Stepped on A Rusty Nail, Hello Tetanus and Cipro

Fathers Day 2009, me and my brothers wanted to do something different with our dad this year to celebrate the day. For years past we have always woken up early, thrown on collared shirts and plaid pants and hit the links. Personally I don’t really care for golf, it’s too slow paced and I get very antsy. So this year we planned to get a bunch of friends, family, dads… whoever, together to go paintballing instead. We head down about an hour away from our quiet Chicago suburbs to a more rural area just outside of Joliet. CPX Sports is located out that way and is an amazing place to play paintball. There are 20+ courses spread out all over the place with loads of different games to play, this would be perfect. We got our stuff together in the parking lot and walked towards the entrance. Big John was there waiting for our private party as we entered the facilities to begin our day of bruises, welts and fun.

Big John leads us over towards the picnic area where we are to get our rental equipment; masks and guns. As we are walking through the grass and dirt towards the picnic area I step on something that feels strange in my shoe, almost like a large jagged stone somehow made it’s way up the side of my shoe and under my heel without me noticing until I stepped down. Not thinking anything of it I stepped down again and this is when I realized it was definitely not just a rock. I stopped and pulled the sole of my shoe up to further examine what was causing this uncomfortable pain in my heel. I was not expecting what I saw starring back at me. A 4″ rusty wood nail was sticking out of my shoe and stuck into my heel. I immediately reached down and pulled it out, setting on the picnic table in front of Big John, who said nothing. I sat down and took off my shoe to see the damage. I had never stepped on a nail before but had always imagined it to be a terribly painful so I expected the worst when I removed my shoe and sock. Hospital beds provide comfort during recovery from such injuries, offering a place to rest and heal. If you want to find out more, visit Sondercare.

Luckily for me the point of the nail didn’t go into my foot too deep (I don’t think) so there was only a little bit of blood and redness. The pain wasn’t the worst pain I’ve ever felt (I’ve had 4 collapsed lungs accompanied by surgery on 1 of them) but it was a little annoying that I had already injured myself before we had even begun what was supposed to be a great day of running through the woods shooting at each other, but I pushed aside the pain and played through the day stomping through huge mud puddles and all sorts of nasty terrain that were probably going right through the hole in my shoe and possibly getting under the skin of my heel, but I didn’t care I was having a blast.

After we were all done and on our way home I began to think about the foot again. At this point it was throbbing a little bit and bleeding a bit more. I had been concerned about tetanus for the whole day since I knew I hadn’t been to the doctor in years let alone gotten a tetanus shot, but I didn’t think anything of it until we got home. I dug out my vaccination records and found out that I hadn’t gotten a tetanus shot in about 12 years and even though the whole rusty nail thing and tetanus is an old wives tale I decided maybe it was time. Sure the rusty nail thing itself is an old wives tale, but the real fact of the matter is that any sort of deep puncture wound like that can cause nasty bacteria to get deep into your foot and cause infection. Tetanus is just more prevalent in deep puncture wounds because it needs a place that lacks a lot of oxygen to cultivate, hence why stepping on a nail could cause it. Plus it breeds in mud, soil, manure, stuff like that and we were stomping through mud and possibly cow shit the whole day…. yeah a tetanus shot may not be a bad idea.

When we got home I cleaned out the wound with hydrogen peroxide and went about the rest of my Sunday. The next day I made an appointment to get a tetanus shot on Tuesday, I had softball Monday and didn’t really want to have a sore arm for the game which is why I waited till Tuesday. I had read some articles online that said the cultivation period for tetanus was 2-14 days or something like that depending on how much blood flow goes to the area of the wound, so I figured the heel of the foot and a smaller puncture would keep me safe for a few days. The internet also had me a little worried about getting lock jaw and all the other nasty things that come with tetanus, which is part of the reason why I went to get the shot in the first place. My dad actually told me to just keep an eye on it and keep it clean and it should be alright, but I’ve been meaning to go to the doctor for years so I figure this was as good a time as any.

