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Bare feet and a snake – what’s next? - (5/29/2018)

By Dr. Ron Gasbarro 

Tony came into the pharmacy to pick up an antibiotic for his wife. The pharmacist asked what happened to Lynn that she needed an antibiotic. “She was on the ground gardening when suddenly she saw a garter snake slither out of her daylilies and she took off. The problem was not the snake, but the rusty rake she stepped on in her bare feet. She got a puncture wound which may have gotten infected.”  

The fear of snakes – medically known as ophidiophobia (ophid-io-pho-bia) – is a common fear among people worldwide. While about half the world’s population become anxious just thinking about snakes, approximately 3% have full-blown snake phobia. The fear of snakes can be tricky to diagnose, as symptoms can vary widely among people. If you have mild ophidiophobia, you may fear only encounters with large or venomous snakes. If your phobia is more severe, you may be afraid of smaller snakes as well – even from seeing a harmless garter snake. You may be unable to look at photographs or videos in which snakes appear. Your symptoms may include, but are not limited to, shaking, crying, or running away from snakes. You may experience heart palpitations, difficulty breathing, or a fatal heart attack.  

Not all snakes are dangerous and it depends where you live. In the US, four species of poisonous snakes exist: rattlesnakes, copperheads, cottonmouths (water moccasins), and coral snakes. Among these venomous reptiles, rattlesnakes are the most common. There are multiple species of rattlesnakes throughout the country. The largest is the eastern diamondback rattlesnake, which can get up to 8 feet (2.4 meters) in length. Due to modern antivenin treatments, human death by snakebite is not common. For example, in the US, venomous snakes bite approximately 7,500 people each year. Of those, five will die, according to the Centers for Disease Control and Prevention. The number of deaths would be much higher if people did not seek medical care. The death toll in Africa and Asia is much higher.

Let’s say you did get bitten by a snake. Do not panic but slowly move away. Remember, most species of snake are harmless and their bites are not life-threatening. Identify the snake. If you are familiar with the types of snakes in your area, then you will be better equipped to name the snake. Non-venomous snakes have a spoon-shaped rounded head; venomous snakes have a triangular head. Look for a rattler where rattlesnakes thrive. Always treat any viper as venomous if you are uncertain of its type and get immediate and professional medical health. Apply first aid if you cannot get to the hospital right away. Lay or sit down with the bite below the level of the heart. Wash the bite with soap and water. Cover the bite with a clean, dry dressing. Note that killing non-venomous snakes, like garter snakes, allow unwanted venomous snake and vermin populations to grow.

The most common treatments for snake phobia are based on cognitive-behavioral therapy techniques, which improve mental health. For instance, you may be encouraged to talk about your fear and taught new messages to replace your fearful self-talk. You may also be slowly exposed to snakes, beginning with photographs, and gradually building up to a live encounter with a small snake in a controlled environment. Hypnosis can be used to assist in relaxation.

The next time Lynn saw the pharmacist, she said she was embarrassed. “I knew it was a harmless garter snake. But it took me by surprise. I’m glad I did not kill it. I only wish I hadn’t stepped on Tony's rake and injured my foot!”

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com                  


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