Off the Contrary

Science Fact - Pay Attention!

noreply@blogger.com (Hanni D) — Sun, 06 Sep 2009 15:25:00 +0000

Elementary school was such a blast. You learn how to count and do basic math functions. You get to read fun children's books with great illustrations like the books by Robert Munsch. And you can do crafts for 3 hours a day and make cool stuff like turkeys out of a hand tracing.

I also remember that there were a few kids in my class who didn't seem to care about making crafts or learning about subtraction. They would be looking off into space, running around the room, and trying to get attention whenever they were bored (which was a lot). There was one kid who was known to jump up on his desk, pull down his pants, and pretend to play his twig & berries like a guitar. These (sometimes disturbing) images are my conception of ADHD.

ADHD, or attention deficit hyperactivity disorder, is a very common disorder that affects between 5-10% of kids. You see ADHD in more boys than girls (4:1 ratio), though it may not be identified as often in girls. It's characterized by 3 major symptoms:

Inattention

Hyperactivity

Impulsivity

There are different subtypes of ADHD, namely the inattentive type and the hyperactive/impulsive type. If you have a combination of the two types and show all 3 symptoms, then you would have the mixed type. This is the most common kind of ADHD.

You may say "Wait a minute, Hanni. Aren't most kids hyperactive? Why aren't more than 5-10% diagnosed with this disorder? And if most kids are hyper, then is ADHD a true disorder?" Very good questions, dear reader!! Well thought out. You're right that most kids are somewhat hyperactive. That's why the definition of ADHD required that there is functional impairment in more than one area in the kid's life. If kids are hyper and easily distracted, but aren't getting into excessive trouble at home and are keeping up in school, then it's not getting in the way of their functioning and therefore it's not a disorder like ADHD. If they only act out in class but not at home, they may have a learning disability instead of ADHD. Likewise, if they only act out at home there could be a lack of discipline or structure at home. Always remember that if the hyperactivity or inattention are not causing problems, then it's not a disorder.

Here are some common characteristics of ADHD to consider for each of the subtypes:

Predominantly Inattentive Type

Easily distracted

Can't sustain attention on activities or conversations

Makes careless mistakes

Disorganized

Loses things necessary for tasks or activities

Predominantly Hyperactive/Impulsive Type

Fidgets and squirms in their seat, leaves seat often

Talks excessively

Runs and climbs excessively

Interrupts others

Difficulty awaiting their turn

Combined Type

Combination of the above 2 types

*Most children with ADHD have this type

If you are concerned that your child has ADHD, you can complete a take-home survey that will help you figure out the likelihood of a diagnosis of ADHD. If the test shows reason for concern, then it may be good to bring them to the doctor to see if they can make a formal diagnosis.

If children with ADHD go untreated, they are likely to have problems with many aspects of their lives. They may have academic problems, health issues, multiple injuries from their impulsive behaviour, substance abuse, increased risky sexual behaviour, problems with the law, and low self-esteem. When looking at that long list, it's easy to get disheartened and overwhelmed.

Well, one of the major realms of treatment that has shown a lot of benefit is medication known as psychostimulants. The most famous of them all is Ritalin (methylphenidate), but there are others such as Adderall and Dexedrine that are used as well. These are stimulants, but surprisingly they are able to calm down kids with ADHD and allow them to focus much better. Another medication that is not a stimulant is called atomoxetine. It works well but is often used as a second option if the stimulants don't work.

Medications have been shown to be most effective in treating ADHD, but there are several non-medicinal treatments that can show similar benefits, and are great when used in combination with meds. Some of these methods include individual or family therapy, exercise routines and extracurricular activities, social skills training, and classroom tutors.

Treating ADHD with the above methods will reduce the chances of running into the problems commonly faced by these children. Some people worry about the addictive potential of giving your kids stimulants, but it's actually been shown that these meds reduce the risk of substance abuse by 85% compared to untreated ADHD!!

Now for the downsides of medication. The major side effects are a loss of appetite and insomnia. It's important to make sure that they eat breakfast every day, even if they are not that hungry, and that you don't give meds in the late afternoon or evening for fear of causing insomnia (problems with sleep). Other side effects are seen at the beginning of treatment but disappear after a couple of weeks, such as headaches and fluctuating moods.

So if you think your kid has ADHD (or if you think you may have it) the first thing to do is figure out whether or not they actually have it. Talk to your doctor and find out if there could be a formal diagnosis of ADHD. The next thing to do is consider all of the treatment options. Remember that if this is left untreated it can cause a lot of problems in their life, and that it's better to get professional treatment (medication, therapy, or support) than it is to self-medicate with cigarettes, alcohol, and harder drugs.

*BONUS! Here is an article that discusses whether it's right to treat kids with ADHD differently than others, namely by letting them skip line-ups at amusement parks because they have trouble waiting. Which side do you think is right?

