Off the Contrary

Science Fact - Pay Attention!

2009-09-06T11:25:00.004-04:00

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)

2009-08-24T21:50:00.003-04:00

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

2009-08-16T17:10:00.009-04:00

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)

2009-07-22T17:42:00.003-04:00

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

2009-07-13T15:24:00.003-04:00

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

2009-07-05T22:18:00.004-04:00

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)

2009-06-29T21:40:00.003-04:00

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

2009-06-29T21:14:00.006-04:00

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)

2008-04-06T23:50:00.002-04:00

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!!!

2008-04-06T23:45:00.005-04:00

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)

2008-03-23T10:43:00.003-04:00

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

2008-02-22T23:25:00.003-05:00

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

2008-02-10T22:38:00.000-05:00

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?

2008-01-27T01:42:00.000-05:00

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

2008-01-24T21:36:00.000-05:00

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

2008-01-14T00:01:00.000-05:00

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

2007-12-13T10:44:00.001-05:00

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

2007-12-01T09:20:00.000-05:00

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

2007-11-29T19:43:00.000-05:00

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!!

2007-11-21T12:54:00.000-05:00

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

2007-11-20T20:00:00.000-05:00

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

2007-11-13T23:47:00.000-05:00

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

2007-10-23T23:59:00.000-04:00

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)

2007-10-18T23:36:00.000-04:00

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

2007-10-11T15:08:00.000-04:00

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.

Science Fact - Quite a Looker

2007-10-03T22:59:00.000-04:00

I was reminiscing about elementary school with a friend today, and it conjured up a memory of mine form grade 4. I was in an almost empty classroom for some unknown reason, meaning that I was alone except for quiet Cindy sitting by the wall. And in order to pass the time I developed a challenging and thought-provoking game whereby I would throw my sharpened pencil into the ceiling tiles to see if I could get it to stick. After a few failed attempts the pencil lodged into one of the foamy squares (victory!) but after a brief second it freed itself and fell to the ground. Right in front of Cindy.

I asked Cindy a couple of times to throw/pass the pencil to me, but to no avail. She was conscuois of me, but completely unresponsive. As this was normal for Cindy, I went to go pick it up myself. But just as I reached her feet and bent down to get it, she swooped down faster than I have ever seen her move before and grabbed the pencil. And then brought it up just as quickly. Into my eye.

I had to wear a patch on my eye for a while, but apart from the ridicule of classmates I escaped any real damage. Lucky for me. And best of all, I could pretend to be a pirate on the playground!

This memory was appropriate for our current medical topic: ophthalmology (aka eye doctor stuff). So I thought I would write down some info on our eyes in order to make you appreciate my story even more.

Let me first talk about each part of the eye and what it does:

Cornea - The cornea is a tough, clear layer of cells in front of the eye. It can heal itself quickly, but it hurts so much if you scratch it.

Lens - The lens helps to focus light onto the back of the eye. It can change shape according to how far away you are looking.

Iris - This is the colourful part of your eye. It can contract or expand to let different amounts of light into your eye. The hole it makes is the pupil.

Pupil - As I said, this is not a structure. It's the hole in the middle of the iris that lets light into your eye.

Retina - This is the photosensitive area in the back of your eye. It converts light into nerve impulses and sends them to your brain. This is the part that contains those cells called rods and cones (cones are used for precise vision and for colour, while rods are good for seeing the “big picture” and for night vision).

Now that we know the basics, let's talk about a few weird things about our eyes. First of all, the retina has an area in the middle that is designed to work super well. All of the cells that may interfere with light are pushed to the sides so that the phororeceptors get the most direct light possible. This spot on the retina is called the macula, and the centre of it is called the fovea. When you look directly at something, you are lining up your fovea perfectly with that object. This allows you to see it very clearly.

The fovea contains mostly cones (the precise vision cells), which makes sense because when you focus on something you would like to see it well. But remember that the cones are crappy at night. The rods are the cells that are best at night, and these cells are found in the rest of the retina. So if you've ever looked at a starry sky, you may have seen a faint star out of the corner of your eye, but when you turned to look at it the star disappeared. The only way to see it was to look 5-10 degrees away. This method uses your rods more than your cones, enabling you to see things that don't produce much light.

Now for the second cool thing about eyes. The retina has to send all of the visual info to your brain, and it does this via the optic nerve. But at this area of the retina there are no photoreceptors. So if light shines on the optic disc (where the nerve meets the retina) you will not see anything at all. This is called the blindspot of the eye. Any object that is 30 degrees away from centre (away from your nose) will magically disappear! You don't notice this very often because one eye will compensate for the other one. But you can test this with the picture below. Cover your right eye and focus on the shape on the right with your left eye. Then move your face closer and farther away from the screen slowly until the shape on the left disappears. This is your blindspot. You can do the same by switching eyes and focusing on the other shape.

