipper's head. This time it was impossible to apply the simple maneuver as the zipper's head was embedded too deep into the foreskin causing excruciating pain each time I tried to peel it off. After giving some local anesthetic injection, I used a plier to cut the hinge at the zipper's head. If I could cut it off, the problem would be solved. Alas! It was not to be. The hinge that bridge the head together was stronger than I thought and refused to break off even when I applied a mighty force, using both hands and enhanced by gritting teeth! After several vain attempts, I suggested him brought to the hospital, as the child is better off sedated during the procedure and perhaps an emergency circumcision would be best for him.

Another similar accident that needs meticulous removal of the causative object would be the fish-hook injury. The most common part of the body to be pierced are the arms and hands but I have seen hooks sticking through the poor patient's eye-brow or lips!




Now, removing a fish-hook that has lodged into a body part can be a painstaking measure. Due to the unique shape of the hook, you can't simply pull it out. You see, a fishing hook has 2 ends, one bearing a sharp arrow-like figure and the other has an eyelet , where the fishing line is stringed to. If you crudely pull from the eyelet end and forcing the arrow-end through the flesh, it will cause a jagged severance of the soft-tissue and more bleeding will occur. Thus the best technique would be to make the embedded end free, which is usually the arrow head. After locating the head by palpating the affected tissue, make an incision till your blade touches it. Once you've exposed it, use a cutter to cut the hook into two. After removing both ends and cleansing the wound, the incision has to be sutured back.



The worst case scenario would be a combination of the above body-part (zippers blooper) and a fish-hook! In which case, I'd leave it to the surgeon to explore under sedation or GA.

A week ago, when the school hols began, many had chosen to bask on the shores of the east-coast. Unfortunately , it was also the season for the jelly-fishes to come ashore. Thus, I had several patients coming in with painful, excruciating swelling of the legs and hands after being stung by the 'harmless' looking creature. After giving first aid treatment and anti-histamine and steroid injections, I'd pack them off to the nearest hospital for observation as jelly-fish stings can be fatal. So, for those who are ruminating to enjoy the beach, be wary of these creatues.

16 comments:

Mama Sarah said...

Thanks for the warning DITH. Definitely no fishing trip and playing by the beach in this season for my children. And oh, no pants with zippers for Amar too.

ikelah said...

the boy ended up with circumcision under sedation at KSH.

i had a good day today. the circumcison went well which was unlike 2 days ago where all the 3 kids got scared, crying and uncooperative. adding to the misery, the diathermy failed to work which forced me to tie all the big bleeders. on top of that, the uncle of a kid questioned me about the presence of a medical student assisting me in a rude manner.

today, all went well; fast and easy circumcision, well reverted SVT with just 6mg adenosine and sustained, thinner fume inhalation victim who responded well,

aaah... i m sleepy... good night. wassalam

neemo said...

oh my, OUCH!

mynn said...

eh macam2 lah case kat malaysia, huuu beberapa tahun kat sini pun tak pernah lagi tengok zipper vs foreskin incident or mata kail incident.

macamana nak kerja kat msia ni huh dith?

dith said...

Nisak:
:))...sian Amar kena pakai bloomers seumur hidup!

iKelah:
Suruh Guna get a new diathermy machine!

neemo:
Ouch to you too!

Mynn-
Lerr...awok kan cardiologist. Pesal pulak nak treat kes2 gini! :p . Mynn awok treat dato and datin je. Pastu depa rekomen ler Sultan Tgganu honor with datuk title sbb awok telah menyelamatkan jantung mereka itu!

Azer Mantessa said...

ouch :-|

Queen Of The House said...

DITH ... Ouch, macam tak sanggup nak baca! Especially since my son is just recovering from his circumcision. And the husband asyik nak gi fishing aje.

Ikelah ... nasib baik my son tak menangis. In fact, he handled it quite well - the SmartKlamp is a wonderful thing!

Has said...

tengok gambar ingat ker anting-anting bibir

ifos said...

missing home and the rain ;)

easylady said...

Saya ada beberapa kes zip terlekat kat kulit ****.Umur around 7 yrs old.Semua kes tak pakai underwear. I just used ethyl chloride spray. So far was successful.My advise to them." Lepas ni jangan culas pakai seluar dalam".

Anonymous said...

missing manusia ceria sokmo. ;)

Queen Of The House said...

One more thing about the beaches ..... I read the gamat are landing on the beaches ala pre-tsunami. Ada ke?

makdah evil said...

hehehe.

i dunno whether to laugh or feel sorry for those people who got "hooked".

=D

Anonymous said...

Pycno disini. Apa kabar?
Hujan belum turun dengan lebatnya di Kuantan?

Kalau hujan renyai pun, tak mengapalah kot..DITH boleh saja menulis entri secara 'rintik-rintik' juga. :)

ikelah said...

apa khabar pycno.... lama tak menulis. mengapa dah jadi anon?

di sini dah mula hujan lebat.

dith said...

Azer:

QOTH- Hubby you dah terror fishing. I thot dia guna pukat? :p

Has- anting2 besar

ifos- missing u too

easylady- tapi hok ni memang masuk habis kulit sampai tercerut ke dalam!

Anon- ni mesti Pycno

QOTH- :p....kat sini rasanya gamat tak dak...tapi jgn ler remind pasai tsunami!

Makdah- awok ni evil sungguh! :p

Pycno- Wah ada org sibuk tengok filem cinta rupanya

ikelah- semalam angin punya kuat, bunya menakutkan!

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