Band/Album Names (Pt 25)

noreply@blogger.com (Hanni D) — Tue, 25 Aug 2009 01:50:00 +0000

It's time once again for the ever-popular band/album names!! These ones were mostly brainstormed in Montreal last weekend when I visited my bro and the Maritime crew (Jack, Danny, et al). Prepare to be blown away:

Hardcore Scenery

Heavens No

Bear The Honey

Say Goodbye To The Germans

Query Latvian Festival

And the best one of the bunch (especially for those of us who grew up watching Canadian TV):

Hinterland's Hoo-Hoo

Science Fact - Contraception and the Amazing Mirena IUD

noreply@blogger.com (Hanni D) — Sun, 16 Aug 2009 21:10:00 +0000

During my time working in obstetrics and gynecology, I learned a lot about having babies. It was fantastic for me to interact with first-time mothers, watch their progress and deliver their little bundle of (messy) joy. But I also learned a lot about NOT having babies during my rotation, in terms of both contraception and infertility. For those who don't know, contraception means countering conception, or birth control. I always love words that have "contra" in it because it reminds me of the Konami code, but I digress. After dealing with women for several weeks, I came to fully appreciate one of the methods available to women for contraception: the Mirena IUD.

You may be asking me why I admire this little device so much. You may also be asking what the heck an IUD is, let alone a Mirena IUD. We will explore these FAQs and hopefully at the end of this entry you may be just as infatuated with them as I am.

There are several general methods of birth control. Let's go through each one and discuss how they work:

Barrier Method (condoms, diaphragm)

As the name suggests, they act as barriers to prevent the sperm and the egg from meeting. They work well when you remember to use them, and use them properly. An added bonus is that condoms can protect against many sexually transmitted infections (STIs).

Spermicides (spermicidal jelly, sponges)

The purpose of this stuff is to kill the sperm before they can reach the egg. It's common to see spermicides teamed up with barrier methods. Also, the Seinfeld-famous sponges are often soaked in spermicide to trap and kill sperm before they enter the uterus.

Hormonal Contraception ("The Pill", depo-provera injections, patch, vaginal ring)

The birth control pill, or oral contraceptive pill, is one of the most common forms of birth control. All pills contain progestin (a synthetic progesterone that prevents ovulation), and many (but not all) contain varying amounts of estrogen as well. They work very well, up to 99.9% effective, but only when the woman remembers to take it every day. The other hormonal options are also based on progestin and work in similar ways. In some women they have the added benefit of making your periods lighter and more regular.

Intrauterine Devices aka IUDs (Mirena, copper)

IUDs are physical devices that are placed inside the uterus in order to irritate the uterus lining and prevent the egg from implanting.

Permanent contraception (tubal ligation, vasectomy)

These methods are for people who are sure they no longer want biological children and don't want to deal with any of the other methods. They are quite effective, but are difficult to reverse if something changes in your life such as a remarriage.

Abstinence

Always remember that you can't get pregnant if you don't have sex. Abstinence is 100% effective. But if you are going to have sex, then that percentage goes down quite a bit.

Now that you know about the major categories, let me elaborate on IUDs. The first IUDs were made of copper and worked by irritating the lining of the uterus, thereby preventing the egg from implanting into the lining and beginning to grow. This worked relatively well (99%) but it caused a lot of cramping and heavier periods. Not fun for any woman...

Then along came the Mirena IUD. Instead of copper, this new device uses a synthetic core that releases progestin (namely levonorgestrel) slowly over time. It prevents pregnancy in several ways now: (1) it irritates the lining of the uterus, (2) the progestins keep the uterine lining thin and less suitable for egg implantation, (3) the progestin also may prevent ovulation, or at the very least slows the progression of the egg through the fallopian tubes so that fertilization is less likely, and (4) it thickens the mucous plug in the cervix that sperm need to travel through in order to reach the uterus. With all that protection, the Mirena provides 99.9% protection (meaning 1 in 1000 women who have sex regularly for 1 year will get pregnant). This is as good as the pill, but you leave the IUD in for up to 7 years so you never have to worry about remembering to take a pill every day!! You also get lighter periods over time where there's a 20% chance of having no period at all after 1 year of using the Mirena IUD (bonus!!). Not only that, your fertility will return to normal 1-2 months after you decide to remove it. It's even cheaper than the pill if you keep it in for over 3 years. What's not to love?

Ok, it's time for the downsides, because all options have downsides and this info would seem too biased without them. Most of the worries occur during the first month of using the IUD. Your uterus may be upset with having something inside it and cause cramping. The other common side effect is having irregular spotting for the first few months. Both of these will settle down over time. Another worry is if your uterus "spits it out", so to speak (expulsion). You can't replace it after that because it may be contaminated, so you'd lose out on the money you spent. More rare but more serious side effects would be if the doctor accidentally punctures your uterus and places the IUD inside your belly, where it would hang out around your intestines for a while until it's discovered. Finally, the Mirena IUD doesn't increase your risk of infections or STIs, but if you get an STI you have a higher chance of the bacteria spreading to your uterus and fallopian tubes. This can cause serious damage to your health and permanent infertility. So if you're in the sex industry and are at higher risk for STIs, you may want to use some other form of birth control.

If you can handle the relatively rare risks of IUD insertion, and you are looking for a more stable form of birth control, I would recommend considering the Mirena IUD. If I was a woman looking for 3-7 years of contraception I would totally do it. No need for memory, light (or absent) periods, cheap, and the most effective on the market today. What else do you need?

***

Let me put a bit of a disclaimer at the end of this topic, since it can be a bit controversial. Some people don't believe in contraception, and I respect that. I feel that everybody has the right to an opinion and should follow their beliefs. But this includes those that believe in contraception. These are my opinions, and you can disagree all you want, but there's no need to be upset with people just because they have different beliefs or principles, especially if they're not trying to change yours.