You can check out more fun eye games at these websites:

Optical Illusions

Visual Phenomena

Science Fact - Nail in the Coffin

2007-09-21T23:37:00.000-04:00

When I was a young child, I hated getting my fingernails cut by my mom. It took away valuable time from playing, and every once in a while she would cut a bit too much and cause some pain. So one time I decided to bite them off. When my mom saw this she said something like “Well, I guess I don't have to cut your nails right now.” Amazing! So I continued to do it, and it quickly turned into a habit (known as chronic onychophagia). FYI, this is considered the most common form of self-mutilation. So I guess I'm one sick puppy.

Anyhoo, I've been trying to give up the habit for the past few years, with varying degrees of success. But as I have recently focused more on the state of my nails, I began to notice the different parts of the fingernail. And this brings me to the today's topic. What is the half-circle of white at the base of my nails, and what can fingernails tell me about my health?

First, let's start with those white patches. These pale crescents are called lunulae, and are part of the nail root where your nail bed and new fingernail is actually produced. You can't see it, but your lunulae extend back into your finger several millimeters. If you damage this part of your finger, you can really screw up the nail.

Some people say that normally-shaped lunulae tell you nothing at all about your health, whereas others argue that the number, size, shape, and colour can tell you a great deal. A couple of things that I found interesting were that your lunula on the thumb of your dominant hand is usually bigger than the one on the other thumb. Also, if you have very large thumb lunulae (>25% of entire nail) or if you have them on your pinkies, then it could be a sign that your heart is working too hard. Possibly high blood pressure or other heart-related issues. Now this is not very substantiated, so take this info with a grain of salt.

You can have other types of white spots on your nails, too. Most often these random white spots (called leukonychia) are caused by minor trauma to the nail bed or lunulae, even if you can't remember ever hitting your fingers. Since it takes 3 weeks for your nails to grow ½ cm, many of the white spots were caused by trauma that happened 6 weeks earlier. And who remembers bumping their finger 6 weeks ago? Sometimes these spots are caused by zinc deficiency, but you should see other signs of zinc deficiency as well like hair loss and immunosuppression. And it's good to know that if you have horizontal white streaks that move up your finger as the nail grows, it could mean that you had been exposed to heavy metals like lead or mercury. Either that, or possibly the time you almost sliced through your nail with that sharp knife you got for your birthday. You know, the one Zaneta gave me. Uh, I mean you.

There are classic signs to look for in your fingernails that have been proven to be a window into your inner health. Let me list a few nail examples and their significance:

Pale Nail Beds - This often indicates some type of anemia (low hemoglobin in your blood)

Very Red Nail Beds - Heart Disease

Clubbing - Lung disease, or possibly heart disease or liver disease

Pitting or Rippling of the Nail - Psoriasis

Yellow Nails with Blue Base - Diabetes mellitus

Spoon-shaped Nails - Iron deficiency or thyroid problems

Just remember that the appearance of nails are not diagnostic. They only help to direct the physician's thought process. In other words if you see that your nails are pale or white, there is an increased chance that you are anemic, so you could go get that checked out to see for sure. But don't just self-medicate based on what your pinky looks like.

FOTC

2007-09-17T23:47:00.000-04:00

My friend Rory just showed me this hilarious folk comedy duo called Flight of the Conchords. These two guys from New Zealand are by no means the new kids on the block, as their group dates back to 1998. But if you haven't heard their songs or seen them on TV, then prepare to have your funny bone tickled and lightly caressed. Here are my favourite songs:

Business Time

Hiphopopotamus + Ryhmenocerus

Albi

Think About It

Check out these funny clips. You won't be disappointed.

Band/Album Names (Pt 18)

2007-09-15T17:45:00.000-04:00

Once again, I have a sweet list of band and/or album names for you all. Be careful, because they may blow your socks off.

Hot Trouble

Inferior Olive

Would Be Good

Customs

The Pons

And for all you fibre lovers out there:

The Rough Age

Have a Happy... Ramadan

2007-09-13T00:09:00.000-04:00

It's that time of year again!! Everyone around the arab world will wake up tomorrow full of childlike whimsy, for it will be Ramadan! And hopefully they are full of that whimsical stuff, because nothing else is entering your body until sundown. For those of you who are unfamiliar with this holy event, let me break it down for you.

