Abhijit's Adventure
Abhijit's Adventure
Abhijit was a diligent and hard-working Ph.D. student at a prestigious Midwest medical school. Coming from an Indian background he didn’t lack in enthusiasm and back breaking hard work. The only thing lacking in his life was good data. Despite being in 5th year of his grad degree he was not making much progress on his goals. As a true Ph.D. student, his motto to overcome the obstacles was to work even harder. Abhijit’s PI once remarked "until you finish your Ph.D. you have only one job... to finish your Ph.D. The onus is on you to finish your project on time. So plan your experiments properly, make efficient use of your time. Plan your experiments irrespective of whether it’s weekend or not. Having no family frees you from bothering of not working on weekend". Abhijit couldn’t muster any arguments against that chain of thought. Being on a visa and desperate to finish his Ph.D. he did as he was told and planned his experiments on weekends too.
That fateful Saturday was like any other Saturday. Abhijit entered his lab post-lunch time to finish some mice injections. That day there were a bunch of intravenous injections scheduled for few of the experiments. In another set of injections he had to inject mouse ascites fluid containing a depleting antibody against a T-cell target. The ascites fluid for depletion was to be injected intraperitoneally. Intravenous injections went without a hitch. Not much animal handling was involved in that procedure. You had to pull the mouse tail through intravenous mouse holder and inject through the veins on either side. The intraperitoneal injections involved a little bit more of animal handling. You had to grab the mouse, completely restrain it and access the ventral region by flipping the mouse and inject it in the belly region. Each time Abhijit had to take a fresh injection, fill it, place it on the table and then grab a mouse from the cage, restrain it, and then inject it and put it in a separate cage. All was going as per the plan, Abhijit was also going to meet a friend in the evening for dinner.
In one moment of lost thought, Abhijit filled up the syringe with ascites fluid and kept it on the table with needle pointing up and absent-mindedly brought his other hand on top of it effectively puncturing his palm. He immediately realized his folly, blood was slowly seeping out of the puncture wound. Abhijit immediately removed his latex gloves and washed his hands thoroughly with soap and warm water. The puncture wound was not too bad and blood flow stopped within 2-3 minutes. Abhijit wiped his hands, re-gloved his hands and started on the injections again. Within 2-3 minutes of the puncture, the back of his hand started itching. Abhijit’s major area of research was in Immunology which immediately made him suspect that this might be the start of an acute allergic response. But he still had work to do, so Abhijit cautiously started back on his injections taking breaks in between. The itch was moving up his hand, in few minutes he could feel the itch move up his arm. It took 20-30 minutes to finish the rest of his injections. Abhijit finished up in the animal room and went back to his lab on the 7th floor.
The next stage of symptoms started out then which involved facial puffiness. Abhijit realized that this was getting out of control. He had to seek medical help. One of the perks of doing biomedical research in a medical school was that emergency receiving was building next to the research and teaching building. Abhijit went down his research building and was contemplating whether to go to the emergency or not. By the time he made up his mind his facial swelling increased up a notch and he could barely see with the puffiness.
He explained his symptoms to the front desk staff and walked in the triage area. He was asked to wait by the triage nurse and she got busy assisting person in front of the line. The next set of symptoms kicked in as if in a clockwork with rapid heart beat. By the time he was called in by the nurse he had trouble seeing with increased facial puffing and a rapid heart beat. Nurse just checked Abhijit’s pulse and was terrified and immediately called up for help. Abhijit was wheeled into the emergency room where he was immediately administered treatment. Luckily he did not develop any breathing trouble which is a classic sign of anaphylactic shock. In few minutes after administering Epinephrine Abhijit's condition stabilized. Abhijit was later shifted to observation. By evening triage nurse came in to see Abhijit. “I am so sorry, I didn’t understand what trouble you were in. I hope you are feeling better”. “Thank you for your concern” said Abhijit “and it’s not your fault”. Smiled Abhijit. Abhijit was shifted two more times before a room was available. Finally around 9 pm at night he was shifted to a room. He was promised discharge by next morning or afternoon. He called one of his roommates using phone. With cell-phone phone book, he didn’t even bother to remember everyone’s phone number. His roommates were concerned but Abhijit told them that he was out of danger. After the phone call Abhijit slept and woke up next morning. He didn’t develop any more complications. His case attracted a slew of visitors who wanted to document his unusual case. Abhijit found this mildly amusing. He was finally discharged that afternoon. He directly went to his lab, tidied up, picked up his backpack and went to his car. He went directly to CVS to fill his prescription of corticosteroids. Finally after more than 24 hours since he started from his apartment on Saturday he went back home.
Next day he narrated his ordeal to his mentor who remarked nonchalantly that hopefully he didn’t miss any of his experimental timeline due to his medical incident!😲 Abhijit didn’t expect any more from her 😠At least the departmental secretarial staff and fellow Ph.D. students showed concern. His parents and relatives were really concerned back home and Abhijit assured them that everything was fine. From that day on he was doubly careful while doing animal experiments. He also made appointment to see an immunologist who prescribed him an Epipen. He was tested for allergy against mice but didn’t turn any leads. Abhijit suspected it must some un-identified component of the ascites fluid which could be the culprit. His professors also told him that he must have been primed before and the latest incident was a memory response. Acute allergic response starts of with a priming event which educates the immune system with allergen in a future hope of a robust response. The memory event is triggered whenever the immune system encounters the allergen again in the future. A rapid onset of action leads to chain of events within few minutes to hours and hence the name ‘acute response’. It is imperative to recognize and seek immediate medical help. Many individuals are prescribed epipen autoinjector which is epinephrine which counters the symptoms of acute allergic response. Epipen gives a crucial help, buys time so to seek help.
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