EP:439 | A Doctor explains a Snake Bite

On this episode we’re joined by Dr. Ned Miller in studio to explain snake bites and provide a road map of what to do plus what to expect.  Ned is a serious hunter himself and understands the scenarios a hunter/fisherman could find themselves facing.  Gamekeepers working on a property face many chances to encounter venomous snakes and stinging insects, and everyone needs to have a plan. Dr. Ned explains it all. 

Listen, Learn and Enjoy. 

Transcript

SPEAKER_00 0:00

I'm Jeff Foxworthy, and welcome to Gamekeeper Podcast. If you want to learn more about farming for wildlife and habitat management, then buddy, you are in the right place. Join the Gamekeeper crew direct from Austrian Land Enhancement Studio as they discuss the latest wildlife and habitat management practices. News, and of course, honey. There's no telling what you'll learn, but I'm gonna tell you. I bet it's interesting. Enjoy.

SPEAKER_07 0:26

We're live in three, two, one. All right, Lanny. Bobby. This you know, this subject, whenever we talk about snakes, you just you just you're like squirming in your seat over there. I don't think anybody likes uh here is a big fan of snakes. I like snakes.

SPEAKER_06 0:40

I think snakes are cool.

SPEAKER_08 0:41

I think they're cool. I was looking for a fake snake laying around here when I walked in too. I was sort of expecting that.

SPEAKER_02 0:48

Yeah, that's a good expectation. I can't believe we let you down.

SPEAKER_07 0:51

Honestly. Yeah. So that voice that you hear, you've heard on here before. We've got the world famous now. Yeah. Dr. Ned Mill. The good doctor. That's right. Yeah, he is he is the he's the treasurer of West Point. Spreading those rumors. Uh the treasurer? The the tree he is a treasurer. Yeah, Ned, we're so proud of you. I mean, you've just blossomed into this this wonderful doctor. Well, thank you, Bobby. I hear so many good things about you. Like I say, yeah, keep spreading the rumors. Keep talking. It's the whole office, though.

SPEAKER_06 1:25

They're all great. How can you be here?

SPEAKER_07 1:28

I mean, is somebody sitting in your office down there right now waiting on you? You know, he's not the only guy that works there.

SPEAKER_06 1:35

Yeah, thankfully, we got some backup.

SPEAKER_08 1:37

I do have some backup.

SPEAKER_07 1:38

Yeah. So uh many, many years ago, we did uh what to do if you know we talked about getting if you got bit by a snake, what to do. But I wanted this is such a serious subject, and we've got some we got more listeners now than we did back then. And I wanted to revisit it and just maybe there's some new information. But a guy that listens to this podcast, us, I mean, we're subject to get bit by a snake at any point in time. I mean, I'm looking all the time. I'm wrong. You are looking all the time. Around them, we see them turkey hunting, we especially see them in the summertime when we're working on a place. It could happen. They should be out right now, matter of fact.

SPEAKER_08 2:14

They are out right now. There you go. Yeah. And that's when it happens, is when you're working on your place or uh in the garden.

SPEAKER_06 2:22

It just seems like when you least expect it, look down and see one. Yeah, go to pick up a gas can on the side of a shop and flip a price under it. I parked the other day right inside my gate and almost stepped on one just getting out of the car.

SPEAKER_02 2:37

Wood piles, stacks of lumber, copper stuff on the ground.

SPEAKER_07 2:41

Piece of tin laying there. They love that.

SPEAKER_08 2:45

Absolutely.

SPEAKER_07 2:46

So, all right, so that's what we're gonna talk about. And we'll later on we're gonna talk about some prevention like snake boots and chaps and all that kind of stuff. So you don't have a favorite snake, Bobby? No, none of them. I don't so there's some that I won't kill. You know, the king snake. You're a king snake. I love a king snake. Well, I'm told that Ned, I'm told that they kill other snakes.

SPEAKER_06 3:08

Well, you know, a lot of venomous snakes also eat a lot of other venomous snakes, too.

SPEAKER_02 3:14

They're all good. I've actually seen a bed of rattlesnakes and king snakes in the same den. That's interesting. Yeah. Well you weren't there. I don't know where you were.

SPEAKER_07 3:24

Yeah, I wouldn't be around for that. Okay, but let's get serious here for a second. Ned, thank you for being here. I know you've done you've done a lot of research. We probably need to let's tee you up. I mean, what makes you this guy that's so knowledgeable about so much stuff? Why you are just when you find a subject you're interested in, you really research it.

SPEAKER_08 3:45

I well, yeah, I do. I'm uh so my background's in family medicine, which is uh sort of a jack of all trades kind of uh uh type of doctor, you know, primary care. We see a little bit of everything. So it's did you help Lanny with his jock itch?

SPEAKER_02 4:01

No, it was not jockich, it was toe fungus, Bobby. Clothing. Get it right. But you cured it, though. I think he's helped you in a few things too.

SPEAKER_05 4:12

Should I listen? That's what he's helping you.

SPEAKER_07 4:13

I get a shot every couple weeks, dude.

SPEAKER_05 4:15

No, I said on that note, Bobby, I thought I heard something about postponing a colonoscopy.

SPEAKER_02 4:22

This is he is putting it off. We gotta talk about this now.

SPEAKER_08 4:28

I think I saw on a podcast recently where we were postponing colonoscopies for turkeys. We gotta get our priority straight. Next Tuesday, yeah.

SPEAKER_07 4:33

Okay. I've got it set. All right. First week of May. Is that what it is? It's uh no, it's the whatever the next Tuesday is.

SPEAKER_06 4:43

Do you need us to come pick you up after? No, my wife.

SPEAKER_02 4:46

Richie, we definitely need to go up there and record you coming out of anesthesia. Exactly. Whatever. I'm sure he'll have some great, great dad Bobby-esque jokes. No telling. So Nick. I think I'll go.

SPEAKER_07 5:00

I'll let me tell us a little bit about yourself.

