Fintan Moore reflects on how his anaphylaxis training was called upon with a recent visit from a teenage girl
Like every pharmacist taking part in the seasonal flu vaccination programme, I keep my CPR and anaphylaxis training up to date. And like the vast majority of pharmacists that do the training, I always had the fervent hope that I’d never actually need to use it. It was filed mentally under the heading of ‘things that I may need to know sometime’, like how to change a flat tyre or how to convince Jehovah’s Witnesses on my doorstep that I don’t understand English. Anyway, I still haven’t had to use my CPR technique, but a few weeks ago I did have to do an emergency adrenaline injection.
As anaphylaxis cases go, this one was probably about as straightforward as they can get, so there wasn’t too much drama involved at my end. The patient’s mother rang ahead to check that we were able to provide the injection, and it took about 10 minutes before she arrived with her teenage daughter, who had a latex allergy.
The daughter said she’d taken an oral nicotine product (I don’t know what one) that caused her mouth and throat to swell. She was a bit out of breath but she was understandably a bit panicky, and also had just walked for about 15 minutes to get to us. On top of that, she had a fear of needles, so she had nearly the full ‘bingo card’ of reasons to be puffed.
Because I had been given the advance warning, I had already got the emergency kit with adrenaline vials, syringes and needles, and had an injection ready to use. Every couple of months I have patients who get Neo-Cytamen injections, which use the exact same technique, so that repeated practise was helpful in terms of getting organised.
I gave the patient a shot in her thigh and she felt better in a couple of minutes. Having had a chance to sit and calm down probably helped her also, and she was well enough to leave shortly after. All in all, it went as smoothly as possible, helped by the patient being well enough to get to me rather than me having to dash from the pharmacy.
As a side note, before coming to me, the girl had gone to another pharmacy who were unable to provide her with an injection, so it’s a good idea for every pharmacy to have a note somewhere of what local pharmacies have somebody trained usually available.
Killing me softly
There’s a lot of chat these days about ultra-processed foods and how bad they are for us, although the picture can sometimes be complicated. For instance, almond milk is ultra-processed but not unhealthy; but generally, foods with more industrialised cheap ingredients are a problem. However, you might be right to worry about ultra-processed foods, but you might be worrying for the wrong reason.
When you look at ingredient lists, you might suspect that the added fats, oils, sugars and chemicals are somehow toxic. And if you Google enough, you may find some study in rats that shows that this dye or that preservative causes cancer or something. But the real reason why ultra-processed foods are killing us is simpler than that.
The reason ultra-processed foods are so bad for us is that they are easier to eat. Their additives include chemicals to keep the food fresh longer, so it stays soft if it’s supposed to be soft, crunchy if it’s supposed to be crunchy. The makers add salts, spices, and oils that taste good. Grains have been stripped of fibre so they are easier to chew and have a better mouth-feel. These are all designed by very smart scientists to be highly delicious and easy to eat. There is even a term they use for this: Cravability.
Grains have been stripped of fibre so they are easier to chew and have a better mouth-feel
They want foods to be as close to addictive as possible, and it works. A study in the US took 20 volunteers and had them stay at the National Institutes of Health for a month. For two weeks they got a normal diet; for two weeks, a diet high in ultra-processed foods. They could eat as much or as little as they wanted, and the average volunteer ate 500 extra calories per day while on the ultra-processed diet. These foods kill us, quite simply, because we eat more of them.
These unhealthy foods are now so ingrained in people’s diets, and from such a young age, that the situation is bleak if not actually hopeless. From a pharmacist’s perspective, as businesspeople it means that we’ll never run short of overweight patients with all the associated comorbidities, and weight-loss products like Ozempic are going to be here for good.
I know that there’s never been more information available to the public on the benefits of eating well, but that’s not translating into what they’re actually doing, so as healthcare professionals, is there any role we can find to help turn the tide?
Fintan Moore graduated as a pharmacist in 1990 from TCD and currently runs a pharmacy in Clondalkin. His email address is: greenparkpharmacy@gmail.com
