WEBVTT 00:00:00.000 --> 00:00:11.940 Ryan Feldman: By creating this podcast and exploring these topics, I get to do the slow thinking that goes into how and why we manage poisoning and dream up new ways that we can manage poisoning. 00:00:11.959 --> 00:00:20.810 So truly just by creating this little adventure, it's kind of created the time in my life to get to explore things in the way that I want. 00:00:22.290 --> 00:00:26.820 Neil McPhedran: Welcome to Continuing Studies, a podcast for higher education podcasters to learn and get inspired. 00:00:26.860 --> 00:00:32.450 I'm Neil McPhedran, founder of Podium Podcasts, an agency for higher education podcasters. 00:00:33.065 --> 00:00:36.265 Jennifer-Lee: I'm Jennifer-Lee, founder of Jpod Creations, podcasting is broadcasting. 00:00:37.655 --> 00:00:39.405 And we want you to know you're not alone. 00:00:39.445 --> 00:00:44.214 In fact, there are many of you higher ed podcasters out there and we can all learn from each other. 00:00:44.615 --> 00:00:48.294 Please also join our community at HigherEdPods.com. 00:00:48.675 --> 00:00:48.885 Neil McPhedran: Yeah. 00:00:48.885 --> 00:00:55.920 And check out some of the updates we've done recently on Higher Ed Pods for searching for cool new university podcasts. 00:00:55.970 --> 00:00:57.550 But Jen, that's not why we're here today. 00:00:57.559 --> 00:01:01.790 We're here to talk about our conversation we had with Dr. 00:01:01.790 --> 00:01:05.150 Ryan Feldman from The Poison Lab podcast. 00:01:05.695 --> 00:01:06.785 Very cool podcast. 00:01:07.315 --> 00:01:17.435 So, The Poison Lab is this educational podcast where experts, toxology, and poisoning discuss the infinite poisons the world has to offer. 00:01:17.455 --> 00:01:18.865 That's from their show description. 00:01:19.035 --> 00:01:28.514 So, what's really cool about this podcast is for sure for healthcare workers and practitioners and whatnot to gain insights and so on and so forth, but it's for any of us to listen to. 00:01:28.514 --> 00:01:32.994 And Jen, we both listened to a bunch of episodes and it was super interesting. 00:01:33.094 --> 00:01:41.784 Ryan even has an episode where you can send in questions and ask a toxologist questions and then he answers them in that episode. 00:01:41.814 --> 00:01:42.344 Very cool. 00:01:42.374 --> 00:01:48.895 Now, Jen, you told me a little secret that you were potentially going to be a pharmaceutical rep one day. 00:01:48.895 --> 00:01:51.255 So this must have been really interesting for you, especially. 00:01:51.425 --> 00:01:51.804 Jennifer-Lee: Yeah. 00:01:51.804 --> 00:02:02.325 When I was in between broadcasting and podcasting, and I thought, hey, wouldn't it be great to be a pharmaceutical salesperson because you'd make lots of money. 00:02:02.354 --> 00:02:05.595 And I did think about it, but I did not go that route at all. 00:02:05.604 --> 00:02:08.624 Neil McPhedran: Well, you wouldn't be here today chatting with me about Dr. 00:02:08.625 --> 00:02:12.005 Feldman's amazing The Poison Lab podcast if you had. 00:02:12.185 --> 00:02:22.674 Jennifer-Lee: I do have to say that I hand it to him to do episodes where people call in because I'm like a hypochondriac and I feel like I would just call in and ask him tons of like, oh, I ate this. 00:02:22.674 --> 00:02:23.234 What happens? 00:02:23.255 --> 00:02:28.574 So I want to know if he gets tons of people calling in on repeat because I feel like that's just asking for trouble, man. 00:02:28.825 --> 00:02:29.095 Neil McPhedran: Yeah. 00:02:29.685 --> 00:02:30.165 No kidding. 00:02:31.089 --> 00:02:31.569 Absolutely. 00:02:31.629 --> 00:02:31.899 Okay. 00:02:32.219 --> 00:02:33.849 Well, let's get into it. 00:02:33.879 --> 00:02:36.629 Here is our conversation we had with Dr. 00:02:36.629 --> 00:02:37.399 Ryan Feldman. 00:02:38.290 --> 00:02:40.269 Jennifer-Lee: Today we have a really cool guest. 00:02:40.329 --> 00:02:45.999 Not that we don't usually have cool guests, but we have a really neat guest that's doing something a little bit different. 00:02:45.999 --> 00:02:46.660 We have Dr. 00:02:46.660 --> 00:02:47.519 Ryan Feldman. 00:02:47.954 --> 00:02:53.815 And, uh, he does The Poison Lab podcast, and I want to get to know him a little bit more. 00:02:53.815 --> 00:02:55.774 And of course, I got to ask you this question. 00:02:55.815 --> 00:02:58.005 Have you ever been poisoned? 00:02:58.014 --> 00:03:00.765 And did that inspire you to do this podcast? 00:03:01.105 --> 00:03:02.054 Ryan Feldman: Hmm. 00:03:02.114 --> 00:03:05.035 Not physically, maybe emotionally poisoned by some. 00:03:05.075 --> 00:03:05.994 No, I, I think. 00:03:06.264 --> 00:03:08.364 Not myself that I know of. 00:03:08.514 --> 00:03:11.594 I guess I could ask my wife if she's slipping me. 00:03:11.594 --> 00:03:18.694 Jennifer-Lee: I don't, I did just listen to your podcast about murders and that most people do try to poison people to kill them. 00:03:18.694 --> 00:03:20.404 And then I went down a rabbit hole. 00:03:20.414 --> 00:03:21.474 So I was like, that was pretty interesting. 00:03:21.794 --> 00:03:24.935 Always seems that arsenic seems to be like the culprit on that. 00:03:24.935 --> 00:03:29.375 I listened to a ton of true crime recently and it's like everyone poisons with arsenic. 00:03:29.375 --> 00:03:30.815 No one goes outside the box. 00:03:31.224 --> 00:03:31.804 Ryan Feldman: Yeah. 00:03:31.864 --> 00:03:32.144 Yeah. 00:03:32.144 --> 00:03:34.154 They used to call that the powder of inheritance. 00:03:35.505 --> 00:03:36.174 Neil McPhedran: I like that. 00:03:36.174 --> 00:03:36.784 That's funny. 00:03:36.784 --> 00:03:37.174 Ryan Feldman: Yeah. 00:03:37.294 --> 00:03:38.264 Thank you for having me on. 00:03:38.304 --> 00:03:39.224 I appreciate it. 00:03:39.224 --> 00:03:41.914 Neil McPhedran: So Ryan, tell us about The Poison Lab podcast. 