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#1 mom4him

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Posted 12 June 2011 - 10:58 PM

My son, 10.5 yrs old, just stepped on a rusty nail. It went in a
ways.UGH! The last shots he got were at about 21months. Any advice?
My husband poured h2o2 over it to help clean it. Soak in warm Epsom
salts? Would you take a chance and get him a booster for Tetanus? I don't want do get the vac. unless it is absolutely a must!
I would appreciate any and all input!
TIA
Sandy

#2 mamachanse

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Posted 12 June 2011 - 11:00 PM

Keep it clean. You shouldn't need the shot unless it get infected. I'll try to find a recent article I read.


Eta: http://guggiedaly.bl...ly-come-up.html

Edited by mamachanse, 12 June 2011 - 11:02 PM.


#3 FrogMom5

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Posted 12 June 2011 - 11:02 PM

I'm not a big fan of vaccines either but I would take him in immediately and get a tetanus shot. Some things you just don't mess around with, kwim?
Denise

#4 Aggie

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Posted 12 June 2011 - 11:03 PM

We just went through a tetanus scare.

The dr told us that the shot is good for 10 years.

Except, they do recommend getting a booster if there's an injury after the 5year mark.

ACK! I just re-read your post. I thought his last shots were 21 months ago.

Yes, go now for a tetanus shot.

Edited by Aggie, 12 June 2011 - 11:08 PM.


#5 Mrs Mungo

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Posted 12 June 2011 - 11:03 PM

I would take him for a tetnus shot now! My friend stepped on something while swimming in a river. She waited and over night she had red streaks running up her leg. She wound up with a tetnus shot *and* iv antibiotics.

#6 Stacia

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Posted 12 June 2011 - 11:05 PM

I would take him to get a tetnus shot right away.

#7 mamachanse

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Posted 12 June 2011 - 11:05 PM

He can get a non-vax TIG shot if it doesn't look like it is healing properly.

#8 Mosaicmind

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Posted 12 June 2011 - 11:09 PM

I do not fool around with this at all. DS's friend died 2yrs ago because his mommy didn't want to get a tetus shot and he got sick. It took just days and he was gone.

#9 kitten18

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Posted 12 June 2011 - 11:11 PM

I would take him to get a tetnus shot right away.

:iagree:

#10 JessicaLady

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Posted 12 June 2011 - 11:13 PM

I would be MUCH more concerned with the potentially life threatening illness caused by this puncture wound than the perceived risk of a vaccine.

#11 kiana

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Posted 12 June 2011 - 11:14 PM

Especially if it's an area where livestock have been, I would get some sort of tetanus shot.

I've seen an animal get tetanus and it wasn't pretty.

#12 Cindyz

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Posted 12 June 2011 - 11:15 PM

Squeeze it and make it bleed and put peroxide on it to get oxygen to the area. Tetanus is anerobic, and can only live without oxygen. By making the area bleed, you are flushing the wound and bringing oxygen rich blood into the area. This will kill the tetanus organism.

Edited by Cindyz, 12 June 2011 - 11:17 PM.


#13 mamachanse

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Posted 12 June 2011 - 11:22 PM

Squeeze it and make it bleed and put peroxide on it to get oxygen to the area. Tetanus is anerobic, and can only live without oxygen. By making the area bleed, you are flushing the wound and bringing oxygen rich blood into the area. This will kill the tetanus organism.


:iagree:

#14 Impish

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Posted 12 June 2011 - 11:25 PM

Get the shot. Not worth the risk.

#15 Jean in Newcastle

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Posted 12 June 2011 - 11:26 PM

Get the shot. Not worth the risk.


:iagree:

#16 silliness7

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Posted 12 June 2011 - 11:26 PM

I would be more worried about infection than anything. I would take him in and if they treat it anything at all like the very, very minor dog bite that I took my ds in for they will clean it, bandage it, prescribe antibiotics, and give a tetanus. My ds was 10, I forgot how old your ds is. Because of his age his tetanus did not have the whooping cough booster in it, which is apparently all the rage now. But it did have diptheria. I asked for JUST tetanus but they claimed not to have any. I also had to get a tetanus this winter and got pertussis to boot. :glare: (not the disease, the vax)

But I really wouldn't mess around with tetanus, even with the other junk. Just think, he'll be good for the next 10 years, barring any other incidents.

