A general internist of 20 years experience gets asked ALL sorts of questions
Especially given the state of modern medicine in US, it seems every second of face time you have with your primary care doctor is too precious to waste on trivia. And, there are some questions that just seem too ...well, junvenile, even though you'd really like to know the answer. Even though I feel I have a very good rapport wtih my own patients, I don't get asked these sort of questions from them, but usually it is in social situations when someone learns I'm a doctor, or quite often if I'm in a chat room and my profile states my profession. On the LENS I am trying to reproduce those questions I have found to be asked the most or those I have found to be the most interesting. Plus, HERE I have the advantage of being able to give a more complete and researched answer if called for. Also, if you've had such a question tugging at the back of your mind for last 15 years, feel free to ask it.
Cracking your knuckles
What makes them "pop" and will you get arthritis
Furthermore, I am convinced that it does NOT lead to arthritis, or any significant damage you the finger or finger joints.
Running out in cold rain...
...your mother was wrong.
Shower urination home cure for foot fungus?
NOT!
This has been around for long time, but I hope it not honestly believed by many people. The theory has been advanced, and I tend to believe given my own jaundiced view of human nature, that this "home cure" is just use by a lot of men as a handy excuse for the questionable pleasure or possible convenience of peeing in the shower. Some people have even tried to use science to defend their incontience with rationale that urine contains the chemical known as urea which has been used in topical compounds for skin diseases, including some fungal infections (otherwise known as tinea, and more specifically as tinea pedis when found on the feet). However, this just doesn't hold water, pardon the pun, because the concentration of urea in the urine is not enough to be effective especially given the further dilution by the shower water. PERHAPS if one soaked the poor feet in pure unadulterated urine for some time, there COULD, and I emphasize could, be some toxic effect on the fungi. However that hardly sounds practical given that we have several good topical medicines both prescription and over-the-counter (Lamisil is favorite of mine) which work very well, thank you. "Am I crazy or are there little lines floating in front of my eyes?"
(yeah, you're crazy but not because of your eyes)
Actually I find that most people these days know what these are, but occcassionally someone will ask me about it. In fact, we commonly refer to them as "floaters," and they do become more common as one ages. What you are "seeing" actually is the shadow on your retina of small "chucks," for lack of better word of the vitreous humor (or gel) in your eyeball which are naturally degenerating. They are quite harmless, although in bright light you'll tend to notice them more. However, if you notice a tremendous increase in amount of floaters or start seeing actually black SPOTS, as opposed the the spider-web like floaters, or bright flashing spots, you should see your eye doctor right away. Any of those type symptoms could represent something more serious such of detachment of retina. What {hic-CUP} REALLY works for hiccups?
....and what the heck causes them?
VERY rarely hiccups could indicate more serious disease, & then they will be very persistent and bothersome. This happens when the nerve going to the diaphragm is being irritated by a pathological process like a large hiatal hernia or an infection (e.g. pneumonia)& rarely by a tumor in the chest. For most part, these type of diseases will be evident to the doctors because of other symptoms (weight loss, GERD, etc) or on exam. Once in a while where will be a HEALTHY person reportedly with hiccups for years..I believe world record still stands at 69....YEARS.
TREATMENT?: As far as prescribed drugs, my colleagues and I do have some meds that can help. If they are caused other diseases as I mentioned before, we would treat that; e.g. Prilosec for bad reflux. Even if they were just the plain, ol' hiccups but just a bad case of them, we aren't without some resources. But most of the meds I have found to work, like THORAZINE which is an antipsychotic for gosh sakes, have side effects which make them impractical. This is even the case for some other less effection meds, such as Reglan and baclofen. However, if you google "hiccup" and "treatment" you'll find lots of positive reports. .in 1 or 2 patients. Seriously, problem often is with case reports with just a few patients, we are never sure if hiccups would stopped anyway. The so-called "double-blinded, placebo-controlled" studies with enough patients to be statistically valid can be expensive.