Band/Album Names (Pt 24)

noreply@blogger.com (Hanni D) — Wed, 22 Jul 2009 21:42:00 +0000

Once again it's time for epic band and album names from yours truly. Let the party begin! And for those of who with any band or album names of your own, feel free to share them with us!

Vagrants Galore

Anti The Yearbook

As Far As The 90's

Aren't You The Jeweler?

And my favourite of the bunch:

But First

Science Fact - The Sweet Smell of Liver Failure

noreply@blogger.com (Hanni D) — Mon, 13 Jul 2009 19:24:00 +0000

I just started a 2 week medical elective in my home province of Nova Scotia. I've been away for so long that I thought I could easily deal with living abroad (read: Ontario) without feeling like I'm missing out on the Maritimes. But now that I'm here I feel like I have been trapped in the Maritime tractor beam and am being slowly pulled back to my heritage. Or at least one of my heritages. The strange thing is that I became most drawn toward Nova Scotia again because of the smell of Downtown Halifax. It's not necessarily the cleanest smell, as the famous Halifax harbour contributes to the overall scent, but it's intriguing nonetheless. It smells like home to me.

Speaking of smells, I had an interesting encounter today in clinic. I am learning about liver disease and liver failure from one of the leading hepatologists in the Maritimes, and we were assessing patients to see if they qualified to get a brand new (or technically second-hand) liver. In the middle of one assessment, my preceptor casually told me to smell the breath of the patient.

Now I don't know what the proper etiquette is on assessing the odour of a patient's breath. Do you ask them to blow in your face? Do you use 2 fingers to waft their breath toward your nose, like smelling a fine wine or a dangerous chemical? Do you put your nose a few inches away from their face? After you smell their breath, do you nod approvingly or keep stone-faced throughout it? So many questions...

The interesting thing was that I could smell something peculiar. Something I had smelled in the hospital before with very sick patients. It's difficult to pinpoint that exact smell, but the closest description would be sweet, flowery feces. It sounds gross, and it really is, but that only dawns on you after a few whiffs. At first you think to yourself "What is that smell? Is it good or bad? Where is it coming from?" Once you get the words "sweet shit" in your mind, it's hard to feel the same curious enjoyment from the smell coming out of someone's mouth.

The technical term for this aromatic breath is fetor hepaticus, otherwise known as the breath of the dead. It's caused by liver disease that is progressing or has already reached the status of liver failure. In fact, it's the most sensitive sign of liver failure out of all the possible signs (such as spider nevi, gynecomastia, ascites).

Here's the science behind the unique smell. The liver is a major organ that's responsible for several things. (1) It detoxifies the blood, metabolizes drugs and removes harmful compounds. (2) It can store glucose in a handy easy-to-use molecule called glycogen. (3) It helps your blood to clot by making hormones that promote the production of platelets, and by making vitamin K which promotes the production of clotting factors. (4) It makes albumin, a very common yet important protein that holds fluid in your blood vessels and helps to transport molecules throughout the bloodstream.

The breath of the dead has to do with the first reason (detoxification). In people with liver disease for some reason or another, they can develop cirrhosis. Cirrhosis of the liver means that the liver has been damaged, and instead of being replaced by normal liver cells it gets filled in by fibrotic tissue. The tough, structural, and nonfunctioning fibrotic tissue "takes over" the liver, so that the overall liver function is greatly reduced. All of your blood passes through your liver in the "portal system", but if your liver is tough and fibrotic can't filter the blood very well. This causes the blood to back up. After a while, the blood gets pissed off and tries to find other ways around the liver to complete the circuit back to the heart. The blood travels through smaller veins that pass along the esophagus, and then end up in the heart and lungs. But by bypassing the liver, the blood is now full of toxins and weird chemicals. Some of these chemicals are aromatic so they get excreted into your lungs, and you breath them out. Thus, the strange smell. It's sensitive for liver disease because only people with bad livers who have developed alternative blood pathways will get this.

The bad news is that these toxins can enter your brain and cause may problems. This is known as encephalopathy. Many people who develop encephalopathy (without proper treatment) have a poor prognosis and will die rather quickly. That's why that smell is known as the breath of the dead.

So the next time you smell sweet excrement, think fetor hepaticus.

Science Fact - Strep Club

noreply@blogger.com (Hanni D) — Mon, 06 Jul 2009 02:18:00 +0000

Have you ever had a nasty sore throat for a couple of days where drinking orange juice felt the same as swallowing shards of glass? It's a horrible experience. But what's even more horrible is when you go to see your family doctor or a walk-in clinic and wait for 2 hours, only to be told to go home and rest. It made no sense to me why they would dismiss you that easily, sometimes without even taking a swab of the back of your throat. A few doctors will still blindly prescribe antibiotics to anyone with a pulse, but the majority these days will hold onto those magical drugs as if they were precious gems. So I wondered: Do doctors ever do anything for people with sore throats?

Since I have completed several hospital rotations, I've had the chance to be on the other side of the situation. Now that I understand the reasons for treating vs not treating, I can more properly take care of patients. And I'm a better patient myself whenever I have a sore throat. Let's walk through some of the science behind sore throats and then explore what doctors consider before sending you on your way.