00:03:42.089 --> 00:03:52.539 Ryan Feldman: Yeah, so one of my jobs is as a clinical toxicologist where I work with a medical team of toxicologists and as well as for our state poison center. 00:03:53.059 --> 00:04:10.669 And, you know, I get to have a lot of fun and I find it really rewarding, uh, helping to identify, manage and treat poisoning for hospitals throughout the entire state, as well as, you know, worried moms on the phone, whose child just ate toothpaste, all sorts of things. 00:04:10.799 --> 00:04:15.980 Doing that caring for poisoned patients is probably my second most favorite thing to do. 00:04:16.390 --> 00:04:20.250 My first favorite thing to do is talk about poisoning. 00:04:20.570 --> 00:04:30.440 And that's because you get all the razzle dazzle of the complex biochemistry and pharmacology without anyone's actual life or limbs being on the line. 00:04:30.860 --> 00:04:37.689 And you get to have a little bit more of an enjoyable time exploring the concepts that we use to actually treat poisoning. 00:04:38.055 --> 00:05:02.770 So I wanted to package that all together into something to share with others who were interested in poisoning and I wound up with The Poison Lab, which is a podcast that covers a variety of topics, but the overarching goal is exploring the science, history, and medical management of poisoning, be it individual ones or as a broad scope of poisonings from specific substances. 00:05:02.770 --> 00:05:03.940 So we cover a lot of different things. 00:05:04.120 --> 00:05:05.980 Jennifer-Lee: Yeah, I thought it was really cool what you do. 00:05:05.980 --> 00:05:15.070 And actually it reminded me in Canada we had this little commercial that would go on, it was like a minute about poisoning when you're little kid, and it was a song and it was like, don't put it in your mouth. 00:05:15.159 --> 00:05:22.659 And it's these creepy monsters and they show everything about, don't put chemicals in your mouth from the cleaning agents and everything like that. 00:05:22.875 --> 00:05:24.335 But that's all I can think about now. 00:05:24.365 --> 00:05:26.935 Obviously, it did a good job because I knew not to do it. 00:05:27.044 --> 00:05:32.284 But that's what makes me think of your podcast every time now is like, don't put it in your mouth. 00:05:32.344 --> 00:05:33.594 It can make really you sick. 00:05:33.615 --> 00:05:35.442 Puppet Monsters: Don't you put it in your mouth. 00:05:35.442 --> 00:05:37.270 Don't you stuff it in your face. 00:05:37.270 --> 00:05:38.836 Don't stuff it in your face. 00:05:38.836 --> 00:05:40.664 Though it might look good to eat. 00:05:40.664 --> 00:05:42.491 Though it might look good to eat. 00:05:42.491 --> 00:05:44.319 And it might look good to taste. 00:05:44.319 --> 00:05:46.146 And it might look good to taste. 00:05:46.146 --> 00:05:46.584 You could get sick. 00:05:46.584 --> 00:05:46.643 Yuck. 00:05:46.643 --> 00:05:46.724 Real quick. 00:05:46.724 --> 00:05:46.765 Ick. 00:05:46.765 --> 00:05:46.845 Real sick. 00:05:46.845 --> 00:05:46.929 Real ick. 00:05:55.770 --> 00:06:05.829 Jennifer-Lee: So I think Neil, you're a little bit older than me, so you maybe didn't see that one, but a lot of people in Canada would understand that that was a great moment teaching us. 00:06:05.889 --> 00:06:11.500 And you also have a connection to the University of Wisconsin Madison with this podcast. 00:06:12.010 --> 00:06:14.314 It's not exactly with it. 00:06:14.314 --> 00:06:16.455 But can you tell us a little bit of how it's connected? 00:06:16.655 --> 00:06:17.215 Ryan Feldman: Yeah. 00:06:17.224 --> 00:06:23.824 So actually I am a graduate of the University of Wisconsin Madison, which is not too far away from Canada. 00:06:23.974 --> 00:06:30.324 And I was featured as an alumni in our magazine related to the podcast. 00:06:30.324 --> 00:06:31.955 So it was kind of fun. 00:06:32.234 --> 00:06:37.940 They covered what the podcast is and the different aspects that we explore on it. 00:06:37.950 --> 00:06:41.469 It was actually really a honoring thing for them to do. 00:06:41.469 --> 00:06:42.640 I was so humbled by it. 00:06:42.640 --> 00:06:43.330 It was really cool. 00:06:43.370 --> 00:06:50.849 I'm actually currently a professor at the medical college of Wisconsin, which is about ninety miles east of them, but still in the state of Wisconsin. 00:06:51.610 --> 00:06:51.950 Yeah. 00:06:51.970 --> 00:06:58.820 So it's associated, it's affiliated with, I guess, just myself, but I have a couple of connections to some universities. 00:06:59.080 --> 00:07:03.490 Jennifer-Lee: Do you ever use your podcast as a teaching tool at all in your courses? 00:07:03.750 --> 00:07:21.049 Ryan Feldman: Yes, so a big part of this is sharing information and education around poisoning, and for instance, I teach in a variety of areas, so I teach not just in the school, but I also teach medical learners and graduated medical professionals who need to continue their education. 00:07:21.135 --> 00:07:37.904 In the poison center on any given day, I have probably ten medical learners, including physicians, medical students, pharmacists, pharmacy students, nurse practitioners, and as well as nurses and people who manage our phone lines, who actually take the calls. 00:07:37.944 --> 00:07:41.534 And all of these people need didactic education in managing poisoning. 00:07:41.674 --> 00:07:48.974 And we use some of the episodes, for instance, the people who manage our phone lines, they need to do a certain amount of continuing education every year. 00:07:49.025 --> 00:07:53.394 And we use a lot of the episodes as some of their continuing education. 00:07:53.704 --> 00:08:03.145 So it's a great way to just keep people informed on current trends in poisoning or go on a deep dive into one specific poisoning that they might come across. 00:08:03.174 --> 00:08:06.894 So I use it for that, as well as we use it occasionally in some of our courses. 