I appreciate the thoughtful response, however, I did not go to a Naturopath. Where I live they don't exist, or not as such. That was why I sarcastically put the rolling eye thing there. I went to where I work, initially just hoping to have one of the docs (either MD or Do) inspect the foot to make sure no debris or splinters were imbedded. Not expecting to be told I needed to be concerned with Pseudomonas, I planned to irrigate the wound and dress it with some bacitracin (basically all that happened). It was only after I talked with my boss and he told me about the need for antibiotics due to the shoe being involved in the puncture, that I decided to be officially seen. The MD refused oral antibiotics on the grounds of my youth and relative health. Having checked into an ER (for something I would never do in the real world, but for 100 miles in any direct, that is all there is) and now expecting to pay a lot of money as a result (they won't take the insurance they offer their own employees) I was really angry I bothered to check in. However, life is like that.
Following up with my boss, who consulted our Medical director, there are two schools of thought on this type of wound and infection. 1) Prescribe antibiotics all the time. and 2) wait and see, and then treat accordingly. Reason being, due to the avascular nature of the subcutaneous fascia, antibiotics will not effectively penetrate that tissue and a latent infection can then result in a bad cellulitis, once the wound has healed on the outside and the medication ceases. If an infection does occur, it needs to be treated surgically, debrided, and antibiotics used to control the infection at that time. This would be very bad. Obviously.
I really hope I have no infection and it looks like that may be the case ( infection free). Inflammation is coming down, and I can palpate gently around the puncture where yesterday it was severely painful. I never had more than moderate inflammation at the site, no streaking, and no drainage other than some serous-sanginous fluid of scant amount. At the time of the puncture, and after removing the stick and taking off my shoe and sock, I brushed away some fatty tissue that was removed from the wound with the stick. There were some pieces of fat that were hanging out, and after irrigation, I reinserted these into the wound. BTW, if you ever have tissue hanging out of a wound and think you want to remove it rather than reinsert it, don't pull on it. It hurts in a really bad way. The wound has closed on it's own.
The main issue today is that I can not really bare weight on the foot, and I walk on the outside of it. Provided I have no infection, I am now primarily concerned with the level of damage I did to my plantar fascia. If it is minimal, I may be fine by the weekend as the puncture heals. If I scraped or punctured the fascia, I don't know how long that will take to heal. I really have no way to determine this, other than to travel to a real town and potentially have an MRI done. That is, if an appointment can be made. It may be moot anyway, as there may be no real difference other than knowing it will take 4 to 6 (or more) weeks to heal vs 4 to 6 days of recovery.
I would like to know if anyone has had a similar injury, and if so, what recovery time was like. Infection aside, the complex nature of the foot and the level of wear it is subjected to can really complicate things. Apparently, one small accident can be disastrous, where a similar injury a mere foot (no pun intended) up the leg would be relatively benign and could be a lot less involved from a convalescence point of view.
Oh, and I am sure I had a Tdap in October when I began working, but it was never charted, so when I was being seen, it was advised I get one. I agreed, since even if I was sure I had one, not charted means it was never done. Anyway, I clearly must have had one, as I had some of the symptoms of a minor reaction to a Tdap when two immunizations are given too close together. I woke up yesterday with the loudest ringing in my ears I have ever had. It was loud and bizarre, and would not go away for about 10 minutes. At least I won't get tetanus.