Ramadan occurs every year during the ninth month of the Islamic calendar. Ramadan gets earlier by about 2 weeks each year because the Islamic calendar is based on the moon, not the sun (when I started to do this it fell on March and April). This is the most holy month of the year, full of prayers, charity, and community spirit. It's also a great time for self-reflection, forgiveness, and new beginnings. But other than these great ideas, what specifically goes on?

Well, one of the most obvious things is that you fast. And this is pretty strict. Between dawn and sunset you are not allowed to eat, drink (not even water), chew gum, or suck on mints. On top of that, you aren't supposed to smoke cigarettes or have sex during the daytime. And even though it is shunned in Islam, you are REALLY encouraged not to drink alcohol or do drugs during the entire month.

The upside is that every meal in the evening is heavenly, and you seem to find so much more time during the day to do things. When you're not tied down to eating lunch, or searching for a good snack, or taking a coffee break (or 5) then you realize how focused and productive you can be.

This year, Ramadan will end around October 12 (just after Thanksgiving for us Canadians). We will know for sure that night when we see a new moon. Or fail to see the moon. Whatever. That's when a new month begins in the Islamic calendar. So until the big feast at the end of it all (known as Eid ul-Fitr), I wish you all a happy... Ramadan.

Science Fact - Hypnic to be Square

2007-08-24T14:11:00.000-04:00

Have you ever slid into bed next to your significant other after a long, tiring day, feeling so good that you can fall asleep quickly and easily while snuggling up to your loved one? And then 30 seconds after you begin to dream about that exciting soccer match last week... you wind up and kick your sweetheart in the shin so hard that they scream in agony and jump out of the bed cursing your name. If this has happened to you, then maybe you could tell my girlfriend that I'm sorry and that I didn't do it on purpose.

These spontaneous muscle movements are called hypnic jerks. During the period between being awake and falling asleep, many people have very vivid dream-like sensations. And it's at these points that you can have muscle twitches. Hypnic jerks can feel like you're falling, or like you just got a big electric shock. When you feel like you've been electrocuted, it's no surprise that you can put your fist through plaster (it really hurts).

But it's unusual for your body to move during sleep. When you fall into a deep sleep, your brain does a great job at shutting off your physical body. By stopping your voluntary muscles from moving, you protect yourself from the unnecessary risk of wild flailing limbs or running through the streets asleep in your PJs. That's a good thing, because you don't want to be acting out all of your dreams in bed. Or do you...?

You will have more of these spasms if you are overtired, or if you are fighting against sleep. So the next time you've had a long stimulating day and go to sleep really late, it may be best to warn your partner(s).

Science Fact - The Straight and Marrow

2007-08-21T12:33:00.000-04:00

Many of us have had a broken arm, leg, or collarbone at some point in our lives. And most of us only think of bones when they're broken or likely to break. But bones do so much more than give us reasons to wear casts that people can sign. Our bones allow us to move around, protect very squishy organs (like your brain, lungs and spinal cord), and store important minerals like calcium. Bones also play an important role in the immune system. But what I want to focus on today is one of bone's most amazing roles: the ability to create all of our blood cells from the marrow stored inside.

Bone marrow is a spongy material found inside your bones. This stuff contains tons of stem cells, which are generic cells that can reproduce many times and change into other types of cells. These stem cells make a continuous supply of red blood cells (erythrocytes) to transport oxygen around your body, white blood cells (leukocytes) that form the major part of your immune system, and platelets (thrombocytes) to help with blood clotting and wound healing. There are many blood vessels inside your bones to supply nutrients to the extremely active cells as well as to carry away the mature blood cells that are being made.

There are two kinds of bone marrow: red and yellow. Yellow bone marrow is mostly fat and doesn't produce a lot of blood cells. You can find yellow marrow in long bones like those found in your legs. Red marrow is the good stuff. It is the most active bone marrow and is found in flat bones such as your hip bones, ribs, skull, and vertebrae. So if a doctor needs to take a bone marrow sample, they will most likely take it from your hip. Otherwise they may take a bit from your sternum (where your ribs meet at the front of your chest). But whatever way they take the sample, it will almost certainly hurt like a bitch.

As with most parts of your body, bone marrow can get screwed up. The most common problem is leukemia, which is a cancer of the blood. Specifically, it deals with the overproduction of early white blood cells (leukocytes <--> leukemia). One or more types of haematological stem cells become overactive and produce too many cells. On top of that, the cells they make are often immature and thus nonfunctional, so all they do is crowd out the good cells and fill up your blood with junk. Since these immature white blood cells are made in the bone marrow, this is where the cancer originates.

