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Dr. Saha
Dr. Saha, Doctor (MD)
Category: Health
Satisfied Customers: 17799
Experience:  35 years of experience
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My 10 yr old is at that accident prone stage - so I dont know

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My 10 yr old is at that accident prone stage - so I don't know when or how it happened, cause he didn't tell me till late on Friday. His middle finger was swollen a bit, warm to the touch & it's to one side - localized above the first joint. It was red as if it had been hit, I figured blunt trauma. He sometimes rage quits on a game, thus taking the mouse and hitting the desk with it. He could have caught his finger doing this or he was messing with my wheelchair again and hit his finger trying to "drive" it out of the room or against my desk. Either way, I've put a cool cloth on it, soaked it with a bit of Epson salt & even used a moist green teabag to help with swelling and pain. I was able to get one 200mg ibuprofen in him, but he isn't good at swallowing pills. The finger has a yellowish area near the side of the nail, I believe it's an infection. Swelling is still bad, skin is tender to touch and I've tried to have him keep it elevated, though that works for only short periods. It hurts him, he says it feels hot and he won't straighten it. I don't have a splint to keep it so either. I'm disabled & can't drive, the bus doesn't run on the weekend & medicaid won't pay for an ambulance unless it is life threatening. (I've had to fight with them about it before.) Medical transport wants 48 hrs min. plus you HAVE an appointment. I'm hoping to get a same day visit on Mon. at the clinic - by calling at 8:30 am since they have a limited # XXXXX them. Otherwise I'll have to take him to the ER since getting an office visit can take 2-8 weeks or longer. I need to know what else I can do for him.

Dr. Saha :

Hello,

Dr. Saha :

Welcome to Just Answer.

Dr. Saha :

Is the swelling increasing?

Customer:

It has not responded well, I have an image of it but don't know how to send it.

Dr. Saha :

You can try to send it by attaching to clip in the tool bar.

Customer:

It is on one side of the finger, but the whole area above the first joint is swollen... mostly on the one side though. There is a yellowish area under the skin that is close to the base - say at 5 o'clock if the tip is 12

Customer:

I will have to upload it to my FB album first...

Dr. Saha :

Please try to send. I shall wait.

Customer:

I'm uploading them now, they aren't the best as he wouldn't straighten out his finger.

Customer:

injured finger
Full Size Image

Customer:

closer image
Full Size Image

Customer:

do these help at all?

Dr. Saha :

Ok. I am looking at those.

Dr. Saha :

Though there are some shadows or blurring, it is likely to be due to an infection.

Dr. Saha :

There can be infection of the skin around the nail base or paronychia.

Customer:

I do have some basic medical, herbal & EMT knowledge - but that was some time ago. I do try to keep up with things, but my youngest is pushing my limits. He's by far the more accident prone of his siblings. I've been able to treat most injuries on my own, but some I know I'm out of my depth.

Dr. Saha :

Yes, he needs an examination by doctor.

Dr. Saha :

Antibiotic can be prescribed to control it.

Customer:

I thought so too, he seems to have a slight yellow discoloring under the skin at the 5' oclock position

Dr. Saha :

Yes, there can be pus collection there.

Dr. Saha :

. Now you can apply warm moist compress. That would be helpful. You can also apply neosporin cream.

Customer:

I'm thinking blunt trauma and then believed that he was building up liquid or and pus... Warm? ok there are no breaks in the skin as yet

Dr. Saha :

If he can take ibuprofen, that would help with pain & inflammation.

Customer:

have the cream, would it still work topical - I figured there needed to be a break for it to get in

Customer:

got 1 200mg ibuprofen in him... took a bit - he's not good about swallowing pills yet

Dr. Saha :

Usually infection enters through some break in the skin.

Dr. Saha :

So neosporin can be applied.

Dr. Saha :

But it alone would not be helpful.

Customer:

That's what I figured... but there's no break not even a puncture... so I'm a bit curious as to how the infection started.

Dr. Saha :

He will need oral antibiotics.

Customer:

as I said I'm going to try to get him in on a same day appt. at the clinic.

Customer:

I was just trying to figure out if there was anything more I could do to treat it in the meantime

Dr. Saha :

It can enter from biting nail, pushing the skin or trimming.

Customer:

I will try the warm water & the neosporin - I'll get another pill in him too.

Dr. Saha :

Those are the measures which you can try meanwhile.

Customer:

He is a nail biter...

Dr. Saha :

That may be the cause.

Dr. Saha :
My goal is to provide you with excellent service today.

If there’s anything else I can do, please let me know
Customer:

thanks I appreciate your assessment of the situation... they cut the local Ask a nurse due to budget cuts... it's been rough since then to get help.

Customer:

Thank you very much.

Dr. Saha :
You are always welcome.
Dr. Saha :

If you are satisfied, please leave an excellent rating

Dr. Saha :

Best wishes.

Customer:

Have a good day

Dr. Saha :

Good luck.

Customer: replied 4 years ago.

I did as you suggested & then at around 8 pm he started to cry out that he was in pain, that it felt like his finger was on fire. I checked it with my magnifying glass to see better. The area around the first joint was very red, the finger was a darker red, the skin shinny from the pressure. I noticed that the yellow area was closer to the surface, only a few layers below - but I also saw that the blue veins on the middle finger were raised up, like they do when they are stressed. They were thicker too... I made the guess that the pressure was impeding the blood flow in his finger.


 


This couldn't wait so I made a call, trusting my training, my experience & my instinct. I took a new sterile needle from the box I had in the closet. (I keep a box for my sister, who's diabetic, for when she visits.) I slipped it under the few layers of skin (that's how close to the surface it was.) Immediately the pus began to flow through and out the top. It was a yellowish and the consistency of custard. I removed the needle and it just flowed out, we used a fresh gauze pad to catch it. But soon needed a second and third. It just kept coming out, finally some pale pink blood came out, more pus mixed with clear liquid too. He was crying about the pain, but as the pressure stopped he said it wasn't throbbing or felt like fire, it just hurt bad.


 


The skin is bruised, (I didn't push on the area, just let it release the pressure, for a while it was just oozing on it's own. Mostly mixed fluid, but the swelling reduced considerably, the bright red around the first joint faded & the veins within a few minutes returned to normal as well. I know there is still more pus inside, the infection isn't completely removed. I gave him another ibuprofen, put some triple antibiotic ointment on it & gave him a fresh piece of gauze to put around it lightly to catch the fluid.


 


He was so happy that he gave me a hug & his big brother one for helping me. I'm still taking him into the doctor in the morning as he still needs to get some medicine & for the infection site to be evaluated also. But despite the bruising coloring, it looks so much better than before.


 


Thanks for all your help with this, I know that it was risky to drain this, but the risk not to do it was greater I felt. I hadn't thought of draining it till I saw how much pressure was building up & how close to the surface the infection had come. I didn't even try to puncture the secondary area that was a bit deeper. I'll let the doctor decide how to handle that part. I just needed to take care of the abscess that was building up inside. This turned out to be the correct move to help him.


 


 

Thank you Lauren, for the follow up.

 

Sorry, i am late to answer as I was busy in hospital & was not on line.

 

Yes, you need to get it examined by doctor now.

 

Doctor will decide about further drainage, dressing, antibiotics after examining the area.

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