00:08:06.945 --> 00:08:07.594 courses. 00:08:07.645 --> 00:08:23.004 If there's something that I'm teaching, like in our toxicology and critical care course, if I have not enough time to really dive into one topic specifically, sometimes I'll just throw up the episode where I cover it for a very in depth amount of time and just talk about it briefly during lecture. 00:08:23.094 --> 00:08:24.975 Jennifer-Lee: I just love that there's a poison center. 00:08:24.975 --> 00:08:26.324 It's kind of like the bat cave. 00:08:27.015 --> 00:08:27.435 Ryan Feldman: Right? 00:08:27.435 --> 00:08:27.915 Yeah. 00:08:28.025 --> 00:08:29.555 It does feel very official. 00:08:29.935 --> 00:08:32.244 But they used to call them poison control centers. 00:08:32.315 --> 00:08:32.605 Um, 00:08:32.664 --> 00:08:34.265 Jennifer-Lee: Oh, that's a better name I feel like. 00:08:35.125 --> 00:08:37.025 Ryan Feldman: Yeah, but who's, nobody's controlling 00:08:37.025 --> 00:08:39.615 Neil McPhedran: Especially if you're calling in because you're dealing with it. 00:08:39.754 --> 00:08:43.254 So the podcast is really targeted at practitioners then, right? 00:08:43.834 --> 00:08:48.625 Ryan Feldman: It's actually for just about anyone with a little bit of science or education background. 00:08:48.655 --> 00:08:58.984 I mean, when I first created the podcast, I think I ran into something that many people do when they're first starting out, which is, you've got something that you want to say. 00:08:59.310 --> 00:09:04.010 And you're not exactly sure which audience is going to adapt to it. 00:09:04.040 --> 00:09:10.790 So I kind of put it out there and by and large, the biggest response has been from the medical community. 00:09:11.200 --> 00:09:15.450 But I did try to make sure that anyone who was interested could come along with me. 00:09:15.530 --> 00:09:25.099 And I get emails from high school students in the Netherlands or librarians in Kansas and they're all, you know, they're people from all over who have no medical training. 00:09:25.210 --> 00:09:31.829 And they've said, you know, this has been a super interesting exploration into the world of how poisonings are managed. 00:09:32.099 --> 00:09:47.395 We do some more focused research and guideline episodes that are really just focused more towards medical listeners, but I, I always try to put in disclaimers on those episodes to let people know, we're going to get into the weeds with jargon and things like that. 00:09:48.015 --> 00:09:48.855 Neil McPhedran: I like that. 00:09:48.855 --> 00:09:49.795 I mean, it's interesting. 00:09:49.795 --> 00:09:56.625 This show is, we're talking to folks like yourself who are typically working in an academic environment. 00:09:56.625 --> 00:10:15.565 And it's either they're creating a podcast to take it to a wider audience outside of their classroom, or it's quite focused on, like, we've talked to other sort of more science and medical, like we chatted with Surgery 101 a while back, and like, that is really meant for surgeons. 00:10:15.765 --> 00:10:16.554 That's the purpose of that. 00:10:16.555 --> 00:10:22.609 But I love how you've tried to incorporate a wider audience that would be interested in it. 00:10:23.119 --> 00:10:29.800 But yet you have episodes that focus in on the medical practitioner world as well, too. 00:10:30.860 --> 00:10:31.140 Ryan Feldman: Yeah. 00:10:31.140 --> 00:10:36.699 And I know that's kind of sometimes a challenge that people come across when they start their podcast. 00:10:36.719 --> 00:10:45.970 They haven't really defined their audience and it's so broad that, you know, nobody gets anything, no one audience gets everything they want out of it and can be hard to gain traction. 00:10:45.970 --> 00:10:48.919 But I think poison has enough of a interest. 00:10:48.929 --> 00:10:53.270 Everybody, it's got a, a lot of baggage associated with the word. 00:10:53.270 --> 00:10:57.790 So it piques people's interests, so you could keep people engaged perhaps. 00:10:58.000 --> 00:11:03.459 Jennifer-Lee: Do you get a lot of, because I know you guys ask for listener feedback and listener questions, and you have some segments on it. 00:11:03.459 --> 00:11:13.219 Do you get a lot of people just asking you questions like, what happened if I get this in my eye or I consume this or hypochondriacs. 00:11:13.325 --> 00:11:16.345 I feel like I was scared after listening to some of the episodes, but you know. 00:11:17.055 --> 00:11:28.355 Ryan Feldman: Yeah, you definitely, when you run a poisoning podcast, the sorts of emails that you receive can be quite variable and some of them very interesting. 00:11:28.605 --> 00:11:38.464 You know, there's a lot of people out there who feel like they have potentially been disenfranchised by the medical system and haven't found anyone to confirm they are being poisoned by this one specific substance. 00:11:38.474 --> 00:11:41.635 So they will occasionally fire off an email to you. 00:11:41.944 --> 00:11:43.855 You know, just working at a poison center. 00:11:43.895 --> 00:11:48.325 That's a free public access line that anyone can call when they think they're getting poisoned. 00:11:48.335 --> 00:11:53.694 You certainly get a lot of interesting calls there, so it's nothing new when they come through as an email. 00:11:53.734 --> 00:11:56.644 Jennifer-Lee: Can you share with us the most interesting call ever? 00:11:58.534 --> 00:11:59.814 This is what I want. 00:12:00.044 --> 00:12:10.355 Ryan Feldman: You know, I cannot share specifically any specific call that I've handled, but the Georgia poison center puts out, they have this great thing on their website. 