August 24, 2016

“This Won’t Hurt a Bit” – A New Column from Blue Ridge Regional Hospital ED Director Gabriel Cade

Blog-CadeBy Gabriel Cade, MD

Blue Ridge Regional Hospital

Hey, my name is Gabriel. I’m the Medical Director of the Blue Ridge Regional Hospital Emergency Department. The article below is one of a series of articles for the Mitchell News-Journal where I’ll talk about a variety of health and medicine topics. 

I was raised to value hard work, but also to appreciate the time to float on the river and be outdoors, just being quiet. I value kindness and honesty. I’m thankful I get to be here in western North Carolina with my wife and two boys, contributing to the community where I grew up and that taught me these values. 

I hope you enjoy the information I’ll be sharing with you in this series. And hopefully this won’t hurt a bit.


We’ve still got a few more weeks to enjoy the summer. It’s beautiful out there. Give the information below a read and then get outside! Step away from your computers, cell phones and tablets.

Go to the river. Go on a hike. It will feel good. It’s good for you. Take appropriate water and food. A light jacket. Wrap some duct tape around your water bottle or hiking poles. I always carry a knife or multi-tool, a headlamp, some way to start a fire and my phone. I also take along my beautiful, but snails-paced children, who are good for bartering, warmth and noise. But don’t worry. I bet nothing will happen. Just, you know, be careful.

Be careful of bees. If you’re stung by something and develop swelling in your lips or tongue, or you have trouble breathing, you should seek immediate medical attention. You could be experiencing anaphylaxis, a serious allergic reaction. If you didn’t already know that word then you might be in trouble, because it means you probably don’t have an epi-pen. Epinephrine is the treatment for anaphylaxis. We have it at the hospital. Get going.

Be careful of the sun. Radiation from the sun — like all radiation — causes cancer. UVA radiation causes cancer. UVB radiation causes sunburns. SPF is not related to cancer prevention. If your sunscreen isn’t “broad spectrum” or specifically mentions UVA protection, you should throw it out. Please remember to put your broad-spectrum sunscreen on 30 minutes before sun exposure and reapply it if you’re out for a long time or wet or active. Getting a sunburn is a physical and social inconvenience. Getting skin cancer can be very serious.

Be careful of ticks. If you live where there are ticks — spoiler alert: that’s us — you should do a thorough check on a daily basis, and more frequently if you’re doing something with higher exposure, like if you’re hunting or if you have a tick farm. The tick requires at least 24-48 hours to transmit infections. If you find a tick and you’re confident it wasn’t there yesterday, then you’re fine. Remove it using a pair of tweezers to grasp the tick as close to the skin as possible and pull straight back. Clean the skin afterward. No twisting. No fire or gasoline. Try to sell it to your local tick farmer if the legs are still moving. If you develop unusual fevers, headache or rash, then consider seeing a healthcare provider.

Be careful of mosquitos. Mosquito-transmitted illnesses are still rare in our area, but I still don’t like getting bit. Wear tight-weave, long sleeve, but loose-fitting clothing, tucked in, and/or use a repellant. DEET is probably most effective: 25 percent concentration for adults, 10 percent for kids (not for infants). It’s good for about four hours. There are some effective natural alternatives like Bite Blocker and lemon eucalyptus oil. Treat your outdoor clothes and tent with permethrin, which kills insects but doesn’t always stop them from biting you. Citronella candles may help a little bit, maybe.

Be careful of spiders. There are two venomous spiders in our area, the Black Widow and the Brown Recluse. Google them. Know what they look like. Don’t touch them. Don’t kill them. Just leave spiders alone. These bites can hurt but are rarely fatal.

Be careful of snakes. That leaving them alone thing goes double for snakes. Just back off. We have rattlers and copperheads. One has a copper-colored head. One has a rattle. They have triangular heads and elliptical pupils and hinged teeth. But if you can see either of those details, then you’re too close. If you get bit by a venomous snake, there’s still a 25 percent chance it was a “dry bite.” Do not try to catch the snake and bring it to me; you will likely show up with two bites. If you are certain there are no bite marks or you are certain it wasn’t a venomous snake, then you’re fine. Otherwise, head to the hospital. Do not suck, ice, burn, electrocute or otherwise attempt to torture the poison out of the body. These do not work. Take a deep breath and get your car keys. Some people need antivenom, some do not. I repeat, do not bring me the snake!

Be careful of screens (TVs, computers, phones). Put them down. Go outside. Pay attention to your world. Protect yourself from all the screens out there; protect your kids. We are lucky to live somewhere so unspoiled and natural. The biggest risk to your health would be ignoring that.

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