To treat leukemia, people are often zapped with radiation and given lots of chemotherapeutic drugs. But you can also have a bone marrow transplant (BMT) to increase your chances of survival. Here is how a BMT works:

(1) The doctor will collect some good stem cells from your bone marrow or your blood (there are a few stem cells circulating in your bloodstream)

(2) You will then be aggressively treated with radiation or chemo in order to kill all of your bone marrow (good and bad)

(3) The collected stem cells will be injected back into your body

(4) Amazingly, the stem cells know exactly where to go and will repopulate your bones to create good bone marrow

So the theory is that by saving some of your good stem cells for later, the doctor can use stronger treatments to increase the chance of killing the cancer. F#*%ing brilliant.

Traffic in India

2007-08-07T01:11:00.000-04:00

After you travel through the streets of Delhi in a tuk tuk, you realize how tame the traffic is here in North America. There are so many things on the road all at once, with no real lanes to divide the different modes of transportation. Even the yellow dividing lines are optional, as seen in this video. On the roads there are nice cars, shitty cars, buses, trucks, tuk tuks, rickshaws, motorbikes, bicycles, carts pulled by donkeys, pedestrians, and (of course) cows. Out of all of them, the ones with the most respect are the cows. People won't even beep at them. Well, unless it's absolutely necessary.

Another thing that's crazy about the traffic is the lack of traffic lights. Or more specifically, the lack of effective traffic lights. Most intersections are made like roudabout/merge/yield sort of things, and in the few places that actualy do have traffic lights, the cars don't really obey them. It takes almost your entire green light to wait for the opposing traffic to stop, and then by the time you can go it's turning red. So of course the cars keep going to make up for lost time, and will only stop when the impatience of the opposing traffic exceeds the speed/safety in numbers of your direction.

There's a good video I found on Youtube that illustrates the ability of traffic to move without a traffic light in India. I'm not sure the exact city, but I wouldn't be surprised if this was Delhi. Check it out.

Band/Album Names (Pt 17)

2007-08-06T22:46:00.001-04:00

Even though I've had over 2 months to collect album names, most of these goodies came from my short stay in Montreal.

Talkin' Up The Nanny

Methodist Man

Almost Business

Start Yer Generator

(You Got Some) 'Splainin' To Do

Maybe Not That Slimy

And last but not least:

Think (with 1st album title: Long & Hard)

Guess Who's Back in the M#@F%*ing House

2007-07-25T15:59:00.000-04:00

After 7 weeks abroad in 3 continents (Asia, Africa, and Europe) I have returned to Montreal. I had so many adventures in India such as climbing a mountain in the Himalayas, seeing the Taj Mahal, and being interviewed for a documentary about Mahatma Gandhi. In Egypt, I saw all of my family (2 uncles, 2 aunts, 9 cousins, and their ~15 children), went to a resort on the Red Sea, and hung out with Cairo's chief of police. And then in England I wandered around Camden and Trafalgar Square, got lost on the underground, barbecued hot dogs at a science fair, and ate fish & chips on Portobello road (George's, to be exact). But that's just a glimpse of what I got up to in those countries.

I've compiled a Top 10 list of interesting things about India and Egypt, so you may get a better idea as to what those countries are really like.

INDIA
1. In Delhi, shoeshine guys are great at secretly throwing massive amounts of shit on your shoes and then overcharging you to clean it up

2. On the road, cows have more rights than pedestrians

3. Any time that you decide not to wear your N-95 mask, your next patient will be suspected of having TB

4. Having electricity for 30 consecutive minutes is a luxury

5. You are 100 times more likely to see two men holding hands than you are to see a man and a woman doing the same

6. Wild marijuana grows everywhere along the roads, but it's supposedly pretty weak stuff

7. Food tastes better when your cook is wearing an old Britney Spears T-shirt

8. The two things that children want from you are chocolate and pens

9. In the Himalayas, over 80% of all jobs consist of breaking rocks by the side of the road.

10. You eventually stop feeling embarrassed when you ask people where you can find an STD and how much it will cost you

EGYPT

1. When getting gas at a gas station, it is not necessary to turn off your car for safety's sake, because the gas attendant will be smoking cigarettes anyway

2. Birthday parties for 4-year-olds begin at 10pm

3. Almost all social situations require you to shout at everyone and look pissed off

4. Canada is known for Celine Dion and gingerale

5. Most people hate the president, but he still gets 99% of the votes in their democratic elections (go figure...)

6. The daily recommended intake of meat is 2-3 kg

7. Women that wear a hijab (scarf over their hair) to be a devout conservative muslim while sporting a tight T-shirt that says “Imagine this shirt WET” really hurts my brain

8. People will wait in line for hours to see artificial snow

9. Swimming pools that have giant stone pillars in the center can cause massive head injuries

10. All coffee is called Nescafe, and all fridges are called Frigidaire

Over the Hills and Far Away

2007-06-02T15:50:00.000-04:00

I'm about to head out on an incredible journey, although it may be different that the most well-known Incredible Journey of our time. The adventure that I will be embarking on will take me to northern India, then to the heart of Egypt and finally ending up in London (in the land of Eng).

