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View Full Version : Doctor Visit to Remove Metal Sliver $$$



wmgeorge
12-06-2010, 08:58 PM
Saturday in the shop had a tiny little sliver of metal in my left thumb, (this is about the diameter of a hair and 1/8 inch long) got the magnifying glass and miniature needle nose and pulled the little sucker out. Today I go to the doctor and wanted him to do a little slicing to remove what I thought was the rest, as it had some infection. Oh no, we had to take 3 Xrays, even after I told him I'm sure it was to small to even show. Sure enough nothing was on the xrays, which were so blurry I don't know how he could tell anything.

Sent me home with antibiotic to take until they ran out. Lets see, 3 xrays to find out nothing, and my thumb is still so sore and with the spot still infected.

What happened to just a slice and drain, a little antibiotic gel and your home getting better? Oh, better yet, he wanted to send me to a hand surgeon??

vpt
12-06-2010, 09:04 PM
I hate those little metal slivers!

Dr Stan
12-06-2010, 09:14 PM
Sent me home with antibiotic to take until they ran out. Lets see, 3 xrays to find out nothing, and my thumb is still so sore and with the spot still infected.

I think you need to get this looked at again as it could be a staph infection and you do not want that. :eek: Been there done that.

Liger Zero
12-06-2010, 09:17 PM
Seconded. It is amazing how much STUFF they drained out of a dime-size infected area and I still have a scar on my arm that'll never heal.

Mcostello
12-06-2010, 10:33 PM
There is an ointment out there called "drawing salve" that would help in this application.

macona
12-06-2010, 10:38 PM
With litigation the way it is now they have to cover their asses every which way to help if they are sued.

AllThumbz
12-06-2010, 10:39 PM
Sounds to me like that "little needle nose" was infected and passed it onto your finger. You didn't sterilize it before you used it on your finger, did you?
I use alcohol on the area and pass a needle through a flame before using it to dig out a splinter.

gary350
12-06-2010, 10:50 PM
We had a microscope where I worked once when I got those tiny little splinners that I couldn't see I put my finger under the microscope. That tiny little splinner looked like a 16 penny nail and the tweezers looked like chop sticks the size of power line poles trying to get hold of the nail. It took some practice pulling that splinner under that microscope but I could always see it, I just had a hard time getting a hold of it.

bborr01
12-06-2010, 10:55 PM
Sounds like you need to invest in a good pair of tweezers.

If you are going to make slivers, and that is what we do, you need a good pair of tweezers.

And while you are at it, a decent lighted magnifying glass is handy.

Oh, and some rubbing alcohol.

Brian

Boucher
12-06-2010, 10:58 PM
The eye doctor has better tools for magnetic splinters. They have a blunt electromagnetic needle. It is surprizingly strong. For non magnetic stickers you are SOL. Anything that you do for yourself should start with alcohol and peroxide and end with Neosporin or Polysporin. Doctors are like other professons there are good ones and bad ones.

ADGO_Racing
12-07-2010, 12:05 AM
For the ones I know about, I use a pair of old calipers, which hit the floor about 20 years ago. Jaws are still in good shape. Jaws close tight and get a good grip on very fine slivers.

The ones I don't know about right away, usually just get a little inflamed (like the one stuck in the callus on my palm now) and come out with a needle at home. I have never had one become infected to the point of needing a trip to the doctor.

914Wilhelm
12-07-2010, 01:01 AM
Long gone are the days when your doctor could use common sense and judgement to attend to your needs. Standard of care for a subcutaneous foreign body includes X-rays, even for traditionally non-radio opaque foreign bodies such as glass. If you don't do it you are considered to be practicing below the standard of care and have an indefensible case when you go to court. The average doc has a 6% chance per year of being sued. The cost of malpractice in Florida for an ob/gyn is 100-200k a year. Getting sued is an emotionally and financially difficult challenge even with no settlement. There are trauma programs that have closed due to not getting neurosurgical coverage due to the tremendous lawsuit risk associated with head trauma. Like many things associated with liability everyone has to CYA. I remember before I started the home machine shop stuff trying to get wheel adaptors made. Had three commercial machine shops turn me down before I found an older guy who said "no problem". He probably wouldn't do it now.

