Need help- advice for possible poison infection

[ADB]

I am reaching out to see if anyone has had this experience, and if you might guide me to the right type of doctor to get help
I was impaled by a Sylvester palm about 4 1/2 years ago in my arm and in my side

I had to have the thorn surgically removed-the doctor in the emergency room that supposedly did this told me there was nothing in my arm. upon returning for a follow up, I told him that my arm continued to swell and I couldn’t use it and forced him to do an MRI.  This disclosed there were still needles in my arm and he took me in for a second surgery said he got them out.
Since that time, I’ve been dealing with a horrible cough that I cannot get rid of. I have seen a pulmonologist and infectious disease and I’ve gone to Mayo Clinic and no one has been able to help me get rid of it.

A year into my journey my pulmonologist recommended I go back to an orthopedic to have my arm MRI again he suspected the thorns were still in there. he was correct they were in there and the orthopedic operated one more time and did get the thorns out because he saved them for me. three thorns all about half inch to an inch long.   I am completely beside myself I cough daily like I have bronchitis and today’s world. It makes it very uncomfortable to be around people because they think you have Covid.
Anyone who has had maybe a similar journey who you have gotten medical help from and what type of medication they might’ve put you on to get rid of the bacterial infection which is what I’m sure I have

I have not been able to really get a doctor to listen to me and believe that that is the root of this cough I’m 57 years old and I have never been sick. I’m on no medication‘s and I am dealing with this cough every day. Please help

Edited December 16, 2023 by ADB
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[Darold Petty]

ADB,  Welcome to Palmtalk !   

I'm very sorry to hear of your medical troubles.  Phoenix palm spine punctures are notorious for pain that seems disproportionate for the mechanical puncture.  One theory is that there is a resident fungus on the surface of the spine, which causes the increased pain level over just the puncture.  So, my only thought is that you should mention to your doctors that the trouble might be a fungus, rather than a bacterium.  Best wishes to you, and good luck ! 

[aztropic]

Same with agave... VERY painful like tips are poisoned or something. A similar stab from a cactus or rosebush or bougainvilla is not nearly as painful.🤷‍♂️ 

Always be aware of your surroundings when working with spiny plants. 

 

aztropic

Mesa, Arizona 

 

 

[Looking Glass]

Sorry that this happened to you.  Palms can be dangerous for various reasons (some more than others) and non-metallic foreign bodies in soft tissues don’t show up on standard imaging, and they can be difficult and sometimes impossible to remove initially without causing permanent damage to surrounding structures (nerves, muscles, blood vessels) worse than the initial injury.  

Since you asked… and are having difficulty with this, I think that you should strongly consider that the chronic cough is not directly related to your arm injury.   You may be anchoring on this concept, and may be preoccupied with the idea that it is directly related.  Even the rarest causes of chronic cough would be more likely.  The series of events related to your arm injury was/is undoubtedly frustrating and stressful.  If the idea of considering this, brings up feeling of anger and frustration, this is a sign that you have emotionally anchored too strongly on that theory.   

Since you have likely seen your PCP and a Pulmonologist, perhaps seeing an ENT would be a good idea.   They can look down and see if anything is irritating the area around your vocal cords, triggering a cough.   They might also suggest further studies to evaluate this.  

You mentioned that you aren’t on any medications.   Perhaps you should be.  Many times people don’t want to be on medications, instead, they want specific answers.  But sometimes trials of medications for a period of time is part of the testing to make the diagnosis.   Doctors may want to try allergy medicines, acid reflux medicines, or respiratory steroids to see if they work.   If you have been resistant to try these, perhaps it is time.   

Lastly, once you have seen Dr House, Dr Dorian, Doogie Houser, and Dr Glip Glop and nobody can figure it out, you have to be careful about becoming mentally preoccupied with the symptoms.   

This happens with chronic conditions sometimes, and the obsession can become more debilitating than the actual problem.   Constant interfering thoughts about the problem become more damaging than the actual problem.  Remember, if you see it as a scratch, it will become a scratch.  If you see it as a huge wound, it will become a huge wound, at least in your own mind.   

Good luck.  
 

[Kim]

@Looking Glass You have presented a logical and thoughtful process to consider escalating the inquiry into ADB's problems. I'm impressed. But (yeah, there's a but...) I note ADB is female and I have to speak up about women and medicine. And this is not specific to you, please don't take it that way. In decades gone by, women were often told that their perceived physical problems were the result of an over-active imagination. Some generations of women have absorbed this message to the detriment of their health and avoid seeking medical care for certain things because of a fear of feeling foolish, as in, "maybe the pain it is just my imagination." It bothers me a little bit that anyone would suggest that a feeling that something is physically wrong might be an obsession. I hope ABD will follow through and eliminate some of the possible explanations and get to the root of the cause of the cough. True enough, the spines that were in her body may be totally unrelated to the cough, but encouragement to follow the steps you laid out is so much more useful than hinting she could be blowing it out of proportion.

