Thom Mack
@thommytox.bsky.social
Clinical Toxicologist☠️🐍🦂🕷️
EM PharmD💊 Breakfast or Bust🌵
EM PharmD💊 Breakfast or Bust🌵
AI turned me into some sort of Disney snake whisperer 🤣
April 18, 2025 at 8:21 PM
AI turned me into some sort of Disney snake whisperer 🤣
Pulled the trigger on a new whip (X6 Msport)… slapped on some fresh tint and ceramic coating! My Jeep (2019 Grand Cherokee) just couldn’t cooperate after 3 waters pumps… now needing a 4th, oil leaking from everywhere, and engine mounts blown. 😎
March 11, 2025 at 5:26 AM
Pulled the trigger on a new whip (X6 Msport)… slapped on some fresh tint and ceramic coating! My Jeep (2019 Grand Cherokee) just couldn’t cooperate after 3 waters pumps… now needing a 4th, oil leaking from everywhere, and engine mounts blown. 😎
Today marks the end of an era… said adios to my Jeep after 7 years, but at 46,000 miles I shouldn’t be on my 3rd water pump needing a 4th, engine mounts shot & an oil leak from who knows where🤷🏻♂️. Found this note in my car from my first month of owning it brand new after someone smashed it🤣#ByeByeJeep
February 23, 2025 at 5:47 AM
Today marks the end of an era… said adios to my Jeep after 7 years, but at 46,000 miles I shouldn’t be on my 3rd water pump needing a 4th, engine mounts shot & an oil leak from who knows where🤷🏻♂️. Found this note in my car from my first month of owning it brand new after someone smashed it🤣#ByeByeJeep
Ok, I snorted when I saw this 🐍
December 21, 2024 at 7:59 PM
Ok, I snorted when I saw this 🐍
So, I found out I got Assistant Professor status (alright alright alright) and I’m wondering if I should go full-tilt ➡️ obtain a tweed coat with elbow patches? If I were to get one @dieworkwear.bsky.social, how do I pick one out?!?!?! #MedSky #ToxSky #RxSky 🐍☠️🦂🕷️📚
December 5, 2024 at 4:33 AM
So, I found out I got Assistant Professor status (alright alright alright) and I’m wondering if I should go full-tilt ➡️ obtain a tweed coat with elbow patches? If I were to get one @dieworkwear.bsky.social, how do I pick one out?!?!?! #MedSky #ToxSky #RxSky 🐍☠️🦂🕷️📚
I was in AZ yesterday, sunny, 70 something degrees… today in NY, snowing, 33 degrees.
Happy Thanksgiving 🦃
Happy Thanksgiving 🦃
November 28, 2024 at 3:48 PM
I was in AZ yesterday, sunny, 70 something degrees… today in NY, snowing, 33 degrees.
Happy Thanksgiving 🦃
Happy Thanksgiving 🦃
Shared with permission, is a good example of myokymia from a rattle-🐍 envenomation. It started in the thigh & spread to the groin, buttocks… the entire leg, persisting for ~48hrs. Indeed was quite a discomfort/painful experience requiring large doses of opioids, benzos, & skeletal muscle relaxants.
November 23, 2024 at 7:18 AM
Shared with permission, is a good example of myokymia from a rattle-🐍 envenomation. It started in the thigh & spread to the groin, buttocks… the entire leg, persisting for ~48hrs. Indeed was quite a discomfort/painful experience requiring large doses of opioids, benzos, & skeletal muscle relaxants.
We found that treatment with Fab2 antivenom resulted in a fibrinogen recovery rate similar to those in non-envenomated disease & a difference in recovery period vs time to antivenom! This is the only study of its kind & obviously more research is needed to confirm.
November 23, 2024 at 1:06 AM
We found that treatment with Fab2 antivenom resulted in a fibrinogen recovery rate similar to those in non-envenomated disease & a difference in recovery period vs time to antivenom! This is the only study of its kind & obviously more research is needed to confirm.
So, I took a look at fibrinogen recovery as a rate (mg/L/h) & period of time vs Fab2 antivenom administration.
November 23, 2024 at 1:06 AM
So, I took a look at fibrinogen recovery as a rate (mg/L/h) & period of time vs Fab2 antivenom administration.
Quick sidebar as to how snake venom, specifically serine proteases causes a “consumption” of fibrinogen. Also, venom contains metalloproteases that are directly fibrinolytic 🐍🩸. This effect is neutralized by giving ANTIVENOM… not blood products, as the venom would keep consuming & destroying FIB!
November 23, 2024 at 1:06 AM
Quick sidebar as to how snake venom, specifically serine proteases causes a “consumption” of fibrinogen. Also, venom contains metalloproteases that are directly fibrinolytic 🐍🩸. This effect is neutralized by giving ANTIVENOM… not blood products, as the venom would keep consuming & destroying FIB!
