Komodo Islands Close Encounter

The danger of infection from a lionfish sting is a serious concern. Seek immediate medical attention to prevent long-term injury, and be prepared to wait at least 12 hours for the pain to dissipate.

BEING STUNG BY A LIONFISH is like being bitten by a poisonous snake. I found that out the hard way.

In January 2023 my husband and I along with five friends did a seven-day liveaboard excursion in the Komodo Islands in eastern Indonesia. The trip lived up to its bucket-list status, with giant mantas below the water and Komodo dragons on the shore.

At the end of a night dive on the fifth day, we had completed our safety stop, and I was enjoying the top of a coral head that teemed with life. Our allotted dive time was about up, so I moved my hand downward to start toward the surface. Unaware of the lionfish right below me, I swept my hand directly onto one of its featherlike pectoral fins with lots of pressure.

The puncture went deep into my left palm, just below my pinkie finger. I signaled the nearby divemaster that I had a problem. After swimming to the tender and climbing in, the divemaster put pressure on my palm to make the wound bleed more. I was yelling in pain but knew it was smart to try to extract as much venom as possible.

Knowing that swelling was likely, I switched my wedding band to my right hand as soon as I got back on the liveaboard. My friends gave me ibuprofen, but it did nothing to alleviate the excruciating pain. We researched the injury on DAN’s website and did a hot water soak to break down the neurotoxin to no avail. Based on DAN’s research, my friend assured me the pain should be gone in 12 hours. I could not imagine enduring the agony in my hand and arm for that long. The boat crew were concerned about my pain level and potential infection of the wound. The dive leader monitored me and after an hour of no improvement decided to take me to the hospital. Two other crew members and the dive leader accompanied me on a tender, where they made a bed for me from boat cushions and blankets. Fortunately, my husband gave me some pain medication that he found in our first aid kit.

After the most painful hour of my life, the three-hour tender boat ride was a bearable blur, with the occasional glimpse of moon through scudding clouds while I drifted in and out of semi-consciousness. My poor husband told me later that he regularly squeezed my hand during the trip to make sure I was still responsive.

We arrived at the emergency room in Labuan Bajo around midnight. My hand was swollen to at least twice its normal size, and the swelling had spread up to my elbow. My initial treatment was IV antihistamines, pain medication, and antibiotics. Once I was admitted to the hospital and settled for the night, the dive leader told us about a crew member on another boat who had a lionfish sting in his hand. Due to the distance to the port, he didn’t receive full medical care for six days. Although his wound had been cleaned well, his finger had to be amputated.

After a night and most of the next day in the hospital, I was much better, so we returned to the dive boat in time for the last day. I had some residual swelling for several days and some pain at the sting site for several months.

LESSONS LEARNED

A lionfish sting is like a snake bite; both venoms are neurotoxins, which affect your nerves and can be very painful. Someone mentioned early in our trip that lionfish are drawn to a diver’s light at night since it attracts their prey. I wish the divemaster had emphasized the danger of a sting as part of the night dive briefing. I would have been much more focused on and aware of the many lionfish I saw during the dive.

I was lucky to have strong pain medication in our first aid kit. We will include some for all future travels.

The danger of infection leading to amputation from a lionfish sting is more concerning long term than the intense pain. If we had been unable to get to port, I could have taken the antibiotics from our first aid kit. I was glad I didn’t have to rely on that option.

The hospital in Labuan Bajo was wonderful, modern, and accommodating. My large room had a comfortable guest couch. Although I was fine by morning, they let us stay until 5 p.m., when the tender picked us up to return to the liveaboard. The hospital charged only about $800 for the care they provided, and my medical insurance reimbursed me for all but $90 of that charge.

Our liveaboard operator and dive leader excellently handled my serious emergency. The hospital’s translation assistance was invaluable. The genuine care and concern from everyone involved provided me with as much comfort as possible in the most uncomfortable position I’ve ever experienced.