Every practice setting has its specialty. For Poipu Mobile MD it appears to be “Wana” stings. Patients often arrive after surfing, or walking on shallow rocks. They generally describe a sudden stabbing pain, which ramps up far beyond what you may feel by stepping on a nail. Puncture by the spines causes one level of agony. But it’s the venom from the spines and “pedicellaria” in between that crank the pain up to 11.
Patients call regularly with this problem. The most recent victim to call said it was the worst pain he’d ever experienced, and far worse than when he broke both bones in his lower leg. He said it was like a wave that took over his whole body, then he couldn’t think straight and nearly passed out. (Naturally, all the mothers in the room rolled their eyes.)
The quick fix in this case was a bupivacaine digital block. That bought time for conversation and a little digging.