SPEAKER_08 5:03

Um oh my well, yeah, you know my name. I um uh am a graduate of Mississippi State, biomedical engineering in way back when. Um did um med school at William Carey here in uh Mississippi, which is sort of a primary care rural medical school. Um did my postgraduate training at North Mississippi Medical Center in Tupelo, and um since then have been in West Point, which is my home.

SPEAKER_02 5:35

Yeah.

SPEAKER_08 5:35

Born and raised. Uh, so it was nice to come back home.

SPEAKER_02 5:39

I tell you, for me, Ned is a rarity in the fact that the reason he's in medicine is because of the community. Uh you don't see that a lot.

SPEAKER_01 5:46

Yeah.

SPEAKER_02 5:46

You don't see that a lot. And and I think it's probably rarer these days than ever. You hear these old stories of these old doctors, rural doctors, you know, riding a horse through the creek because they knew a lady, you know, had a sick baby and doing all those things. And I think Ned does a uh a better job of of being that person than than I've I've seen anywhere around here. He really cares. He does. That's a funny thing. He really cares.

SPEAKER_08 6:07

He really does. You're gonna get me on a soapbox, but no, uh, small town primary care where you know your patients is I I think the best form of medicine there is.

SPEAKER_06 6:15

Yeah, I bet he knows so much on so many people that he can't talk about, yeah, including me.

SPEAKER_08 6:22

Yeah, you ever been paid in chickens? Oh, yeah, we've yeah. Chickens and apple pies and brownies and turkey hunts. Yeah, turkey hunts, yeah, absolutely.

SPEAKER_01 6:33

Yeah, yeah.

SPEAKER_07 6:34

Well, if Toxie were here, he he would be singing your praises too. Oh, he's a major fan to say the least.

SPEAKER_02 6:40

Yeah, yeah, yeah. We are. And you look what you did, you know, for Mr. Fox, you know, obviously it was important to the family. Yeah, and and uh important to everything around here. So thank you for that. Absolutely, thank y'all. I was at his grave this morning, matter of fact. Is that right? Popped a turkey feather on it. There you go. Have you missed a turkey lately? Yeah, I sure have. Have I missed as many turkeys as you have, Bobby?

SPEAKER_07 7:03

I didn't ask that question.

SPEAKER_02 7:05

I'm asking that question.

SPEAKER_07 7:07

Yeah, okay. Let's just let's get sheers. Why don't you go ahead and start with your rapid fires, Dudley? The nutrient rapid fires.

SPEAKER_06 7:14

I would love to. Um I think Ned knows the game here, so uh let's just get into this. Are you ready? Come on with it. What is a medical profession you don't specialize in that really interests you?

SPEAKER_08 7:30

Um probably surgery. Um I I like procedures. Um and um and we do some small surgeries in office surgeries and and do a handful of procedures at the hospital here too. So um I almost ended up as a surgeon a hundred years ago, but um yeah, if I had it if I wasn't a primary care doc, it'd be a surgeon.

SPEAKER_06 7:55

Well, you've operated on me on minor things, so that's good. Uh have you ever smoked or used nicotine?

SPEAKER_08 8:01

Absolutely. How many drinks do you have per week? None.

SPEAKER_06 8:04

Uh uh zyrtech or Claritin.

SPEAKER_08 8:09

Oh, um Zertec in the morning clariton at night. Hey.

SPEAKER_06 8:13

Pepsid or Nexium?

SPEAKER_08 8:16

Um Pepsid if you have allergies, um never Nexium, and uh protonics if you have heartburn.

SPEAKER_06 8:28

Okay, I got hooked on Nexium once, and somebody told me it's terrible for you, so I got off of it. Yeah. Uh do you have a self-imposed limit on turkeys at your place?

SPEAKER_08 8:39

Yeah, well, my limit is often less than the state limit, so yeah, you go.

SPEAKER_06 8:46

One or two, yeah, it's probably the best I can do. Yeah, what is your favorite item from Daylight Donuts? Um, what is the type of habitat work you just love doing at your farm?

SPEAKER_08 9:03

Um pumpkins, actually. Planting pumpkins. Huh. Yeah, we have two acres of pumpkins. And um you cannot believe what deer will do to a pumpkin. It's like magic the way they make them disappear. Okay. I've heard that. Yeah. Yeah. I have not heard that.

SPEAKER_07 9:22

I've heard Bruce Hudaly used to talk about that in Minnesota. Yeah. It's unbelievable.

SPEAKER_06 9:27

And you can break them, give them away or sell them for Halloween and whatnot. What is a common pace for you on a long morning jog?

SPEAKER_08 9:38

A common pace? Um nine minute miles. Okay.

SPEAKER_06 9:44

Describe the perfect cup of coffee.

SPEAKER_08 9:48

Um you're gonna get me on another soapbox.

SPEAKER_06 9:52

Well, I mean, I know you I know espresso counts, right?

SPEAKER_08 9:56

So um espresso with heavy cream instead of milk, and it's life-changing.

SPEAKER_06 10:04

Okay. Um, and last but not wait, no, no. What is your favorite wild game animal to eat?

SPEAKER_08 10:10

So far, uh, elk. Okay. Yeah, but I hear Axis Deer is uh is always wait there. I haven't ever had it though. I'm looking, yeah.

SPEAKER_06 10:18

And last but not least, have you ever skipped appointments to be on the podcast? Never ever once. Okay, good answer.

SPEAKER_02 10:28

Has he looked away from me?

SPEAKER_08 10:30

Yeah, I won't look you in the eye and say that, but as far as anybody knows, that may be a HIPAA violation to discuss.

SPEAKER_06 10:38

All right, good stuff.

SPEAKER_07 10:39

Well, before we get started with this, thank you, Dudley. But do uh is there don't you have like a little legal thing you need to say?

SPEAKER_08 10:45

Yeah, so yeah, the lawyers have told me just to be sure that I say that the information provided here is for informational purposes only and does not constitute medical advice. Yeah. I've seen that before.