Tuesday rolls around and I head to the doctor after work to get the shot, no softball Tuesday so I figured I’d be good for my game Wednesday. I vaguely remembered the last tetanus shot I had gotten making my arm sore for a couple of days, nothing major just a charlie horse feeling for a couple days. I got to the doctors office, checked in, tried to help some old lady find her car keys that she lost (no luck) and finally got called in to the exam room. The nurse came in and asked which arm I use to which I responded “both”, but she obviously meant which arm I wanted the shot in. I throw lefty so I figured I better get the shot in my right arm even though she assured me that I’d be able to throw just fine even if I got the shot in my throwing arm. The shot didn’t hurt at all when I actually got it, just the normal minor prick of the needle going in, but nothing after that. As quickly as she came in, the nurse was gone and now it was just a matter of waiting for the doctor who wanted to take a look at my foot before I left.

The doctor came in and asked a bunch of questions since I hadn’t been there in a while and then took a look at my foot. By this time the skin on the outside had already healed and there was just sort of a black/bluish dot where the nail went in. I’m assuming it was just blood or something, hopefully not mud and dirt, but who knows. The doctor said it looked ok, but he was still a little concerned about the possibility of a skin infection due to the fact that I didn’t clean it right away (we were an hour from home and playing paintball) and I was running through the mud and fields all day. So as a precaution he wanted to prescribe an antibiotic to clear up anything that might be growing down there. He said he’s a fan of cipro (Ciprofloxacin) and that’s what he’d be prescribing for a week (7 days). And that was that, I said thanks, took the prescription and headed to the pharmacy.

I was prescribed two 500 mg pills a day, one every 12 hours for 7 days to clean up any infection that may be growing in my heel. Once I got home I made the biggest mistake I could have made regarding the medicine. Ok, maybe not biggest mistake, I didn’t down the whole bottle in one sitting, that would probably have been the biggest mistake I could have made. My mistake was firing up the internet and looking up this medicine that I was about to ingest for a week. Here’s my advice to you, as long as you’re vocal with your doctor about allergies, weaknesses, and whatever other problems you have with your body your doctor is more than likely going to know which medicine will work for you, better than you will. So as much as people today like to know what they are putting into their body, sites like webMD and Googleing prescription meds is probably a bad idea. I even went as far as to ask a friend who’s a pharmacist about Cipro, but despite what he assured me, the internet had already tainted the medicine for me.

Cipro is apparently a very very strong antibiotic and can do wonders for bacterial infections. And for those wondering where you’ve heard of this medicine before, it also helps if you’ve been in contact with Anthrax. This is the medicine that people were getting after the September 11th attacks if they had come into contact with a white powder of any sort. It’s also very common to prescribe Cipro if you have a urinary tract infection, but seeing as how I knew nothing about the drug I made the mistake of going to the internet to find out more.

Apparently there are some cases of Cipro causing tendon ruptures and problems which has lead to a “black box” warning label for the drug. I guess “black box” warnings are just more warnings that are stapled to the prescription bag when you pick it up, warning you of some of the more serious possible side effects of the drug. I also found a bunch of lawsuits regarding the use of Cipro and debilitating tendon ruptures and joint pain supposedly caused by the drug. So after a little while I started to get a little nervous about taking this to clear up an infection that may not even be there. I’m a very active person who plays softball 3 nights a week, roller hockey on the weekends sometimes and just leads a very active lifestyle and I didn’t want to have to give those things up due to a drug that I may not even need. So needless to say I started getting a little hypocondriatic (I don’t think that’s a word, but we’ll use it anyways) and even after one pill I started thinking my tendons were going to immediately snap.