00:12:10.475 --> 00:12:16.894 Uh, basically they, they put out twenty-four hours worth of their poison center calls and just the general themes associated with it. 00:12:17.274 --> 00:12:22.655 You know, you get calls from people who, sometimes you would get calls because someone didn't know who else to call. 00:12:22.665 --> 00:12:27.305 They, they didn't speak English and they were assaulted and they didn't know how to call nine one one. 00:12:27.335 --> 00:12:29.150 So they called the poison center somehow. 00:12:29.150 --> 00:12:34.820 Or you get people who, you know, just want to talk or you get all sorts of interesting things. 00:12:34.820 --> 00:12:43.240 But Georgia put out a really cool log of their poison center experience and covers the hundreds of calls they go through in a day. 00:12:43.240 --> 00:12:47.149 You know, somebody thought they were injecting methamphetamine and ended up being magnesium. 00:12:47.149 --> 00:12:52.339 So they call a poison center and it's like, well, yeah, but did you know that that's probably better than what you were trying to inject? 00:12:52.650 --> 00:12:54.810 There's all sorts of interesting things. 00:12:54.839 --> 00:13:12.009 And about fifty percent of our calls are from parents at home or people at home who may be double dosed on their medicine or who maybe, uh, their child accidentally got into some ibuprofen or something like that, or hair cleaner or cosmetic products. 00:13:12.339 --> 00:13:19.109 And the other fifty percent are from hospitals who have maybe a challenging or unique case of poisoning and they, they could really use some help. 00:13:19.200 --> 00:13:25.920 You know, we've published a couple of cases that I've been involved in, so I could talk, I guess, a little bit about those. 00:13:25.940 --> 00:13:32.710 Like, when somebody gets bit by a, uh, Thai green pit viper that they keep in their basement. 00:13:32.790 --> 00:13:37.069 Jennifer-Lee: What, what is that first, can you explain what a Thai green pit viper is? 00:13:37.880 --> 00:13:44.190 Ryan Feldman: Yeah, well, a pit viper is a snake, they call them pit vipers because they have heat sensing pits, uh, that look like nostrils. 00:13:44.210 --> 00:13:46.050 But they're not a nose, it's a heat pit. 00:13:46.550 --> 00:13:55.770 And so in America, and I have to assume Canada has similar snakes, since we are only separated by a imaginary border. 00:13:56.190 --> 00:13:59.260 The pit vipers are snakes, like rattlesnakes. 00:13:59.299 --> 00:14:09.220 There's a couple other very similar snakes, like cottonmouth snakes, but when they bite you, it causes your blood to become super thin and you can bleed into many different places. 00:14:10.179 --> 00:14:11.659 So that's what we have in America. 00:14:11.659 --> 00:14:14.329 And I have antivenom for snakes from America. 00:14:15.069 --> 00:14:24.210 But if you say order a snake from a different country, like Thailand, and you get bit by that snake, we don't have antivenom for that. 00:14:24.609 --> 00:14:28.500 But there is antivenom, but it's not commercially produced in the United States. 00:14:28.510 --> 00:14:38.240 So you get to have a lot of fun calling every zoo in the country to try to see if somebody has Thai green pit viper antivenom and get it flown to your hospital so you can treat these patients. 00:14:38.270 --> 00:14:40.720 So we get all sorts of interesting things. 00:14:40.720 --> 00:14:45.400 We've had people ingest whole bottles of mercury, which we wrote up about that. 00:14:45.450 --> 00:14:52.920 You know, people just find interesting ways to accidentally create potentially problems that we get to solve. 00:14:52.950 --> 00:14:58.870 And the solving part of it is a lot of fun, that you get to use a lot of education and training that you don't always get to use in other fields. 00:14:58.870 --> 00:14:58.960 Neil McPhedran: Right. 00:14:59.089 --> 00:15:00.650 Jennifer-Lee: It's like detective work, yeah. 00:15:01.360 --> 00:15:09.720 Neil McPhedran: Ryan, when we chatted before, you had mentioned this term, and correct me if I have it wrong, but high acuity, low occurrence. 00:15:09.770 --> 00:15:15.839 And you said through that, some of the topics you lean into, and that's a really good reason to having the podcast. 00:15:15.869 --> 00:15:16.670 Do I have the term right? 00:15:16.670 --> 00:15:19.539 And can you explain what that is and how you lean into that? 00:15:20.489 --> 00:15:21.009 Ryan Feldman: Yeah. 00:15:21.029 --> 00:15:23.399 So we call it a HALO event, right? 00:15:23.400 --> 00:15:24.949 So high acuity, low occurrence. 00:15:24.980 --> 00:15:26.680 When it happens, the stakes are high. 00:15:26.689 --> 00:15:30.150 Somebody's life was on the line or sometimes many people's lives are on the line. 00:15:30.634 --> 00:15:36.844 But it's a low occurrence, so it's not necessarily something you're going to end up getting reps in managing every single day. 00:15:36.864 --> 00:15:40.275 Examples of this would be like mass poisoning outbreaks. 00:15:40.314 --> 00:15:46.795 For instance, not too long ago in Ontario, there was a mass poisoning outbreak of aconite from a restaurant. 00:15:46.854 --> 00:15:49.064 And something like twelve people were hospitalized overnight. 00:15:49.104 --> 00:15:54.344 Now, aconite is a substance, it's actually from monkshood. 00:15:54.535 --> 00:15:55.324 Or wolfsbane. 00:15:55.404 --> 00:15:56.775 I don't know if you guys have ever heard of that. 00:15:56.854 --> 00:15:58.785 But it was called like the first poison. 00:15:58.924 --> 00:16:00.005 We've known about it forever. 00:16:00.005 --> 00:16:01.505 It's literally in Greek mythology. 00:16:01.584 --> 00:16:13.295 I've actually written an entire review paper about aconite, and I published it, and me and my co authors together have managed one single case of aconite poisoning between all of us. 00:16:13.614 --> 00:16:20.549 So it's very low occurrence, but when it does happen, you got to have somebody who can figure out how to manage it. 00:16:20.549 --> 00:16:25.255 And what's really helpful there is the experience of others who have managed it. 00:16:25.385 --> 00:16:40.374 So in some future episodes, I'm actually going to be interviewing the people who helped take care of those twelve aconite overdoses that occurred in Ontario, and we're going to learn a little bit from their experience and how they managed that. 00:16:40.485 --> 00:16:48.695 And that way we can have that information that's available for the next person who might run into a potential aconite exposure that they need to manage. 