Hermes has been doing blogs about his rotation in occupational and environmental medicine which I find extremely interesting. So this patient I saw today with lead poisoning was very interesting as well, I’m glad I grabbed his chart.
He is a weekend warrior and has been refinishing his home. In his outdoor workshop he’s been stripping paint off of woodwork without wearing a respirator. He presented to his PCP with a months worth of fatigue and was found to have an elevated lead level (>50). An interesting factoid I learned while looking up lead toxicity on poisondex is that the average lead level in adults has decreased from about 13 in the 70s to less than 3 (or was it less than 1) since removing lead from gasoline, paint and other common items.
I called poison control for advice, but treated him pretty much as I had thought based on my quick reference search. I started him on oral chelation therapy for three weeks. Chelators are large molecules that wrap themselves around heavy metals like lead, mercury and arsenic. I took down his record number so I could follow it. I think I’ll do my next lecture on heavy metal poisoning…but it probably won’t be as fun as my first lecture on priapism.