That One Time A Sea Urchin Almost Killed Me

It’s funny how your best and worst travel moments can be so intertwined.

That One Time A Sea Urchin Almost Killed Me in Cambodia

For those of you wondering where I’ve been, I spent the last two weeks traveling Cambodia! I really thought I could find time to write on my two-week whirlwind trip, but boy was I wrong. This post was originally meant to be a quick overview of my amazing trip, along with the route I took and some travel tips if you ever plan on experiencing Cambodia for yourself.

Unfortunately, after my crazy last few days, I figured I owe you all an explanation for why I’ve been so quiet. Aside from not having any time to write, and having no internet for a solid 5 days, I’ve been feeling a bit under the weather and ended up spending the entire day in a Chinese hospital.

Koh Rong Sunset

The beautiful sunset Instagram, completely unedited. Can you believe it?!

If you follow me on Facebook or Instagram, you may have seen a beautiful sunset photo of a beach pop up, where I talked about the incredible Cambodian island Koh Rong. The day I took that photo was one of my all-time favorite travel days. Trekking through the jungle to a hidden beach, swimming in turquoise water and laying in the sand, snorkeling just off shore, and taking a boat ride to swim with sparkling plankton- it was a day I’ll remember forever.

Unfortunately for me, it’s also what landed me in the hospital.

Koh Rong Long Beach

Sometimes paradise is dangerous

When paradise isn’t so perfect

While I was snorkeling in and among the rocks, I was hit by a small wave that pushed me back into a rock. My foot just barely grazed the rock, which normally wouldn’t be a problem, except for the fact that there just happened to be a sea urchin in that exact spot. What a freak accident right??!

I had been snorkeling all of about five minutes before this happened. I didn’t even realize what had stabbed me until I pulled my foot out of the water and saw black quills embedded deep into my foot. Then I realized the pain of the spikes was more than just that of a bad splinter. It shot up my leg and almost blinded me as I doggy-paddled my way back to shore.

My friends ran up to the beach bar to ask for some tweezers, and I started to worry about my health. Aren’t sea urchins poisonous??! Did I need to take a boat back to the village and see the doctor? Did I have to take the ferry back to mainland and go to the hospital?

Koh Rong Long Beach

Don’t know what I would have done without them

My friends finally came back with tweezers and told me that the injury wasn’t serious. Apparently it happens all the time on the island. It even happened to another girl about an hour after me! The important thing was to just get the spines out, and I should be okay. If I couldn’t get them out I could see the island doctor later that night or the next morning and he would do it for me.

My friends and I dug into my foot until it bled with the blunt tweezers but we couldn’t get any of the spines out. I tried everything, but they’re so different from normal stingers or splinters. The sea urchin shoots its poisonous spines deep into the skin. Since they’re black, it looks like they’re close to the surface and easy to remove, but in reality, they’re much deeper than you might think.

Sea urchin sting

So tiny but so painful

While a part of me knew I should have seen the doctor right away, I didn’t want to ruin my amazing day. It was my last day on the island and I didn’t want to miss out on the sunset or swimming with the bioluminescent plankton. I’m crazy and I have a death wish, I know, but the reassurance from the locals and the foreign bartenders made me feel like I could stay. It happens all the time right?

That evening after an incredible sunset and glowing nighttime swim, I headed to the pharmacy to have the doctor look at my foot. The doctor, who seemed very well-educated and spoke perfect English, told me that he could remove them from my foot, but it would be better to leave them in. He said that small cuts all over the bottom of my foot would be a risk for infection, and it would be better to let my body take care of it. He said the pain should subside in a few days, and I would be better. I figured I could trust him because the injury was so common, right?

Kep crab Kampot pepper

AMAZING crab lunch with fresh Kampot pepper

No Appetite= Big Problems

So I left the spines in my foot, and continued my travels as planned. It really hurt to walk, especially barefoot, but I didn’t let it stop me from visiting Kampot and having a great time. However, two days later I started to notice there was something wrong with me. After eating an amazing crab lunch in Kep, I felt so full I thought I was going to explode. While it was a lot of food, the “so full I feel sick” feeling isn’t very common for me. I figured it was because I had a big breakfast that morning, and I’m usually used to eating something small like coffee and fruit.

eggs florentine

An unusually large breakfast

However, later that night I wasn’t hungry for dinner at all either. I forced myself to eat something small around 9pm, but I felt so incredibly full after that meal too. When I returned to the hostel, I wanted to have a fun night because it was my last day in Cambodia. I still had a free cocktail from the hostel bar! I forced myself to stay up until around 2am, even though I was exhausted. I figured I could sleep on the 5-hour bus the next day to Phnom Penh.