[Looking Glass]

1 hour ago, Kim said:

@Looking Glass You have presented a logical and thoughtful process to consider escalating the inquiry into ADB's problems. I'm impressed. But (yeah, there's a but...) I note ADB is female and I have to speak up about women and medicine. And this is not specific to you, please don't take it that way. In decades gone by, women were often told that their perceived physical problems were the result of an over-active imagination. Some generations of women have absorbed this message to the detriment of their health and avoid seeking medical care for certain things because of a fear of feeling foolish, as in, "maybe the pain it is just my imagination." It bothers me a little bit that anyone would suggest that a feeling that something is physically wrong might be an obsession. I hope ABD will follow through and eliminate some of the possible explanations and get to the root of the cause of the cough. True enough, the spines that were in her body may be totally unrelated to the cough, but encouragement to follow the steps you laid out is so much more useful than hinting she could be blowing it out of proportion.

It can easily become an obsession.  I understand your viewpoint, but I also consider that the most important advice I can give when it comes to chronic pain or discomfort.  

I’ve been through two separate series of traumatic injuries both causing years of a lot of pain, and both requiring multiple surgical procedures over time each.   Each eliminated my ability to perform certain higher level athletic function permanently, and basic functions for a long period of time.   The longest period I was unable to walk for, at one point, was 9 months.   But that actually wasn’t the worst part.  

These days I don’t squat more than 225lbs for reps, and I’ve long trained myself to walk without a limp, as opposed to the opposite, but let’s just say not every bone could be straightened to its original angle, and not every controlling nerve connection survived, and not every joint has full mobility.   Not that you can tell in everyday life.  

When you are faced with an issue that causes you loss of function and intense long term discomfort and some disability, it becomes the last thing you think about before you fall asleep, it wakes you up at night, and it is the first thing you think about when you exhaustedly wake up.   Before long, it becomes all you think about all day.  And not long after that it begins to dominate and degrade every aspect of your life.   It’s hard to imagine.  You can no longer go out, you can no longer work effectively, and you can no longer concentrate, interact like you used to, or even smile.  You begin to be pulled into a very dark place.  Down that path, is nothing good, and it’s a hard road back.  

It’s best to be aware of this and try to break that mental cycle before it spirals out of control, and takes you out.   Anyone can follow the cookbook for working up a chronic cough, or the steps for managing an occult retained foreign body, but no one talks about this other stuff.

This problem is separate from the actual medical diagnosis or lack thereof.  And it is one of the most debilitating aspects of serious chronic medical issues.   You won’t really find it it talked about in the scientific journals, because few of the people who write the articles have ever noticed its existence.   And who in the medical or surgical sub-specialties has the time or desire to go down this rabbit hole with a patient?  

The doctors may be able to find problems, and fix them totally, or to only some degree.  But some situations are beyond our, and their control.   So it’s important to keep a disciplined mind and personal awareness during these events and time periods.  It’s just good to be aware of this issue and practice introspection intensely, because it can sneak up on you.  

I don’t mean to say don’t advocate for yourself, or go after things medically though.  That’s the more straightforward part.   

[mnorell]

8 hours ago, Looking Glass said:

...Lastly, once you have seen Dr House, Dr Dorian, Doogie Houser, and Dr Glip Glop and nobody can figure it out, you have to be careful about becoming mentally preoccupied with the symptoms. ..

I think @Looking Glass has written some really valuable wisdom in his posts here. I have one anecdote related to this...about 25 years ago, a co-worker of mine (and both of us, by the way, were working for the creator of Doogie Houser!) had taken a trip to Death Valley, and was staying at Furnace Creek, where there is a large grove of date palms. She walked through and enjoyed this grove...and after she returned to Los Angeles, she was feeling pain--and experiencing swelling--in her leg. She went to the doctor, who assured her there was no problem, she should just wait for it to go away. The pain persisted and increased, and she was literally hobbling around our offices at 20th Century-Fox. Finally she went to a doctor who did another x-ray and confirmed that she had a large object in her leg, and removed it. It was a large spine from a Phoenix dactylifera! She could literally not remember any pain from a puncture while in the palm grove. But after they extracted the spine, she kept it in a bottle by her desk. It was formidable, indeed. She recovered and didn't suffer any other issues, but did suffer mightily under its presence...and I for one have always been very concerned about walking in the vicinity of young Phoenix palms. Later, when I lived in Mississippi, I had a very dangerous P. sylvestris, and an even worse pair of Phoenix theophrastii. Both of those latter specimens died in freezes and I have never been happier to see them go off to Palm Heaven. I agree that the best way to fix the problem (and relieve your mind) might be to visit an ENT and/or another pulmonologist (one to re-diagnose you after removal of the spines) so that you have a definitive diagnosis specific to your symptoms. The connection with the palm-needles is understandable but I agree that, whether there is a real connection or not, our minds--and I believe this afflicts all of us equally, male and female--are capable of dreadful imaginings. We have all fallen victim to the worries over that mole, that recurring pain, etc. and tried to make sense by connecting it with any issue that we could possibly draw a line to, or some dreadful outcome that may turn out to be unwarranted. Chronic issues such as yours have a repeatable presentation, so diagnosis should at least be much more straightforward than something more mysterious or irregular. There's certainly nothing harmful about getting the professional opinion of a trained medical doctor.