As time went by and my experience with treating these patients grew, I noticed something… noticing after a certain amount of antivenom, a pattern of fibrinogen recovery seemed to be present… but what exactly was it?!?!
November 23, 2024 at 1:06 AM
As time went by and my experience with treating these patients grew, I noticed something… noticing after a certain amount of antivenom, a pattern of fibrinogen recovery seemed to be present… but what exactly was it?!?!
Our gang took a look at delayed, recurrent, & persistent coagulopathy (thrombocytopenia, hypofibrinogenemia) in those treated with Fab vs Fab2. What was interesting, of those who were treated with Fab2, none of them developed late hypofibrinogenemia! PMID:35413335
November 23, 2024 at 1:06 AM
Our gang took a look at delayed, recurrent, & persistent coagulopathy (thrombocytopenia, hypofibrinogenemia) in those treated with Fab vs Fab2. What was interesting, of those who were treated with Fab2, none of them developed late hypofibrinogenemia! PMID:35413335
Well, there’s a multitude of toxins found in rattle-🐍 venom that can cause different toxicities in humans. (below by Calvete et al PMID: 19371136). However, expression of venom makeup not only varies between different species of 🐍s but also within a particular specie of 🐍s!
November 23, 2024 at 1:06 AM
Well, there’s a multitude of toxins found in rattle-🐍 venom that can cause different toxicities in humans. (below by Calvete et al PMID: 19371136). However, expression of venom makeup not only varies between different species of 🐍s but also within a particular specie of 🐍s!
Rattle-🐍 envenoming produces a number of clinical consequences. Below are some of the more common findings. But who gets what symptoms or combination thereof???
November 23, 2024 at 1:06 AM
Rattle-🐍 envenoming produces a number of clinical consequences. Below are some of the more common findings. But who gets what symptoms or combination thereof???
First things first: I’m from the North East originally, we had squirrels & chipmunks not rattle-🐍 & 🦂s. I was initially terrified, but I eventually came around thanks to the help from my herpetology buddy Dan.
Pic: Me & Dan holding a western diamond-backed thicc-boi 🐍
Pic: Me & Dan holding a western diamond-backed thicc-boi 🐍
November 23, 2024 at 1:06 AM
First things first: I’m from the North East originally, we had squirrels & chipmunks not rattle-🐍 & 🦂s. I was initially terrified, but I eventually came around thanks to the help from my herpetology buddy Dan.
Pic: Me & Dan holding a western diamond-backed thicc-boi 🐍
Pic: Me & Dan holding a western diamond-backed thicc-boi 🐍
If you happen to be in Malaysia, stop by the Asia Pacific Association of Medical Toxicology (APAMT) 2024 conference & see my poster! Of course, I won’t be there because I’m in Arizona… but stop & talk to Mazda Shirazi! #MedSky #RxSky #ToxSky #APAMT2024 ☠️🐍☠️🐍
November 12, 2024 at 2:32 AM
If you happen to be in Malaysia, stop by the Asia Pacific Association of Medical Toxicology (APAMT) 2024 conference & see my poster! Of course, I won’t be there because I’m in Arizona… but stop & talk to Mazda Shirazi! #MedSky #RxSky #ToxSky #APAMT2024 ☠️🐍☠️🐍
Let me know if you need a consult… 🐍
November 10, 2024 at 3:12 AM
Let me know if you need a consult… 🐍
Well, I was a hit with the brunch crowd today…
May 26, 2024 at 7:41 PM
Well, I was a hit with the brunch crowd today…
Seth, how often does one get to rec medical urine aka “The R. Kelly”…
May 26, 2024 at 2:06 AM
Seth, how often does one get to rec medical urine aka “The R. Kelly”…
Latest manuscript is out! We discuss the kinematics of rattle-🐍 venom expulsion & patients who thought venom was sprayed on their face, really got a face full of musk aka “ass-juice”. Free link below
authors.elsevier.com/a/1j98v9Knft...
authors.elsevier.com/a/1j98v9Knft...
May 26, 2024 at 1:43 AM
Latest manuscript is out! We discuss the kinematics of rattle-🐍 venom expulsion & patients who thought venom was sprayed on their face, really got a face full of musk aka “ass-juice”. Free link below
authors.elsevier.com/a/1j98v9Knft...
authors.elsevier.com/a/1j98v9Knft...
And last but not least, Eastern Indigo Snake (Drymarchon couperi) a federally protected non-venomous snake found in the southeastern U.S. 🐍🏜️
December 16, 2023 at 8:38 PM
And last but not least, Eastern Indigo Snake (Drymarchon couperi) a federally protected non-venomous snake found in the southeastern U.S. 🐍🏜️
The Western Massasauga and Banded Rock rattlesnakes are best friends apparently after being bunked up in the tank outside my office. 🐍🏜️
December 16, 2023 at 8:37 PM
The Western Massasauga and Banded Rock rattlesnakes are best friends apparently after being bunked up in the tank outside my office. 🐍🏜️