After about twenty minutes of hiking with two guys holding onto my shoulders to support me, we hit a trail. The guys built a makeshift stretcher out of branches, backpacks, and ponchos. We still had a long way to go, and I became concerned about the time it would take to get to a hospital.
Gaboon viper - Wikipedia
The guys gently helped me onto the stretcher and carried me along two miles of trail. We came to a small house with a tin roof and a round barn near some dirt tracks. A 4 x 4 truck was waiting there to pick us up. The pain really started to kick in during the truck ride. I felt every bump on the dirt road. Each jostle sent a spike of pain from my foot all the way up to the top of my thigh. Waves of searing heat pulsed through my leg while stabbing pains, like knives shoved into my flesh, added more agony. After a ten-minute drive, we arrived at the lodge, where a chopper was waiting. Thirty minutes later, I was at a hospital in San Jose.
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All told, it took two hours to get from the bite site to the hospital. At Clinica Biblica, the medical team checked out my foot, administered antivenom, and gave me antibiotics and painkillers. Two doctors, Dr. Wu and Dr. Nunoz, checked my condition frequently.
I felt safe. My leg continued to swell for the next five or six days.
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My left foot blistered as the pain from the bite subsided. The trouble was, every time I stood up, the pain from the swelling took hold. I remember It felt like every muscle fiber in my leg was full of pressure and about to explode. Picture a bubbling sausage on a grill about to burst. That pressure was more painful than the pain immediately after the bite. Then Dr. Wu sniffed my foot and frowned. The flesh in my foot was rotting. Nurses put me on a gurney. As they wheeled me away, I watched my foot drip a trail of pus and blood onto the hospital clean floor.
The surgeons opened up my foot and removed the infected, liquefied flesh. They cut away any extra bits of tissue that were beginning to go bad and dressed the ankle and foot with a vacuum bag—a big polythene sack that they wrapped around my lower leg and attached to a pump. It felt something like a throbbing concrete block. I wondered if I was going to keep my foot. The people in Costa Rica knew their stuff about treating snakebites. A lot of people at work said it was best to deal with the snakebite in Costa Rica because they dealt with so many. But the reconstructive surgery I needed would be better in the U.
After one more cleaning operation on my foot, Clinica Biblica released me on April 5. In Los Angeles, an ambulance drove me to Cedars Sinai Medical Center, where a team of new doctors took a look at me every few minutes. They performed an eight-hour operation that included taking a chunk of flesh from my left thigh and grafting it onto my foot. On my birthday, April 11, Jackie brought me cupcakes, cards, and gifts.
It cheered me up. A woman played happy birthday for me on a flute. After she stopped, I noticed the sound of my arterial and venous pulses on the Doppler probe. Over the next four days, I listened for changes in the strength or rhythm of the beeping. It got stronger. The snake bit him in defense. When he stepped into the snake's strike range, the snake felt threatened and instinctively struck him.
I am not surprised that he did not see the snake before he stepped near it. The fer-de-lance, Bothrops atrox, is cryptically colored so that it blends almost invisibly against the rainforest floor. It is common for a large fer-de-lance bite to lead to this sort of reaction. These snakes have a very sophisticated venom-delivery apparatus that seldom delivers a "dry bite. The primary purpose of viper venom in nature is predatory. As soon as it is delivered, it begins to pre-digest tissue.
This is so that an animal with no means to break prey down into smaller pieces can efficiently digest it: from the inside out at first strike, then from the outside in when the snake swallows it. The venom also causes the victim to bleed abnormally. Bleeding prey loses blood and blood pressure so that it cannot perfuse its muscles and brain, which causes it to stop running at a distance that is not too far for the snake to recover.
Now the snake can track the prey at the snake's own pace while the prey starts to digest.source url
As cobras and vipers spread their deadly venom, it’s getting harder to save lives
When human tissue gets digested and bleeds abnormally, the result is tissue death. Dead tissue necroses, or rots. The biggest lesson from this story is that getting to an appropriate hospital and antivenom as quickly and safely as possible, as was done in this case, can save your life.
Bush, MD. The fer-de-lance, a pit viper that can reach lengths of up to six feet, is responsible for more than half of all venomous bites in the lowlands of Central America. Joe Spring. Jun 21, The average rattlesnake needs 21 days to replenish expended venom. This adds yet another variable to any given envenomation. Luiza H. Eladio F. Like other viperid snakes, the venom of B. Based on their hemorrhagic activity two classes of SVMPs were purified to homogeneity and termed leucurolysin-a leuc-a and leucurolysin-B leuc-B , respectively.
Further characterization has been conducted by this group. Acting in a similar way to other P-I class fibrinolytic metalloproteases  , leuc-a proteolytically cleaves fibrin, independent of plasminogen activation to plasmin and directly dissolves thrombi of whole blood clots [3,5,6]. Moreover, the enzyme also degrades the plasma fibronectin but not the major constituent of the basement membrane protein laminin and type I collagen, which bear tensile forces in the interstitial stromal matrix.
It has been shown that endothelial cells are highly resistant to leuc-a in culture and also the enzyme does not induce changes in cell morphology.
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In connection with these activities, leuc-a induces edema in mice peritoneum and foot pads, and this effect is slightly more significant than B. Ana M. Moura-da-Silva, Mark J. The Brazilian pit viper or jararaca, Bothrops jararaca , recently renamed as Bothropoides jararaca by Fenwick et al.
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The name jararhagin was derived from the snake species jarar- and the hemorrhagic activity -hagin of the enzyme. Elisa M. Mazzaferro, Richard B. Management of pit viper envenomation largely involves maintenance of normal tissue perfusion with intravenous fluids, decreasing patient discomfort with analgesia, and negating circulating venom with antivenin. Hydrotherapy to the affected bite site with tepid water is often soothing to the patient.
The empiric use of antibiotics is controversial but is recommended because of the favorable environment created by a snakebite i. Administer amoxicillin-clavulanate Monitor the patient closely for signs of local tissue necrosis and the development of thrombocytopenia and coagulopathies including DIC see Management of Disseminated Intravascular Coagulation. Treat coagulopathies aggressively to prevent end-organ damage.
Peter M. Lora E. Fleming, in Human-Animal Medicine , The Crotalinae subfamily of pit vipers includes venomous snakes such as copperheads, water moccasins, and rattlesnakes. The name pit vipers comes from heat-sensing glands pits located on either side of the triangle-shaped head Figure Figure Pit viper's head. Note the elliptical pupil and the heat-sensing pit for which these reptiles are named.
Viewed from above, the head has a distinctly triangular shape. Many nonvenomous snakes also possess triangular heads; therefore this is not a reliable means of differentiation. The fangs of pit vipers are hollow and can deliver a dose of venom deep into tissues. Pit viper venom is a highly complex mix of toxins, including metalloproteinases that cause local tissue destruction and thrombin-like proteins that cause a coagulopathy.