SPEAKER_02 10:57

We should open every podcast up that way.

SPEAKER_07 10:59

Whatever Ned tells us today, I would take it to heart as what I would do if I was in a situation. W even with what Ned said. I think they are just trying to make sure people, you know, if they don't have complete care by Ned, that they might miss a step or something. So but with that said, let me paint a scenario, Ned. Okay. So this time of year, we're always doing all this stuff, we're out working. So let's say Lanny's planting some vetch and and I'm over here doing something, I'm working and trying to help. Maybe I'm probably running a chainsaw or something. But Lanny gets off the tractor to go take a leak. So he he's he's gotta take a leak. He gets off the tractor, he goes over there. Next thing you know, he's been bitten by a rattlesnake. Where? Well, we just let's just let's just hope it's your ankle. So he gets bitten in the and he's bitten on the ankle. And all of a sudden, what should he do at that point?

SPEAKER_08 11:58

The first thing you should do is put a little distance in between you and the snake. Hey, and you you it's it sounds intuitive, but I you you'd be surprised, you know, the the fight or flight response can also come with a freeze, and and that's the worst thing. I you know, and and we've had patients come in with bites on the left hand and the right hand because uh you know they couldn't get out of the way or or froze or or wasn't quite sure what happened. So anyway, number one is put a little distance between you and the snake. That's the first thing you should do. Um, the second thing is um you know, if you have your wits about you after a snake bite, is to um to take off rings, take off a watch, if you have any tight-fitting clothing or jewelry, uh anything like that. And again, this is you know from from a treatment perspective. Um so get tight-fitting jewelry, clothing, get that kind of stuff off, get some distance between you and the snake. Um, and then if you can identify the snake, that's sort of helpful. But what really guides treatment is symptoms and and not necessarily the type of snake, because in you know, in North America or in the US really, what we're dealing with is pit vipers. And the and the anti-venom is you know covers all of them. There are coral snakes are a little different, but um, but but copperheads, water moccasins, uh, and rattlesnakes are the vast majority of of bites in the U.S. uh every year. Um and then um get to somewhere quick. You know, the sooner you get to medical care, the better.

SPEAKER_07 13:52

Um don't take off running. That's probably that and that's why I said I was there. So with Lanny like, hey, holler and get me to come up. I run past you. Come on!

SPEAKER_08 14:06

Don't chase the snake either. Yeah, uh, you know, uh don't don't be so worried about identifying the snake that you're chasing it through the woods and trip on a vine and and fall on the snake and end up, you know, instead of with a bite on the ankle, a bite on the neck, bit all over the place. Yeah. Um yeah, so and that happens. So yeah, don't chase after the snake. I a little bit of identification is fine. Um, you know, when you show up at the hospital, there's really two questions that that are somewhat helpful uh with snake bites. Um and and one is did it have a triangular-shaped head? So if uh that's that's helpful to know. Um and then the other is is was it colorful? And and so if you can answer those two questions, that tells us a lot about uh you know what we need to do when you get to the hospital. Um we do have people show up in the clinic in the ER with bites from rat snakes or garter snakes or black racers or you know, snakes that are that are not venomous, and um you know, you do not want the anti-venom if you don't have to get it. Um neither does your bank account.

SPEAKER_07 15:18

No, no, no.

SPEAKER_08 15:19

And you don't want us to bring the snake if we do not bring the snake to the ER. Even if you were at a church service and you're handling snakes and it's fine, you know, it's you don't you don't have any problem holding a snake. Uh, you know, we don't want to uh turn one patient into five with with uh a snake in the ER, um, which does happen. Um so yeah, and and even with even if you chop off the head or or whatever you do, just we don't need you to bring it to the ER. If you can tell us if it had a triangular safety head and if it was colorful, um we can pretty well go from there.

SPEAKER_06 15:55

What about that kit that snake bite kit that's been in the box for the drawer for the last 40 years?

SPEAKER_02 16:02

Yeah, leave that in the drawer suction thing. Yeah, the tourniquet had the tourniquet on it too.

SPEAKER_08 16:06

Yeah, leave that in the drawer. Um that uh don't don't use that kit. Don't cut the wound and try to suck out venom. That's that doesn't work. I the bacteria in your mouth are way worse than the bacteria in a snake's mouth. Wow. And and so if if you you know put the bacteria from your mouth in a snake bite, you could complicate things. You're not gonna get any of the venom out if you're trying to suck it out. Um the uh I had this I had this professor or this attending in med school who used to work in West Texas and he was he was an ER doctor and he was the snake bite guy. And he did a lot of lectures on snake bites, and um there's there's uh articles out there um about uh electrotherapy and cryotherapy for snake bites. There is no data that says that shocking someone is gonna help with a snake bite. And he actually got the question on multiple occasions about um whether or not your buddy should shoot you with a taser after you get a snake bite. So we don't recommend that, but I did get it. I'm gonna carry around a taser in my turkey vest just in case we're ever with somebody and we see a snake bite. I'm gonna try that out. Yeah, I've always wanted to see if that works.

SPEAKER_02 17:27

I think I remember sucking the venom out.

SPEAKER_06 17:30

Yeah, I remember seeing an article about that in an old hunting magazine about you know, hooking a car battery up and stocking.

SPEAKER_08 17:36

It shows up. It's it's out there. That that information is out there.

SPEAKER_02 17:39

So what I mean is it just neutralizing the venom?

SPEAKER_08 17:42

The rationale that I've read, it's been a while since I've read it, but the rationale was that it quote unquote denatures the proteins in snake venom. Um, but I have not, I'm not aware of any evidence that that's actually true.

SPEAKER_02 18:00

Interesting. Never heard that one.

SPEAKER_08 18:01

Yeah. If you get snake bit, you don't want to get shocked.

SPEAKER_02 18:04

Right afterwards. Yeah. Piling on, man.

