need advice... for myself re: Tetanus shot - Mothering Forums
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#1 of 19 Old 06-23-2013, 07:07 AM - Thread Starter
 
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I saw a thread somewhere recently about a very similar situation, but can't find it. I need some advice on what to do. Last night, about 10 hours ago, I slipped and fell. My foot either was cut by wood or a somewhat rusty screw/bolt thing. I was barefoot and this happened outside. I cleaned my foot, soaked it, and put Neosporin and a band-aid on it. It didn't bleed that much. The cut is on my heel. Upon inspection this morning, it looks as though whatever went into my foot went into it sideways a bit and through several layers of skin. It's deep I guess. I'm a little worried and am considering getting a tetanus shot. Am I being paranoid? Last plain tetanus shot was 12 years ago. I washed it again this morning and put more Neosporin on it. It hurts too.


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#2 of 19 Old 06-23-2013, 07:39 AM
 
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If it was me, I would have a Dr. look at it.  I don't think I would get a tetanus vaccine, because it is my understanding that the vaccine will not help prevent tetanus in a current injury (correct me please if I am wrong).  But I would discuss my options with the Dr.  If you are not opposed to the tetanus vaccine, you may as well get it so that you won't be so worried about tetanus in the future.


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#3 of 19 Old 06-23-2013, 07:52 AM
 
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You'd need TiG at this point, not a tetanus shot

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#4 of 19 Old 06-23-2013, 08:48 AM - Thread Starter
 
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Thanks for replying. I do plan on heading to an urgent care place later today. What is the difference between a regular plain tetanus shot and TIG?


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#5 of 19 Old 06-23-2013, 09:05 AM
 
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Tig is the immunoglobulin for tetanus and is what is given to patients who have contracted the disease. You may have to look around for it though if you decide that is what you want, since many er and doctors don't seem to carry it or want to give it out. But it is appropriate for post injury treatment even when you haven't been diagnosed, per the manufacturer insert.

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#6 of 19 Old 06-23-2013, 09:15 AM
 
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The tetanus vaccine takes too long to work for a current injury, and all doctors should know that. If they offer you the tetanus vaccine and no TIG, you'll know they're not actually worried. If they offer you the TIG, they are worried. So I suggest you go in and see what they offer, before you ask for anything. That will give you information about what they think your actual risk of tetanus is with this injury.

 

TIG stands for tetanus immunoglobulin. Here is its package insert.

http://www.talecris-pi.info/inserts/hypertet.pdf

 

Here are the package inserts for both brands of Tdap (tetanus/diphtheria/pertussis), which is the vaccine they would most likely give you if they gave you a vaccine.

http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM142764.pdf

http://www.fda.gov/downloads/BiologicsBloodVaccines/UCM152842.pdf

 

Keep in mind that tetanus is extremely rare. About 30 cases in the U.S. per year. I can't think of anything else that rare, that people are so aware of, and worry about so much, so often.

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#7 of 19 Old 06-23-2013, 09:19 AM - Thread Starter
 
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Thanks so much for the info! Going armed with knowledge thanks to you all!


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#8 of 19 Old 06-24-2013, 04:23 PM
 
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Quote:
Originally Posted by ma2two View Post

The tetanus vaccine takes too long to work for a current injury, and all doctors should know that. If they offer you the tetanus vaccine and no TIG, you'll know they're not actually worried. If they offer you the TIG, they are worried. So I suggest you go in and see what they offer, before you ask for anything. That will give you information about what they think your actual risk of tetanus is with this injury.

 

TIG stands for tetanus immunoglobulin. Here is its package insert.

http://www.talecris-pi.info/inserts/hypertet.pdf

 

Here are the package inserts for both brands of Tdap (tetanus/diphtheria/pertussis), which is the vaccine they would most likely give you if they gave you a vaccine.

http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM142764.pdf

http://www.fda.gov/downloads/BiologicsBloodVaccines/UCM152842.pdf

 

Keep in mind that tetanus is extremely rare. About 30 cases in the U.S. per year. I can't think of anything else that rare, that people are so aware of, and worry about so much, so often.

 

 

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Originally Posted by emmy526 View Post

You'd need TiG at this point, not a tetanus shot

 

Actually, this is incorrect.  The correct management would be a tetanus booster now.

 

http://www.health.state.mn.us/divs/idepc/diseases/tetanus/hcp/tetwdmgmtc.pdf

 

Treatment algorithm link above.

