Oregon People got Plague - why is his hand black?

Articles hereand here.

Is his hand black from gangrene? If that’s so, why hasn’t that hand been amputated already!? Does it not spread? Are all of the black parts going to fall off?

Now that I have suddenly been enlightened as to how the Plague is not extinct, inquiring minds desperately need to know!

The first article you link to says: “Doctors are waiting to see if they can save a portion of his fingers” so that’s why they haven’t amputated already.

I have experience with gangrene in a cat. Someone wrapped rubber bands tightly around its leg when it was out. It didn’t come home for three days and the leg was in really bad shape by then. The leg wasn’t 100% dead, though. The vet amputated the foot and removed the skin around the whole foreleg, but the interior of the foreleg wasn’t dead. After a very long time, skin grew back over the foreleg and the cat was able to hobble around better than if it has lost the foreleg.

So I’m guessing the same dynamic is at work here - some of the blackened portions of tissue are still alive and may be possible to save.

I’m not entirely sure that picture goes with that patient - I’ve seen it used as a stock photo for several “plague” stories.

But yes, it appears to be gangrene - dry gangrene, to be specific - which can happen with plague. It’s how plague got its other name: Black Death.

Dry gangrene tends to be the, uh, less worrisome gangrene. Don’t get me wrong, it’s still horrible and yes, the fingers will probably have to be amputated. But dry gangrene is caused when the blood supply is cut off, not because of bacteria in the bloodstream. It can happen with peripheral vascular disease, blood clots, diabetes and other conditions where the blood supply is cut off. But it’s not actually infected with anything, just suffocated on a cellular level. It doesn’t spread past the point of blood occlusion, and as long as it doesn’t get infected with bacteria, is not going to lead to sepsis (“blood poisoning”). Wet gangrene is caused by bacteria infection, and that’s the one that can spread very quickly, and that we associate with Civil War surgeons amputating limbs with hacksaws.

There’s just the off-est chance that his body will be able to reroute blood to the fingers by making new capillaries and they’ll turn pink and healthy again. If you read the article, that’s what doctors are hoping for - that it will resolve on its own. As long as it doesn’t appear to be getting infected, they’ll probably wait-and-see.

The best treatment I’ve personally seen is one I can’t actually recommend, because it’s not considered “evidence based medicine”. But when I worked for an acupuncturist, she was able to reverse the dry gangrene of a diabetic patient using acupuncture.

Um, please don’t post pictures, but is it called dry because his skin looks all mummified? Which then leads to the question if the wet kind is all … gah. Erk.

Can you elaborate in normal english instead of doctor english what the bolded part means? :slight_smile:

That’s… hopeful. Wait, how “off-est” are we talking here? One in a hundred, one in a million? Are there things you can do to help those chances along? How do you know if it’s infected or not if it doesn’t have blood flow and already looks like death?

It’s called dry because that’s what we call it when a body part turns black and cellular death is caused by blood being cut off. It’s called wet when it’s because of a bacterial infection. Wet spreads, dry doesn’t. Dry can become infected and turn to wet, though.

Oops! Sorry, I missed that one. “Occlusion” means “blocked” or “cut off”, that’s all. So if the blood is cut off, say, at the bed of the fingernail, but it’s getting through up until that point, the finger will turn black from the bed of the fingernail to the tip. Unless something else happens to cut off - occlude - the blood closer in, the black won’t spread.

(Thanks for asking…I’m still learning how to educate patients, and sometimes I forget what is “medicalese”.)

That, I don’t know. I think it’s one of those “it depends” things. It depends on how generally healthy the person is. It depends if what caused the blood to stop flowing there and if that’s been corrected. It depends on whether it was just the teeny-tiny capillaries that were cut off, or if it was the larger vessels. It’s easier for your body to reroute and make new capillaries than big blood vessels.

If it’s a medical condition that’s caused it, like diabetes or peripheral vascular disease, then you should follow your doctor’s instructions about medication, diet and exercise, wearing special socks if she says you should, elevate the limb as directed, etc.

In the case of plague, um…don’t reach in the mouth of a stray cat to fish out a mouse, I guess. Ick. Poor guy. (Poor cat.)

It’s easier to prevent these things than to treat them once they happen. Often there’s not much that can be done other than amputate and teach the patient how to better manage their disease to try to prevent it happening again to another body part.

It will get bigger. The edges may look swollen, red, maybe have puss, yellow or green gunk oozing out, feel hot to the touch, maybe have red streaks working their way up your hand. Red streaks are bad. If you have *any *cut or scrape that gets red streaks, that’s an ER visit, not a “see your doctor in the morning” visit.

They’re going to be watching this guy pretty closely, believe me.