Thursday, August 28, 2014

Scary Spice: The Problem with Synthetic Marijuana

I'll be the first to say as a mother and pediatric nurse, I was less than thrilled when my home state of Colorado legalized marijuana. I think it's a very bad idea because, even though there is an age limit, we know when something is legal, the stigma with using is goes down. I have seriously heard more than one teen say, "It's legal. It can't be bad for you."

But, we'll save that discussion for another time. 

Recently, the state of New Hampshire has been in the news for 34 overdoses related to Spice. Spice is a "legal drug" of dried plant material with a chemical sprayed on it that is structurally similar to THC, the active component in marijuana. Typically, it is smoked to induce a high. 



Law enforcement if having a hard time keeping this stuff off the streets. The issue becomes, once they identify the chemical nature of the substance and make it illegal, the street chemist can simply differ the compound by one molecule and it will be legal again because it doesn't exactly match what was outlawed. Some states are trying to combat this by making a law more inclusive by saying "this compound and similar molecular structures". Thus far, they are having difficulty doing that. 

What are some of the symptoms of a Spice overdose? This list comes from the linked article. 

1. Seizures. 
2. Decreased level of consciousness to coma. 
3. Vomiting.
4. Hallucinations and paranoia. 
5. Increased heart rate and blood pressure-- enough to be dangerous. 
6. Anxiety.
7. Threatening behavior. 
8. Headaches.
9. Difficulty Speaking.

There is no reversal agent for a Spice overdose. In the ER, treatment centers around controlling the symptoms and supporting dangerous changes in vital signs

Are you for or against the legalization of marijuana? 

Tuesday, August 26, 2014

Ingestion of Mushroom

It's not unusual for kids to ingest things. Young kids put in their mouth whatever is in their environment. Question is, what do you do if your child eats a mushroom from the yard? Worry or not?

Wikipedia
Pediatric nurses face a lot of interesting scenarios each day they work because of the curious nature of their patients. When a case like this presented itself-- it was the first of its kind in twenty of years of peds nursing. And we ask ourselves the same thing-- should we worry or not?

The best resource for anyone for all things ingested is the Poison Control Center. They are our first line resource for discussing these cases. I knew I would call them but didn't really know what help they could offer. In my mind, they'd be limited to known pharmaceuticals or toxins. Something with a label on it.

I was clearly wrong.

Because the Poison Control Center I called actually had a "mushroom specialist" available by phone. Some who had worked in the field for twenty-five years.

Luckily, we had a specimen available to us. This is where my authorly skills came in-- in describing the mushroom.

What I found interesting was some of the questions she asked about the mushroom in order to help identify it and ultimately determine if it was poisonous or not.

1. Where was it found? In a "cultivated lawn" or a wooded area? From what I gather from her, poisonous mushrooms are less likely to grow on manicured lawns.
2. Did it grow near a tree? What type of tree? How close did it grow to the tree?
3. What color is the cap, stem and gills?
4. How big does the cap measure?
5. How long is it?
6. What is the width of the stem?
7. When the stem is bent-- does it bend or break?
8. Does it have gills? These are the page-like structures underneath the cap.
9. Does it have a ring? This is a structure that might cover the gills and you wouldn't know gills were present unless the ring was removed.

In this case, we were able to send photos of the mushroom to the specialist via a smart-phone. This is one way smart phones have really enhanced medical diagnosis.

Good news, in our case, the mushroom was edible. In fact, her favorite edible kind called a fairy-ring mushroom or marasmius oreades. She enjoyed them so much she wished they would start growing in her yard again.

The mushroom specialist encouraged the family to keep the specimen in wax paper (definitely not plastic) for an additional 24 hours in case the child developed any other symptoms. Not because of the mushroom itself but what could be on the mushroom. She said, often kids have ingested something around the mushroom (perhaps a pesticide) that is causing their symptoms but the "mushroom gets blamed."

I guess that's a perk of being a mushroom specialist, knowing what you can eat from your lawn without killing yourself.

So, know that poison control is a good option for ingestions of these sorts but, if at all possible, pick a couple of the specimens to take with you. And, if the child is okay, feel free to call poison control before proceeding to the ER.

Often times, they can save you a trip.

Sunday, August 24, 2014

Up and Coming

Hello Redwood's Fans!

How has your week been? Mine? Good. I finally feel like I'm getting caught up on some writing tasks now that the kids are back on school.

This week we're focusing on plants. I'm certainly not a botanist by any means but plants are getting kids into trouble. Particularly plants laced with a chemical similar to the active component in marijauna. New Hampshire is having a hard time with some Spice overdoses. Do you think synthetic/designer drugs become more palatable when their counterparts are legalized?

Do you think all drugs should be legalized?

For you this week:

Tuesday: A curious case of mushroom ingestion. What does Poison Control need to know?

Thursday: The New Hampshire Spice Overdoses. Why is it so hard to keep this stuff off the streets?

Have a great week!


Thursday, August 21, 2014

Head Injuries: Jason Joyner

There was that time when the editor saved the medical professional.

As a physician assistant, I enjoy having medical aspects in my story. But even medical folks can slip up and have errors in our fiction.

I have a scene where my heroine gets head trauma and wakes up later in the clutches of the villain. The freelance editor, Ben Wolf, wondered about that. He had read that if there was significant time of loss of consciousness (LOC), then it suggested a serious injury that would be hard for the victim to bounce right back from to be active.

One of my pet peeves is when characters are injured and recover too fast, so I had to look into this again.

Basically, my heroine suffered a concussion, also known as a Traumatic Brain Injury (TBI). Symptoms of a concussion can include headache, confusion, dizziness, visual changes, a blunted affect, and may or may not include LOC. (People always flash lights in pupils to check for concussion. If the pupils are affected, it is a serious sign and they won't be up and active soon.)

LOC usually is only for a few minutes, and as my editor noted, will mean a much more severe injury if it lasts for hours.

Blast. Foiled by the editor.

Except, you can use the amnesia angle.

A concussion with LOC may have retrograde (before the incident) or antegrade (after the incident) amnesia. According to one research article, the antegrade amnesia can last for a few hours after the incident. I can attest – I had a concussion in 5th grade and couldn’t remember a couple hours afterwards.

So if you need your protagonist to be out of it for a while, keep the actual LOC on the short side and use the amnesia angle to get you where you need to be. The victim may be incoherent, unsteady, with a blank expression during this time. Use these symptoms to add drama to the situation.

When your protagonist comes to, it is actually the end of antegrade amnesia. I remember with my concussion it was like I "woke up" after lunch during our quiet reading time at school. I was confused, unsure of what happened. I could remember part of the morning, but about two hours was blank. I even found a goose egg on my head later, but I didn't know how it got there.


So that was my work around. My heroine didn't have LOC the whole time. But there was enough injury to cause confusion and amnesia, keeping her from attempting escape. There you go Ben. A few minor tweaks, and all is well. Except for my heroine, who's tied up and threatened. But that's another story.

**************************************************************************

Jason loves good stories and wants to use words to make a difference. When he's not writing, playing soccer, or losing in fantasy football, he works as a physician assistant in southeast Idaho. He also tries to keep up with his awesome wife, three high-energy boys, and his little princess. He writes suspense and YA supernatural, and likes to use his medical experience to punch up the stories. You can find him on Twitter @JasonCJoyner or his blog at www.jasoncjoyner.com/blog.