Compote river cruise

My last night in Kampot, before it all went downhill

The next morning when I woke up I felt absolutely awful. My throat hurt, my stomach hurt, I was exhausted and I had no appetite. I had a 12:30 bus to the capital, so I forced myself to eat brunch at the hostel around 11. On the bus, I slept almost the entire bumpy ride. I knew something was wrong, but I just figured I was rundown from so much busy travel.

My flight back to China wasn’t until midnight, so I went to a random hostel and ordered a tea to use their Internet. The weirdest thing for me was my complete lack of appetite. Finally around 8:30pm I ordered a soup for dinner and only ate half of it. I hadn’t eaten anything since 11am!

red eye flight

Really enjoying my complimentary OJ at 2am

The flight back to China was pretty miserable. The plane was one of the most uncomfortable and crowded I’ve ever experienced. I’m 5’4” and my knees touched the seat in front of me! It was a four-hour flight and they kept us up for two of those hours so that they could feed us a meal. Really China Eastern? Who is hungry for a giant meal at 2am on their 4-hour redeye flight?!

I landed at 5am China time and spent the next 6 hours making it back to Ningbo. It took almost two-hours to ride the subway across Shanghai, and three hours on the bus to my Chinese city. It was absolutely freezing (It was actually below freezing), and I had no real winter clothes with me; just tennis shoes, leggings, two sweaters, a waterproof jacket and a summer scarf. It was a ridiculous outfit straight out of the 90’s but at least it did the job.

Koh Rong sunset

At least I got to enjoy this

Heading to the Hospital

When I arrived home to China, I was exhausted but I figured it was from my redeye flight. That was until 10pm when I noticed my back was very itchy. When I looked in the mirror I found my entire back covered in a huge rash! It was unbearably itchy, so I ran to the health clinic on campus. There was no real doctor, just a student who prescribed me Clarityne, an allergy medication. I tried to explain to her in a mixture of Chinese and English that I had just returned from Cambodia, but this girl was really ill-equipped to handle my situation. Not only did the Clarityne not work, the rash also spread onto my legs.

The next morning I called the school’s English-speaking medical advisor, who tried to convince me the rash was just from my fever, even though I told her literally five times that I didn’t have a fever. I eventually insisted that I was worried this had something to do with my recent trip to Cambodia, and there was no way I wanted to wait two full days to see a doctor on campus. Who knew if I had some strange tropical disease?! My mom was convinced I had Typhoid Fever, even though I didn’t have a fever. You’d think that would be the main symptom right?

Sea urchin sting Koh Rong

Post-sea urchin vacation face

The English medical advisor eventually agreed to meet me at the hospital, and I hopped in a taxi. The main problem is that I had no idea what was wrong with me. It could be the sea urchin, a weird tropical disease, something I picked up from mosquitos, or a random coincidence. There were so many possibilities, and I was worried of a misdiagnosis.

To be honest, I don’t 100% trust Chinese hospitals, especially with their overuse of antibiotics. Granted, I don’t 100% trust American doctors either after my university specialist failed to diagnose a hematoma (really horrible internal bruise) I had in my foot after dropping a mixing bowl on it, when a doctor back home in Seattle knew what was wrong with me within 5 minutes.

Chinese doctor handwriting

And you think your doctor has bad hand writing: I give you the Chinese doctor.

Blood Tests and “Surgery”

At the hospital, I looked up the Chinese for “sea urchin” and made sure to mention it to the doctor. The doctor seemed pretty nonchalant about it until I mentioned that the spines were still in my foot. “THEY’RE STILL IN YOUR FOOT??” Whoops, I guess I should have made that part more clear. Immediately the doctor knew it was the sea urchin causing all of my problems. Apparently it’s pretty important to get those things out ASAP. I did a few blood tests and then was ushered to surgery, to get the spines removed.

