Sunday, August 31, 2014

Up and Coming

Hello Redwood's Fans!

What's new for you this week? Me? Recently, I took the ice bucket challenge that is raising money and awareness for ALS. It was COLD but I do like that it's talking about a disease that needs more funding and it's been fun watching well-known types undertake getting ice water dumped them. 

I think my favorite so far is from author John Grisham. I mean, he leaves his cigar in his mouth! 

Whether or not you've participated in the ice bucket challenge-- please support a charity. There are lots to choose from and many who need financial support.

For you this week:

Tuesday: My medical analysis of TNT's The Last Ship

Thursday: Amryn Cross stops by to discuss how twin murder suspects could be forensically distnguished form one another.

Have a great week! 

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?

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!