English Language & Usage: Multi-Layered Discourse Room

Whenever I read those words, it will 99 % of the time be about the seat of emotions or whatever, never about anything medical, so "some place inside the body" is precise enough hehe.

David M

Then, a company in the US came up with a method to synthesize it. They named it Adrenalin (sans the -e)

Cerberus

I see. Was that useful?

David M

It angered the medical community in the US, and they started referring to it as Epinephrine

Cerberus

Why angered?

David M

@Cerberus VERY

Cerberus

3:21 AM

OK when do they feed you adrenaline?

David M

@Cerberus IDK. It just struck them as distasteful. (This is probably back in the 1960s before brash consumerism.)

@Cerberus It is injected intravenously to restart the heart during cardiac arrest.

Cerberus

You mean the cutting off of the -e struck them as distasteful?

David M

@Cerberus The use of the proper name as the trade name.

Cerberus

So it does strike me, but the obvious solution would seem to be: keep using the term adrenaline?

David M

Essentially branding nature.

Cerberus

3:22 AM

@DavidM Ah OK, noted.

David M

I would never have found offense in this. I think that the process of naming drugs with trade and generic names is silly.

It makes my life confusing.

Cerberus

That is absolutely true.

Just use whatever chemical or other scientific term you were already using.

David M

I understand the desire to set your product apart, but why not just give it a name, and then later call it GENERIC (Name)

@Cerberus That could get confusing for some of the more complicated names.

Cerberus

This desire can be quenched by the state, or rather, stamped out.

David M

Some of the antiviral drugs have names that are unpronounceable.

Cerberus

3:24 AM

@DavidM Abbreviate them?

David M

@Cerberus Complicated, but medicine abhors certain abbreviations, and loves others.

Pen = PCN = Penicillin.

Cerberus

Or come up with one scientific name that describes the function of the substance.

Hah.

David M

@Cerberus That would be sensible.

Cerberus

And use that always.

Adrenaline sounds OK?

David M

@Cerberus It should be.

And, in the UK and the rest of the world, it is the preferred term.

Cerberus

3:26 AM

It is the one I know.

Which doesn't mean much.

David M

It is really easy to say EPI, though in an emergency.

@Cerberus It means more than you know.

Cerberus

Yeah?

David M

Weekly I have to tell patients that they are NOT allergic to Epinephrine.

Cerberus

(You can also say adre fast in an emergency?)

David M

Perhaps

Cerberus

3:27 AM

Have to tell them?

David M

Yes.

Cerberus

Why?

David M

They go to a dentist who give an injection of lidocaine + epinephrine. (Epi causes vasoconstriction to prevent bleeding).

Cerberus

Okay.

David M

Some of this combination gets injected intravascularly, and they have a typical reaction. Their heart races, they feel panicky, etc.

Cerberus

3:29 AM

Which should be normal for adrenaline?

David M

Some might even go into supra ventricular tachycardia.

Yes.

Normal.

Cerberus

Above the stomach?

David M

But, because they don't know what Epinephrine is, they think they are allergic.

Cerberus

What does supraventricular mean?

Hmm.

David M

Supraventricular = originating above the ventricle

That is, in the atrium of the heart.

Cerberus

3:30 AM

Ah, it is part of the heart.

David M

Yes. Heart is divided into four chambers

Cerberus

I knew that.

David M

Right and Left Atria, Right and Left Ventricles

Cerberus

Ah OK.

David M

Ventricular tachycardia = VTach = bad arrythmia

Cerberus

3:31 AM

And those people do know the term adrenaline, presumably?

David M

Supraventricular Tachycardia = SVT = Usually an annoyance.

Cerberus

@DavidM Ah, particularly bad, OK.

Noted.

David M

Can be really bad, at times.

Yes, they do know adrenaline.

So, I have to explain to them that if they were truly allergic, they would have died the minute they were born.

Cerberus

Heh.

David M

Actually, in-utero, but that's just splitting hairs.

Cerberus

3:33 AM

It strikes me as odd that people should even think of allergy when they respond by stress-like symptoms to an injection.

David M

Another pet-peeve of mine.

Cerberus

Allergy makes me think of rashes and bumps.

Although...asphyxiation can also occur, of course.

Or what is it called?

David M

All correct.

Anaphylaxis

Cerberus

Right, that. I get that a little bit from exercise sometimes.

And I imagine it is the same as what my friend gets when he eats nuts.

David M

Anaphylaxis from exercise?

Cerberus

3:35 AM

Yeah.

David M

Yes. Definitely a nut allergy.

Cerberus

It exists, I Googled it haha.

It's really weird.

David M

I've heard of it, too. But it's rare.

Cerberus

Only happens the first couple of times when I haven't exercised in a while.

David M

Hmmmmm . . . .

Cerberus

3:36 AM

Oh, you have even heard of it!

And you know what's strangest?

David M

Stretching my memory to remember the causal relationship.

Cerberus

It is not directly related to exhaustion.

David M

American ignorance makes people associate untoward reaction with allergy.

