Seal Finger / Bear Finger....A Cautionary Tale.

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Jan 6, 2014
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With the spring bear season on the horizon I thought I'd write up a little synopsis of a medical issue I dealt with last spring involving a knife, a brown bear, and my left thumb. There was recently a thread in the general forum that talked about wearing gloves while skinning or working on an animal, so I thought this would be a good opportunity to share my experience and maybe help someone avoid the ordeal I went though if this happens to them in the future.

So, last spring I was working on a brown bear hide that one of our hunters had shot. I was using a Havalon knife in my right hand while holding the bear paw with my left. The person sitting next to me on the back deck accidentally bumped my right elbow, which in turn caused me to cut myself on my left thumb with the Havalon. It wasn't a bad cut, maybe a half to 3/4 inch long, more like a quick little slice. I've cut myself worse many times and thought nothing of it. Anyway, I got up immediately and thoroughly washed out the cut, dressed it, and got back to work.

Fast forward about three days later. I am out with a couple hunters when I wake up one morning and take a look at the cut on my thumb. Uh oh. The area surrounding the cut had turned a dark purple. I immediately realized that this didn't seem right from my experiences with prior cuts and became concerned that it had become infected. This was what it looked like on that third morning after the initial cut:

IkMbG8um.jpg


Knowing how dangerous infections can be when not properly treated, I decided the prudent thing to do would be to seek medical care. This was not an easy decision as one, I am a man who doesn't like going to the doctor and two, I had a couple clients out that probably didn't appreciate their morning hunt put on the back burner so I could get my thumb looked at. But, sometimes you have to play it safe. So I pulled anchor and headed to the nearest small village which I knew had a medical clinic.

I was able to get in and see the doc who subsequently gave me a tetanus shot for the "dirty knife wound," along with a shot of an antibiotic (Rocephin). He also gave me a 10 day course of another antibiotic (Bactrim). He assured me this should take care of the infection no problem and I was on my way.

I went back to work and completed the course of antibiotics over the next 10 days, but saw little change in the condition of my thumb. In fact, it became very painful, swollen, and I had little use of my thumb/hand. So, now two weeks later, it was strongly encouraged to me by a coworker that happened to be a former nurse to get it checked out again. Once again, not an easy decision as our location was quite remote at this time and well, missing work was not something I wanted to do. It was clear that the infection had not improved and had spread to other areas of my left hand, so in trying to make the smart decision, off I went. After a skiff ride to a small fishing village, followed by a float plane hop into Juneau, I found myself in an urgent care facility. Here's what the thumb looked like at that point, May 26th. The original cut was on May 9th with the first signs of infection on the 12th.

pIeQqYPm.jpg


I took an X-ray, some blood tests, and the lady evaluated my thumb and the history of the infection. Her concern and thought was that the infection had gotten into the bone and that I would need to have it surgically cleaned out. Just the news I wanted to hear. Her thought was that I could either have that taken care of at the hospital in Juneau, or her preferred advice would be to have me see a hand specialist in Anchorage and have them perform the operation. This was all starting to sound very expensive, but getting it cleaned out would sure beat the alternative of possibly losing my thumb.

So off I went, straight to the airport and hopped on the evening jet to Anchorage. I was able to get into the hand specialist the next day, a Cornell trained doctor that is renowned as one of the best hand specialists in the country. He took a look and said it didn't seem to be as bad as he thought it was going to be from the briefing he had received. He prescribed me a 7 day course of Keflex and sent me on my way. The plan was to come back in a week and see how it looked, but he was sure the Keflex was the proper antibiotic and would clear it up.

During the course of this ordeal, I thought I was doing everything right. From cleaning it out, getting it looked at immediately once I realized it had became infected, and seeing a specialist once I realized that it was not getting better. Anyhow, a week went by on the Keflex and it did seem like the swelling had started to go down. While it was still very painful and I had very little mobility of the thumb, it did seem to be improving. I went back to the specialist, he cleared my to go back to work and wrote me another week's worth of Keflex just in case.

Back to work I went. A few days later and here we go again. It seemed like maybe my thumb was swelling back up. I immediately started that second course of Keflex, yet realized that it hadn't done the trick. Now I was at a loss. I thought I had done everything right and here I am, a month later from the initial cut and my hand and thumb is as painful and swollen as ever. Here's how it looked on June 11th:

iugWCvVm.jpg


I immediately called the hand specialist. They decided they were done with me and referred me to an infectious disease specialist, oh joy. Well, the office of the infectious disease specialist didn't seem to show much urgency in getting me an appointment, which was very frustrating. I did not want to lose my thumb. I called the state epidemiology office and they as well offered little help. I was reaching my wit's end and didn't know what to do.

So, as a recovering hypochondriac, I did the one thing I knew I shouldn't, Dr. Google. I started doing my own research. After reviewing various literature and case studies that I could find online, I decided that my infection was something known as "Seal Finger," also known as "Spekk Finger." The way my case presented almost mirrored the NIH case study that I had read. Seal Finger is an infection more commonly found amongst seal fisherman, particularly Norwegians, and people that handle seal meat and other seal parts. In the old days, a fisherman would get Seal Finger and with no known cure, most of them would amputate that particular finger so they could get back to work.

The infection is caused by a specific, very novel bacteria that seals often carry. It's not too far fetched to think that this dirty old coastal brown bear may have eaten a dead seal and became a carrier of that bacteria. Here's a little wikipedia information along with a link to the NIH case study I read for those that enjoy that sort of thing.



The thing with this infection is, it doesn't respond to broad spectrum antibiotics. According to the case study I read, the only antibiotic that works on Seal Finger is tetracycline, one of the oldest antibiotics around and not a particularly fun one to take.