#17 sbgrace

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Posted 12 June 2011 - 11:31 PM

Ouch!

Did it bleed a lot? That's a good sign if it did. Tetanus is a problem when oxygen doesn't get to the wound. But...you said it went in relatively deep...

My son recently had injury where oxygen could theoretically not get through (his was a wound where the item went under the skin at one point leaving the skin above intact and he had stitches to boot). I did do the tetanus. I didn't feel it was worth the risk. I'd do it in your place I believe. The window to decide is relatively short--two days or three? I can't remember how much time they told us we had to decide. My son got the shot the day after his injury/stitches.

Edited by sbgrace, 13 June 2011 - 12:22 AM.


#18 Plucky

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Posted 12 June 2011 - 11:35 PM

You can take him into the doctor tomorrow for a tetanus shot. Don't bother going to the ER.

#19 Aggie

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Posted 12 June 2011 - 11:37 PM


I've seen an animal get tetanus and it wasn't pretty.


Same here.

And do not google tetanus images, either. Scary.

#20 CalicoKat

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Posted 12 June 2011 - 11:46 PM

I'm not a big fan of vaccines either but I would take him in immediately and get a tetanus shot. Some things you just don't mess around with, kwim?
Denise


:iagree: My doc had us redo the kid's tetnus shot once they reached age 10 because the effectiveness of what they'd originally got should have worn off.

#21 Lawana

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Posted 12 June 2011 - 11:52 PM

Squeeze it and make it bleed and put peroxide on it to get oxygen to the area. Tetanus is anerobic, and can only live without oxygen. By making the area bleed, you are flushing the wound and bringing oxygen rich blood into the area. This will kill the tetanus organism.

Can you give us some references where this is documented? I'm very interested in learning more.

#22 LittleIzumi

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Posted 12 June 2011 - 11:54 PM

As a delayed/selective vax'er--get the shot!!! Tetanus is one of the few shots I really believe are necessary/definitely outweigh the risks. Especially with a deep puncture.

#23 DianeW88

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Posted 12 June 2011 - 11:55 PM

Peds nurse here. He needs the shot. You have a 72 hour window. Take him in to the doctor tomorrow morning. Tetanus is NOTHING to mess around with. At. All.

#24 mamachanse

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Posted 12 June 2011 - 11:56 PM

Can you give us some references where this is documented? I'm very interested in learning more.


There are a bunch of references here: http://guggiedaly.bl...ly-come-up.html

#25 Slartibartfast

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Posted 13 June 2011 - 12:23 AM

I would take him for a tetnus shot now! My friend stepped on something while swimming in a river. She waited and over night she had red streaks running up her leg. She wound up with a tetnus shot *and* iv antibiotics.


I would be MUCH more concerned with the potentially life threatening illness caused by this puncture wound than the perceived risk of a vaccine.


:iagree:

puncture wounds need to be seen. It is the blood poisoning not the vpd that is the bigger danger

Edited by Sis, 13 June 2011 - 12:27 AM.


#26 angel marie

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Posted 13 June 2011 - 12:38 AM

i am a nurse. child needs a tetanus if hasn't had one in last 10 years. also, watch for infection. keep site clean. if signs and symptoms of infection begin (redness, drainage, swelling, increased temp at site) go back to doc. i'm sure your little one will do just fine.:001_smile:

#27 BlsdMama

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Posted 13 June 2011 - 12:43 AM

As a delayed/selective vaxer, I learned a lot about tetanus the hard way. :glare:

First, tetanus is relatively rare. Second, there is more that one kind of tetanus. The kind you are most likely to have gotten from this wound IS technically medically treatable in most cases. Technically it's not usually deadly, though risks run at about what? I think I've read 10% fatal. It isn't a great risk really but the risk from the vaccine IS lower than the disease. The DTP shot was the most risky vaccine out there (it could be argued I suppose) for a long while because of the "P" part of it - the pertussis. They were using whole cell pertussis. It became less of a risky vaccine when they went to DTaP - acellular pertussis. But the "T" part is relatively safe, vaccine speaking. And, when you go in, you'll most likely be getting the Tetanus Immunoglobulin - the "TIG" shot that was mentioned.