I'm going to take tons of pictures and will try to give everyone updates as often as I can, so please don't cry continuously while I'm gone. I'll be back in Canada at the end of July so I'll try to party with as many of you as possible (at least the readers that I know personally).

Until then, have a fantastic summer and keep your mind open to new science!

Band/Album Names (Pt 16)

2007-05-16T16:12:00.000-04:00

It's been difficult for me to find the time to follow up my sleeping post, but I assure you that it will be coming soon after I finish my exams. In the meantime, enjoy some more band and album names!! I'm surprised at how fast they have accumulated in the past couple of weeks. Again, let me know which ones you like, and add your own to the list.

Wake Up To Paint

Hypnic Jerks

Counter-Rant

Large With Child

Raging Murmur

Our Everything

And my favourite of the bunch:

The Rivers and Lakes' Deceitful Trick

Science Fact - Bright Eyed and Bushy Tailed

2007-05-09T00:06:00.000-04:00

My exams are in about a week, and since I need to cram about 7 years worth of medical information into my brain by then, I have resorted to drinking coffee again. I had given it up for a long time, or at least limiting myself to one or two cups each month. But now I'm relying heavily on my caffeine fix in order to study for at least 10 hours each day, especially since studying is my most effective natural “sleeping pill.” This external source of consciousness helps me keep my eyes open long enough to learn about the pathway for type 2 hypersensitivity, the differential diagnosis for oval macrocytes, or the major joints affected by ankylosing spondylitis.

But I've been imagining how much more productive I'd be if I didn't have to sleep. That's an extra 7-8 hours each day, or almost 50 hours over the next 6 nights before my exams. Everyone has pulled an all-nighter at some point in their lives, whether it was to study for that f#*king physics final, playing Halo 2 from start to finish, watching the sunrise over Lake Ontario from your cottage, or partying in an open field in the Maritimes after consuming vast amounts of alcohol and illegal substances. But who has actually stayed awake for more than 2 or 3 days in a row? Sorry Shireef, but your short-lived grade 12 biology project over Christmas break doesn't make the cut.

The more important question in all of this is: why do we need to sleep? What does sleep do for our bodies, and what would happen if we didn't sleep at all?

There are several theories as to why people sleep, but nobody knows for sure. Some say that it is to recuperate and save energy, but the amount of energy conserved is almost laughable. If this was the only reason why we slept, you would have to decide whether to sleep for 8 hours or to eat an extra piece of toast. Tough decision.

Another theory is that sleep, and more specifically the dreaming phase of sleep known as REM, helps with memory. Think of it as a secretary that works overtime each night to keep the office tidy and organized. REM sleep would go through the day's thoughts and events and then file them under “Important Filing Cabinet”, “Box in the Back of the Closet”, or “Recycling Bin”. This theory also has holes in it, because there are people who don't have REM sleep (e.g. people on MAOI antidepressants) who have functional memories.

The last theory I'll mention is that certain nerves in our brains need to rest. That way, they can be more sensitive to neurotransmitters during the next day and be able to work more efficiently. I like this theory a lot because it explains why you feel mentally 'dull' when you get very little sleep, and why you need to make up for the lost sleep in order to fully resensitize your neurons.

There are other theories out there, but I'll leave them for you to discover.

So what would happen if we don't sleep? The most common symptoms are feeling irritable and forgetful, but if you can make it to the 100 hour mark (~4 days) you'll start to hallucinate and become delusional.

The longest that any North American has stayed awake was 11 days. Randy Gardner did this in 1964 when he was 17 years old, and he did it all without any stimulants. Although his short term memory sucked, and even though he thought he was a professional football player for a while, he was able to talk and function normally by the end of it all. So Randy showed the world that going without sleep was not harmful. Right?

Well after a lot more research, it seems that sleep deprivation is actually pretty bad for you. It may contribute to diabetes, stunted growth, ADHD, memory loss, and psychosis (to name a few). But if you want to risk it and try it out for yourself, maybe you can stay awake long enough to help me pass my exams.