00:16:48.945 --> 00:16:58.410 So, in the world of poisoning, comparatively to other medical fields, we have a lot of HALO, uh, type poisonings, right? 00:16:58.480 --> 00:17:04.790 So arsenic, thallium, these are all things that, you know, maybe one person is going to see once in their career. 00:17:05.250 --> 00:17:08.570 Certainly most medical professionals will never see these things. 00:17:08.680 --> 00:17:14.360 By working for a poison center, I'm getting to get a catchment area of say my entire state. 00:17:14.389 --> 00:17:16.840 So it increases the odds I'll run into one of these rare poisons. 00:17:16.869 --> 00:17:17.889 So what do I do? 00:17:18.070 --> 00:17:27.590 Well, I need to make sure the next person who takes care of one of those poisonings has the right resources available or can at least get the insights of someone who maybe has. 00:17:27.639 --> 00:17:32.040 And these podcasts are actually super useful tools to share that kind of information. 00:17:32.139 --> 00:17:39.689 So to get insights from these HALO events and put them out there so everybody has access to the wisdom that was gained from them having to manage it. 00:17:40.159 --> 00:17:45.030 Jennifer-Lee: I'd be curious how you find other experts in this field that maybe have dealt with something so rare. 00:17:45.120 --> 00:17:51.755 Are you finding people come out of the woodwork and they're like, oh, I've dealt with this before, from listening to your podcast and want to connect with you? 00:17:52.580 --> 00:17:57.680 Ryan Feldman: I definitely have people who reach out to share their experiences of how they've managed certain poisonings. 00:17:57.700 --> 00:17:59.820 The toxicology world is pretty small. 00:18:00.250 --> 00:18:06.619 There's probably a thousand, maybe up to fourteen hundred toxicologists in the United States who manage all the poisonings. 00:18:06.620 --> 00:18:08.370 And we all go to the same conference every year. 00:18:08.720 --> 00:18:16.409 And we all share the same, you know, somebody says, well, I had this overdose and then someone else comes up to the microphone and says, well, I had one of those too, but I did it this way. 00:18:16.700 --> 00:18:19.380 And it becomes a whole thing. 00:18:19.400 --> 00:18:21.520 So it's a really tight knit community, which is nice. 00:18:21.730 --> 00:18:29.300 It makes it easier for me to know who an expert is in what specific area, and tap them to come on and share their expertise with other people. 00:18:29.700 --> 00:18:33.130 But also I get a lot of de novo outreach. 00:18:33.420 --> 00:18:42.094 For instance I recently did a podcast about a medication you might know, called bupropion or Welbutrin. 00:18:42.895 --> 00:18:54.044 This is a medicine that is really, really common nowadays because of its use for pretty much everything, but you know, depression, smoking, weight loss, it's in a bunch of different medications. 00:18:54.415 --> 00:19:01.875 It's also the number one cause of very severe, uh, medical effects during overdose from antidepressants. 00:19:01.904 --> 00:19:03.005 So it's really, really common. 00:19:03.005 --> 00:19:05.404 It causes seizures and arrhythmias, in overdose. 00:19:05.525 --> 00:19:07.625 Pretty safe, you know, therapeutically. 00:19:07.784 --> 00:19:09.284 And I did an episode about that. 00:19:09.745 --> 00:19:16.915 And then one of people who, you know, in my episodes, I usually will do a teaser of what the case is. 00:19:17.380 --> 00:19:24.810 And people will write in their guess as to what the case is, a little bit of a chance to practice their differential diagnosis in poisoning. 00:19:24.990 --> 00:19:36.919 And one of the guests who wrote in to me, uh, for that bupropion episode had this great part about how bupropion causes delayed seizures, which is really tricky, right? 00:19:36.920 --> 00:19:46.529 If I get somebody who ingests a tablet of bupropion, you know, it's really easy when I could say, well, they'll be okay in four hours, but bupropion can actually cause seizures like twenty-four hours later. 00:19:46.719 --> 00:19:52.065 So it gets really tricky to decide whether you keep him in a hospital or not, all sorts of things you got to think about. 00:19:52.315 --> 00:19:54.585 But this guest had some really fun insights about it. 00:19:54.594 --> 00:20:06.344 So I ended up bringing him on the show and we did a whole section, an entire episode about delayed seizures and bupropion, which I think was really useful for medical learners and people training in the field of toxicology. 00:20:06.384 --> 00:20:12.264 So it definitely happens spontaneously from conferences or just from working with people in the field. 00:20:12.625 --> 00:20:17.365 And there's a lot of international collaboration, but also just some people reaching out to share their experience. 00:20:17.365 --> 00:20:19.845 And that leads to some fun, spontaneous education. 00:20:20.055 --> 00:20:28.745 Jennifer-Lee: I just wondered how you guys do it because I know it's not really a poisoning, but the hard thing they have identifying sometimes is rabies, especially when it comes from bats. 00:20:28.924 --> 00:20:32.045 And then they don't find out until the person is deceased. 00:20:32.295 --> 00:20:34.565 Ryan Feldman: Yeah, that's actually really, really tragic. 00:20:34.565 --> 00:20:37.895 I think there was just a case in Canada of a young person. 00:20:37.905 --> 00:20:39.125 Jennifer-Lee: Yeah, he was biking. 