Tetanus doesn't come from a rusty nail like most people think. Tetanus is essentially a bacteria that can lie dormant for anywhere from fifty to one hundred years. Strange isn't it? So, it's not the rust that is the problem. It's the indication that if it's rusty - it's old and dirty. And since you don't know where your nail was fifty years ago, you have no idea if there is tetanus on it. Tetanus lives in the soil and particularly likes livestock feces, especially horses.

It doesn't matter if it bled or not, unfortunately. Because it isn't if the wound GOT air, it's if the wound is OPEN to the air.

So, let's say the wound bled profusely and air circulated through it. If the little tetanus bacteria was up and inside, generally puncture wounds tend to heal first on the outside - it's why they are so darn dangerous. Because when that outside part closes up, the inside "tunnel" is still open. It's like a vacuum in there and it's called an "anaerobic environment" simply meaning it's closed to air. This is what the dormant bacteria needs to begin producing toxin. It's the toxin that we react to - pretty much a nerve agent.

Now, there IS absolutely another option. Take a razor blade and slice a line into his foot vertically or horizontally up and until you get to the depth the nail went into. Make it large enough that you can get into the wound to clean it thoroughly and keep it open. You'll need to re-open the wound a couple of times each day, cleansing and re-cleansing it. Keeping it open will force the wound to heal from the inside out. This way that wound can NEVER become anaerobic. It guarantees no tetanus can multiply.

If that doesn't appeal to you, get the shot.

We chose not to vax our younger set for tetanus. A few years ago DD fell onto an old wire canning pan insert. The insert broke and the wire slipped into her thigh and traveled about 2.5". Puncture wound. Perfect environment and, btw, we bought the stupid thing at an old farm auction off of a hayrack. Sigh.

Not only was it NOT properly opened and cleaned in the ER, but when we discovered how deep it was (it wasn't apparent that night - only the next AM when there was a bruise and a streak) they denied us treatment based on vaccination status and forced us to travel to the ER in Iowa City. Nice, right?

I learned a WHOLE LOT about tetanus that night, let me tell you.

So, unless you're willing to cut him and he's willing to let you cut him, I'd get the shot. Because all the other points are really moot.

#28 Abigail4476

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Posted 13 June 2011 - 12:49 AM

...Now, there IS absolutely another option. Take a razor blade and slice a line into his foot vertically or horizontally up and until you get to the depth the nail went into. Make it large enough that you can get into the wound to clean it thoroughly and keep it open. You'll need to re-open the wound a couple of times each day, cleansing and re-cleansing it. Keeping it open will force the wound to heal from the inside out. This way that wound can NEVER become anaerobic. It guarantees no tetanus can multiply.

If that doesn't appeal to you, get the shot....


Good grief. Is that REALLY another option? :001_huh:

#29 nmoira

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Posted 13 June 2011 - 01:06 AM

There are a bunch of references here: http://guggiedaly.bl...ly-come-up.html

From your link:

And what does it mean to ‘oxygenate’? It means to bleed. Blood is oxygenated by passing through the lungs and then blood flows through our body to oxygenate all our tissues. That is how we live. We are oxygenated creatures. So if you step on a nail and you bleed, the Clostridium tetani cannot live. In other words, Tetanus is impossible to get if you are alive, pumping blood through your body and taking care of the wound.


Oxygen doesn't kill the spores, only the bacterium. It's the dormant spores that are introduced into the body from the type of puncture wound we're talking about in this thread, and the spores do not germinate immediately. So, unless you're absolutely sure there's no tissue damage affecting highly localized blood supply and that the affected area is entirely open to the air, I'd be more than hesitant to place my faith in having bled.

And from PubMed:

Without treatment, one out of four infected people die. The death rate for newborns with untreated tetanus is even higher. With proper treatment, less than 10% of infected patients die.


This is why it's a big deal even though the number of cases are relatively few: We're not talking about a 1 in 20,000 chance of death if tetanus is contracted.

#30 nmoira

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Posted 13 June 2011 - 01:08 AM

Good grief. Is that REALLY another option? :001_huh:

Yes, surgery as described is an option.

#31 Abigail4476

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Posted 13 June 2011 - 01:10 AM

Yes, surgery as described is an option.


