# 48 A - The Stingray Barb

#48 – The Sting Ray Barb.

One of the Island things to do is reef walking, to take a stroll out on a low tide reef exploring tidal pools and rocky crevasses, and explore the intricate fractalism inherent in the coral itself, is relaxing.  I was sitting some rocks yesterday afternoon watching some fellas wade through knee deep water, as clear as Gin, they had spears in hand and were catching flat fish, sole, flounders, sting rays, flat head…I guessed.  As I sat there I wondered how many of these blokes score fish stings.  They are at one with the land and sea, they seem impervious to the sharp jagged coral and shell encrusted rocks as they traverse their patch of bay with a leopard like prowling.  Not one of these blokes wearing shoes, and I made a mental note at that time to look back at the clinic stats to see how many presentations from coral and fish injuries there had been through the health care centre.  With string bags they would occasionally stop, spear and then retrieve some flipping morsel destined no doubt for an island feast that is legendary in these waters.

That was about mid afternoon.  These blokes might go till dusk about 630pm before returning with a full tote.

Fast forward to me sitting in my unit last night, 745pm and the oncall phone rings.  It is one of the health workers. “Uncle Rob, my cousin bala has a sting ray sting, and he is in a lot of pain, can I bring him up”?

I smiled to myself as I reflected on the ponderings I had had just 4 hours prior while watching the stealth hunters at work.  “Waa, bring em come!” I said in my best attempt at Creole.

The young bloke hobbled in his foot was white and shriveled like he had been in the bath too long.  I pointed to his foot, and said “Yu b putem in otwata (hot water)”, he raised his eye brows (the island equivalent of our nodding in the affirmative), “Good boy” I told him.  I knew that this was not the first time a fish sting had happened to him or his family, as bathing a stung limb in the hottest water one can stand is the first line treatment.  I asked when it happened, his reply was 3 hours ago.  I smiled again.  He was one of the blokes I had been watching perched on my rocky observatory.

Drawing up 5 ml of lignocaine (local anesthetic) he started to shiver.  I asked if he was ok and he tells me he is scared of needles.  I smiled again, amused at  the paradox  of a man walking bare foot in sting ray infested waters and a needlephobic.  I was torn between full disclosure of informing him right now that he had a Tetnus booster and an opportunistic Flu needle coming in a few minutes, or not.  For the moment I chose ‘not’.

With a deep breath I inject the ‘local’, he holds still, then clink, my needle hits something hard.  Bugger, there is still barb in the wound.  Out come the forceps and scalpel, I open the wound a few millimeters, and forceps in. A piece of barb is easily removed, and I pull out.  Relieved, and shaking myself.  We get taught principles of surgical wound closure, but I have never had to cut and retrieve a foreign body from a fish sting.  That was a first for me.  Bleeding is a bit of a problem for these injuries, so after 5 good minutes of pressure, I have stopped the flow, applied a pressure dressing, and am preparing his Tetanus and Flu shots.  He’s gonna be sore tonight when that ‘local’ wears off!  I supply him with some strong pain killers and off he hobbles.  I hope to see him this morning at follow up, but it is anyone’s guess.