While four had healed and didn’t hurt anymore, there was one in the soft underside of my toe that hurt pretty bad. When the doctor couldn’t get the spines out of the tough underside of my foot, he set to work on the painful one. With tweezers and a needle, he ripped into the skin on my foot, pulling the spine out in small pieces. A nurse grabbed my toe and forced it backward, making me fear she’d break it, while the doctor set to work with his tools. I wish I could say it wasn’t that bad, but with no pain medication there were a few times I actually screamed, and I may or may not have started sobbing at one point. Although the doctor’s comment in English, “So big, so deep” did make me laugh out loud.

Chinese antibiotics

SO MANY PILLS

 Pills, Pills and More Pills

Long story short, apparently I have an “infection in my immune system”… or something. The doctor was able to remove the main spine causing me the most pain, but left the rest in. To be honest, I don’t think I could handle him removing the others without some localized anesthesia. I’m on a ridiculous amount of antibiotics, which is typical for China. Right now I’m taking two pills in the morning before food, one in the morning after food, three pills three times a day after my meals, and one pill in the evening before bed. I’ve also been given two creams for the rash, which has now spread to one of my forearms. If in three days I don’t see improvements, I have to go back to the hospital for more tests, and possibly some shots. Even if I am feeling better, I have to go back to the hospital on Friday anyway for a checkup.

Altogether, I spent about $45 without insurance, about $30 of which was the giant bag of antibiotics and creams. The kind Dr. Zhang didn’t charge me a cent for pulling the spine out of my foot, even though it cost about 30 minutes of his time! I was shocked. I’d honestly hate to see how much all of this would have cost me if I had gone home to the US rather than China. I think the cost to get a consultation at a doctor might have been almost $45, let alone the blood test, antibiotics and fees for removing the spine in my toe.

As much as I try to be careful when traveling, sometimes freak accidents happen. Hitting a sea urchin with my foot while snorkeling is definitely not something I could have anticipated. Luckily, it wasn’t that bad and I’m going to be okay. I thought I was doing the right thing by trusting the doctor on the island, but now I know I should have done some research once I got to Kampot and had Internet. After four days of walking, the spines were so imbedded in my foot, they were almost impossible to remove.

Koh Rong Long Beach

Something bad can always happen, even on a beach like this

Don’t be stupid, buy travel insurance

Wherever you travel in the world, I would consider getting travel insurance. Had I gone to the hospital in Cambodia and had them remove the spines in my foot, I could have had it all paid for by my insurance. Got forbid something worse happened in the water, I could have been rushed to a mainland hospital without worrying about expenses. After reading about Dave from Planet D Travel,

After reading about Dave from Planet D Travel, who broke his back in the Amazon just by slipping on some steel steps, I knew I was stupid to have never purchased travel insurance before. You never know what will happen while traveling, so it’s best to be prepared. I never really thought I’d need travel insurance until I was sitting in a hospital bed!

On this trip I used World Nomads Travel Insurance. It covers everything from illness and injury to theft and even military evacuation. It’s specifically designed for adventurous travelers, and has different plans depending on what activities you are doing. They cover everything from scuba diving to base jumping! Even if you’re just on a quick trip to Europe, you never know what will happen when you travel. While I didn’t end up using my insurance, it sure felt good to have it just in case. This was the first time I have ever purchased travel insurance (I’m stupid, I know), and I will definitely be factoring it into my budget for every trip from now on.

Koh Rong

Koh Rong main village

Moral of the story: don’t be stupid like me. Buy travel insurance no matter what, and do your own research when it comes to your health. Don’t try to be the cool girl (or guy) that brushes off injuries and illness to make the most of your trip. Now I’m stuck spending my time at the hospital, taking tons of antibiotics and wasting money I could be using for my trip to Thailand in two weeks. Let’s hope I make a full recovery before I fly out again!

Full Disclosure: The World Nomads link above is an affiliate link. This means that if you book your insurance through the link above, I get a few dollars towards my next insurance purchase through them. World Nomads is the insurance provider I use, and I highly recommend them. 

Snorkeling Koh Rong

Dun Dun DUN Watch out for the SEA URCHINS!!!!