00:20:39.145 --> 00:20:40.845 I don't know if it's the same one, it was a few years ago. 00:20:41.015 --> 00:20:48.625 And it's sad, but like that and poisoning, I guess, because they're not common, is that why things are hard to put together sometimes? 00:20:48.635 --> 00:20:49.894 Ryan Feldman: Well, sort of. 00:20:50.094 --> 00:20:54.444 It's certainly part of it, there's often cases where we don't come to a conclusion. 00:20:54.455 --> 00:20:56.315 There's infinite poisons, right? 00:20:56.615 --> 00:20:59.324 They can all share similar presentation. 00:20:59.784 --> 00:21:02.705 But you can only narrow something down so much based off a presentation. 00:21:02.705 --> 00:21:04.425 Sometimes you need to be able to test for it. 00:21:04.675 --> 00:21:09.875 And there's probably, the most sophisticated lab I know of can do about fourteen to fifteen hundred substances. 00:21:10.460 --> 00:21:17.589 So if you consider that there's infinite poisons, that still means, you know, fourteen hundred divided by infinity is a very low percentage. 00:21:17.839 --> 00:21:22.110 So there's a lot of poisons that, uh, we can't test for, or can't always figure out. 00:21:22.659 --> 00:21:28.809 What you're kind of getting at is a term that I like to call a toxic time bomb, where you can show up looking totally fine. 00:21:29.515 --> 00:21:31.785 And then eventually decompensate. 00:21:32.075 --> 00:21:36.325 And by the time that you're showing symptoms, it's kind of too late for us to do very much. 00:21:36.385 --> 00:21:38.905 Now, rabies is a sort of an entirely different thing. 00:21:38.905 --> 00:21:45.444 So one of my other jobs is in an emergency department and we treat people for rabies prophylaxis there all the time. 00:21:45.845 --> 00:21:52.195 Because rabies has a period of time it takes for the symptoms to start to show up. 00:21:52.485 --> 00:22:05.665 So if you're ever suspected of being bitten by an animal that carries rabies, usually we'll get a vaccine for rabies, as well as we'll give you antibodies to rabies as an injection right away to prevent those from developing. 00:22:05.925 --> 00:22:14.310 This is why if you, even if you wake up in the middle of the night, or if you wake up and you find bats in your house, you're often supposed to get evaluated. 00:22:14.310 --> 00:22:20.630 Because they can cause these micro bites that are very small and you can't necessarily see your skin break. 00:22:21.060 --> 00:22:25.690 And that's why because this the outcome can be so severe, we just say hey go in and get treated. 00:22:25.990 --> 00:22:27.100 Go in and get assessed. 00:22:27.360 --> 00:22:31.425 Because it's way more likely to happen, a bad outcome if you never get assessed. 00:22:31.445 --> 00:22:32.585 Jennifer-Lee: I'm just terrified now. 00:22:32.635 --> 00:22:33.215 So, uh, 00:22:33.425 --> 00:22:34.295 Ryan Feldman: Yeah, I mean, 00:22:34.495 --> 00:22:35.845 Neil McPhedran: Well, I think you've got a solution. 00:22:35.855 --> 00:22:41.585 If anything, anyone listening to this podcast, you know, if they have a bat in their house, I think we've learned something here. 00:22:41.665 --> 00:22:48.435 Ryan Feldman: I will say I was once struck by a bat while I was walking down the street in Madison and I did not go get checked out. 00:22:48.435 --> 00:22:49.794 So please don't do what I did. 00:22:49.964 --> 00:22:58.275 I happen to be lucky, but you know, even if they hit you, sometimes they do a little bite anyway, that's a little bit of a side conversation. 00:22:58.275 --> 00:23:01.255 Neil McPhedran: So this is a really, a fascinating conversation. 00:23:01.305 --> 00:23:02.784 Do you do the show all yourself? 00:23:02.785 --> 00:23:04.045 Do you have a team? 00:23:04.095 --> 00:23:06.365 It's really interesting what you put together here. 00:23:07.445 --> 00:23:08.105 Ryan Feldman: Yeah. 00:23:08.155 --> 00:23:10.865 You know, I have a lot of input from colleagues. 00:23:10.934 --> 00:23:16.725 At the end of the day, the scrubbing and final creation is all upon myself. 00:23:17.550 --> 00:23:21.910 It's great because it allows me to explore avenues that I want to explore. 00:23:21.910 --> 00:23:34.320 And that's been one of the biggest values of this show, is it allows me to explore topics and have access to experts that, you know, if I want to corner them for an hour on a Zoom call to ask them about something, they're going to be like, what are you talking about? 00:23:34.350 --> 00:23:37.550 But if I say it's for a podcast, now they want to chat with me for an hour. 00:23:37.590 --> 00:23:43.490 And then I get to learn so much from these people and become, you know, better myself, which is really, really wonderful. 00:23:43.599 --> 00:23:47.320 But, at the end of the day, yes, I do all of the production. 00:23:47.320 --> 00:23:50.670 So I record, I edit and put it out. 00:23:50.690 --> 00:23:54.670 And it is, you know, I heard something from a guest who you had on your show. 00:23:55.380 --> 00:23:58.850 There's this content art spectrum of podcasting. 00:23:58.860 --> 00:24:03.900 You're either pure content delivering something that, you know, an audience is going to absolutely need. 00:24:03.910 --> 00:24:05.740 You've identified a need and you're delivering it. 00:24:06.489 --> 00:24:12.319 Or you're kind of pure art where you are making something for the sake that you find it valuable. 00:24:12.319 --> 00:24:15.440 And you don't care if anybody listens to it and it's for you. 00:24:15.940 --> 00:24:20.605 I probably lean more on the art side, which I don't know that I would advise everyone to do. 00:24:21.045 --> 00:24:31.754 Over many years I'm learning more to craft it into more usable content for people, but I like putting my artistic touch on it. 00:24:31.755 --> 00:24:33.009 It's a lot of fun for me. 00:24:33.010 --> 00:24:36.020 Neil McPhedran: But it, but it sounds like this has been super helpful for your career though. 