SPEAKER_07 18:08

Well, and is there anything to holding uh like if to holding the bite above your heart, like propping up the if you bit on the ankle, laying down, holding up the yeah, it's a good question.

SPEAKER_08 18:19

Um, so uh yes and no, you you want to get it at about the level of the heart, um, not necessarily above or below. Um just you you just want to sort of neutralize blood flow. You don't want to stop blood flow. Tourniquets are a no-no uh for uh pit viper venom. So the uh snakes in the US, um again, uh except for the coral snake or pit vipers and and their venom is um is mostly hemotoxic and cytotoxic, which means that it breaks down blood cells and it breaks down tissue cells. And when that happens, you get this this severe swelling almost, you know, immediately, although it can occur our uh up to hours later. Um but uh but yeah, if you use a tourniquet and you sequester that venom into a small area, the damage from the bite is typically worse in that area. And if you allow the venom to sort of dissipate, um you you don't uh the severity is is a little bit uh less. Yeah.

SPEAKER_06 19:25

So what about driving? I mean, does it impair you to where, you know, does it make you feel drunk or something to where you shouldn't drive? Should you call an ambulance, or if if you are by yourself, do you and you have phone reception, do you drive to the hospital or yeah, um the um coral snake has a neurotoxic venom.

SPEAKER_08 19:45

The pit vipers is the cytotoxic and hematoxic venom. And so you can drive yourself uh if if it's a pit viper. Um and and really you just want to get to the hospital as quickly as possible. So if that's via EMS, great. If that's in your own car, great. Um, but uh not likely you're gonna uh pass out while you're you know driving.

SPEAKER_07 20:10

Okay. So like some of the places landing on we're an hour away from you know, any kind of medical attention. So would that be a the a major problem or would we be within some kind of window of yeah, we could that'd be okay?

SPEAKER_08 20:24

Yeah, time matters um when it comes to snake bites. And so the further you are away, I mean, the the worse the the injury can be, and the quicker you get to the anti-venom, the better you do. Um so just as a little background, um there's about seven to eight thousand snake bites per year in the US, and and out of those seven or eight thousand, about five people die. Um for comparison, um about fifty people die from dog attacks every year. So you're probably gonna make it. You're probably gonna make it. Yeah, you're probably gonna make it. But time does matter. Um and so yeah, the further out you are, um, the worse off it's gonna be. Um and um uh well I hope that yeah, to answer your question, yeah. Is the time matters.

SPEAKER_02 21:13

Is the anti-venom how is it applied? Is it injected or okay into the side of the area? No, it's a IV.

SPEAKER_08 21:19

Ah yeah, it goes in into the um systemic bloodstream. So um uh and the the dose of well, the way the venom works is that it's an it's an antibody that binds to venom in your bloodstream and it neutralizes the venom by by binding to it and allowing your own immune system to sort of scavenge the antibody antigen complexes and get rid of them. Um and so the the dose of anti venom is dependent sort of on the dose of venom that you're given by the snake. And so, like a 250 pound man is gonna get the same dose. As a 50-pound child because we're treating the venom and not the person, right? Um so yeah, it's given via IV. Um you know, on that note, when you show up to the hospital, what to expect is you know, you're gonna get this sort of initial assessment where they're gonna look at you and there's gonna be uh a few things that trigger the anti-venom just immediately. Uh and not everybody gets the anti-venom, um it's dependent upon your symptoms and how severe they are. Um but if you get it, if you have a bite on the face or the neck or anywhere near your airway, you're gonna get the anti-venom immediately. Um if there's um if if it's evident that the swelling is sort of progressing up an extremity and getting closer to the center of the body, you're gonna get the venom immediately. If your blood pressure's low, if you're getting a little lethargic or or tired, you're gonna get the anti-venom immediately. Um and and with those neurotoxic snakes like the coral snake, it's very rare. Out of those 8,000 snake bites a year, about 50 to 75 of them are corals. The rest of them are all pit pipers. Has anybody at the table ever seen a coral snake in the wild?

SPEAKER_06 23:18

Um not that I remember. I've seen one. I think I've seen a scarlet king snake.

SPEAKER_02 23:22

Yeah, that kind of yeah, yeah. And I think they have to like chew on you, do they don't they don't really strike?

SPEAKER_08 23:28

Yeah, they don't, yeah. They their teeth aren't, they don't have those hollow teeth where they you get a big bolus of venom on a single bite. They do have to sort of hang on.

SPEAKER_06 23:36

It's almost like you're on you a minute.

SPEAKER_07 23:37

Yeah, it's almost like you have to be asleep or unconscious to get is there any truth to I've heard that you can only get the antivenom once in your life. Is there any truth to that? No. Not that I'm aware of.

SPEAKER_08 23:50

Is the anti-venom made from real venom? Um, yeah. So the anti the anti-venom in the US is uh the one we use around here is crowfab. And um you uh it you take small amounts of venom and inject them into mammals, typically horses, horse or sheep, and then you extract what the horse's antibodies to the venom, and that's what's that's how you make the anti-venom. Whoa. Which which means that sorry, horse. Yeah. But that also means um that nowadays um that would mess up my alpha gal. Yeah. Yeah, we see a lot of uh anaphylactic reactions from alpha gal um these days. So getting the anti-venom is not without some risk. So it needs to be uh um you know worthwhile to give it. So is it basically horseblood? Purified a little bit. Yeah.

SPEAKER_06 24:46

Purified horseblood.

SPEAKER_02 24:48

They run it through a sea of something like that.

SPEAKER_07 24:51

Do most hospitals have this already or or do they have to get it sent in? Most do.

SPEAKER_08 24:56

It's got a very long shelf life. I mean, the shelf life is years, and a lot of times it's stored in a powder and then reconstituted uh with some sterile fluid in the hospital. But but yeah, most most hospitals do, uh, especially in in areas where snake bites might occur. Yeah.