Stay tuned for the next installment: What's Sleep Got To Do With It?

Band/Album Names (Pt 15)

2007-04-30T18:40:00.000-04:00

It's that time again!! Even more band and album names coming at ya, with sources ranging from hematology class to drunken Montreal parties. If you have any ideas, send them my way for the next installment.

In The Biz

Hungrymore

CBC Machine

I Don't Know Furniture

Christmas Disease

And my favourite of the bunch (thanks Garagan!):

Come 32

Science Fact - A Nose for Booze

2007-04-22T21:48:00.000-04:00

At some point in our lives, most of us have gotten completely drunk. This may have been unintentional (“whoops! I think I had one too many glasses of chardonnay tonight”) but it's more likely that you were intentionally wasted (“I'm gonna prove to everyone that I can finish the whole 40-ouncer of Canadian Club before we hit the bars”). There is usually an inverse proportion between your desire to get drunk and the quality of booze that you consume. An example would be drinking one snifter of brandy vs drinking a 3L box of cheap wine.

An image that has been shown in many cartoons and movies is a dirty alcoholic with a red nose and a bad case of the hiccups (or more correctly spelled hiccoughs). He has a bottle in one hand and is lying in an alley where he can enjoy his state of semi-consciousness without any interruptions. I have seen drunk people get hiccups, and I have seen people in drunken stupors outside of my apartment, often with an almost empty bottle of gin hanging loosley from their hands. But do some people actually get a red nose when they drink? If so, why does this happen?

First of all, alcohol has several effects on the body. It makes you drunk (surprise surprise), acts as an analgesic (dulls pain) and a diuretic (makes you pee), and lowers your blood pressure by opening up your blood vessels. This last effect is responsible for giving people the characteristic red nose.

When you drink alcohol, the small blood vessels (capillaries) in your face expand, making you look more red than usual. For some reason, the blood vessels in a few people will not return to normal afterwards due to a lack of elasticity. Their capillaries will be stretched a lot each time that they drink heavily, and it gets harder and harder for the blood vessels to shrink back to their original size. It's common to see thin red lines on their nose and cheeks that stand out from the rest of the general redness.

Your face will get more and more damaged if you drink heavily or often (or both). The redness can stay around for a long time. In many cases the redness is permanent!! There is no cure for this, mainly because nobody really understands why some people are affected while others aren't. The best thing to do is to avoid the things that cause your face to turn red (binge drinking, high stress, spicy foods, etc). Smoking can also worsen the problem by making your capillaries even more sensitive to the effects of alcohol, so cut back or quit altogether if you're worried about your nose.

There are a few potential explanations for this redness. The most common theory is that the affected people have a condition called rosacea. This is a disorder that affects about 5% of the caucasian population, and usually first shows up around age 30 or 40. The blood vessels in your nose and cheeks enlarge and become leaky, causing inflammation and redness in your skin. Over time this redness becomes more and more permanent. Severe cases of rosacea can cause acne-like bumps and eventually make your nose lumpy and swollen like W C Fields. There is no cure, but there are ways to manage rosacea. Check out this website for more info.

Another potential theory is that these people have a vitamin deficiency due to their drinking. It's possible that a vitamin B1 (thiamine) deficiency could cause “booze nose”. This could be due to the alcohol, or the fact that alcoholics often have piss-poor diets. The best way to treat this is to eat a more varied diet including meat and eggs, get more exercise in the sun, and (of course) cut down on the booze. However, I think that thiamine deficiency (aka Beriberi) is a very unlikely cause. One would almost certainly have the other major symptoms: heart failure, extremely high blood pressure, peripheral edema (swelling), and nerve damage. So if you get a slighly red nose when you drink, don't go around telling people that you have beriberi.

Science Fact - The Feet of an Athlete

2007-04-16T14:43:00.000-04:00

If you've ever been in a locker room or public shower facility, you probably got a lecture from a parent or friend about how dirty the floors are. "Don't walk around barefoot in there! You'll catch something aweful," or "Those places are covered in fungus!" or some equivalent nagging comment. Well, as annoying as they may be, they're often telling the truth.

Let's begin with an overview of fungus (if you want a real lesson about fungus then talk to Shireef, everyone's friendly neighbourhood mycologist). Fungus is neither a plant nor animal. It's sort of in between, but also quite different and special. Without them we wouldn't have any lichens, cream of mushroom soup, or leavened bread, and many of the dead and rotting organic matter wouldn't break down and keep the circle of life alive.