Cerberus

I don't remember the details, but I seem to remember they weren't sure how it works.

David M

Yeah. It's a complement mediated reaction or something.

Cerberus

3:37 AM

It gets worse as I get older, I think.

David M

But, is it full-blown anaphylaxis? Requiring epinephrine injection to reverse it, throat swelling to the point of inability to breath, etc?

Cerberus

I once thought anthistamines helped, but...not enough, or placebo.

No, I can stop in time.

David M

Hmmmmmm ... Give me a minute to google.

Cerberus

I probably don't have the worst kind/degree.

David M

emedicine.medscape.com/article/886641-overview

Yeah, Exercise Induced Anaphylaxis

They don't mention how to mitigate it, though.

Cerberus

3:40 AM

Some people on the Internet (I know!) recommended antihistamines.

David M

ncbi.nlm.nih.gov/pmc/articles/PMC3020292

This is a more in-depth article.

Cerberus

@DavidM I think I read that exact article once.

David M

It's 4 years old.

The journal is a so-so publication. But, it's respectable enough.

Cerberus

That's probably ancient, in medical land?

David M

@Cerberus Not ancient.

Just had enough time for adequate peer review and digestion.

Cerberus

3:43 AM

Heh OK.

David M

10 years is ancient.

Cerberus

But hey, it's not a very serious problem, at least for me.

David M

@Cerberus Like most issues of the sort, it's never serious until it's serious.

Cerberus

But this builds up gradually.

David M

You should have an adrenaline self-injector available.

We call it an Epi-Pen.

Cerberus

3:45 AM

Or I can just stop exercising when I feel it coming.

David M

@Cerberus Granted.

Cerberus

Would this pen help me continue to exercise?

Or can it even be preventative?

David M

@Cerberus Mmmmmmm . . . probably not.

You wouldn't use it preventatively

Cerberus

Right.

I mean, I can predict when it will happen.

David M

You would use it to keep your throat from swelling shut.

Cerberus

3:46 AM

It never gets that bad for me.

David M

It sounds like you have a mild enough form. But, perhaps you should discuss this with a physician. Having this device on hand is never a bad idea.

Cerberus

Perhaps I should.

David M

I would.

Not to make you worry.

Cerberus

But I feel like I'm in control: I know what it feels like, how it works, when it will happen.

Heh.

David M

It's just a better safe than sorry.

You probably are.

But, I'm sure you've purchased insurance in the past.

Cerberus

3:47 AM

I can feel the itching in advance.

Heh.

David M

My attitude is never take an unnecessary chance.

Cerberus

Right.

But I really hate sounding like a hypochrondriac with a "rare disease" to my doctor.

I know, it's silly.

David M

Rare, but potentially dangerous.

If it was just itching skin, I would say . . . eh

But, the throat is nothing to fuck with.

Cerberus

It starts with itching, then nausea, can be severe. It feels horrible, but no other symptoms.

David M

@Cerberus May be a different process at work, then

Cerberus

3:51 AM

I mean, apart from short of breath.

David M

Short of breath or difficulty moving air through your glottis? Makes a difference which.

Cerberus

All I know is that's quite different from just the normal shortness of breath from exercising.

David M

@Cerberus Well, I wouldn't say to run to your doctor. But, next time you have a physical mention it. ;-)

Cerberus

Heh.

Perhaps I should.

David M

I would.

You have socialized health care. Get your money's worth

Cerberus

3:53 AM

Haha.

Yes, it's free.

David M

Nothing is free.

You pay much higher VAT and other taxes.

Cerberus

Sure.

I haven't seen my doctor in years btw.

David M

He's probably lonely.

Cerberus

Haha unlikely.

David M

People in socialized countries tend to visit the doctor more often from what I hear.

Cerberus

3:55 AM

Is that so?

David M

@Cerberus That's the data I've seen.

Cerberus

Hmm.

On average?

How about the top 10 % visitors, do they also visit more often?

David M

@Cerberus I'm not sure the measurement method. I just remember hearing that it was up to 3x more often than in the US.

Cerberus

It would of course make sense for poor people to see their doctor more often.

David M

True.

Cerberus

3:57 AM

I have to pay all costs up to € 360 a year, anything over that amount is paid for my insurance.

David M

I remember reading that in England, people see their physician for conditions most Americans would likely ignore.

Cerberus

I hear you have very complicated systems with co-pays and such.

David M

That's just the surface

Cerberus

Heh.

Derobert in the other room showed me some forms and menus on the Obamacare website.

David M

The insurance companies pay what they want.

@Cerberus I try not to look.

I'm lucky to be a salaried employee.

Cerberus

3:58 AM

By the way, the theory here is that people should see their GP more often, and that this saves money in the end, because disease can be diagnosed earlier, and they don't need to go to specialists as often.

David M

I don't worry about my billing beyond a cursory interest in making sure the hospital does well.

Cerberus

Good for you.

David M

@Cerberus I don't disagree with it.

Cerberus

I only know that total healthcare expenditure in America is about 60 % higher than here...

And the quality is about the same.

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English Language & Usage: Multi-Layer…