SPEAKER_07 25:13

Would you recommend a guy if if we we were traveling, if if if Landy got bit and I've somehow got him in the back of the truck and I'm taking him to the hospital. You wouldn't let him right up front. Probably not. I don't want to.

SPEAKER_02 25:24

And you'd probably stop for everyone. Let me check see if the turkey's gobbling right here first on the way out.

SPEAKER_07 25:28

But would it would it make sense to call the hospital and say, hey, I'm coming in with this is what I got?

SPEAKER_08 25:33

Yeah. Yeah, if you can um, yeah, that's or call 911, even let them know. Um, and get everybody on the ready. Yeah.

SPEAKER_07 25:43

I'm just preparing, Landon. This is gonna happen one day. I just want to know what I need to do.

SPEAKER_02 25:48

Yeah. Well, the last snake you and I ran into, it didn't bite me, but it completely ruined my hearing because you shot at it so many times with this short nubs pistol that my ears are still ringing. I think that was oh 15 years ago.

SPEAKER_07 26:02

So Nick one time it near Aberdeen, Mississippi, late one afternoon, I'd been told that there was a I'm I've seen a turkey up there late in the afternoon. And I so I I got off work and I drove up and I was gonna listen. And while I'm standing there deciding to listen, I leaned my gun against a tree and there I had a wood duck box. The water was down, it was low. And I said, I wonder if there's a wood duck's nesting in there. And I started walking over to the box, and I got I had a blackberry at the time, and I was gonna stick it in the box and take a picture. And when I got to the bottom of the box, I looked down and I had stepped on a coiled up water box. And when I looked down, his head splayed wide open, and it's just white. And as I'm looking at him, he strikes. And I jumped back and scared me to death. And my heart started going so fast, I've never experienced something like that. And then I thought, let me get my gun. Went and got my gun, and then I couldn't find the snake. And I then I got scared. I was I just said, I gotta get out of here. But for the next 20 or 30 minutes, I was a mental wreck. Yeah. And my heart just it I've never experienced my heart racing like that.

SPEAKER_01 27:19

Yeah.

SPEAKER_07 27:19

So I can only imagine if and I I didn't get I didn't get enveninated, veminated, or what would you say that like bit. I didn't get bit, yeah. But I'm just telling you, I just can't imagine You almost had a heart attack.

SPEAKER_02 27:36

Yeah, I really did. I wonder if there's any have you ever heard of that? I'm sure. I don't know. Having a heart attack after a snake bite? Yeah, or I did even bite you, you just thought you got bit.

SPEAKER_08 27:45

Yeah, I no, absolutely. People, you know, and people show up in the ER, like I said, with uh garter snakes and rat snakes, and um, and they're uh the anxiety is is um you know almost as dangerous. But um but yeah, staying calm is a whole lot easier said than done. Yeah, but yes, it helps to to stay calm and and try to remain level-headed. But but we can talk about the fight or flight response sometime too, and and and why your brain just shuts down um and and your sort of primitive brain takes over uh when you're in a situation like that. Yeah.

SPEAKER_02 31:30

I think my primitive brain takes over a lot. Yeah, it's full time.

SPEAKER_07 31:36

So I I've recently heard about a guy that got struck by a rattlesnake and its fangs hung in the den his denim pants. And so when he jumped back, the snake the snake stayed attached to it. Oh goodness. I cannot um does that happen often?

SPEAKER_08 31:51

Have you I've never seen that? No, I uh I haven't heard about that either. Uh but I'm of course it could happen, yeah. Um you know, you're um I don't I I don't know that you're gonna get any additional venom uh in you if that happens. Um but you could. And um same treatment though. Yeah, you're we're gonna watch you, you're gonna get those about 10 vials, five to ten vials at five to ten thousand dollars, depending on you.

SPEAKER_02 32:23

Have y'all seen the have y'all seen the I've saw it on Instagram or something? It's the guy on the golf course and they tie the snake. Yeah, yeah, those are that guy's having a heart attack. The old time. Yeah, that's good stuff. So if you know, do you go to the hospital if it scratches you?

SPEAKER_08 32:40

Yeah, absolutely. Okay, yeah, um, or yeah, or get headed that way. Um, sometimes typically symptoms will appear within about 30 minutes or you know, 20, 30 minutes, you'll have some swelling and it'll start sort of progressing. Um, but about 20 some odd percent of bites are dry bites. Uh and um, and and so there's a about a one out of five chance that even if you do get bit by a venomous snake, you're you know, nothing's gonna happen. But um here again, time matters. So you get headed towards the hospital and and we'll if you're lucky enough to get a dry bite, we'll uh we'll we'll just keep an eye on you then. But uh, but yeah, I'd get headed that way.

SPEAKER_02 33:22

And and um with there's uh it may be an old wives tale that you know that the younger snakes would put more venom into you than that shows up in the literature too.

SPEAKER_08 33:31

Um I have read that. I I don't know, um, haven't really studied that a whole lot, but I that I have read that.

SPEAKER_07 33:38

The thought is they can't control their venom like an older snake could. Yeah. Yeah. So would you know immediately if you like if you didn't even see the snake bite you, would you like feel it and like would it be a real sharp pain?

SPEAKER_08 33:50

Not always, yeah. The pain is not immediate. Uh with pit vipers, it takes it a little bit too, and it is magnificent, I'm told, when it does show up. I've had uh one guy uh describe it as um someone taking a soldering iron or uh and and just sort of driving it into your skin. It's it's a boring, sort of uh really intense pain, um, I'm told. But uh but maybe not. You might not know it uh initially, especially if you're you know in the adrenaline in the garden or something, you know, and you're not not out in the woods somewhere. And honestly, the mo I think around here the the most common cases that we see are gonna be like groundskeepers or gardeners that are don't see a copperhead in the mulch and they get a bite on the hand or something.