The bacteria that we worry about the most with sore throats is Streptococcus pyogenes, aka Group A Strep. Why do we worry? It's not because the throat infection is particularly bad, or that you cannot recover from the infection on your own. The reason is that throat infections with Group A Strep ("strep throat") can spread from the throat to other areas and cause worse infections. There is a chance that the bacteria can enter the bloodstream and travel to the heart, brain, and joints. This is called acute rheumatic fever. People with rheumatic fever often have a fever and joint pain beginning 1-3 weeks after getting strep throat. The biggest concern from a medical point of view is that the bacteria can infect the heart tissue and cause major problems. You can end up with permanent damage to your heart muscle or valves.

So with all of this scary information about strep throats, why don't we treat every sore throat with antibiotics to prevent rheumatic fever? First of all, sore throats can be caused by viruses as well as bacteria. In fact, most sore throats are viral in nature. The common culprits are adenovirus and the common cold viruses (rhinovirus, coronavirus, parainfluenza). Antibiotics would have absolutely no effect in this case. Secondly, if the sore throat is bacterial, it may not be strep that's causing it. There are a few other bacteria that could be the responsible organism. To be fair, though, Group A Strep is the most common bacteria that causes sore throats.

Lastly, and this is a big point, most of the strep infections will be successfully eradicated by your own body. It's often the case where people with throat infections do not get medical treatment. Their sore throat resolves after several days and they move on with their lives. The reliance on antibiotics has been a recent development in our history, and we did quite well without them, especially with minor infections. It is NOT true that strep throat will always cause rheumatic fever if untreated. The prevalence of rheumatic fever is very low, and is even lower in developed countries like ours. In fact, some countries like England don't bother to test people for Group A Strep because they don't give antibiotics to patients with sore throats unless their mouth is about to implode. You can bet that there are numerous times when patients have strep throat and are not treated, but the amount of rheumatic fever in England is as low as it is here in Canada. This shows how rare it is these days to develop complications from strep throat.

This brings us to how we in Canada treat sore throats (known as acute pharyngitis in the medical community). There is no mystery behind it at all. There are 4 criteria that we look for which may indicate if strep is the culprit. Here they are:

1. Fever (Temp >38°C or >100.4°F)

2. No cough

3. Swollen tonsils with exudate/pus

4. Tender lymph node enlargement in the neck

If you have all 4 of these criteria, then you are about 40-60% likely to have strep throat. In this case, the doctor will prescribe penicillin to you right away, and likely get a throat swab to confirm the diagnosis. If, on the other hand, you have a sore throat with a runny nose and cough, no fever, no white stuff coming out of your tonsils, and no swollen lymph nodes, then your infection is almost certainly viral. In this case you would definitely be told to go home and rest. Even if you had one of these criteria, you'd still be sent home sans prescription.

If you have either 2 or 3 of the criteria above, the doctor will likely swab your throat and culture the goop to see if Streptococcus pyogenes will grow. This usually takes 2 days, and often by then the sore throat has resolved. If it hasn't and the culture is positive for strep, then the doctor will prescribe anitbiotics.

So what does this all mean for you, the patient? The next time you get a sore throat and are debating whether to go see a doctor, think about these 4 criteria. If you score a 2 or higher, you may want to go in and get swabbed, or antibiotics if you're lucky enough to get 4 points. But if you score a 0 or 1, stay home and get some chicken soup into you. Wait until tomorrow to see if you get better on your own, or if your score goes up. This may prevent an unnecessary doctor's visit. And more importantly, it will save you from an annoyingly long wait in the waiting room surrounded by other sick people and copies of outdated Readers Digest magazines.

* Click here for an online version of the criteria that you can fill out on your own and find out what to do!

Band/Album Names (Pt 23)

noreply@blogger.com (Hanni D) — Tue, 30 Jun 2009 01:40:00 +0000

It only feels right to start off my posting with the 23rd set of band and album names. I truly hope that some of you will use these for your up-&-coming garage band, or at the very least for a mixed CD that you make for a friend (or your special lady). Here they are!

The Kitchen Skivvies

Largely in my Undies

Dirty Servant

Second Winter Burning

Nuts & Gum

Oh Hey Hey

And my favourite of the bunch:

Double Whammy

A New Hope

noreply@blogger.com (Hanni D) — Tue, 30 Jun 2009 01:14:00 +0000

This is it! The glorious return of Off The Contrary after over a year of being lazy/studying medicine/traveling. I was originally going to title this entry "Return of the Jedi", but I thought that was far too pretentious as I am a Padawan learner at best. The chosen title is more humble, and is far more fitting for a story that has taken a lengthy hiatus and now sets out on the second (and final?) saga.

In the coming weeks you can expect some medical tidbits, some random thoughts, possibly some answers to questions that you (my beloved reader) would like to ask me. And, of course, band and album names galore.

Oh, and before I forget, I have to give a shout-out to those who have stumbled upon my blog over the past year and have left me very interesting (and sometimes inappropriate) comments. I was even mentioned by other blogs like Broke-Ass Stuart's website, which blew me away because it actually looks like an established site! Well, at least it's way more professional than this one.

Stay tuned for the second coming of Off The Contrary!!