After deciding that this was what I was inflicted with, I was able to obtain a script for a months worth of tetracycline. Low and behold, it worked. The swelling and pain eventually went down and over the course of many many months, I've finally regained most of the mobility in my thumb. Here, 8 months later, I'd still say its not back to 100 percent but I still have my thumb. Here's what it looked like on June 24th, a month and a half after the initial cut:

U5Nm4cxm.jpg


Anyway, I share this not to bore you all to death, but rather as a cautionary tale in the small chance that this happens to one of my fellow bear hunters in the future, as assuredly, while the odds are slim, it will. That bear got his revenge, but he didn't win the war. So, if you ever find yourself in a similar predicament with an infected cut after dealing with a brown bear, keep this experience in mind. Tetracycline was the cure.

Happy Hunting!

Josh
 

Marbles

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Thank you for sharing.

Interesting, working at the Native Hospital in Anchorage I had heard of this, but had never researched it. So, thanks for getting me to learn more.
 

Steve O

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Yes thanks for sharing. Can’t be too careful, especially around bears. Friend of a friend died rather quickly from a blood infection.
 

Fatcamp

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That initial presentation was funky looking. I'm surprised they didn't culture that wound.

Very interesting thread and information.
 

KneeDeep

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Thanks for sharing this! Those rare infections can be very difficult to diagnose, you were smart in taking the matter into your own research hands since Infectious Disease physicians often don't think about the stuff that we get infected with from wild animals (or farms animals). FYI, I know of an infectious disease company that specializes in diagnosing rare infections like this...https://kariusdx.com/. Hope it's ok to post something like that in hope of saving someone's finger or life, feel free to delete post if not!
 

chinook907

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Oct 1, 2014
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Sorry to hear that Josh. Another friend got bear finger maybe 5 years ago after skinning a big AK Penn bear that had been fighting, with lots of facial wounds. For him, the docs figured it out quicker but still the treatment and recovery took a long time.
 
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Don't know about the bear finger thing, but while in the Marines picked up an infection in my left ring finger that cost me 33 days in isolation in a army hospital, was told by the surgeon the finger would probably need to go, some sort of weird jungle microbe. The finger is still with me, but it was a rough recovery and operation. Be careful out there as there is some weird shit around.
 
OP
adventure907
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Happy to share my experience with the hope it may help someone if this ever happens to them. It was quite the ordeal that I wouldn't wish on anyone, but thankful in the end it didn't turn out worse.

Happy hunting!
 

IDplumber

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Great story and good for you on sticking with it. Also a sad narrative on today's medical system. The hand specialist can't be too big a rock star if he ran when the going got tough. As a conventionally trained MD that is disappointing to hear. I take pride in obtaining a painfully detailed history and individualizing treatment based on the history as well as thinking outside the box. Too few that do it now days. If the peg doesn't fit in the hole they move on to the next peg. Glad you got to keep the thumb.
 
OP
adventure907
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Great story and good for you on sticking with it. Also a sad narrative on today's medical system. The hand specialist can't be too big a rock star if he ran when the going got tough. As a conventionally trained MD that is disappointing to hear. I take pride in obtaining a painfully detailed history and individualizing treatment based on the history as well as thinking outside the box. Too few that do it now days. If the peg doesn't fit in the hole they move on to the next peg. Glad you got to keep the thumb.
That was one of my biggest disappointments with the medical portion of this experience, the interaction and care of the hand specialist. He also wasn't cheap. His office then referred me to the infectious disease specialist and I couldn't even get a phone call back from them.
 

IDplumber

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That was one of my biggest disappointments with the medical portion of this experience, the interaction and care of the hand specialist. He also wasn't cheap. His office then referred me to the infectious disease specialist and I couldn't even get a phone call back from them.
The cost it was to you (both financially and in terms of stress/loss of work, etc) was significant. I'm not sure if you ever followed up with any of the providers you saw but I always try to learn from my patients, and if there is someone I was stuck on I like to hear what if anything worked down the road. I would be willing to bet some if not all of them would actually appreciate follow up on what you learned, in the form of a letter or something. You don't owe it to them by any means but I can imagine the providers in the small villages could use this to better treat future patients. Same for the hand specialist. Still sucks that it went down like this for you though.
 

bmrfish

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Holy crap, glad to hear of the positive outcome. What an ordeal and disappointing doctor experience. Thanks for sharing.


Sent from my iPhone using Tapatalk
 

dtchhuntr

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Happy your outcome is a good one. Always, always, always be your own best advocate in the healthcare world. I absolutely do not want to be Dr. Google, but have had to inquire multiple times about potential treatment avenues after giving the specialists a chance. It always has turned out better because of it.
 
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Stuff like that is no joke. I got an infection from a bald hornet that came off a rotten gut pile. Hand swelled up, turned red and felt like it was on fire. It made it above my wrist in about 3 days Doc gave me some anti biotics, it took about a week and a half to calm back down.
 

keller

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Glad your on the mend Josh and good on you for doing your own research or you still may not know anymore. I had an issue with my foot.dr had no idea what it was.my wife did some research and found the correct treatment. Dr said tell your wife good job
 

SDHNTR

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Aug 30, 2012
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Crazy! Glad you are doing better. I deal with a lot of pigs, and they are filthy like bears. Good warning.

Now please! Do your gut a favor and get on a regular regimen of probiotics. Eat Greek yogurt. All of those hard-core antibiotics had to have taken a toll on your beneficial gut flora. I have had a C diff infection after antibiotics killing off all the good gut bacteria and it was terrifying. Can be fatal.
Take care of your gut, you need it!
 

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