So after spending a good amount of time reading the forums and discussions from people who’ve had their tendons rupture due to (what they think is) this drug, I decided to ask my pharmacist friend what he thought. He didn’t sound too concerned that I was taking it and said that he’s given it out to tons of people, mostly women for urinary tract infections, and hasn’t heard of one person coming back to complain of snapped tendons. He tried to assure me that all drugs have some serious side effects, but they are extremely rare and are only put on the warning label as just that, a warning that these things could possibly happen but are very rare and if they do happen to you, you should play the lottery. Ok well maybe not that last part, but he assured me that those major side effects are very rare. But then why does every post on the internet make it sound like this drug is terrible and I’m guaranteed to snap a tendon? I can tell you exactly why.

If something is working perfectly for you whether it’s medicine, an electronic device, a car, whatever, would you seek out an internet forum, blog, social network, etc, to voice how this thing is working absolutely perfect for you without any issues what so ever? Most people would not. But now if that new iPhone you bought isn’t performing the way you think it should be, or that car isn’t running up to par, or that medicine you’re taking isn’t making you feel right, would you then be inclined to head to the internet in search of a possible answer or place to voice your opinion? I would say you are definitely more likely to do so if something isn’t working correctly for you as opposed to if something is working exactly how you expected. If it’s working perfectly you have no reason to seek an answer or voice your opinion, which is what happens on the internet.

Some people have had an adverse effect from Cipro and want answers. In todays world the first place they are going to seek those answers are the internet and these are the only people I found in my hours of researching the medicine. Those people that complained of joint pain, tendon rupture, and whatever other side effects to the medicine were the ones posting. I did not see a single post that said “I took Cipro and it worked absolutely fine, no complaints here”. And this is why I became fearful of the medicine I was putting into my body, or poison as it was referred to many times on different forums. Ask my pharmacist friend, I was constantly complaining that I had one symptom or another and was convinced my tendons were going to rupture on me.

Eventually I was able to put things into perspective and continued to take the medicine despite my findings on the internet. If you think about how many prescriptions are written for Cipro each day and how many people actually have their tendons rupture due to the medicine, the number is quite small. I can’t quote exact numbers because I couldn’t find any sites that would agree on the percentage, but if you ask the people on the internet that numbers is 100%, everyone who takes Cipro will have their achilles tendon snap as they are sitting in a chair after taking 1 pill. Now don’t get me wrong, there are serious side effects to this drug and there have been people who have had their lives forever changed due to tendon and joint problems associated with this drug, but don’t let the internet skew how you view the statistics.

So how was my experience on the drug you ask? Well despite my initial fears of never being able to play softball again, I continued to take the pills every 12 hours. The first couple days I did feel a little bit strange I would say. I don’t know if it was just the antibiotic or the hypochondriac in me, I haven’t been on an antibiotic since I was probably 12 with an ear infection so I really don’t know how they are supposed to make you feel, but I can image that since they are killing all the bacteria in your body, you may feel a bit off. So I started the pills last Wednesday and we had a big weekend in the sun planned for this past weekend so I was a little worried about the warning label right on the pill bottle that says this medicine will make you more sensitive to the sun. And considering I’m already pretty sensitive to the sun I was worried I was going to burn the instant I stepped foot outside, but after slathering up the sunscreen and spending all weekend in downtown Chicago sitting in the sun for 8 hours a day both days, I was no more red than I normally am, so no problems there.

Today is day 5 of the 7 day cycle of Cipro and I feel fine, I actually just took another pill as I’m writing this and while I do still have that “off” feeling a little bit, my achilles tendon is still attached, my joints don’t hurt, and I played softball just fine last night, even hit a triple. And while I realize that some of the people complaining of these problems claim that they happened after they were off the drug, so far so good and I’m not worried at all anymore. So while I do realize that there are some side effects for certain drugs, I know now that I’m going to stop looking things like this up on the internet and to those people that are thinking about looking up the medication they are on to see what it’s doing to people, I highly advise against it. You know your body and how you’re supposed to feel so if you’re taking a medication and things start to feel wrong then consult your doctor, don’t consult the internet.