Band/Album Names (Pt 22)

noreply@blogger.com (Hanni D) — Mon, 07 Apr 2008 03:50:00 +0000

I know I haven't been writing much in terms of scientific education and hilarity, but after my crazy exams this week I'll be sure to write down the plethora of ideas that I've had while studying. In the meantime, I'll share with you a special installment of band/album names. Each one is medically themed and is a set of band & 1st album. Enjoy!!

Fat Legs and the Crackles - Hyper Trophy

Bolus - Push It

Pertussion - Whoop Dreams

Melena - Poop Out

Anal Tone - Sounds Like The End

Failure To Thrive - Small For Dates

XXY - Congenitalia

It's A Trap!!!

noreply@blogger.com (Hanni D) — Mon, 07 Apr 2008 03:45:00 +0000

What's better than a short clip featuring an obscure Star Wars character? A short clip featuring an obscure Star Wars character AND a new breakfast cereal!! Check it out:

Or, if you don't like embedded videos, you can click here

Band/Album Names (Pt 21)

noreply@blogger.com (Hanni D) — Sun, 23 Mar 2008 14:43:00 +0000

It's been a while since I wrote in my blog, and so it just makes sense that I'm overflowing with high-quality band and album names. Take a good look through them. And if you're fancy is known to be ticklish, let me know which names tickle it.

Kindergarten Pop

Minutia

False Bravado

Royal Jelly

Sweet Melons

Begat

The Darning

And my personal favourite of the bunch:

Sometimes It's Never Easy

Party In My Tummy

noreply@blogger.com (Hanni D) — Sat, 23 Feb 2008 04:25:00 +0000

I recently gave a presentation to a community group about healthy eating. It went well, and they loved the idea of making ants on a log, but I think it would have been better if we acted out this mind-blowing song.

Science Fact - Sweet Action

noreply@blogger.com (Hanni D) — Mon, 11 Feb 2008 03:38:00 +0000

I remember a brief period in high school when one of my friends believed that by eating pure sugar you couldn't gain weight. This theory was based on the fact that the chemical structures of sugar and fat were so different. My friend reasoned that if you weren't eating fat, then how could you store it in your body?

Glucose

Lipid (fat)

Well, as most of you know, that theory is utter crap. I never believed him, but it took me a couple more bio and chemistry courses to understand exactly how you turn sugar into fat. Sugar gets broken down in several step into smaller and smaller compounds in order to harness its energy, and one of these compounds (acetyl-CoA) can be taken away from the sugar-burning pathway and into the fat-making pathway. If you eat too much sugar than what your body can use, you will have too much Acetyl-CoA and end up producing lots of fat with it.

And then there was the artificial sweetener!! This sensationally sweet product has a different chemical structure than natural sugar, and because of this it can't be broken down into energy-producing molecules. Better yet, it can't get turned into fat! So it makes your coffee, pop, and cookies sweet without all of the added calories. Even if it does taste gross and leaves a weird aftertaste in your mouth...

You would think that artificial sweeteners, also known as sugar substitutes, should be encouraged with people who are trying to lose weight. It makes sense. Or does it?

A new study that just came out showed that rats who were fed artificial sweeteners (saccharin) actually gained more weight than rats being fed natural sugar (glucose). This seems counterintuitive, but the scientists had an explanation for it.

Normally, when you eat sugary foods your body senses this and gets ready to use the energy boost. It also tells you to eat less because you're probably eating a bunch of calories. But with artificial sweeteners, you confuse your body by tasting sweet without delivering a lot of calories. Because of this, your body stops trusting its "sweet sensor" and decides to eat a bunch of food no matter what, as well as reduce the amount of energy that it burns. Once this mistrust has developed, it's easier for you to gorge yourself on naturally sugary foods without slowing down or burning more calories to compensate.

Now everyone should take this with a grain of salt (also granular and white...) because the study was done on rats and not humans. And since body weight depends on about a zillion things, you shouldn't think that by switching back to natural sugar you will start to lose weight, or that you can blame your obesity on Sweet 'N Low. Just be aware that zero-calorie foods and additives may not be completely guilt-free.

Who Are Mario and Luigi?

noreply@blogger.com (Hanni D) — Sun, 27 Jan 2008 06:42:00 +0000

Back in the 80's, the news really knew how to get to the bottom of a breaking story, cutting to the chase and asking the toughest questions. An excellent example of this was Inside Edition TV when they uncovered a new craze called "Nintendo". Watch and learn.

I love Ron Leingang's part about level 3-1, and the CRAZY secrets that he reveals. Who knew that there was a beanstalk? Jack, I can picture you doing an amazing impersonation of him :)

So if you missed the answer to the eternal question "who are Mario and Luigi?", remember that "they are us".

Also, if you're in a Nintendo mood and have 10 minutes to kill, then check out this collection of 100 Nintendo games. But play your own music in the background.

Science Fact – Broken Hearts are for Assholes and Post-Menopausal Women

noreply@blogger.com (Hanni D) — Fri, 25 Jan 2008 02:36:00 +0000

Many of us have experienced heartache in our lives, and some would go so far as to say that they suffered from a “broken heart”. We have all heard this expression ad nauseum in conversation, literature, and in an abundance of songs. But is there any literal meaning to the term? Can your heart actually break when left by a lover, or when finding out that your child had died overseas?