[EPaul]

@ADB A similar issue occurred to my father many years ago while trimming a phoenix canariensis or phoenix roebelenii. He ended up getting a severe infection that was visibly running through his arm. Shots of penicillin didn't cure it because a second doctor ultimately diagnosed him as having not just a bacterial infection, but a fungal infection. The doctor said he had seen this before due to some of the fungus existing on these palms and getting into the bloodstream. After treating the fungal infection, he started healing.

[Jeff zone 8 N.C.]

Seems like you are getting some good advice here. You should follow it. I am not a doctor or experienced in any kind of problem like this so take what I say with that in mind. I think you are on the right track already. My questions are for you to answer to yourself. Many things in life happen simultaneously so do keep in mind that this could be something not related to the spines or some weakening of your health due to the injury or even just getting older. Maybe you could consider things in your environment that did not bother you before but do now,  like mold in your environment (remember to check air conditioner duct system), pet dander issues, or everyday items brought into your home like pillows or carpet. Also consider chemicals and cleaners used not only in your home but at work. Is grass debris in the air from mowing nearby carrying a chemical into your lungs. Are there chemicals like mold or dirty sock syndrome suppressants being used in an air conditioning system that you are exposed to. Did you move into a different home or environment around the start of your problem. What was on your current living area before you moved there (orange grove, farm, manufacturing, dump). Are neighbors having similar problems. Some of these questions can be answered if you find you are better when you travel and are staying in a different environment.  Last year I got a cold and could not shake the cough part for weeks on end. I finally thought maybe it was a persistent infection. I had some antibiotics from a previous problem and so took them. That worked. A friend had the same and the same remedy worked for him.  Just trying to give you a little thinking out of the box.

Edited December 17, 2023 by Jeff zone 8 N.C.

[PalmatierMeg]

15 hours ago, Kim said:

@Looking Glass You have presented a logical and thoughtful process to consider escalating the inquiry into ADB's problems. I'm impressed. But (yeah, there's a but...) I note ADB is female and I have to speak up about women and medicine. And this is not specific to you, please don't take it that way. In decades gone by, women were often told that their perceived physical problems were the result of an over-active imagination. Some generations of women have absorbed this message to the detriment of their health and avoid seeking medical care for certain things because of a fear of feeling foolish, as in, "maybe the pain it is just my imagination." It bothers me a little bit that anyone would suggest that a feeling that something is physically wrong might be an obsession. I hope ABD will follow through and eliminate some of the possible explanations and get to the root of the cause of the cough. True enough, the spines that were in her body may be totally unrelated to the cough, but encouragement to follow the steps you laid out is so much more useful than hinting she could be blowing it out of proportion.

I totally agree with Kim. I inherited from my parents a predisposition for obscure, unnamed autoimmune conditions that numerous male doctors could not diagnose much less treat. When that happened they invariably defaulted to the "hysterical woman syndrome" (HWS) and told me I needed a shrink not a medic. Totally discouraging.

I had a co-worker who became very sick and went to numerous doctors to find the cause. None of these pillars of medicine could figure out what went on with her but happily diagnosed her with HWS. All our male co-workers sympathized but suspected she was having a mental breakdown. I totally believed she was ill. Finally, she booked a week of tests at the Mayo Clinic in Jacksonville in the hope that these esteemed men of medicine could put a name to what ailed her. At the end of the week she met with the head doctor who looked at her and said, "You need to go back to Cape Coral and relax with a glass of wine."

After 3 years of misery my co-worker found a doctor who listened to her then took on the baffling investigation. Turns out she had a severe case of lupus.