00:24:36.030 --> 00:24:46.769 Your point about an expert hopping on an hour Zoom with you would be hard to do versus if you got a podcast, they're going to be a lot much more apt to hop on a recording session with you. 00:24:46.770 --> 00:24:58.960 So I would imagine your reach of people over the years by having the show and then the experts who've come out of the woodwork or you reached out to have helped your career. 00:25:00.210 --> 00:25:00.690 Ryan Feldman: Yeah. 00:25:00.780 --> 00:25:14.470 You know, it's hard to measure specifically how, but I know intrinsically the value that I've gained from being able to network with these people and get access to their insights has been super useful for me. 00:25:14.470 --> 00:25:18.750 And to, and to be truthful when you're dealing with a poisoning, so to speak. 00:25:19.760 --> 00:25:23.050 I don't know if you've ever heard about thinking fast and slow. 00:25:23.700 --> 00:25:28.970 There's sort of, you kind of have your automatic thinking where, you know, it's kind of already built in. 00:25:29.310 --> 00:25:31.430 It's the thing that drives your car for you, right? 00:25:31.760 --> 00:25:36.960 It's when I say two plus two, you can't not think of four, you have to think four, right? 00:25:37.349 --> 00:25:39.359 A lot of medical management is that. 00:25:39.360 --> 00:25:45.350 You learn the guidelines, you learn the evidence, and you ingrain treatment algorithms into your brain and treat people via those algorithms. 00:25:45.450 --> 00:25:50.600 And when somebody is, you know, in extreme illness, you need to know those things like the back of your hand. 00:25:50.795 --> 00:25:54.705 And you don't always get to stop and think, well, why does two plus two equal four? 00:25:54.925 --> 00:26:03.735 And you don't get to do what we call the slow thinking, which is the foundational understanding of why we have our treatment paradigms. 00:26:04.325 --> 00:26:10.465 And without ever doing that slow thinking, you never get to challenge the treatment paradigms and make things better. 00:26:11.025 --> 00:26:23.804 So by creating this podcast and exploring these topics, I get to do the slow thinking that goes into how and why we manage poisoning and dream up new ways that we can manage poisoning. 00:26:23.815 --> 00:26:32.765 And this has led me to getting some grant funding to do research for novel antidotes, or at least different therapeutic strategies and specific overdoses. 00:26:32.765 --> 00:26:42.045 So truly just by creating this little adventure, it's kind of created the time in my life to get to explore things in the way that I want. 00:26:42.215 --> 00:26:42.695 Jennifer-Lee: That's great. 00:26:42.695 --> 00:26:48.180 I love it because podcasts are great business building relationship tool that I can't stress enough. 00:26:48.490 --> 00:26:57.040 And that you're getting grant funding to do more research on things that are very important to find answers to like, this is why people should podcast. 00:26:57.610 --> 00:27:07.620 I want to know before we go, is there a poisoning you have not covered yet that you would love to dive into in an episode, or a special guest that you would love to have on. 00:27:08.425 --> 00:27:11.455 Ryan Feldman: Yeah, that's a great, great question. 00:27:11.455 --> 00:27:17.594 I mean, uh, I'm actually going to be starting another version of the show. 00:27:17.594 --> 00:27:24.984 I'll probably house it in the same feed, but looking at specifically poisoning outbreaks, right? 00:27:25.025 --> 00:27:32.215 Uh, I've had the opportunity to be a part of, uh, a couple of outbreaks of poisonings in my career. 00:27:32.225 --> 00:27:53.180 I don't know if it made the news up in Canada, but we had a fair amount of people who were smoking synthetic cannabinoids and bleeding out of every orifice because they were contaminated with rat poisons So we had a couple of those show up and I had got to deal with those through our poison center, and honestly just in my city we, we had some. 00:27:53.659 --> 00:27:57.980 And then there was also e-cigarette and vape associated lung injury. 00:27:58.420 --> 00:28:06.930 Our hospital that we're affiliated actually identified the first cases and we were largely involved in looking at, researching and managing that outbreak. 00:28:06.930 --> 00:28:11.720 So those are very high acuity, low occurrence events, right? 00:28:11.880 --> 00:28:14.930 Not, even just one specific poisoning is a high acuity, low occurrence event. 00:28:15.120 --> 00:28:20.790 But now when we talk about outbreaks, it's a lot more and there could be a lot of lives in the line. 00:28:20.820 --> 00:28:36.365 So I'm really excited to get to explore with others who have been involved in these and hear about how they identified outbreaks, their treatments, while things were unknown, how they collaborated with other federal or local agencies to actually control the outbreak. 00:28:36.585 --> 00:28:45.475 All these things that are actually super valuable to anyone who's going to end up in this position, or even people who want to know just what happens when these outbreaks are occurring. 00:28:45.904 --> 00:28:49.055 And that'll be kind of the next avenue that I'm starting to explore. 00:28:49.800 --> 00:28:50.210 Jennifer-Lee: Yeah. 00:28:50.260 --> 00:28:54.770 It's interesting, I wouldn't think that those would be considered as poison outbreaks. 00:28:54.770 --> 00:28:57.280 I think that's the one thing that we think of is mass outbreaks. 00:28:57.280 --> 00:28:58.320 We just think of viruses. 00:28:58.320 --> 00:29:00.150 We don't think about poisoning. 00:29:00.679 --> 00:29:02.049 Ryan Feldman: Well, all things are poison. 00:29:03.060 --> 00:29:05.930 All things are poison and nothing is without poison. 00:29:05.949 --> 00:29:08.280 The dose alone is what determines the poison. 