ABSTRACT
In summary, we are presented with a patient who ingested mussel that are suspected to contain toxins that cause paralytic shellfish poisoning or PSP. Upon reaching the stomach, the digestive process accelerates the release of PSP toxins. The toxins are rapidly absorbed in the stomachs acidic medium and starts to work on the cellular Na channels, blocking the movement of Naions thus preventing the progression of the action potential with the absence of the action potential, there is a continued state of depolarization. This explains the feeling of numbness of the lips and fingertips, as seen in our patient, since these are the areas where nerve endings abound, and thus, are the areas most sensitive to these chemical changes. Our patient experienced this whole gamut of neurologic manifestations. He also started experiencing gastrointestinal symptoms such as epigastric pain and vomiting which are initially erroneously diagnosed as a separate problem Hearing hearsay reports on coconut milk being used as antidote for cases like these, the patient tried it too. The coconut milk, being an alkaline substance, must have stabilized some of the toxins, thus explaining the mild relief experienced by the patient prior to hospitalization. Upon reaching the hospitals, NGT was inserted and NaHCO3 lavage was done which further stabilized the toxins that were not yet absorbed, while those that were absorbed were excreted through the kidneys with the help of mannitol. After all these measures, the patient experienced considerable relief of the neurologic symptoms, though still with the intermitent epigastric pain erroneously diagnosed as Acid Peptic Disease and treated with antacids. Improvement of the neurologic complaints eventually lead to the discharge of the patient Our patient is just one of the lucky ones who benefited from immediate medical intervention to save his life. Many others arent so lucky - - - most of them never even know what hit them and thus could only look heavenwards hoping for divine intervention. Others are left to languish in understaffed overcrowded hospitals in far-flung places. Worse, a lot of those who have died of PSP never even get to a hospital Grim scenarios such as these are bound to occur yearly as long as pollution, deforestation, ignorance, and poverty prevail. We physician may not be able to curb these ills of society but we can certainly help, first and foremost by initiating the more crucial preventive measures, then by administering immediate and knowledgeable modes of treatment, and finally, by never losing the family physicians most important therapeutic tool: genuine concern for the patient. Hopefully, in doing so, we family physicians can join the family of man down to the sunset of our lives, enjoying Manila Bay for its red beautiful scape, and not for its red deadly tide.