SPEAKER_02 34:39

You know, I would think the copperhead would be the most would be the one that's most people are bitten by. It is around here. Yeah, because I mean the the cotton mouth displays he's very aggressive, you know, but he displays the rattler, obviously. You get a little warning. Bobby, wait, have you got your there it is. Yeah, you get a little warning. Yeah, but a copperhead will lay there. Yeah, they they sure will. And then and then when you get close to them, they get you. Yep. Well I've looked down and seen them next to me several times, just sitting there. Yeah, they just sit there.

SPEAKER_06 35:09

They don't other ones seem to want to move. It makes you wonder how many times you've just, you know, like sitting there in the turkey woods or just doing whatever and and not even realizing there's one next to you.

SPEAKER_07 35:21

That's where I think I'm gonna get bit, is because sitting down in the dark or laying a cob beside me and then later reaching for it or something, or that's where I was.

SPEAKER_08 35:31

My one my one encounter with a rattlesnake was I'll I'll tell you about it, was in um was it in South Texas? I think it's around San Angelo, I believe. But anyway, uh we were hunting this um creek bottom with a little clearing next to a creek bottom, and um there were a few of us hunting um this area, so we had these ground blinds that we uh sort of put side by side where you could go in and out between two different ground blinds, and we staked them down. But um, of course, with the doors facing each other, you can really get out. So the whole time I was sitting there, I was constantly looking at the ground, waiting on a snake to just kind of slither in one of these things. And so uh we got done with this one afternoon hunt, and um I uh to get out of the blind had to crawl out from under it. And um, right about the time my head popped out the other side of the ground blind, I heard that, you know, and I if uh a rattlesnake will before they rattle, they buzz. And and that buzz, it's it's bored into my brain from from that experience. And I lost about two or three seconds of time. I don't remember what happened after that, but the ground blind went everywhere. And I was running around and the snake, it was uh had had had crawled up on a um a little rock right beside the ground blind, and I guess was was getting some heat uh from the rock, but didn't strike. But it was probably yay close to so less than a foot, you know. Yeah. Less than a foot from the neck, from the face and the neck. And those ranches in Texas, I think that ranch, you when you go in the gate, it's another 45-minute drive to the other gate. Yeah, where it to wherever it is you're staying. So we were hours from uh from medical care down there. Um and snake bites on the face or neck, um, get somewhere quick if that happens.

SPEAKER_02 37:32

You remember the lonesome dove scene when they're crossing the river? I don't know. You don't remember that? Richie, do you remember that? How do you know a swarm?

SPEAKER_04 37:41

Yeah, a swarm of water moccasins.

SPEAKER_02 37:43

Yeah, and he's just is it Ricky Schroeder? Uh I'm not sure who it's what.

SPEAKER_04 37:47

No, it's just one, it's one of the young kids. The young Irish kids at uh brothers that dies.

SPEAKER_02 37:52

Yeah, comes out of the water and a water moccasin bites him on the side of the face. Have you not ever seen this? I don't know.

SPEAKER_07 37:59

I don't know that I've ever seen Lonesome Die. I have, you know, I do remember parts of it, but I don't know where every time I watch it.

SPEAKER_02 38:06

That's what I think about.

SPEAKER_07 38:08

So Ned, what else about snakes? Because I got another subject I want to hit you with before we go.

SPEAKER_08 38:13

Uh that's that's really it. I mean, um, you know, I I I wanted to sort of tell people what what to expect when you get to the hospital, you know, they're gonna do that that sort of initial assessment and then um some venoms have have a rebound effect where after you get the venom, you can have a rebound uh or some rebound symptoms um a few hours later. So uh if you do actually get bit by a venomous snake and it's not a dry bite and you do get the anti-venom, um you need to plan on staying in the hospital for a day or so. Um because they're gonna We're gonna check labs on you uh about every hour after you get the anti-venom initially. Um and if the and and you're gonna keep getting anti-venom until there's a demonstrable improvement in symptoms. So if that that swelling stops spreading, um, or if other symptoms start to subside, like we'll do some blood tests to check for um the the hemotoxic effects of of venom, and um, and we'll do that every hour while you're in the hospital and and um and you'll get anti-venom until those symptoms subside. And then after uh symptoms subside or start to improve, um, and we can send you home, um you need to be able to go see your primary care doctor uh at 24 hours, 72 hours, and then a week after you're out because you can get rebounds in this venom uh symptoms during those time frames too. So it's it's not a it's it's not an overnight stay. It's a it's a it's a week-long sort of endeavor um when you get bit by a snake. So yeah, just just plan on being there for a minute. Yeah, plan on being there for a minute. Yeah, if you get bit.

SPEAKER_07 40:01

Yeah, I guess what I'm taking away from it is uh I mean it people have a healthy fear of snakes, and and that some have it more than others. But at the end of the day, if you can if you are bit, if you can get to the hospital as quick as you can, chances are you can't. You're gonna do pretty good. Yeah, I got one more tooth.

SPEAKER_06 40:19

I mean, I'm just thinking about the odds. I mean, the odds are pretty low.

SPEAKER_02 40:23

Oh man, I have we've been in the woods. You oh yeah.

SPEAKER_06 40:26

You think about people that you know, just say you take people that go into the woods at least once a week and and really get into the woods.

SPEAKER_02 40:34

Um how many been bit? Yeah, what are the odds still? But you had a cousin that got bit in the head by a copperhead. Yeah. I mean, we podcasted with them.

SPEAKER_06 40:42

But I used to, but I used to work for a beaver control specialist walking up and down beaver dams and stuff all summer long. And yeah, the most common scenario. We used to be a good one. But I wore shoes, yeah.

SPEAKER_08 40:54

Yeah, it's gardeners. It's gardeners and and groundskeepers at, you know, and and and that's the most common scenario. Going going turkey hunting is you know, and you get, I mean, uh where you I mean, we talk about them smelling.