Paul Alciatore
12-07-2010, 01:32 AM
I've had many such wood and metal splinters/slivers. I have a good pair of tweezers that I have hand sharpened to fine points and very flat surfaces between them. But my favorite tool is an Xacto knife with a new blade. It is better than a needle as you can slice it open with the knife blade and the sliver will usually just squeeze out then. Don't slice inwards. Run the point of the blade in following the path the sliver took and follow the greatest pain. Then slice outwards. I'm only talking about 1/32 or worst case, 1/16 deep here and not much wider.

A 10X magnifier helps a lot.

But always use alcohol on both the tools and the finger first. Always! And use a band-aid with some antibiotic ointment afterwards. And change it and use more ointment when you quit for the day.

EddyCurr
12-07-2010, 01:55 AM
Good tweezers/forceps are as close as the nearest cosmetics counter.

Spend a few dollars and buy a couple of pairs. Take the time to study
the different tip styles and choose ones that have sufficient cross section
at the tips that they don't deflect under pressure.

Replace them from time to time when they no longer grip well and it is
not practical to refurbish them.

Ditto on the suggestions to practice good hygiene & sterilize instruments.

.

John Stevenson
12-07-2010, 03:49 AM
Stanley knife followed up by brazing flux and masking tape.

No joke, it's done me proud for all these years.

taydin
12-07-2010, 04:25 AM
I use a hypodermic needle and my microscope. The needles are manufactured to be very sharp in order to minimize the pain during an injection. That sharp tip makes it really easy to push the foreign object out.

Another use I found for microscopes is stain removal from fabric! Again using a newly opened hypodermic needle, I basically look at the stain under the microscope and do microsurgery to grind it away :)

A.K. Boomer
12-07-2010, 06:08 AM
Im in the modified tweezer group, Start with a sturdy set of slanted edge tweezers and hand stone the ends so they match up perfectly - then take 400 grit sandpaper and fold it double - then place it in the jaws and with moderate pressure on the paper draw the paper out away for the tweezers - repeat till the jaws close down perfectly -- the extra thickness of the paper and the direction that your pulling it out will wear the inside flats at an angle so that when they are properly closed without the paper they will have an outer edge bite on even the smallest sliver,
Im also in with the razor knife crowd if I have to open things up a little and go in after something.

I rarely use any kind of disinfectant but that's just not having good follow through and it should be done.

Black Forest
12-07-2010, 06:10 AM
There are two jobs or professions I would never do. Doctor and Policeman.

Third is a teacher.

What with all the people looking for a free ride via suing you for their stupidity they are the worst jobs out there.

You are lucky you didn't come to me. I would have admitted you to the hospital and done a complete body scan and every other test possible.

One of the things I hope Germany never catches up to the USA is in rewarding stupidity. Here in Germany if you fall down on a property and hurt yourself and lose three days work the court will give you three days pay. No spousal damages because you couldn't service your wife, etc. etc..

Ron of Va
12-07-2010, 07:12 AM
Since you canít hold a magnifying glass and a pair of tweezers in the same hand and pull a splinter out of your other hand at the same time.I bought a pair of magnifiers that go on my forehead (magna visor). I have two, one for the shop and one for inside the house. I keep them next to my splinter removal kit, which contains tweezers, and two needles. The magnifiers are great, especially for these old worn out eyes. I keep the 2.6x lenses in them.

http://www.use-enco.com/CGI/INSRIT?PARTPG=INLMKD&PMPXNO=12387396&PMAKA=326-1095

Mcgyver
12-07-2010, 07:13 AM
914Wilhelm, good post. As with most things look to the system as the cause of the behaviour you don't like, and look to your crummy politicians as the creators and tweakers of the system. I think most people are unaware how they carry the litigious burden through increased prices of good and services ......maybe if more were there'd be impetuous to change the system....or maybe they like making litigation lawyers wealthy

on slivers, my standbys are a 10x plastic loupe (cheap) and nice little tweezers lee valley sells....they really are the best at removing slivers. when excavation is required a new exacto blade is handy....or bust of the used blade of the utility knife to a fresh section.