Surgery by a surgeon, I presume. The way it was written, it seemed [to me] like a recommended home remedy. :001_huh:

#32 nmoira

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Posted 13 June 2011 - 01:11 AM

Surgery by a surgeon, I presume. The way it was written, it seemed [to me] like a recommended home remedy. :001_huh:

Well, sometimes you can't get to a doctor. If you can get to a doctor in time, there are far less drastic precautions that can be taken, as BlsdMama said.

#33 twoxcell

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Posted 13 June 2011 - 01:19 AM

I would take him in for the shot the first chance I had.

#34 Audrey

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Posted 13 June 2011 - 01:24 AM

Get the shot. Not worth the risk.

:iagree: And I am not generally a vax fan.

#35 joannqn

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Posted 13 June 2011 - 01:26 AM

Tetanus is the only vaccine my doctor was concerned about when we told him our decision to not vaccinate. We're making a dirt area out of an old planting space for the kids to dig in. There are rusty metal rod things that the wood sides of the box are screwed to, and there are nails/screws everywhere. I've been thinking about taking the kids in for tetanus shots (DT as our family history is contraindicated for pertussis vaccination) so they can play without worry. But if they did get a puncture wound before we do that, or if we don't do that, we'd definitely get them the TIG.

Edited by joannqn, 13 June 2011 - 02:01 AM.


#36 mamachanse

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Posted 13 June 2011 - 01:35 AM

From your link:



Oxygen doesn't kill the spores, only the bacterium. It's the dormant spores that are introduced into the body from the type of puncture wound we're talking about in this thread, and the spores do not germinate immediately. So, unless you're absolutely sure there's no tissue damage affecting highly localized blood supply and that the affected area is entirely open to the air, I'd be more than hesitant to place my faith in having bled.

And from PubMed:



This is why it's a big deal even though the number of cases are relatively few: We're not talking about a 1 in 20,000 chance of death if tetanus is contracted.


Yes, but IF the disease is contracted, THEN there is a chance of death. The chances of contracting tetanus are small. And, as I stated before, the TIG shot is available if symptoms occur. I'm not completely non-vax, I'm more non-alarmist. I'm not trying to cause a vax debate. I'm just offering options since the OP stated she didn't want to get the vax. :001_smile:

#37 nmoira

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Posted 13 June 2011 - 01:44 AM

Yes, but IF the disease is contracted, THEN there is a chance of death. The chances of contracting tetanus are small. And, as I stated before, the TIG shot is available if symptoms occur. I'm not completely non-vax, I'm more non-alarmist. I'm not trying to cause a vax debate. I'm just offering options since the OP stated she didn't want to get the vax. :001_smile:

From the TIG monograph:

Duration of Immunity
TIG provides only short-term protection against tetanus.104 110

As soon as possible, initiate or complete active immunization against tetanus using a preparation containing tetanus toxoid adsorbed.100 110



#38 mamachanse

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Posted 13 June 2011 - 01:48 AM

From the TIG monograph:


Yes, my understanding is that after TIG is administered, the patient would be observed for further symptoms.

#39 BlsdMama

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Posted 13 June 2011 - 08:04 AM

Good grief. Is that REALLY another option? :001_huh:


Well, I didn't say *I* would do it ;) but yep, it's really the other option. It's the reason the good 'ole days weren't so good and it does pretty much ensure you won't get tetanus.

#40 MelanieM

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Posted 13 June 2011 - 08:08 AM

My understanding is that a tetanus shot after an injury is useless because of the amount of time it takes for it to go through the system. I have some info here on how to treat tetanus... I'll see if I can find it and come back and post again.

#41 Carrie12345

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Posted 13 June 2011 - 08:13 AM

I'm an almost-no-vaxer, but we've always operated under the plan of doing the tetanus shot if that sort of injury occurs.

#42 SweetMissMagnolia

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Posted 13 June 2011 - 08:40 AM

I would at the least call the doc and see what they reccomend....I'm another one who would get the tetnus booster....

#43 Mommyfaithe

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Posted 13 June 2011 - 08:42 AM

I would take him to get a tetnus shot right away.


Yup, :iagree: tetanus shot and maybe an anti biotic....today.
Faithe

#44 ChristusG

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Posted 13 June 2011 - 09:02 AM

I'm a non/selective vaxer. In this situation, I'd get the shot.

#45 JFSinIL

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Posted 13 June 2011 - 09:12 AM

I would be MUCH more concerned with the potentially life threatening illness caused by this puncture wound than the perceived risk of a vaccine.