Well, there is recent evidence suggesting that people who are faced with sudden, intense emotional stress can develop serious heart muscle weakness. This is called Takotsubo cardiomyopathy, stress cardiomyopathy, or simply “broken heart syndrome”. People with this condition can have symptoms that feel like a massive heart attack, including:

Shortness of breath

Severe chest pain

Low blood pressure

Congestive heart failure

Broken heart syndrome is a relatively new idea, so the mechanism isn’t well understood. However, it is believed to be caused by a huge release of adrenaline from your adrenal glands (the glands that sit on top of your kidneys) when you experience sudden emotional trauma. This massive amount of adrenaline will “stun” your heart muscle, preventing it from working properly.

Although stress cardiomyopathy is life threatening, it is surprisingly reversible. Unlike real heart attacks, you can recover from a broken heart in a matter of days to weeks with little to no permanent damage. The only problem is that you could have serious consequences or even die during the initial phase.

Is there any good news to this? Well, the symptoms are so severe that you’re unlikely to ignore it. And if you recover (which often happens) you shouldn’t have any permanent damage to your heart. Finally, there is no increased risk of recurrence. If you have one broken heart, you’re no more likely to suffer from another broken heart than anyone else.

Let’s finish off with some epidemiology. We all know that broken hearts are for assholes (thank you Frank Zappa for enlightening us with your controversial song). But now we can add post-menopausal women to this group. For some reason this is the most likely demographic to suffer from stress cardiomyopathy.

Let's Go To The Mall

noreply@blogger.com (Hanni D) — Mon, 14 Jan 2008 05:01:00 +0000

To celebrate my 1 month absence from blogging, I thought I would share a video that has everything you could ever want: 80's music, Canadian content, and robots. If you've seen it in a cheesy 80's music video, they have it here.

Brain Holiday

noreply@blogger.com (Hanni D) — Thu, 13 Dec 2007 15:44:00 +0000

I just finished my last exam this morning! This means that I'm done yet another medical block and am one step closer to getting my MD. And best of all, I don't need to worry about ridiculously miniscule details of neuroanatomy. No more brain!!!

But before I take a holiday from thinking, I thought I would share a good prank that you can play on your friends during the next exam period. I learned about this last week in the lovely Stauffer Library here on campus at Queen's. It was about 9:30pm and I had just grabbed a tea and sandwich to help me get through another 4 hours of studying. Stauffer was super busy, as you would expect for any library when exams begin in 2 days. But Stauffer is extra busy because on top of studying, many students get all gussied up to attract all of the people that they don't get to see in class in the hopes for a pre-exam romp. In any case, there were no available seats anywhere. Anywhere except for a perfect seat along the row of single desks, completely clear, clean, and all ready to go.

I sat down, unloaded my stuff, and began to eat & study. But after 5 minutes this big angry guy came over to me and tapped me on the shoulder. He said "Did you move my stuff off of this desk? Was this desk empty when you sat here?" I was confused and was about to explain that I had no idea what he was taliing about, when he looked behind me and became super upset. I turned around and saw that all of his notes were shoved in the garbage can 1 foot behind me among the sandwich wrappers, soggy tea bags, and coffe cups. He grabbed his stuff out of there, gave me the worst look ever, and stormed off.

This leads me to the prank: if you're in a really busy place where everyone is studying and there are many people roaming the aisles for a place to sit down, then go find a seat where somebody left their stuff unattended for a few minutes and throw it away beside the desk. A new student is sure to sit down before the original guy returns. Hilarity will ensue.

Motivational Posters

noreply@blogger.com (Hanni D) — Sat, 01 Dec 2007 14:20:00 +0000

You have probably worked at a place where there were motivational posters up on the wall, encouraging you to keep your feet on the ground while reaching for the stars. But recently there has been a flood of funny motivational posters or even de-motivational posters. Here are three that I always laugh at when I see them (especially the last one).

*Click on the posters for a better look*

Science Fact - TKO

noreply@blogger.com (Hanni D) — Fri, 30 Nov 2007 00:43:00 +0000

When I was young I loved playing Mike Tyson's Punch Out for old-school Nintendo. It was such a realistic boxing game where all you need to do is analyze and take advantage of your opponents' patterns and weaknesses in order to knock them out. That, and knowing the password to get to Mike Tyson (007 373 5963), was all it took to beat up guys that were about 20 times bigger and stronger.

But now that I'm learning about brain injuries I feel bad for all of the concussions I must have given to Don Flamenco, Piston Honda, and Bald Bull (both matches). You may be wondering exactly what a concussion is, and why these guys should have stayed away from me to let their brains recover before facing me in the ring again so quickly. Well, you've come to the right place to find out.

A concussion is a brain injury that happens when you get hit pretty hard or fall down, such as with high impact sports like hockey, boxing, or football. Your skull is usually good at cushioning any impact with it's brain-covering membranes and cerebrospinal fluid (CSF), but it only has a limited protective value. If you get hit with more force than you can deal with, then your brain can get shaken around or hit the sides of your skull. Medically speaking, this sucks.

The injury caused by a concussion is not focused in one area. In other words it is a diffuse injury. It is thought that the brain gets bruised and that many nerves get broken. There may not be noticeable permanent brain damage with a concussion, but repeated concussions will accumulate the damage and be apparent over time.