http://www.leevalley.com/US/gifts/page.aspx?p=10434&cat=4,104,53208&ap=5to

These tales of infection are good - I've not been worried about it and sounds like i should...Dettol will be on the shopping list

snowman
12-07-2010, 07:32 AM
Jeeeeezuhs

Get a #11 xacto blade, baptise in fire to red heat and allow to cool in air to touch, pre-scrub sliver area with antibacterial hand soap and alcohol, alternate three times, ending with soap. make incision parallel to drainage tract. once foreign object is located, remove with tweezers that were also baptised in fire.

now pour unpasturized honey over incision, place telfa pad on incision site and wrap with gauze. replace bandage every 6 hours for first day, 12 hours on day two and three and every 24 hours until healed.

honey is natural antibiotic and fire is the most reliable method of killing bacterins on the tweezers. alcohol is not an applicable alternative, at least in my house, i work around bacterins that were cultured on our alcohol bottles at work.

Liger Zero
12-07-2010, 09:17 AM
I find epsom salts work great for drawing out unwanted slivers and aiding in the healing of infections.

I understand it is NOT an antibiotic but through osmosis/diffusion or something or other it helps pull the infection out.

That, plus soaking the affected appendage in VERY WARM WATER helps too.

wmgeorge
12-07-2010, 09:51 AM
I'm going to wait until the antibiotic kicks in, flame sterilize my sharp blade, scrub the area and then use some iodine to cover. Then just make a small cut the relieve the pressure and I think whatever could be inside will come out with the juice. Some antibiotic gel and bandage, just like the doctor could have done...

I might use the epsom salts and very warm water soak, I know that works.

My little needle nose pliers never touched my skin, but of course the sliver had cutting oil and whatever else on it from the shop.

Liger Zero
12-07-2010, 09:54 AM
...have you tried grinding the affected area flush with the surrounding skin? If you don't have a bench-grinder they can be had cheap at Tractor Supply.

Tinkerer
12-07-2010, 10:49 AM
For the little daggers that can't be seen but sure can be felt.... I use tape rub it down and snatch if off at different angle till it comes out. ;)

Dr Stan
12-07-2010, 11:22 AM
I think you need to get this looked at again as it could be a staph infection and you do not want that. :eek: Been there done that.

wmgeorge,

There have been several good pieces of advice on how to remove a needle shaped chip, but this is more than sliver removal. You have an infection so I'll repeat myself. Go to a physician again. I've had a staph infection, MRSA to be exact, which was absolutely no fun.

Get thyself to a surgeon, now.

Stan

MichaelP
12-07-2010, 11:29 AM
Wmgeorge,

I'd strongly suggest you NOT to play a doctor, but rather find a hand surgeon nearby and let him take care of your finger. It'll be the best and safest bet.

Internists/family physicians are not very well trained in this area, so if you see obvious signs of infection, go the route I suggest. Without knowing your past medical history and seeing your finger, it's hard to say if you need any surgical intervention at this point.

Most incidents like this may be cured very easily, but some may lead to very unpleasant surprises you don't want to experience first hand (pan intended).

Good luck!

whitis
12-07-2010, 03:36 PM
now pour unpasturized honey over incision, place telfa pad on incision site and wrap with gauze. replace bandage every 6 hours for first day, 12 hours on day two and three and every 24 hours until healed.

honey is natural antibiotic and fire is the most reliable method of killing bacterins on the tweezers. alcohol is not an applicable alternative, at least in my house, i work around bacterins that were cultured on our alcohol bottles at work.

Although honey has significant anti-microbial properties (including against staph and MRSA) , there are viable microbial spores that can contaminate honey. Honey is available in Sterile (irradiated) form. Sterile Manuka Honey from New Zealand is the best. Honey is an excellent wound treatment, used historically and often neglected today, but still very competitive. Manuka Honey has outperformed other medical dressings in scientific tests. They now sell expensive FDA approved sterile manuka honey dressings. Some people can have alergic reactions to pollen in honey; medical honey is available filtered.
http://www.worldwidewounds.com/2001/november/Molan/honey-as-topical-agent.html
Cutting fluids can culture nasty microbes in vast quantities if they are not properly maintained.

