Health Scan: Unpleasant encounters with sea urchins

Hope for brain injured; Dancing back to health.

Dancing 311 (photo credit: Courtesy Western Galilee Hospital)
Dancing 311
(photo credit: Courtesy Western Galilee Hospital)
Sea urchins are small creatures that look like pompoms and dwell in shallow sea water. But they are not as innocuous as they look. Stepping on one and getting punctured by its spines can cause not only local trauma and pain but – unless treated in time, can result in a chronic condition called synovitis of the feet. Synovitis, or inflammation of the synovial membrane that lines joints, causes joint tenderness or pain, swelling and hard lumps called nodules.
Writing in a recent issue of Harefuah, the Hebrew-language journal of the Israel Medical Association, doctors at Rambam Medical Center in Haifa warned of the risk and described the case of a teenager still suffering with chronic synovitis of the feet two years after he stepped on a sea urchin.
The sea creatures, that live along Israel’s coast move slowly and quietly, but there are three types with poisonous chemicals in their spines. Unpleasant encounters with sea urchins can result in pain, swelling, cellulitis infections, irregular heart rhythm, soft-tissue gangrene, respiratory distress and even death, the researchers wrote.
They reported on a 15-year-old boy who reached their hospital clinic complaining of pain, swelling and redness in the heel of his right leg – two years after his foot was punctured by a black sea urchin when walking barefoot on the beach in Eilat. Soon after he was hurt, he was treated with oral antibiotics, and the situation improved, but inflammation and pain returned every few months.
Ultrasound and CT scans showed bits of material remained stuck in his foot. The Rambam doctors, who say there is little public awareness of the dangers of such injuries, recommended careful removal of all remnants from the sea urchin as soon as possible after the puncture. As for chronic inflammation and pain months or even years after the injury, careful removal of the urchin spines plus giving antibiotics can bring an end to it.
Wearing plastic or rubber shoes while walking on the beach or in shallow water can prevent all the trouble, they conclude.
Israelis almost take for granted the loss annually of between 300 and 400 people in road accidents.
But the additional human tragedy of the over 30,000 injured is not often discussed. The Beit Loewenstein Rehabilitation Hospital in Ra’anana specializes in working to restore the functioning of road accident victims and has much success.
It reported recently that a surprising 72 percent of those who have suffered serious head injuries are discharged fully conscious. Over 86% of those treated in the head injury intensive care unit are sent home at various levels of consciousness, the hospital said.
Even of those who admitted in a post-traumatic vegetative state, almost two out of three were restored to full consciousness at Beit Loewenstein, said Dr. Ben-Zion Krimchansky, head of the unit.
He conducted a study of 173 such people seriously hurt in road accidents between 2003 and 2008 and found that they were aged 16 to 76; 75.7% were men; 60% rode in vehicles, a fifth were pedestrians and the rest on motorcycles. The average patient was hospitalized for 36 days, while those with very severe injuries were in intensive care for an average of 119 days.
Those treated in various rehabilitation units stayed for an average of 173 days – about half a year.
“The likelihood of restoration to consciousness of victims of serious head injuries depends on the quality of treatment they get in a hospital,” Krimchansky concluded. Our accumulated experience and improved understanding of the vegetative state – together with the great advances in medical care – have brought about an increase in survival and chances for return to consciousness.”
Women suffering from cancer probably don’t feel like dancing, but workshops for those who have undergone treatment and start rehabilitation have been shown to benefit significantly from dance workshops. For four years, the oncology institute at Western Galilee Hospital in Nahariya has been holding such events for breast cancer survivors. Despite physiological and psychological difficulties from chemotherapy and surgery, the feelings of helplessness and pain reportedly fall away due to the experiences of movement in the workshops.
Hava Sharoni-Feldman, who runs the workshops, said many women who participated in the five-week, two-hour-weekly program found it much easier to return to the routines in their lives after dancing (with the help of scarves, hoops and other objects) and getting support from social workers and medical staffers. The Israel Cancer Association has funded a study that is formally examining the beneficial effects of dance on recovering cancer patients. The project also took first prize in a national competition initiated by a pharmaceutical company, in competition with other projects in 15 hospitals around the country.