Here are some of the symptoms that you may see with concussions:

Seeing stars

Feeling dizzy

Memory loss (especially beginning from concussion onward)

Nausea and vomiting

Headache

Blurred vision

Slurred speech

Poor concentration

Overly tired

Agitated and irritable

People may or may not lose consciousness, so you can't diagnose a concussion just based on whether they were knocked out or not. There is a grading system for determining the severity of a concussion. You need to know this because it helps to decide how long to wait before playing hockey again.

Grade 1: Some symptoms lasting less than 15 minutes, no loss of consciousness (LOC)
--> You can return to sport after symptoms disappear
Grade 2: Some symptoms lasting more than 15 minutes, no LOC
--> Wait one week before returning to sports
Grade 3: Some symptoms with LOC lasting less than 5 minutes
--> See a doctor as soon as you can, don't play sports until the Dr says so
Grade 4: Some symptoms with LOC lasting between 5 and 10 minutes
--> Go to hospital ASAP
Grade 5: Some symptoms with LOC lasting more than 10 minutes
--> Go to hospital ASAP

If you get a second concussion before you have fully recovered from the first one, you can injure your brain so much more seriously than you did the first time. Therefore it is crucial that you let your brain heal before getting back in the boxing ring. And since the damage caused is permanent, the smartest thing to do is to prevent concussions from happening in the first place.

One last tidbit for you would-be boxers and drunken alleyway streetfighters: You are far more likely to lose consciousness if your head gets turned at the time of impact. So the easiest way for you to knock out your opponent is with a roundhouse punch.

One more nerdy Nintendo clip, mainly for my brothers.

Band/Album Names - Special 20th Edition!!

noreply@blogger.com (Hanni D) — Wed, 21 Nov 2007 17:54:00 +0000

To commemorate the 20th installment of my famous band/album names, I have compiled what I believe to be the top 20 names from my previous posts. It was a tough call, but I eventually decided on these goodies. Here they are!

Hot Trouble

Hypnic Jerks

Us Kids Know

Summer Nun

BEDMAS

Almost Business

Smellin' Like Yesterday

Right English

Raging Murmur

Second Minute

Manhole

Talkin' Up The Nanny

No Man's Romance

Christmas Disease

Little Once

Inferior Olive

Back To The Bottom

The Sniffles At Night

Amish Homage

Some Kid's Grandma

Thanks to everyone who helped me come up with these names. This has been a team effort, and I couldn't have done it without your support. If you think that others deserve to be on this list, let me know.

Science Fact - News To Me

noreply@blogger.com (Hanni D) — Wed, 21 Nov 2007 01:00:00 +0000

For most of my life, I considered myself to be a shy guy. I wasn't a hermit or an antisocial kid, but I often felt very self-conscious and had trouble feeling comfortable around anyone new. Especially with girls I liked. In this mindset it was easy to believe that everybody saw the many stupid things I did, like walking around for 5 minutes with a half-done-up zipper or burping not so quietly in class. On occasion I would think that people were laughing at me or talking about me when I walked by, even strangers. When this happened I would always do a subtle check to see if there was anything on my face or if my clothes were on properly. I'm not sure if anyone else has experienced this feeling, but I bet that those who are very self-conscious can sympathize with me.

I learned in our psychiatry block that this is called ideas of reference. This means you believe that common everyday things are referring to you specifically. So if you see two people whispering, your immediate thought is that they are whispering about you.

But what I'm most interested in is the concept of delusions of reference, an extreme of the more benign "ideas of reference". People who have delusions of reference believe that television and radio announcers are talking about them or directly to them, and that news stories are meant only for them. For example, Mr K may hear a news story with the title U.S. Accuses Iraqi Photographer of Aiding Rebels and think to himself "They're getting suspicious of me. This is a clear warning for sure. I should be more careful about who I show my pictures to." Or maybe he sees the weatherman on TV and suddenly thinks "He's wearing a purple tie!! He must be telling me that I should be cautious when dealing with my problems with Sally."

The difference between the ideas of reference and delusions of reference is that the former are often due to self-consciousness, and the person understands that these thoughts and ideas are not real. People who have delusions of reference have a firm belief that people are sending them these messages. This is more serious and is a common symptom of psychiatric illnesses such as schizophrenia, delusional disorder and paranoid personality disorder.

This is what I love about psychiatry. There are so many interesting symptoms and behaviours that someone can have. And you can often see how many criteria you fit for each condition :)

DWA - Straight Outta Kingston

noreply@blogger.com (Hanni D) — Wed, 14 Nov 2007 04:47:00 +0000

So I'm still computerless, but I hope to get my new MacBook within the next day or two. In the meantime I've been busy with MVN (Queen's very own Medical Variety Night) that took place last weekend. My good buddy and current class president Eric was my co-MC, and except for a few jokes we managed to get quite a few laughs from the audience. Well, at least from the drunk Saturday night crowd.

A bunch of my friends worked really hard over the past 2 months to put together a rap video, and it turned out way better than I could have imagined. Our director just put it up on YouTube, so I thought I would spread the word. You may not get all of the medical and Kingston references, but it should still be very enjoyable.