Flame "sterilization" is not the best way. In practice, it has not been found to be reliable and is no longer an accepted medical practice. An autoclave is better. However, for "sharps" such as blades or needles, reuse is not allowed even if autoclaved. You can obtain sterile scalpel blades at tractor supply, probably southern states, and other farm/veterinary supply stores; careful, they are wickedly sharp. They also have hypodermic needles, but typically not the smaller gauges.

MRSA is, indeed, bad news. The first antibiotic used to treat mrsa costs about $8000, IIRC, for the full round and often isn't in stock locally.

Hibiclens, the chlorhexidine gluconate scrub used for surgical prep, is good for MRSA. You must wash for a full three minutes (most surgeons don't which is one of the reasons for the MRSA outbreak). Avoid weak solutions of anti-microbials, including natural ones, such as found in a number of hygene products - their use contributes to antibiotic resistant bacteria. Use it right, or don't use it.

Dr Stan
12-07-2010, 05:05 PM
MRSA is, indeed, bad news. The first antibiotic used to treat mrsa costs about $8000, IIRC, for the full round and often isn't in stock locally.


The total for my MRSA treatment was almost $60K. This included multiple surgeries, almost a week in isolation, six weeks of IV Vancomycin (750 ML 2X/day), weekly home nursing visits (first week daily), weekly blood work, and daily wound debreeding for six weeks (with no pain killer :( ).

My options were:

1) get better
2) loose my right leg above the knee
3) buy a coffin

Fortunately option #1 came through.

Please get this looked at by another physician.

EddyCurr
12-07-2010, 07:38 PM
This included multiple surgeries, almost a week in isolation, six weeks of
IV Vancomycin (750 ML 2X/day), weekly home nursing visits (first week
daily), weekly blood work, and daily wound debreeding for six weeks (with
no pain killer.Wowser !


Methicillin-resistant Staphylococcus Aureus (MRSA) (http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus)

.

GKman
12-07-2010, 08:02 PM
When digging becomes too painful I tape a small strong magnet over the sore spot and sleep with it on. I'm not sure if it works but I feel like I'm doing something.

TGriffin
12-07-2010, 08:22 PM
Be thankful they weren't in your eye. I've had metal dug out from mine twice, once my fault (no glasses) and once not (with glasses and side shields).

I have a tiny pair of tweezers sharpened to a point that do a great job. For the occasional sliver you can't see try putting a little turpentine on it. That makes the skin transparent and the sliver much easier to see.

Tom

PeteF
12-07-2010, 08:52 PM
In case you think Stan and a few others here are over-reacting here's a true story (very much shortened version). Earlier this year I'm on a cycling holiday and notice a red lump on my leg, no problems I say, I'll just sterilise this blunt instrument and dig out the wasp stinger (I thought it was). Few days later, lump is bigger, few days later bigger again, few days later I start feeling sick so go to doctor with a decent infection in my leg. Doc gives me some lame antibiotics and shows me the door. Few days later puss is coming out, but nothing good old salt water won't fix hey! Next day I'm in a big city (Melbourne) and doctor looks worried, tells me to go to hospital, convince him I'll drive back up to Sydney if I assure him I'll check myself in to hospital as soon as I arrive. Get to Sydney and reckon it's all a storm in a tea cup, but wife insists I go to hospital. Few hours later I'm laying in emergency with doctor doing her best to drain what she can, unsuccessfully. Surgeon is called in. Now at this point let me tell you that sucking on do-nothing gas in a puddle of sweat while a surgeon is literally hacking away at your leg in some of the most extraordinary pain imaginable, while listening to the emergency doctor say "I could never do that", and the surgeon is saying "Well ... right now I'm saving this man's life!!" (and that's verbatim), that has an extraordinary way of gaining one's attention. Sadly the story goes on, and it doesn't get any better, but that's not important to this situation. The important thing is I got to keep my leg and my life. I was strong, very fit ... and lucky.

