Tuesday, September 25, 2012

Rules 2 and 4

Don't just apply to guns.

Yesterday, I was removing a tag from a new collar for Butcher, with one of those evil zip-tie attachments that it is impossible to break and equally impossible to get scissors under unless they deliberately leave you room.

So, of course I had out my handy-dandy Kershaw (which, by the way, is sharp as hell, and thus able to cut through the hard plastic without sawing at it, which is why I was using it.)

Knowing, as I do, that knives are sharp and will cut you, I did not, in fact, have the knife laid across my hand applying downward pressure. I had the tip against the edge of the plastic, sharp side away from my body, applying pressure down and away.

My mistake came in after I'd gotten a bit of a cut in the plastic and had to re-arrange my left hand for leverage, as the damn tag was attached to the ring on the collar, and sliding back and forth.

I got my leverage, and continued with steady pressure, rocking the knife around so that when it broke through the blade would hit the metal of the ring and the back side of the plastic.

Except it cut through sooner than I was ready for. And the blade, not being in the position I wanted it in, skidded off the metal and into the index finger of my left hand.

Have I mentioned that knife is sharp enough to perform an autopsy?

 This was taken after I'd applied pressure for long enough to stop the bleeding (or, at least to stick the subcutaneous fat together in such a way that it didn't bleed as much) but I know the knife stopped when it hit bone.

Once I'd gotten the bleeding stopped (and oh it bled like a stuck pig, that picture was after I'd used a damp paper towel to clean up the surrounding area so that I could tell where all I was actually cut, because I couldn't see and there was enough blood I was sure I had to have caught myself somewhere else) I sat for a few minutes and contemplated the injury and the first aid tools we had on hand. I also ransacked my (somewhat hazy thanks to adrenaline, endorphins, and sheer panic cause for a while there I didn't know if I was going to be able to stop the bleeding) medical knowledge, put laceration + gaping open + needs closed together and came up with Butterfly Closures! I was fairly certain we had some so I dug out the first aid kit where everything more exotic than gauze pads and bandaids lives, and went into the bathroom, where a lightbulb hit and I realized that I had friends with real life medical knowledge.

Not here, of course, but technology is wonderful. I snapped that picture above and shipped it off to AD with the question "can I stick a couple butterfly closures on this and go or do you have a better plan?" I was, of course, hoping he wouldn't say "Stitches" but that is what he came back with, and the grudging alternative that I could theoretically superglue it shut and immobilize the finger.

We have finger splints! I got all ready to do so when it hit me that the superglue bit was really more of an addendum as if he figured I'd think of it for myself anyway.

"Do I really need stitches or will the superglue actually work? I'll go get stitches if I actually need them."

"You really need stitches. I know you, you're not going to be able to keep that finger immobile enough to keep it from breaking open."

And so I sighed and went to the ER.

After meeting the nursing student who took my vitals, the doctor came in and took a look at it, said "Yep we can stitch that up in a jiffy. Unfortunately where it's at, we may not be able to numb it completely." I sighed and said "Well shit."

As soon as the Doc left the room I pulled out my phone and texted AD. "Damn you, doc just said he can't numb it completely!"

To which he answered "Why can't he do a nerve block?"

This I passed along to the Doc, to whom I had already explained that I probably would have taken care of it myself at home if my paramedic friend hadn't threatened to beat me with sticks if I didn't come get stitches. I got a dirty look, which I replied to by holding out the phone and asking the doc if he'd like to talk to AD about it, I was just along for the ride here. 

"I could do a nerve block, but where that cut is we'd have to stick needles into the palm of your hand to block all of those nerves in order for it to work."

"Hey, I was just passing the question along."

"If he wants me to do that to you, tell him he's welcome to come down and I'll do him at the same time, cause that's just mean."

"He's in Louisiana."

"Tell him it's too proximal for a digital block." The doc then stalked off to get the lidocaine to numb my finger.

AD replied with "Yeah I figured. It's right by where they'd inject for that." Gee, thanks mister wizard, I didn't understand the word "proximal."

Back the doc comes with the lido, me having been re arranged on the bed for best angle, and hits about six spots with the needle, while I do my best warrior stoic routine and remind myself that yes this sucks but it'll feel better in a moment. While this was going on and afterwards I heard a lot about what a "trooper" I am, most big men get all whiny and squirmy when the lido is injected.

"Well, I knew it was going to burn, and squirming and whining would just make it take longer, so why bother?"

Once the lido kicked in they sent in a very nice young lady to wash it out with some gauze and magic soap that dissolved the clotting I'd been able to produce and made it bleed. Again. To which I responded "dangit, I'd just gotten that to stop bleeding."

She looked at me funny.

Then back in came the doc with the suture kit, got himself all set up, and my little nursing student came in to watch. And apparently to distract me so that I didn't freak out about the stitches. Unnecessary, since I'd looked at the mess around my hand, and the needle, pondered it a moment, and decided for myself that I didn't really need to watch.

I'm not squeamish, needles don't bother me, but for some reason, I get grossed out by my own blood being drawn, and a moment of contemplation told me that watching myself get stitched up wasn't likely to be any better. It doesn't bother me a bit to have my blood drawn, or apparently to get stitches, I just don't want to watch.

So we chatted about our dogs, and the Doc got all ready to go, I wasn't looking when he took the first stitch but I felt it. See, he'd chosen the one small spot of skin where it hadn't been numbed to take his first stitch. The skin hadn't, everything underneath was, so I felt the needle stick, then everything else was tugging. Weird.

I guess I tensed, since the Doc paused and asked "You felt that one, huh?"

"Just the skin," I told him. "Everything else is numb, which was odd as hell."

"Ok, let me know if we find anywhere else that isn't numb."

And off he went putting the stitches in. A bit later, I felt a pinch on my middle finger.

"That's the other finger, Doc. I felt that one."

He'd been reaching for the end of the suture to tie a knot, and it happened to be up against my middle finger, and he pinched me with his forceps. No biggie but the nursing student started giggling.

She got called away for more valuable learning opportunities, and I looked over at my hand as the doc was tying off the third stitch. Might as well get a picture, I thought.

I pulled out my phone and the doc paused a moment to let me get a shot as I explained that I planned on doing a blog post about being dumb with knives.

"Oh, well, yeah, get it now then, once I'm done we'll clean it off again and it won't look so gory."

"I got one right after it happened, too, once I got the bleeding stopped. That's what I sent to my paramedic friend that made him tell me to come in and get stitched."

 And the finished job:

It hurts like a bitch, by the way, and I'm discovering just how intertwined the muscles in the hand are, every movement of my hand seems to pull on something right there, except maybe for wiggling my pinky finger. It's taken me a couple of hours to put this post together, because I'm typing with three fingers on my left hand and having to pause now and then while I look at the gauze and vet wrap (awesome stuff) bandage around the base of my finger (covered and antibiotic ointment for three days, doctor's orders) like it jumped up and bit me cause that motion shouldn't have hurt that spot that bad.

So, folks, remember, the Rules are applicable with things other than guns. Like really sharp little knives that I'd like to throw out the window, but... hell, the damn thing cut me so fast and clean it didn't even get bled on.