Straight Outta Kingston

** Update (Nov 22, 2007): Due to a combination of unforeseen circumstances and a pack of highly trained velociraptors, the video has now been taken off of YouTube. Hopefully you were one of the lucky ones who watched it before the dinosaur attack.**

The Two Worst Letters In The Alphabet: B & E

noreply@blogger.com (Hanni D) — Wed, 24 Oct 2007 03:59:00 +0000

I came home from the hospital today after interviewing a lovely patient. You know, a very nice middle aged woman who could describe an illness amazingly well, and who didn't answer the question of "where is your abdominal pain?" with the words "I had two barn fires back in 1974..."

So when I reached my door, I noticed that it wasn't closed all the way. It was extremely strange since there really isn't anything that can prevent this heavy steel door from closing. Until I noticed the dent and scrapes beside the lock. And the jagged piece of metal stopping the door from latching shut. And the missing deadbolt that I'm sure was there this morning.

So obviously the first thing that entered my mind was "Well, it sucks that my computer was stolen again," followed by "I can't believe that someone broke into my last 2 apartments." When I entered my 3rd floor apartment I was surprised to see that many of my things were untouched. But I quickly saw the rectangle of empty space on my desk that used to be my laptop.

It turns out that my roommate was hit harder than me, but my laptop was a lot better than his (which is a given, because mine was a Mac). So there's one upside to having a bunch of worthless crap instead of nice things that you can be proud of. Now I need to deal with the claims adjuster and police, as well as decide whether I should get a new computer now or wait for the insurance money (minus $1000).

On the bright side, I'm glad that I backed up 15 GB of music and some of my pictures (including the ones from my travels). And also that I'm not in the middle of writing my thesis.

Band/Album Names (Pt 19)

noreply@blogger.com (Hanni D) — Fri, 19 Oct 2007 03:36:00 +0000

It's time for another installment of band and/or album names! Will the excitement ever end? Maybe. Tune in to find out. But until then, enjoy these beauties:

The Sleep Terrorists*

Sandals Are Fun

Big In Kenya

The Speech Bananas

If I Was A Chick

The Physical Tickets

Coma Village

*this term refers to people who have sleep terrors at night and wake up screaming. Unfortunately (yet predictably), the band name Sleep Terror has already been used.

Science Fact - Clean & Dry

noreply@blogger.com (Hanni D) — Thu, 11 Oct 2007 19:08:00 +0000

If you are like me, you own several pieces of clothing that have specific washing instructions. Things like "hand wash only", "do not tumble dry", or "dry clean only". And if you are like me, you don't pay attention to these things and have shrunken, discoloured, or pretty much ruined all of these garments. Boo-urns. I know I would get more mileage out of my clothes if I just paid more attention to the stupid tags, but I always forget just the one time, and then it's too messed up for me to care about following the instructions anymore.

Anyway, the topic of this post is dry cleaning, that magical process whereby your clothes become clean and (hopefully) not damaged, even if you've spilled red wine and/or 10W40 all over yourself. What is dry cleaning? Do your clothes actually stay dry? Can I do this myself in my basement? And does dry cleaning cause cancer? The answers to all of these questions are coming up, so stay tuned!

The origin of dry cleaning came about in France when Jean Baptiste Jolly realized that his tablecloth became a lot cleaner after someone spilled kerosine all over it. Thus, the idea of cleaning clothes using non-polar chemicals and NOT water (thus the "dry" part of dry cleaning) was born.

Normally we use water and detergents to clean our clothes. But sometimes the water and/or detergents can ruin the fabric. In other situations the things that we spill on our clothing are not water soluble, so the normal washing methods can't get rid of the stain. This is when dry cleaning is the best choice. Let's talk about how this process works.

Your clothes are first sorted into groups like "heavily stained / last saturday night's party clothes" and "delicates / nothing that belongs to a man". Then the clothes are searched for anything in the pockets (especially pens) and for buttons or clips that could get damaged during the actual cleaning process. After that, it's ready for action.

The clothes get thrown into a big washing machine, but instead of water they use non-polar (or water-repellant) chemicals. The standard dry cleaning chemical is called perchloroehylene, or PERC. This solvent gets added to the clothing at a certain temperature and gets mixed around. As the liquid gets dirty, it gets diverted to a chemical recovery mechanism while new chemical is added to the machine. The used liquid is filtered several times and then is distilled, recovering about 99.99% of the original perc. That's pretty good recovery. Once the clothes are clean, they get spun down and dried. The drying step uses warm air to be blown over the clothes, and then cool outside air for the deoderizing final step.

Sometimes the dry cleaners use other chemicals to help remove certain stains. Very oily stains like grease can often be removed by perc alone, but more organic ones like red wine and blood are harder to get out. In these cases they add "catalysts" or enzymes to the stain, or they add a small amount of detergent to the perc.

These chemicals are not very good for you, so it would not be a good career choice to work in a dry cleaning facility (if you were very concerned about your health). The cancer rates are higher around a dry cleaner's than around a power plant or oil refinery. And if you wore 1 piece of dry cleaned clothing each week for 40 years, you would exceed the amount of perc exposure deemed to be the "safe" by 150 times!! That doesn't sound very good.

The good news is that there are other chemical being used for dry cleaning. Some of these, such as liquid CO2 or liquid silicone, have a much lower health risk. The downside is that they are more mild so don't clean your clothes as well. Hopefully in the future we will figure out the best way to clean clothes without giving everyone cancer.

Oh, and don't set up your own dry cleaning system in your basement. It's way too risky. Leave it to the professionals who you pay to take that risk for you.