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Now browsing: Hometown News > Columnist Archives > Counseling - R.J. Oenbrink

How to recognize, treat common summer emergencies
Rating: 2.74 / 5 (232 votes)  
Posted: 2007 Jun 15 - 02:56

Editor's note: This is the first of a three-part series

Summer's here, let's go have some fun! But let's be careful out there, too.

It's inevitable that occasionally things will go wrong, but we can be prepared, and in this case, knowledge (and a few basic supplies) is power.

Let's review the most likely culprits to ruin a good time this summer and what we can do about them.

Marine envenomations

Jellyfish are the most frequently encountered critters that will inject venom into you (yes, that's right, they have microscopic harpoons that shoot venom under your skin, this gives them their "sting"). Even handling dead jellyfish or seaweed that may have tentacles (don't forget the Portuguese Man O' War) can hurt you, too. Brush tentacles off of the skin and put a caking agent, such as baking soda and water on the sting, then scrape them off carefully.

Don't put the injury in fresh water. Osmotic changes can make the stingers fire again, aggravating the wound.

Oral antihistamines (putting antihistamines such as Benadryl on the skin can sensitize some people and cause a medication induced rash. Don't use these on the skin. Swallow the medicine) and steroid creams can help. A severe allergic reaction called anaphylaxis with swelling in the throat is a true emergency and can also occur in previously sensitized people.

Venomous fish include the bony fish (catfish, lionfish, scorpion fish, stonefish), sea snakes (which live in the Pacific but not around here) and stingrays.

These fish and stingrays have a dorsal (top of the animal) spine that injects the venom. These venoms can also remain potent 24 hours after the fish dies. Be careful with dead fish.

These venoms are often inactivated by heat; soak the injury in the hottest water you can stand and the pain gets better. Stingray wounds are notorious for having severe pain out of proportion to the injury. Hot water (not hot enough to burn) gives quick relief.

Stingrays usually burrow in sandy bottoms and get stepped on by waders. Shuffle your feet!

Sea urchins and corals produce dirty wounds that are contaminated with a mild toxin that causes irritation. Again, hot water and spine removal will help. Sea cucumbers produce slime with a similar toxin. Those injuries also resolve with hot water.

Various mollosks can inject a nerve toxin by shooting a harpoon-like apparatus from their top surface as well.

Aquatic dermatology

Swimmers ear is an infection of the ear canal that causes a lot of local tenderness and pain. It's often made worse by earwax that keeps the water in the ear. The germ that causes this likes a moist alkaline environment. Simply washing your ears after swimming with a solution made of equal parts of 70 percent rubbing alcohol (isopropanol) or vodka and white vinegar helps dry the ear and restore normal ear canal pH or acid/alkaline balance.

Keeping excessive wax out of the ear is also helpful.

Contact dermatitis can occur from masks, suits, goggles, bathing caps and other worn articles.

Treatment involves avoiding the offending agent, and applying antihistamines, local cortisone creams and Burrows solution soaks.

Cold often helps relieve itch, unlike with the venoms where heat helps. If you have a rash that itches, cold usually helps. The envenomations listed above don't itch, they hurt.

Sea lice have been attributed to many different agents, including microscopic larvae and other creatures that cause a rash and itch that is typically worse on swimsuit-covered areas.

As the skin dries, these critters sometimes migrate to wear the moisture remains the longest. Though uncomfortable, they're not too serious, and therapy geared toward the symptoms and itch with oral antihistamines and topical cortisone helps.

Theoretically, this is a good argument to allow skinny-dipping to avoid the bathing suit problem.

The lesions are often present where skin is covered and stop where the suit stops.

Marine acquired infections can be a bit more complicated to treat and require different antibiotics. Tell your doctor if you think you developed a problem while in the water so you get appropriate treatment.

R.J. Oenbrink of Tequesta Family Practice is a board certified doctor of osteopathy. His offices are located at 395 Tequesta Drive, Suite B. Send your questions to: pbnews@hometownnewsol.com. He is available to speak to groups on this or a variety of other topics. Please call his office, if interested, at (561) 746-4333.

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