A big characteristic of many fungi is the desire to grow in cool, moist areas. You rarely see mushrooms growing in the sunniest or driest part of your lawn because they'd rather be in the shade. It's not as hot, has little UV light, and usually has more water available for optimal fungal growth.

Let me jump topics for a second and discuss keratin. For all of you non-dermatologists, keratin is a protein that makes the protective layer on the outside of your skin. Mucous membranes (like the inside of your cheeks) don't have a keratin layer, so it's less protected and more permeable to chemicals and viruses. Keratin is also made into nails and hair. Because these keratin structures are made out of protein, they can possibly be a food source for certain organisms. These organisms are known as dermatophytes.

One type of dermatophyte loves to eat the keratin on your feet. Why would this fungus like foot keratin, you may ask? Well, many people don't fully clean their feet in the shower, and may not dry them properly either (especially between their toes). Socks and shoes are put on them, creating a moist and dark environment where they can grow easily. Showers and locker rooms are also cool and wet areas where the fungus can spread from one person's feet to another. Thus, tinea pedis is commonly called athlete's foot.

Surprisingly, you can spread athlete's foot to your crotch, armpits, or other body parts by scratching your feet and then scratching somewhere else. These other fungal infections are caused by the same organisms, but we give them a different name because of the affected body part. So the fungus that causes athlete's foot (tinea pedis) is the same fungus that cuases things like jock itch (tinea cruris) and ringworm (tinea corporis).

Once the fungus starts to feed on the outer skin layer of your feet, it causes scaling, flaking of the skin, and lots of itchiness. These symptoms help to spread the infection. You may also have cracked and blistered skin resulting in pain and inflammation.

Now for the big question: How do you get rid of this pesky fungus? A simple way that may work would be to clean your feel properly in the shower and then make sure they are completely dry afterwards. Some people will take showers in the evening instead of the morning so their feet will be very dry by the time they put on shoes. Wearing fresh clean socks is always smart. Another good idea would be to alternate pairs of shoes from day to day so you allow them to dry out in between uses. And some people advocate walking around barefoot in the sunshine to help kill the fungus.

If you don't have complete confidence in those methods, you can get drugs to help you win the battle. There are many topical (meaning things you put on your skin) medications that you can use, but they will only increase your chance of getting rid of the fungus by 15-30%. Drugs like itraconazole and terbinafine are often used. If you get prescribed these creams, you need to use them for a while, like 6 weeks. You may feel better after a week or so (no itch), but if you stop using the cream too early then the fungus will almost surely come back.

So here are some parting words:

Don't walk barefoot in wet public places like showers and locker rooms.

Keep your feet dry and wear fresh socks, even if this means doing an extra load of laundry every two weeks.

If you get athlete's foot, try not to scratch it. And definitely don't scratch the rest of your body afterwards.

Using non-medicinal methods of getting rid of athlete's foot work well, and should be done before jumping to medications.

Finish your prescriptions, even if you start feeling better quickly.

My New Shirt

2007-04-12T19:51:00.000-04:00

Tell me what you think of my new shirt. It's pretty yellow, but I like it a lot.

This photo was taken on one of the only sunny days in Kingston this month. Come on spring! Hurry up and be summer!

Science Fact - Stage Fright (To Pee Or Not To Pee)

2007-04-10T00:31:00.000-04:00

Many people have difficulty speaking in front of a large audience. This is well understood and, to a large extent, met with sympathy. The problem itself is psychological, but it has physical effects such as anxiety and rapid heartbeat. Some people may avoid certain social situations, university courses or even types of employment because of the worry that public speaking will be involved. It's plain to see that something that starts out as a small fear can have a big impact on someone's life.

The same is true with another type of fear. The fear of urinating in public places. There are several names for this such as bashful bladder, pee shy, shy bladder syndrome, or paruresis. People with paruresis have difficulty urinating when others are present or within earshot, either in public or at home. Some will also have problems with urination when time is a factor, when there is a remote possibility of others being nearby, or when they are travelling on moving vehicles.

You may think that paruresis is pretty silly and uncommon, but it's a serious and embarrassing problem for those who suffer from it. It is estimated that about 7% of the population is pee shy, and most (but definitely not all) of these people are men. For many of these guys, it's difficult to bring this up with their urine-confident friends who may not understand. You know, the guys who do things like have piss-for-distance contests or who team up to put out a small fire with their nitrogenous waste.

This condition can be quite serious. Many people will only go to restaurants and bars where there is a private bathroom, or pass up employment because of the bathroom facilities, or even avoid social situations altogether. It's common for paruresis sufferers to lower their fluid intake in order to reduce their urge to urinate. And the anxiety felt in public restrooms is very significant. Each time they can't pee in public they feel horrible, and the next time they try they will feel more anxious, making it even more difficult to let loose.