The bottom line is, my case was misdiagnosed initially and no swabs were taken. If they had been then they would have shown MRSA and I would have been given the CORRECT antibiotics. YOU DO NOT WANT MRSA TO GO UNTREATED. Even now when I go in to hospital (as I recently did after being hit by a car), I'm in an isolation area and that will be the case every time I'm admitted for the rest of my life. Everyone who enters the room needs to take special precautions regarding gowning up etc and removing again as they leave. I appreciate the US doesn't have the basic level of inexpensive health care we take for granted in other countries, and costs may be clouding your judgement. But I can only strongly suggest you put that to one side and have any infection like this properly swabbed and diagnosed. It may be nothing ... or you may not be as lucky as I was!

metalmagpie
12-07-2010, 09:29 PM
Saturday in the shop had a tiny little sliver of metal in my left thumb, (this is about the diameter of a hair and 1/8 inch long) got the magnifying glass and miniature needle nose and pulled the little sucker out. Today I go to the doctor and wanted him to do a little slicing to remove what I thought was the rest, as it had some infection. Oh no, we had to take 3 Xrays, even after I told him I'm sure it was to small to even show. Sure enough nothing was on the xrays, which were so blurry I don't know how he could tell anything.

Sent me home with antibiotic to take until they ran out. Lets see, 3 xrays to find out nothing, and my thumb is still so sore and with the spot still infected.

What happened to just a slice and drain, a little antibiotic gel and your home getting better? Oh, better yet, he wanted to send me to a hand surgeon??

He must need some new sails for his boat or something .. find a new doc, this guy's a crook.

daniel9ds
12-07-2010, 10:00 PM
I am a newbie here and just wanna say Hi to everyone. I am Daniel from Pennsylvania, US.


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Ed.
12-08-2010, 08:38 AM
Hi, I just use a pair of large nail clippers (not scissors) specifically for that purpose, I weld, grind and machine but I find I usually get very tiny slivers from the grinding that get embedded in my skin. So I just use the clippers to cut out the surrounding skin which also usually takes out the sliver or if it is embedded too deep then at least it allows access to it so I can remove it with a pin. Using the clippers doesn't hurt unless I go way too deep. Then a dab of Betadine (Iodine based) and that is it.

I frequently get small infections caused by having hot metal shavings hit my skin when machining. I make it a practice of not wearing sleeves when machining and so the little bits that fly off, burn when they connect. But the Betadine is great, also any sort of infection or cut from around the house or garden usually is also fixed with this stuff. If I ever get anything that doesn't respond to it then off to the Doc I go. Better safe than sorry.

madman
12-08-2010, 09:20 AM
Leeches suck the evil poison right out. Use antibiotic and sopap water soak in warm water and dig with a heated sterilized Pin.

Dr Stan
12-08-2010, 09:58 AM
Here is some more "lite reading" about MRSA:

http://www.cdc.gov/niosh/topics/mrsa/

http://www.cdc.gov/mrsa/

http://www.mayoclinic.com/health/mrsa/DS00735

Bluehill
12-08-2010, 10:29 AM
What happened to just a slice and drain, a little antibiotic gel and your home getting better? Oh, better yet, he wanted to send me to a hand surgeon??

The simple answer is malpractice lawsuits. In NJ just being named in a malpractice lawsuit will raise you malpractice insurance premiums by roughly $10,000/year for 10 years if you are a surgeon. This is totally independent of whether you are actually guilty of malpractice.

Just look at it from the doctors point of view. If he doesn't do the X-rays and that sliver was larger than what he could see and dig out. You could go home get a nasty infection and possibly, in an extreme case wind up loosing part of your finger. Now you have one less finger and are looking for someone to blame. Your lawyer will sit in court and ask your doctor why he didn't do an X-ray and everyone will watch him blush as his response is "well the patient said it was only a little sliver".

I'm not trying to imply that you would ever go this route, but many people will. This is also very dependent on your geographic area. In NJ where there is a personal injury lawyer advertisement on every billboard it is much more of a concern. Areas that are considerably more rural this sort of mentality decreases greatly.