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Put to sleep to remove a splinter
Jul 1, 2004

I had a splinter in my hand for about 6 months. I saw my HIV doctor about it when it occurred and he could not find it and assumed that all of it had been removed. He placed me on an antibiotic to clear up the resulting infection. All was well except that scar tissue had formed around the "twig" that was left behind and this required that it be removed. I was referred to a hand specialist who scheduled day surgery. He was going to remove it under a local. I had provided him with my medical history in his office. One the day of removal (surgery) I was going over my medical history with a nurse when I mentioned HIV. The hand specialist heard this and perked up. He left the room for a couple of minutes and came back to inform me that I would be taking a nap. He stated that since I was HIV+ it was too dangerous to him and his staff to handle this under a local. He stated that when they give injections into the hand to numb it that some patients "jerk" their hands. If this was to happen with me, well it would be too dangerous. My question is - is this guys theory worth the danger of putting me under? Had I not mentioned the HIV within his earshot, no matter how many times I listed it on medical history forms he would have administered a local.

Response from Dr. Pierone

It is hard to know if this approach was a reasonable precaution or an overly cautious action. There is not question that injections of numbing medications into the hand can produce a reflexive jerk that could lead to a needle-stick exposure. However, you rightly point out that the decision to use conscious sedation should have been discussed with you beforehand so that you could be fully informed and on board with the decision.

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