SPEAKER_02 41:07

I know the guy at Stage's like, they don't smell. I mean, the water moxins do you get in certain areas where you know if you're crossing to beaver dam, you gotta look. You better stop and look. Yeah, yeah, yeah. Prevention is worth, yeah. I swear the patterns too, I know they blend in, but you they become more recognizable over time. But yeah, look before you leave. I got one more question, too. So if you get bit and you know it's by a water snake and water water water moxin, you just put some neospore on it and see what happens. No, I wouldn't know. Go on ahead and head to the ER. Okay, okay. Well, I didn't go. I probably I should have. Maybe that's what's wrong with it. Did you get bit? Oh, yeah. No kidding. Yeah, I've been bit by a water snake. Um did it swell up? Was it a dry bite? Uh it just it was like a razor cut. Yeah. Yeah, it was like it didn't, it would just it just cut me like a razor.

SPEAKER_06 43:51

Um, I've never known, you know, which ones actually have fangs versus you know, those small teeth. You know, a lot of people handle snakes. I I never do. I've kind of been interested in, you know, like can you pick up a rat snake? And you know what I'm saying? Like a rat snake. Sometimes lizard, you know, when a lizard bites you, it doesn't hurt that bad. And I think some snakes have mouth parts like that.

SPEAKER_08 44:14

Yeah, the non-venomous ones do. They don't they don't have those those articulating fangs that you know come out and hit you. Yeah. Yeah, and that sounds like a dry bite, Lenny. I mean it if you but um I I have had a lot of patients, um or not a lot, but uh some who who sort of did the wait and see, you know, what would what would happen.

SPEAKER_07 44:34

Well he was saying he knew it was a water snake, not a water moccasin. Okay.

SPEAKER_02 44:38

Yeah, isn't that what you're saying?

SPEAKER_07 44:39

Yeah, I knew it was like you knew it was not.

SPEAKER_02 44:42

I should have caught it abandoned water snake instead of a water snake. Yeah, so I knew what it was. I knew it wasn't a moccasin.

SPEAKER_08 44:47

Yeah, okay. Well, yeah, I mean if you're yeah, if you know it's not venomous, then yeah, all you gotta worry about at that point is is maybe infection. Um, and and in that case, just keep an eye on it. Yeah.

SPEAKER_02 44:57

I cleaned it up and wrapped it up. Yeah.

SPEAKER_06 44:59

And you know, snake ID, uh, it's one of the more difficult ones for me. But uh, you know, I don't get on Facebook a whole lot, but I when I do, it's frequently on Facebook groups where I'm, you know, I'm trying to learn things. There's some Snake ID Facebook groups that are fabulous. And and if you if you check those out and look at the photos, uh it's you'll learn your snakes pretty quickly. Um and one of the big biggest ones for us is knowing the difference between a water snake, like Lanny mentioned, yeah, and the the cotton mouth, aka water moccasin.

SPEAKER_02 45:39

And that water snake, too, when he's threatened, he will flatten out and his head looks triangular. Right. So often I've been I guess a water snake, then he gets mad.

SPEAKER_01 45:47

I'm like, oh my god, it's a moccasin.

SPEAKER_02 45:49

And after the fact is like, nah, it's a water snake, but we ain't got to worry about him anymore, no matter what. Right. He ain't around no more. Yeah, right.

SPEAKER_08 45:56

Yeah, no, that's they can there can be some some uh uh mis identifications. And but here again, when you get from my perspective, when you get to the hospital, um we're gonna go through our steps, you know, almost no matter period. Yeah, no matter what the snake was, yeah.

SPEAKER_03 46:13

And a rat snake sometimes they'll like shake their tails trying to act like a rattlesnake.

SPEAKER_02 46:16

A lot of young snakes will shake them, yeah. And if it's in the leaves, you're like, ugh. Yeah. Yeah.

SPEAKER_03 46:21

I might miss this, but did you talk about like what that venom actually does to you internally?

SPEAKER_08 46:26

Yeah, briefly, I'm so there's um basically three major types of venom. Um so cytotoxic, hematoxic, and neurotoxic. Uh, there's some subcategories within those uh cytotoxic um venoms, but um like with a neurotoxic venom, it interrupts the in the transmission of information from a nerve to a muscle. Um and so it's almost like a short circuit um in a wire that that muscle can become overactive or spasm or it can become underacted and and and be sort of um I don't want to say paralyzed, but but sort of flaccid. But um cytotoxic venoms and and hematoxic venoms, uh they just they break down cells is what they do. And and so they break down skin cells or muscle cells or they break down blood cells. Um when you break down cells in the blood, you can trigger um uh clotting cascades, and and and in some cases they can make you clot more, and in some cases they can make you clot less, and you just you can bleed everywhere. Depending on the snake, I mean some of the real bad ones are the you know, like the ones in Australia and like a black mama and that kind of thing, which we're not gonna do. Yeah. Um two-step. Yeah, yeah. But around here in the US, it's cytotoxic and hemotoxic, pit vipers. I mean, that's it's that that's what we got. And and um, yeah, they're just gonna break down cells. Their venom is gonna break down cells and cause severe swelling and and um and pain and and break down of blood products. Yeah.

SPEAKER_07 48:11

So while we're here, I wanted to ask. I mean, it's probably just as much of a danger, but doing some of the activities that we do, we're liable to roll up on a bumblebee nest or some yellow jackets. Yeah, and get stung really by bumblebee. So what uh what does a guy need to be watchful? If you get bit four or five times, I mean what do you need to be uh w watching for?

SPEAKER_08 48:41

Um well i uh you're probably asking about anaphylaxis with the with hornets and and insects and that sort of thing. And um for the most part, those things are painful and they swell and and you do just fine. But um they can be very dangerous if you uh have an allergy to them or if you're um hypersensitive. to to those venoms too. But um start heading towards medical care if you think they're if you have any doubt about whether or not you're allergic, um, you need to start heading towards medical care. Um in those cases you can get a Benadryl uh um on board or or a pepsid like we talked about earlier that can help with allergies too. If you know you have an allergy and you're gonna be outside just have an epi pen nearby and and don't be afraid to use it.