00:29:09.210 --> 00:29:09.760 Neil McPhedran: Okay. 00:29:10.180 --> 00:29:10.530 Jennifer-Lee: Love it. 00:29:10.530 --> 00:29:13.700 I feel like we could talk to you the whole time, but I feel like you just wrapped it up really well. 00:29:14.840 --> 00:29:14.960 Neil McPhedran: Yeah. 00:29:14.960 --> 00:29:16.320 Well, thank you so much, Ryan. 00:29:16.320 --> 00:29:20.460 This was great and really exciting to hear about your podcast journey. 00:29:20.460 --> 00:29:31.990 And I think that there's a lot to be taken away and even folks that aren't in the medical or science world, I think there's a number of takeaways for us here, sort of just general to the academic world. 00:29:31.990 --> 00:29:33.920 So thank you so much for joining us today. 00:29:34.910 --> 00:29:35.370 Ryan Feldman: Yeah. 00:29:35.490 --> 00:29:36.040 Okay. 00:29:36.100 --> 00:29:36.570 Thanks guys. 00:29:38.900 --> 00:29:41.500 Neil McPhedran: Jen, another great conversation. 00:29:41.500 --> 00:30:00.930 It really is one of these examples of a podcast that is focused on this academic slash practitioner world, but is super interesting for anyone like you and me as well, too, who might be interested in this topic. 00:30:00.930 --> 00:30:13.770 And I think it's a great example of university higher education podcast that sort of cross those two chasms of like deep, deep, deep into a topic for those that are also deep into that topic. 00:30:13.860 --> 00:30:19.489 But at the same time, this is not for everyone, for sure, but could be interesting to a wider audience. 00:30:20.429 --> 00:30:29.544 Jennifer-Lee: I just get excited about all these podcasts we do in the medical field, like you mentioned it earlier when we chatted with him about Surgery 101 and it like makes the content accessible. 00:30:29.554 --> 00:30:31.194 Now I feel like I can do rhinoplasty. 00:30:31.195 --> 00:30:34.934 I feel like I'd be a toxicologist. 00:30:35.344 --> 00:30:36.014 I don't know. 00:30:36.274 --> 00:30:36.834 This is great. 00:30:36.834 --> 00:30:40.734 Neil McPhedran: Now you're going to be a rhinoplasty, moonlighting as a toxicologist. 00:30:40.844 --> 00:30:41.344 Jennifer-Lee: There we go. 00:30:41.344 --> 00:30:42.354 This is the whole point of podcasting. 00:30:42.764 --> 00:30:44.445 It's like I'm going to school, free school. 00:30:44.485 --> 00:30:55.965 But that's the whole point of building a community and that's what I really liked is that he was able to put information out there that maybe is not readily accessible because there are only so many of these people around the world. 00:30:56.144 --> 00:31:04.034 And he gets a whole bunch of people writing in and they only see each other so many times if they're lucky, if they could go to a conference together. 00:31:04.034 --> 00:31:13.075 So it's nice that they're able to build this and showcase that they are an expert in this field and let's the general public call in with their questions. 00:31:13.285 --> 00:31:14.205 And what did he say? 00:31:14.205 --> 00:31:18.475 It was like, uh, he has a poison hotline, no poison central they can call into. 00:31:18.475 --> 00:31:23.425 And anyways, I feel like that's a podcast in itself just to play the clips from like poison central. 00:31:23.724 --> 00:31:24.144 Neil McPhedran: Yeah. 00:31:25.314 --> 00:31:28.274 My kid, uh, drank, uh, such and such. 00:31:28.324 --> 00:31:28.704 Jennifer-Lee: Yeah. 00:31:28.774 --> 00:31:31.504 And that's why they should have watched that commercial. 00:31:31.594 --> 00:31:33.054 I've been telling you the whole time this episode. 00:31:34.915 --> 00:31:35.705 Neil McPhedran: Bring it all back to us, Jen, with the song. 00:31:35.705 --> 00:31:37.305 Jennifer-Lee: With the little monsters. 00:31:37.395 --> 00:31:39.094 Don't put it in your mouth. 00:31:39.540 --> 00:31:40.459 Gonna make you sick. 00:31:40.489 --> 00:31:42.290 I don't know the rest of it, but it's from the 90s. 00:31:42.429 --> 00:31:43.909 Puppet Monsters: Don't you put it in your mouth. 00:31:43.910 --> 00:31:46.315 Till you ask someone you love. 00:31:46.315 --> 00:31:50.323 If it's okay to eat, if it's okay to eat. 00:31:50.323 --> 00:31:52.728 Like a muffin or a beet. 00:31:52.728 --> 00:31:55.133 Like a muffin or a beet. 00:31:55.133 --> 00:31:58.339 If you don't know just what it is. 00:31:58.340 --> 00:31:59.849 Remember boys and girls. 00:31:59.850 --> 00:32:04.699 Don't put it in your mouth. 00:32:05.779 --> 00:32:06.579 Jennifer-Lee: I looked it up on YouTube. 00:32:06.919 --> 00:32:07.799 It's terrifying. 00:32:08.020 --> 00:32:10.929 Production value is very low, but it gets to the point. 00:32:10.949 --> 00:32:14.989 Neil McPhedran: We're going to put a link to that in our show notes to that video. 00:32:14.989 --> 00:32:17.429 So you can sing along at home. 00:32:18.100 --> 00:32:19.070 Jennifer-Lee: There we go. 00:32:19.140 --> 00:32:19.950 Hey, you get it. 00:32:19.950 --> 00:32:23.729 Hey, obviously worked because I'm still here. 00:32:23.830 --> 00:32:24.780 And many kids are still here. 00:32:25.000 --> 00:32:25.659 Neil McPhedran: And you're still here. 00:32:26.369 --> 00:32:26.760 That's good. 00:32:26.840 --> 00:32:27.150 Okay. 00:32:27.369 --> 00:32:27.909 Jennifer-Lee: So there we go. 00:32:27.910 --> 00:32:30.834 Anyways, tune in next time as we learn so many things. 00:32:30.834 --> 00:32:36.500 So thank you for tuning into the Continuing Studies podcast, a podcast for higher education podcasters. 00:32:36.869 --> 00:32:40.019 We hope you found this episode informative and inspiring. 00:32:40.299 --> 00:32:46.949 If you enjoyed the show, we encourage you to follow and subscribe to our podcast on your preferred platform so you'll never miss an episode. 00:32:46.969 --> 00:32:55.829 But if you found this episode particularly valuable, please consider sharing it with your friends and colleagues who also might be interested in higher education podcasts.