Pharmacy School Associate Professor Publishes Toxic Mushroom Card Game, Children’s Book

To make teaching mushroom toxicology more engaging and fun for learners, an MCW Pharmacy School associate professor developed a card game. Mushroom poisoning is a disease state that anyone could be confronted with – not just physicians – so playing the game can also benefit the public. “In the U.S. there are about 5,000 foraged mushroom exposures reported to poison centers annually, with at least 20 percent developing significant symptoms and a few deaths each year. So, if people aren’t sure what they’re doing, they can really run into trouble,” said Ryan Feldman, PharmD, BCPS, DABAT. In addition to being an associate professor, Dr. Feldman is an emergency medicine pharmacist at Froedtert Hospital and a clinical toxicologist and certified poison specialist with the Wisconsin Poison Center. He estimates Wisconsin sees about 140 mushroom-related poison calls annually, peaking in the months of May through October. Depending on the type of mushroom, symptoms can include nausea and vomiting, and medical conditions can escalate to the lungs filling with fluid or even kidney, liver or heart failure. “There are 150,000 known mushrooms, 200 of them are toxic, and they make about 15 different toxins,” explained Dr. Feldman. “So, you only need to learn about 10 to 15 different toxic syndromes that they can produce to gain an understanding of different types of mushroom poison.” The game is paired with a blog where players can see pictures of the cards and read about how each mushroom causes toxicity, what the symptoms are, basic identifying features and where they are found, so foragers can avoid the ones in their area. Players combine toxic mushroom cards and antidotes, modifiers or actions to gain more points. The name of the game “GOTTA PICCEM” is a mnemonic device for the 15 different toxic mushroom classes, organized by the timeframe when symptoms appear. This is one of the most important clues doctors use to determine toxicity, where delayed symptoms (onset longer than six hours after ingesting) are associated with significant toxicity. After making the card game and a rhyming presentation to help keep his students engaged while learning mushroom anatomy, Dr. Feldman realized he had all the necessary components to write a children’s book. The book titled “Poisonous Fungus Amongus” explains how mushrooms grow and reproduce. The story is paired with vivid illustrations pointing out mushroom features that help indicate which are toxic. “The important part is recognizing symptoms early enough to get care and treatment before you lose an organ or worse – that's what the game and book teach,” said Dr. Feldman.