[Merlyn]

I will second (or third) the suggestion on fungal infection.  Phoenix thorns cause at least a week of localized pain, swelling and redness...stabs from agaves, cacti, other palm species, and pretty much anything else does nothing more than cause a puncture wound or slice.  They all heal up fine, except for Phoenix. 

One possibility that I hadn't seen mentioned is an underlying allergy.  I mention this because the coughing and breathing issues can be (as @Looking Glass mentioned) unrelated to the Phoenix thorns.  Without getting into too much detail, my wife was misdiagnosed with asthma and then allergies to the entire planet, and it took a trip to the Mayo Clinic in Jax to determine that she was not allergic to the whole planet, and did not have asthma.  The local allergy doc was a scammer, who ran the "normal" needle test, then ran it again with 10x the dosage, and declared that she was allergic to EVERYTHING.  The Mayo's solution (which worked) was acid reflux irritating her throat, exacerbated by snoring/sleep apnea, raising the head of the bed a couple of inches, finding a good pillow that opened her breathing, and a severe allergy to dust mites (but nothing else). 

The solution in her case to coughing, difficulty breathing, severe fatigue turned out to be very simple and inexpensive.  Going to a good ENT might help figure out if the breathing/coughing is related to the thorns or a relatively simple fix.

[Looking Glass]

I’ve been stabbed in the forearm by one of my lowly Pygmy Dates, many times, but one poke did result in a nasty abscess that needed antibiotics and added to my collection of scars.  

I’ve also had suboptimal experiences with doctors, over the years.  At one point, after an accident, I kept telling my ortho-god that my lower leg angle was obviously a bit off in its cast.  He kept blowing it off for weeks, then one day he said, “Wow, it really is quite off!”.   So he took me to the OR, and rebroke my leg “over his knee” as he put it, so we could just start over….  After that, under the cast, I kept saying I was having a stabbing pain in a small area.  Very specific feeling.  That resulted in more eye rolls and blow offs.   So I went to see another surgeon higher up in the next Ivory Tower down the road.   He thought we better operate immediately, and put in a metal rod,  so I was booked for the OR again. 

When I woke up from that surgery and asked, “How did it go?”    
“It didn’t”, was the new doctor’s response….  That was a cold, empty day.  

It turned out, when they cut off the cast to do the operation, they saw a large bone fragment was poking my out of my shin, and the leg was now badly infected from having an open wound for weeks under the cast.  So they yanked out the piece of bone and canceled the operation.   No wonder the pain was so stabby under there. 

 After a weeks in the hospital, the infection was better, and the wound was healed, so I did get the surgery.   Unfortunately, they severed my peroneal nerve during the repair, resulting in a loss of function and sensation to part of the foot and ankle.   Days later, he said I needed to try to start walking again… right now!  I hadn’t walked in 9 months.  

That was a difficult period in my life.   I didn’t know it at the time, but I believe now, that it was a necessary warm up to prepare me for what was yet to come, many years later.  

I can’t say the events of those months, or others over the years, were due to any sort of prejudice, as a member of the serial republic villain class in more ways than one.  It was just old-fashioned, regular physician arrogance mixed with bad luck.  

As you go up the chain of prestige with doctors, you also up the arrogance quite often.  But one thing those sub-specialist are correct about...  avoid the complex conversations.  (Unfortunately, I’m an idiot who talks too much.). 

[mnorell]

2 hours ago, Looking Glass said:

...As you go up the chain of prestige with doctors, you also up the arrogance quite often.  But one thing those sub-specialist are correct about...  avoid the complex conversations.  (Unfortunately, I’m an idiot who talks too much.). 

Sounds like an absolutely horrible situation you went through...but I must disagree on one point: it is everyone's duty to have complex conversations with an M.D. Information is the cure for much that goes awry in the medical profession. Ask many tough questions, and give yourself the ability to double-check every detail a doctor gives you, research every malady, proposed medical procedure, prescription drug suggested/prescribed. If the doctor doesn't like it...find another doctor!

[Looking Glass]

2 hours ago, mnorell said:

Sounds like an absolutely horrible situation you went through...but I must disagree on one point: it is everyone's duty to have complex conversations with an M.D. Information is the cure for much that goes awry in the medical profession. Ask many tough questions, and give yourself the ability to double-check every detail a doctor gives you, research every malady, proposed medical procedure, prescription drug suggested/prescribed. If the doctor doesn't like it...find another doctor!

I meant that I should be avoiding complex conversations….  Somewhere out in cyberspace, some wise old doctor forum-member is reading this thread and having a chuckle to himself, as he closes his laptop, shaking head, before going to bed.  I strongly agree that everybody should take absolute responsibility for their own health and well-being.  In all honesty, most of the time, doctors are more like our helpers, than our saviors.  They’re only human, after all.