Date: Wednesday, June 21, 2000 4:08 AM Subject: Bitten by Brown Recluse
Thank you profusely for your web site on the Brown Recluse spider bites. It got me to the hospital in time to get help and validation. Wow, what a nasty beasty! Below, my letter to Dr. Stanley Abrams:
Dear Dr. Abrams,
I found your name on Mark's web site: http://www.highway60.com/mark/recluse1.htm#abrams and was grateful to find your e-mail address. I hope you don't mind my contacting you`.
I was bitten by a Brown Recluse spider in Massachusetts, on May 31, 2000. Itwas described as classic, although this spider is not native to our area. I was bitten on my back, above and to one side of my waist. It looks as though it could be more than one bite now, in the same area. So far, it is not healing. I have never seen anything like this and admit to being rather scared.
At first I felt a hard pinch, but didn't pay much attention to it. That evening my physical therapist told me there was a red pimple-like bump on my back with two distinct, dark holes close to one another. The surrounding area was swollen and sunburn red. She thought it should be looked at. Two days later I saw a doctor. At that stage there was almost no pain and a blistered top had formed. This doctor put on gloves and squeezed it hard. That caused immediate and intense pain. He put on a Bandaid and told me to go home and apply hot compresses or towels. On the way home I became nauseated, just making it in time to begin vomiting, and had a bad headache. Then the fever and chills began. I could feel a large, hard area of swelling and see a quarter-sized dark brown area around a central indurated area filled with blood. That night I lost a lot of fluid, including sweating enough to change my night clothes. (The nausea and sweating continued for nearly three days).
By the next evening I drove myself to the Newton-Wellesley hospital emergency room. I was quite sick, and the bite area had become black, blistered, and was the size of a half-dollar, with the same blood-red cratered center and a dark red ring around the black area. The skin was sunburn red for about 6" around that. At the hospital they put me on 500 mg of Keflex and I saw several doctors that night, including a surgeon who said he would follow me in his office.
The surgeon told me to keep it clean by showering and to bandage it with non-stick 4" square gauze to which I applied Silvadene cream to prevent secondary infection.
At this stage the black (necrotic) skin has dissolved away and there is a central, white ulcerated, oval area about 2 1/2" in diameter, with the red bite (deeper) center and another smaller place like it to one side. It still looks blistered. Around this area is a quarter-inch reddish ring of raised skin. The ulcer is ugly and raw. It continues to ooze brownish liquid into the bandage.
I have several photos of the bite, but have not processed them yet.
I would appreciate any and all information about the treatment of bites at this stage. I would also like to know what I can expect, including the strange re-occurrences I have read about on Mark's web site.
The information and photos I found on the internet convinced me to go to the hospital emergency room where my suspicions were confirmed.
Thank you, Mary Anne
Mark, I would like to keep in touch with anyone else who has had this experience. I will be glad to share my photos when they are processed. An entomologist told me today that several spider experts she read about went into the woods and never returned. How cheerful!
------- Date: Friday, July 28, 2000 5:14 PM Subject: Re: Spider Bite First Aid - Dr. Andrew Weil
I am now two months after being bitten: The bite wound has closed but I still have a red, itchy, burning rash covering my back - worse around the bite area. Ice packs and witch hazel are the only remedies I own, which give me relief. BTW, Massachusetts General Hospital Dermatology Department was brown reclueless. I didn't mention the stun gun remedy so as not to risk being committed; what isn't documented at Harvard, doesn't exist. Here it is on Dr. Andrew Weil's web site. Mary Anne
Friday July 28, 2000 First Aid for Rattlesnake Bites?
Q. My girlfriend's husband was recently bitten by a rattlesnake. They'd read that zapping the bite site with an electrical charge would keep the poison from spreading. In the 45 minutes it took to get him to the hospital, they zapped the site and the surrounding area with a taser five times. He was watched at the hospital for two hours but never showed any bad effects from the bite or the taser. How on earth could this work?
A. (Published 7/18/97) This is very interesting. First of all, rattlesnake bites are rarely fatal. More than 45,000 people get bitten by snakes every year in the United States, but there are only about a dozen deaths as a result. However, rattlesnakes are responsible for most of the deaths that do occur. Their venom is a mixture of neurotoxins and tissue toxins, with the most dangerous snakes -- such as the Mojave rattlesnake -- having a higher percentage of neurotoxins. No matter what the proportion, the bite delivers a complex mix of poison that can affect both the nervous and the vascular system. Even though fatalities are unusual, the toxin is very potent and can cause a great deal of pain and disfiguring tissue damage.
At up to five feet in length, the Eastern diamondback (Crotalus adamanteus) is one of the largest rattlesnakes to be found and rates as the most aggressive and dangerous snake in North America. Smaller rattlers such as the massasauga (Sistrurus catenatus) and the pygmy rattlesnake (Sistrurus millarius), less than two feet in length, are far less dangerous.
In up to one third of cases, rattlesnakes don't even inject venom. But when they do, there's usually immediate pain and much swelling over the next 10 minutes. Panic, dizziness and vomiting may follow, as well as shock. After, bruising and large blood blisters may occur at the site of the bite. In most cases the local reaction and tissue damage are the most serious consquences; rarely, systemic reactions, including breathing difficulties and collapse, may occur six to 12 hours later. Among other things, the venom harms coagulation and injures blood vessels; it may also lower blood pressure, cut down the number of red blood cells and platelets, and cause an abnormal heart rate.
When someone's been bitten, it's important to get them to a hospital as soon as possible. In the meantime, keep the injury just below heart level and remove rings, watches and any restrictive clothing. Try to limit movement and calm the victim in order to slow the spread of the venom. Don't incise the bite or apply a tourniquet or cold to the injury.
However, a good first-aid device is a vacuum extractor (available from outdoor supply stores) that will remove venom from the punctures. Medical doctors usually treat rattlesnake bites with antivenin (prepared from horse serum). This treatment reduces risk of systemic complications and death but often does little to prevent local destruction of tissue. And antivenin treatment can cause adverse effects of its own.
The method you mention, a taser, was described in the Oklahoma Medical Journal as a way to promote healing of bites from brown recluse spiders. For you city slickers and peaceniks, tasers are similar to stun guns, which shoot out an electric current to stun their target, rather than injure or kill it. A taser shoots tiny wires into its target, then immediately zaps the recipient with enough electricity to immobilize him. Apparently the jolt of direct current denatures the venom, altering it chemically so that it's no longer active. My understanding is that this treatment originated in Australia as an antidote to poisonous snakebites. I've heard it is becoming a popular method for treating livestock that have surprised rattlers, but I don't think many of my colleagues know about it. I'm delighted to hear that somebody tried this out -- and with such success.