As far as NON-DRUG CURES: I'm sure everyone heard (& likely tried) as many as I. Holding your breath as long as you can stand it could work by the higher carbon dioxide in blood causing diaphragm to relax. Trying to stimulate the vagus nerve to diaphragm & "break the cycle" has a certain logic: one way is to press as hard as you can stand it in soft area of skull behind ear & stick out tongue for 30 sec. Best "water" cure is 9-10 quick small gulps making the esophagus contract. A tsp. sugar/honey on back of tongue & swallow. For kids, who may not always follow direction well:big tsp. PEANUT butter OR ice cream may be just the thing.
Can I really knock someone out with single blow to head like in movies?
---and then just wait and watch them get up 10 minutes later: no harm, no foul?
Books of similar ilk
Embarrassing Medical Problems: Everything You Always Wanted to Know But Were Afraid to Ask Your Doctor
Amazon Price: $14.95 (as of 10/06/2008)
Can a Guy Get Pregnant?: Scientific Answers to Everyday (and Not-So-Everyday) Questions
Amazon Price: (as of 10/06/2008)
Straight Dope
Amazon Price: (as of 10/06/2008)
The Explainer
Amazon Price: $11.65 (as of 10/06/2008)
Some of my favorite links...
....that you may not alreay be familiar with.
- PostSecret
- Web site where where people from all over have been mailing anonymous postcards with confessions written, often with some sort of illustration. These range from the very trivial to the heart-breakingly serious.
- Go Fug Yourself
- This site gives your a chance to poke some fun at celebrities and the fashion choices they make....well, what makes it REALLY funny it that probably they are paying so-called professional stylist big money to make some of these choices.
- Arts and Letters Daily
- Great site to keep on your bookmarks for when you are bored and looking for something to occupy your mind for 5-10 minutes. This site lists short one-sentence summaries of articles dealing with books, history, the humanities, psychology and medicine, popular culture, European and American politics....and the articles range from the fairly academic to those written for popular magazines and newspapers.
- Mighty Optical Illusions
- Name says it all.
Great Stuff on Amazon
Below I have listed a few of the favorite things I've bought from Amazon over last year or two.
Blink: The Power of Thinking Without Thinking
Not sure if I totally buy into his thesis but made for interesting reading.
Amazon Price: $10.87 (as of 10/06/2008)
![Freakonomics [Revised and Expanded]: A Rogue Economist Explores the Hidden Side of Everything](http://ecx.images-amazon.com/images/I/51Z1scnqz1L._SL75_.jpg)
Freakonomics [Revised and Expanded]: A Rogue Economist Explores the Hidden Side of Everything
...if, li,me me, you took Economics 101 in college, and thought you came away from it a better informed citizen....prepare for an eye-opening experience reading this. I have always wondered why the so-called law of "supply and demand" seemed not to be working even in our free and informed marketplace (take for example, why all three prescription drugs for "ED" are still priced as high as when there was only Viagra on the market).
Amazon Price: $18.45 (as of 10/06/2008)
Stumbling on Happiness
No, this is not another self-help book and how to find secret of happiness, but a very interesting investigation into why we are so often unhappy, even in circumstances one would have thought would guarantee contentment. (E.g. lottery winners....after you finally get that big raise....once you gotten into you dream house that you've been planning for 10 years, etc)
Amazon Price: $16.47 (as of 10/06/2008)
Introducing Neuro-Linguistic Programming: Psychological Skills for Understanding and Influencing People
Never heard of NLP? I think this is one of the better introductions to this marvelously versatile psychological technology. If you are in sales, or have to deal with the public a good deal, or are in healthcare/mental healthcare or..well you get my point, these techniques for communicating effectively can be used in almost any work environment, plus also when trying to communicate and make effective changes in your own life or at home. Not only are you able to communicate better but NLP teaches shows you that the WAY you communicate, even the simpliest choices of words, will effect how others act or react to what you way. As a doctor, I have found these techniques to be astounding, especially when it comes to establishing "rapport," which obviously is of great importance in my field. The methods of NLP will shows you how to establish rapport within first 1-2 minutes of talking to someone. As an aside, some of the psychological technology of NLP as been used in great and positive ways (such as the seminars of Tony Robbins), but, on other hand, these methods are also sold in "how to" videos on books promising sure fire methods to "get women in bed."
Amazon Price: (as of 10/06/2008)
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