Here’s some medical info if a sea urchin gets you too:

A sea urchin’s spines can inject painful venom. Soaking the area in hot water (110-130˚F) for up to an hour and a half can break down the venom and help to alleviate the pain. Spines need to be removed carefully with tweezers. Fragile spines may be crushed or broken while under the skin. If a spine can not be easily removed, is near a joint, or is close to delicate nerves and blood vessels in the hands or feet, it is best to have it surgically removed by a doctor. Dark colored spines dye the skin so that it appears that a spine remains. This coloration should disappear within 2 days, if not, see a doctor to remove the spine.” –About Sports

Also, apparently peeing on the injury really helps, but you have to do it right away. I tried peeing into my hand and rubbing it on my foot later that night, but it didn’t do anything. Apparently I should have peed on it sooner and used a bit more than a handful of urine. I didn’t believe it actually really worked until I read this story. If only I had a native insist he pee all over my foot, I’d probably be better by now!

Koh Rong Sunset

UPDATE 1/27: Yesterday I was able to get one of the spines out of my foot on my own (I guess those antibiotics are working!) using a needle and angled tweezers. It was HUGE!! I didn’t take a picture, but it was the length of the tip of my pointer finger. I can not believe I was walking around with that in my foot. No wonder it hurt so bad! It honestly looked like lead from a mechanical pencil with a sharpened tip. Now there’s only one left in my foot and it’s in the side of my toe so it’s probably fine… hopefully.

sea urchin surgery

Yes, that is my blood all over everything

UPDATE 1/29: I thought I was pretty much all better until my toe started hurting really bad and felt a bit numb. I went back to the hospital to get it checked out, and the doctor insisted on removing the tiny spine in the side of my toe. Since it couldn’t come out with tweezers and was really sensitive, he had to surgically remove it by cutting into the side of my toe. They had me lay down on the operating table and numbed my foot, which was really painful! Then they sliced my toe open and took out a spine the size of a small splinter.

It’s crazy something so small can cause so many problems. Now I have to go to the campus clinic daily to change my bandage, but on the bright side I’m off all medication besides one antibiotic and pain medication for my surgery. Hopefully my foot will be mostly healed by the time I head to Thailand, and all better by the time I hit the beach! I’ll just make sure not to step on any more sea urchins…

What’s your craziest injury abroad? Do you usually buy travel insurance?

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About Richelle

Expat, traveler, and spicy food lover, I've spent the last few years living in China and traveling around Asia. In my spare time I enjoy salsa dancing, exploring night markets and stuffing my face with street food.

28 comments on “That One Time A Sea Urchin Almost Killed Me

  1. Holy Crap!!!! that’s so horrible. I would probably have just died because I can’t stand pain and I’m just huge baby. I’m glad you’re ok. I have been on the fence about buying travel insurance for when I travel after CNY but I’m definitely starting to think it would be a good idea

    • Yeah I never bought it before but I’m definitely glad I had it. I also had multiple friends who had things stolen and I was really glad I had it in case of theft too!

  2. Oh my gosh, what a scary experience! I’m happy to hear you got everything sorted out!

    I had similar trouble snorkelling in Rarotonga in the Cook Islands ten years ago (I just realised it was ten years ago! It does NOT feel like that long ago!). I was also pushed into some rocks by a wave, and cut my leg. I didn’t even realise until I got out of the water about half an hour later. It was still bleeding, but not too much. When I went into the hotel to get a bandage, they asked me what I grazed it on. I said “Just some coral I think” They asked me the colour of the coral, but I couldn’t remember, and asked why. “Oh, if it was black coral, it’s very poisonous” they said. “Here’s some antibiotic cream. If you feel worse, it was probably black coral, so come back!” hahaha. Needless to say I spent the night worrying it had been black coral, but in the end I was fine!

    Completely agree with you about getting travel insurance! Those were some scary reads from other travel bloggers, it really shows how necessary it is.

    • Wow that’s scary! I think I’d rather be overly cautious and not get sick than have a doctor tell me something’s fine when it’s not though. I’m definitely extremely glad I got the insurance, especially since I know a lot of people who had things stollen too!

  3. That sounds scary! And painful. Glad to see it all worked out in the end. Cambodia looks beautiful btw and you’re writing style is really fun to read. Looking forward to the next one!

    • Thanks so much Tom! That was the best compliment I’ve heard all week :) Cambodia was amazing, and despite stepping on a sea urchin, that day was one of my all-time favorite travel days

  4. Heading to Cambodia later this year.. will have to remember to watch out for urchins :)

    Those sunset photos are stunning!