I agree. Get the shot. Maybe some antibiotic, too!

#46 unsinkable

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Posted 13 June 2011 - 09:56 AM

Tetanus is the only vaccine my doctor was concerned about when we told him our decision to not vaccinate. We're making a dirt area out of an old planting space for the kids to dig in. There are rusty metal rod things that the wood sides of the box are screwed to, and there are nails/screws everywhere. I've been thinking about taking the kids in for tetanus shots (DT as our family history is contraindicated for pertussis vaccination) so they can play without worry. But if they did get a puncture wound before we do that, or if we don't do that, we'd definitely get them the TIG.


Just make sure your kids know to tell you if they get a puncture wound.

One day I saw DS limping and asked him what was wrong.

My foot hurts.

From what?

Probably from the nail that went into my heel a couple days ago.

WHAT!?!?!

Apparently, he jumped down from a fence and caught his foot on the bottom of it. A nail went into his heel and he just put a bandaid on it. He said it didn't really hurt until a couple days later!

He got a tetanus booster w/in a couple hours of that conversation.

#47 Nakia

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Posted 13 June 2011 - 10:02 AM

Get the vaccine!! Don't wait, it's not worth it!

#48 BatmansWife

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Posted 13 June 2011 - 10:05 AM

I would be more worried about infection than anything. I would take him in and if they treat it anything at all like the very, very minor dog bite that I took my ds in for they will clean it, bandage it, prescribe antibiotics, and give a tetanus. My ds was 10, I forgot how old your ds is. Because of his age his tetanus did not have the whooping cough booster in it, which is apparently all the rage now. But it did have diptheria. I asked for JUST tetanus but they claimed not to have any. I also had to get a tetanus this winter and got pertussis to boot. :glare: (not the disease, the vax)

But I really wouldn't mess around with tetanus, even with the other junk. Just think, he'll be good for the next 10 years, barring any other incidents.


I just got my tetanus shot two weeks ago. I hadn't had one in like 18 years and every year my doctor would say, "you should really get your tetanus shot"...but she'd leave it up to me and I would never get it.

Well, my oldest dd will be going to a tech school in the fall and needs to send in her immunization records. One, of the two, required vaccines is the tetanus....which she hasn't had since she was 5. So...I figured I might as well get my shot if I'm telling her to go get hers. I was glad I got it so I knew what to expect.
One of the nurses kind of let it slip, in her conversation, that it was the Tdap.

I said, "I just want the tetanus shot and nothing else".

She said, "We don't have just tetanus. It's either tetanus/diptheria or tetanus/diptheria/pertussis. We recommend the Tdap."

I said, "I don't want the Tdap one."

She said, "but your doctor ordered that one."

I said, "I don't want that one."

She said, "I'll go ask your doctor." Like it would be my doctors decision??

She comes back and hands me the paper about the two different tetanus vaccines and says my doctor said the Tdap and she explained why they recommend that one.

I said, "I don't want that one". I just really didn't feel it was necessary to have that "p" part of it. She was very nice and said, "well, you have the paper there and if that's your decision, then fine...we'll get that one for you." 10 minutes later another nurse came in to give me the shot. Before she did I asked her which one it was, and she said the Td.

I was glad this happened because I knew my dd wouldn't have had any idea what to say...she would have just done whatever they said. So I talked to my dd and told her I really didn't feel she needed the Tdap but to just ask for the Td. The next week was her appointment and she went by herself after work. I asked her if she only got the Td. She said, "I think so. I told them I only wanted the tetanus." I was looking at the paper she brought home and it appeared that she got the Tdap. I called today to verify.....sure enough....she was given the Tdap. :cursing:


#49 Hill Country Kat

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Posted 13 June 2011 - 10:17 AM

Another delayed/selected vacc'er. I'd have DS in the doc's office today to get the shot if it were us. Tetanus is not something to mess I want to mess around with.

#50 mom4him

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Posted 13 June 2011 - 10:27 AM

I thought I would do an update.
We are headed in to see our Chiropractor this morning. He will look at the wound and then advice. DS will also do a foot bath that draws out toxins. I do trust this Dr as he isn't rabid about NEVER doing anything medically, he knows my ds and the issues we deal with in him. If he recommends the shot that is what we will do, if he recommends something else we will look at that.;)


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