SPEAKER_07 49:37

Well I guess I was also I mean you might know if you're allergic ahead of time but is there like a threshold if you're if you run up on some ground hornets and all of a sudden you've got seven or more bites on you is there like a okay even if you don't know you're allergic that's too many bites for a is there like a limit or a not that I'm aware of um the the signs or symptoms that should uh be alarming to you um are um when you have two different organ systems involved in a reaction to a bite or a sting.

SPEAKER_08 50:11

So if you have like nausea and trouble breathing so your your GI tract and your lungs are acting up that's a problem. And so that's the beginning of of anaphylaxis is when you get multiple organ systems involved.

SPEAKER_02 50:23

Never heard that that's good advice.

SPEAKER_08 50:25

Yeah and so yeah and nausea actually nausea and vomiting is one of the uh most often overlooked signs of an allergic reaction you know everybody thinks that it's wheezing or coughing or rash or swelling but but nausea and vomiting is a that's a sign of an allergy too. So if you have like I say multiple organ systems getting involved in a reaction to a bite you need to get somewhere.

SPEAKER_06 50:50

And like you said it it probably wouldn't hurt to just keep some Benadryl or Pepsi or both in you in your vehicle or in your backpack or whatever.

SPEAKER_07 50:59

Yeah. Well we want our guys to be safe and I mean and enjoy the activities and and and be productive when they're outdoors and not worry about well I can't do this because I'm worried about a snake. It's just it's just ways to be a little more proactive and a little bit later on we're gonna talk about snake boots and snake chaps and those kind of things a guy there's a lot of comfortable snake boots that are being made now and that's a that's a way to have some peace of mind for sure yeah and an ounce of prevention is worth a pound of cure.

SPEAKER_06 51:26

I mean like from a hunting standpoint um if you know you're protected then you're probably gonna spend more time not looking at the ground and so you can hunt a little more easily.

SPEAKER_07 51:38

Yeah peace of mind matters yeah sure yeah yeah and I'm thinking as much about just working on a place as I am hunting on a place because you get busy you know trying to hack and squirt privet or something like that.

SPEAKER_08 51:51

Yeah that yeah you know that's when it happens yeah yeah well Ned this has been really interesting you've got uh boy you've got a lot of knowledge we appreciate you sharing it with us well thank you glad to be here yeah always appreciate the invite well uh kind of circling back to something a little more fun how has your turkey season been yeah it's been good we've had some um had some just great hunts um killed two turkeys I have not missed a turkey this year ah good for you yeah which I did it's uh I think I missed one uh last year the year before with Toxy but um but uh but yeah it's been a good year that's good is it hard as a doctor here to to slip away in the mornings uh yeah it is um it's it's always hard to slip away um I we're we're fortunate um we have a spot pretty close to the hospital um that I can make it to every now and again um pretty quick I have killed a turkey in scrubs before that has happened I think I've got I think Mandy may have a picture of it but yeah are you being real careful about chicks yeah yeah it's um and they are becoming a problem um you know the the anti-venom for snakes has alpha gal in it um it has an alpha gal moiety in it so if you you can have if you you're sensitized to alpha gal you can have a reaction to snake anti-venom to crowfab uh which is another reason you really need to need to be monitored sort of in the hospital if you are if you do get the anti-venom and so yeah um and it we see a ton of alpha gal now um we don't see as much Rocky Mountain spotted fever um Lyme disease is pretty rare um uh in especially in Mississippi um we don't have a lot of deer ticks around here uh but we got a lot of lone star ticks and um can you describe some of the symptoms somebody might have with alpha gal that yeah you won't have symptoms until you have a reaction and and so alpha gal sensitization it'll it causes you to react to mammalian products and so um and alpha gal uh from a medical perspective is extremely hard to diagnose because sometimes the symptoms don't happen until 12 to 18 hours after you eat a ribeye steak or um or or eat some cheese or drink a glass of milk the the reaction is is delayed and so um a lot of times it it gets um it gets missed um anaphylaxis is pretty easy to recognize and and all ers and hospitals are really good at at taking care of that but as far as the uh precipitating factor being alpha gal that that gets missed a lot well we're hearing about it more and more yeah and I'm sure people listen I mean we every time we mention it somebody emails in and has some suggestion or or or saying that they're experiencing it also so yeah I thought I was uh getting better and then I was um out with my wife we're we're building a chicken coop in the backyard and let my guard down I didn't tuck my pants in my pants were actually treated yeah uh and one got up my leg and bit me before it died and um I started eating the little pea size piece of meat and whatnot and my symptoms are coming back.

SPEAKER_06 55:31

No kidding. So I gotta start all over again it seems.

SPEAKER_08 55:35

Yeah good news about Alpha Gal is it can go you can get over it. It can go away um and um um there's um some avoidance measures you can use and there's some alternative um medicine type um treatments that that some people are utilizing with some success that I'm not I don't fully understand but um but there's uh there are some things you can do.

SPEAKER_07 56:01

Well Dr. Ned Miller wow we are so lucky to have you right here in West Point being able to watch out for us and take care of everybody and Richard. Have you got another question? No we're good. I think y'all hit everything. Yeah I th Ned I think it's been super helpful. We hope everybody listening doesn't have to take any of your advice but yeah absolutely there it is if they if they get in a scenario maybe we'll help somebody all right yeah well Dudley you got anything else?

SPEAKER_06 56:26

No that was very very informative. Thank you Dr.

SPEAKER_07 56:30

Ned thank y'all yeah we'll let you get back to saving lives and doing whatever you do.

SPEAKER_00 56:34

So why don't you say goodbye goodbye Dudley get us out of here Richie thanks for tuning in to this week's episode of the Game Keeper Podcast and be sure to tune in again subscribe to GameKeeper Farming for Wildlife magazine and don't miss the Mafio Properties Fistful of Dirt podcast with my good buddy Ronnie Custer