Saturday, August 23, 2014

Saving a Thumb

August 18, 2014
Sergio uses stick and decapitated plastic liter-size Coke bottle to tease the ripe duraznos off the tree in his museo courtyard. 
The last time I was here we had a patient show up asking Don Sergio for help after a lasso accident. The cow (or horse) he had roped, pulled away and the rope tightened around his left thumb and pulled the skin almost completely off the bone. This happened 2 weeks prior and he had gone to the local hospital. The patient, we'll call him Caballero, is about 63 years old, excellent health, and has a pleasant and calm demeanor.
Caballero's thumb 2 weeks after injury.

At the local hospital, the skin was sewn back on to the base of where it had separated. The photos tell the story. Upon his return visit to the hospital for suture removal, his thumb was black and necrotic (tissue not viable). He was told they need to cut off the thumb. Caballero declined and showed up at Don Sergio's museo clinic.  How he heard of Don Sergio I don't know but word gets around.

Upon first sight of this tragedy, my first thought was the same, 'oh no, the thumb needs to come off'. However, Don Sergio with his 40 plus years of experience of treating some grotesque back-country wounds thought there was a chance to save it. The thumb did have a small amount of viable tissue remaining on the dorsal side and this is what he focused on.
Side of thumb with small patch of viable skin.

The few days following Caballero's first visit to Sergio's I returned to the US. Prior to my leaving I had asked him to please return in August so I can see what his thumb looked like.  He did return and and proudly showed me the results. Don Sergio's poco a poco daily and every other day cleaning and debriding allowed the viable skin and adequate tissue underneath to regenerate and cover the thumb. He had mobility and use although the skin was scarred and sensitive and the tip of the thumb had nail remnants with still a little healing to go. Caballero was happy and grateful to Don Sergio and was glad to show me his thumb.
~12 weeks later, remnants of nail base at top.

When one donates to Don Sergio, they are giving him resources to help people like Caballero. Working folk that eek out a living to support themselves and their families and being a part of a community. They are hard working and humble. It is stories like these that make Don Sergio a legend.

Caballero gave verbal permission to share his story.
Posted by Patricia Ferrer

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