27Nov/09Off

Itchin’ to get out

Last night, Melle and I went to a public lecture at the UW Pharmacy School. This one was about Anaphylaxis with Dr Mark Greenwald.

Greenwald pulled about 150 slides in 70 minutes (well over the promised 45), and slid right through the stuff I think most of the people wanted to learn about–how allergens engender the development of t-cell receptors and white blood cells, why anaphylaxis is hard to predict, hard to analyse and hard to manage, and so on. Since he said several times that he was presenting to “pharmacists”, and only one person in the room was a pharmacist, that might explain it.

He presented a few case studies, which had the potential to be good learning tools if they weren’t so rushed. In one case, he presented a young boy who’d never had peanuts, but whose older brother had a severe allergy to them. Question was: should he have an epi-pen? How do you know if he’s at risk for anaphylaxis? As Melle and I turned to each other and muttered give the kid a peanut, Dr G joked that a double-blind study with a peanut is what should be done. But then he said something ethically you can’t do it. I still think it’s a good idea. Whatever.

I did learn a few things:

  • For venom allergies (like bees & hornets), the best thing to do for a child is immunotherapy (i.e. allergy shots)
  • Many anaphylaxis events are dual – the person has a reaction, then nothing and then something comes back, and sometimes it’s much worse. Problem is that the “downtime” is most often longer than how long patients are kept under observation in a hospital.
  • You can outgrow some allergies, but not others.
  • There’s a high concordance of poorly managed asthma and chance of a strong anaphylaxis reaction to food or other allergens.
  • In many cases, epi-pen doesn’t work: the needle isn’t long enough (hello rampant obesity), no one knows how to use them properly, and it must be in the muscle, not just the skin, and even more than that, apparently the thigh is the only sweet spot (the arm isn’t good).

The question period devolved into some older lady telling us about her visits to the allergist, and stopping just short of her sharing about her poops (as Melle so aptly described the exchange).

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Being a big fan of the PI public lectures and these, I have to say that there is a big difference in the attendee profiles. Physics nutters are loveable. They ramble a lot, and some of them think that the laws of physics include aliens and tinfoil hats, but pharmacy nutters are hypochondriac know-it-alls. Instead of it being fun, it’ s really a race to the door before they start telling everyone aboutĀ alimentsĀ and why xy medication should/should not be taken in higher/lower doses.

Not sure I’ll be attending in person again. It was just that painful.

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