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#9 of 19 Old 06-24-2013, 04:57 PM
 
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Rust and wood don't confer tetanus. Are there any pastured animals on your land, therefore a risk of manure (which can carry tetanus) having made it into the wound? Also, did the wound bleed? Tetanus can't live in an oxygenated wound (ie. blood would negate it).
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#10 of 19 Old 06-24-2013, 06:28 PM
 
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Rust and wood don't confer tetanus. Are there any pastured animals on your land, therefore a risk of manure (which can carry tetanus) having made it into the wound? Also, did the wound bleed? Tetanus can't live in an oxygenated wound (ie. blood would negate it).

Again, not true. First of all, clostridium tetani spores live in the soil. It doesn't have to be pastures land. Second, it is not true that if a wound bleeds you can't get tetanus.

Clostridium tetani is an obligate anaerobes, so yes, it is true that it can not replicate in the presence of oxygen. However, in general, once you get a wound it stops bleeding, eventually. If it is not cleaned out completely, as is possible with a typical puncture wound, deep laceration, or animal bite, it is very possible that there will still be some foreign matter in the wound. Your skin will heal around it and leave the spores in a lovely anaerobic environment, where they can replicate and produce toxin. And it doesn't take much- tetanus toxin is extremely potent.

That's why the incubation phase for tetanus is up to a week- it takes time for you to heal, create the anaerobic environment, and for the bacteria to reproduce from the spore for. That's also why it's not "too late" to get a tetanus booster if you're overdue and have had a primary series.
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#11 of 19 Old 06-24-2013, 07:42 PM - Thread Starter
 
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So, I got a tetanus shot 13-14 hours post-injury. The doctor didn't really seem concerned. However, it was advised that since it had been 12 years since my last one, it would be a good idea. I agreed. Arm hurts today, pretty bad actually. I am not sure which one I got. I forgot to ask. I was given Cipro as a precaution for infection. Was supposed to start it yesterday, but I started tonight. Wound looks ok I guess. I am amazed it doesn't hurt more. Went back to where the injury occurred and that screw is totally rusty, but it is sticking out of wood and not covered by dirt or anything. It is totally exposed to the air.

 

There are no farm animals nearby so no manure around.


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#12 of 19 Old 06-24-2013, 08:14 PM
 
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Cipro is some nasty stuff. They couldn't give you something else? Are you aware that has a black box warning on it and can cause tendonitis or rupture the tendons? Two days worth of the stuff had me barely walking and unable to lift my head.

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#13 of 19 Old 06-24-2013, 08:19 PM - Thread Starter
 
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I was not aware of the black box warning. I am allergic to penicillin.


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#14 of 19 Old 06-24-2013, 08:25 PM
 
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Me too, well amoxicillin, but they are all related. Anyway, under no circumstaces would take the class of drugs that Cipro is in again or ever allow my children to take them. 

 

http://www.facebook.com/FluoroquinoloneToxicity check out this page

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#15 of 19 Old 06-24-2013, 08:35 PM - Thread Starter
 
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Just read a brief article about it. Hmm, pending lawsuits. Black box warning is the sternest warning the FDA gives. Scary. Perhaps I should call the doc tomorrow and inquire about something else. I took Cipro last year, had food poisoning. Nothing happened then, luckily. Sheesh, there's always a complication. What antibiotics are left after penicillin and Cipro? Sulfa drugs? I'll check out that facebook link. Thanks!


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#16 of 19 Old 06-25-2013, 04:10 AM
 
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Cipro is the last antibiotic i can take... i am allergic to ALL others....i never had a problem with cipro....yet

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#17 of 19 Old 06-25-2013, 06:09 AM - Thread Starter
 
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I am wondering if I should even bother taking any antibiotic. Wound shows absolutely no signs of infection, and it is 55+ hours post-injury. I hate taking anything especially antibiotics. I went on that facebook page. Sheesh. There are many, many people on there that describe terrible reactions to Cipro. Many of them years-long, health/life changing events. Scary stuff.


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#18 of 19 Old 06-25-2013, 06:19 AM
 
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Taking garlic is useful for helping fight off infection and also just making sure the wound is kept very clean.

 

I have taken z packs a few times without issue, although the fda is now saying it increases risk of heart issues especially in people with certain conditions.

 

Nitrofuantoin is what they gave me last time for a uti.

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#19 of 19 Old 06-25-2013, 05:18 PM - Thread Starter
 
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I ate garlic tonight... in pasta. Yeah, keeping the wound ultra clean. I am going to take a wait-and-see approach. I have taken Z-packs in the past without problems. I have also taken Septra. I think I have taken amoxicillin, Macrobid and some others I can't remember. Just no penicillin.

 

Wound still looks good. Thanks for your help!

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