  5. I am so sorry you went trough all this, but Im glas you are ok! I sat on one urchin while in Greece, but it want so bad :(

    • You sat on it? That sounds awful! hahaha. I’m glad you were okay. I think the problem for me is that the fingers and toes have lots of joints and vessels making it more problematic

    • Even I step on it recently…..it was worse….almost 10 spines got inside…i managed to take 5 out( not completely) it breaks inside….and rest of it is still inside me. …:(

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  11. I, too, stepped on a sea urchin in the Philippines. It was also a random occurence, while I was snorkeling. I’m so glad to have read your story, knowing there is someone else out there who had such a similar, strange, experience. The needles are still in my foot to this day, no pain though.

    • Oh wow they’re still in your foot? Yeah the same thing happened to another girl at my hostel in the Philippines and she had to go back to a mainland hospital and get them all taken out. It’s so painful!

  12. I’ve just had the same experience. I was snorkelling and got stung by a sea urchin. I trusted the doctors and everyone else who immediately became “experts” on the issue and could have actually caused my death had I not been adamant. I got a severe allergic reaction (which is very rare, my luck) and my foot ballooned up with blisters, I got cellulitis. Eventually, after 10 days of suffering, I had to be rushed into surgery for fear of getting septicaemia. They did a surgery called debridement to remove the spine and all the dead tissue which if not removed would have meant amputation… and I now have a crater in my foot. It’s been 2 weeks since my surgery and I feel horrible. The hospital charged me £1000, I learnt my lesson the hard way too, always buy travel insurance.

    • Wow that’s crazy, and so expensive! I agree, sometimes I forget to buy it and then kick myself for forgetting. It seems so pointless but you never know what can happen on the road. Thankfully you didn’t have to get your foot amputated though- that would’ve been horrible!

  13. Ouch, that sounds terribly painful, I’m happy that you’ve recovered, Have fun in your future trips, and watch out for those urchins, and whatever else is out there..

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  16. 9 June 2017
    I’m a Malaysian. My bottom right foot was stung by sea urchin while I was snorkelling in Krabi on 9 June 2017. The locals said it was very normal. So I didn’t seek any medical attention. It was 6 stungs on the bottom of the toes and foot. It leaves behind 6 black ink dot.

    27 June 2017
    On 27 June 2017, my 3rd toe swollen and pain.

    Early July 2017
    I visited 2 GP Doctors in early July 2017 and they prescribed me with pain killer and antibiotic. The toes and bottom of the foot continue to swollen and pain increased.

    Middle of July 2017
    Middle of July 2017, the swollen spread to the top of the foot. I then admitted into Tropicana Medical Centre for further check-up. First, I visited a Physician and they prescribed me with antibiotic and pain killer. On second visit (swollen continue and pain), I was referred to Cardio & Orthopaedic Specialist, was prescribed with pain killer and antibiotic. On third visit, I was referred to Foot Specialist.

    End of July 2017 until now
    I have been engaging with the Foot Specialist for 10 weeks until today. Treatment includes x-ray, MRI, medicine (Prednisolone, Celebrex, Arcoxia, few types of positive and negative antibiotic) and a foot surgery on 23 August 2017, which performed on the top of the foot to take away the “something”. The surgery report came out and the “something” is the poison from the sea urchin. Right before the surgery, the swollen has spread to 2nd and 4th toes.

    28 Sept 2017
    5 weeks have passed after the surgery and the 2nd, 3rd & 4th toes are still swollen. The bottom of the foot is still swollen and very pain. I did not understand why the surgery was not performed on the bottom of the foot because that was the root problem of the sea urchin stung (maybe the MRI show that the swollen liquid goes to the top of the foot).

    I still have to take Celebrex and Prednisolone twice a day and cannot skip even a course. If I skipped a course, I can hardly walk because the pain is terrible. The pain is mainly on the 2nd, 3rd & 4th toes adjoining the ligament-tendon-bone to the bottom of the foot, when stand or walk.

    Re: I also have started 3 sessions of physio on the toes and foot – Ultrasound, IF Therapy, Rehab Application, Massage, Ice, etc so the toes are not stiff and improved blood circulation. I’ve also been doing home therapy, exercise and ice twice a day (at home) everyday.

    2 October 2017
    The 1st toes started to swollen today. The bottom and its surrounding bottom area is very pain. I’ve seen it coming 2 weeks ago (spreading to the 1st toe).

    Now I really have no idea what I can do to treat my foot? Any recommendations here?

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