If you have a bashful bladder, there are some things that you can do to make micturition easier:

Relax - Take some deep breaths, let your muscles relax, and let this inner peace help release your inner pee.

You're Not Important - The bathroom doesn't revolve around you, and the people in the bathroom don't give you a second thought. Don't think that everyone is watching, listening, and ridiculing you. They have other things on their mind than analyzing the bathroom habits of some stranger.

Wait - Eventually the bathroom will be empty, so wait until you have the privacy you need. Nobody will notice you lingering in the lavatory.

Use A Stall - If there are many people at the urinals, go into a stall. You can even sit down to pee to minimize the tinkling sound.

Waterfall - The sound of water running can be helpful psychological, and it can also mask the sound of your own waterfall.

Shift Your Focus - Instead of thinking negative thoughts and worrying about everyone around you, shift your focus to something else. Look at the stupid graffiti on the bathroom walls, study the tiles on the floor, read the fine print on your credit card, or think of all the animals that begin with the letter V.

Tell People - Talk to your friends about it, and get their support. They will understand that it's a serious thing to you, and will help make it easier for you when you're out in public.

So for those who have some type of paruresis, remember that you are not alone and that it is becoming more recognized as being a serious condition. Supposedly it's now a valid reason to get out of jury duty!

P.S. There is an equivalent type of fear related to pinching a loaf, laying cable, or dropping the kids off at the pool. It's called parcopresis.

When You Wish Upon a Death Star

2007-03-31T14:39:00.000-04:00

One of my friends directed me to this hilarious video of a phone conversation between Darth Vader and Senator Palpatine. I believe this takes place between A New Hope and The Empire Strikes Back. If you're a Star Wars fan, you should definitely check this out!

Science Fact - Turn Your Head and Cough

2007-03-30T13:52:00.000-04:00

There have been many jokes made about doctors and their examinations. One of the more popular topics is the classic "turn your head and cough" part of the physical exam for men. It seems irrational to many people why the doctor need to grab your junk in the first place, especially when he gets you to do something like cough at the same time. Why do doctors do this? What are they checking for? What does the cough do? And why do you have to turn your head?

First of all, the doctor isn't grabbing your junk. He/she is feeling for weak spots in your inguinal canal. Let me explain. Your inguinal canal runs diagonally along the line where your leg meets your torso. There are two weak spot within this canal, one of them being very close to your twig and berries. If you're unlucky then there could be a break in this spot, resulting in a scrotum full of small intestines. This is a type of hernia called an inguinal hernia.

Let's talk about hernias some more. A hernia is when an organ (commonly your small intestine) pushes through your abdominal wall. This causes a lot of pain, and the only way to fix it is to get surgery. Why do hernias happen? There are two things that come together to make a hernia. The first thing is a weakness in the abdominal wall. Usually this is congenital, meaning you are born that way, but previous abdominal surgery can also cause a weak spot. The second factor is excessive pressure/straining. There are a few ways for the strain to occur:

Obesity or sudden weight gain

Lifting heavy objects

Diarrhea or constipation

Persistent coughing or sneezing

Pregnancy

The inguinal canals of all men have weak spots, making it likely that a hernia would occur here. In fact, inguinal hernias are among the most common hernias that you can get. So when the doctor puts their hand down there, they are feeling for those weak spots and making sure nothing is poking through. Coughing adds some pressure to you abdomen, allowing the doctor to assess the strength of those weak spots under added stress.

And finally, why does the doctor get you to turn your head? Well if you were the doctor, would you want patient after patient coughing in your face? I don't think so.

For more information on hernias, check out Weird Al's video Living With A Hernia.

Look-alikes

2007-03-24T22:54:00.000-04:00

When I was reading Mike's blog today I stumbled across this excellent website about some uncanny resemblances between known celebrities. There are some great ones here. My favourites are definitely:

Britney & Sloth

Hugh Hefner & Hoggle from The Labyrinth

Vintage Cap'n Crunch & Modern-day Hulk Hogan.

Who knew there were so many look-alikes out there?

Science Fact - Crack Isn't Bad, Right?

2007-03-20T00:45:00.000-04:00

How many of you have bodies that sound like Rice Krispies cereal? You know, the type of body that snaps, crackles, and pops at every movement. There must be even more of you who like to crack their knuckles on occasion (like during every single class and before you set out to type an email). Some of us find this act extremely pleasing and rewarding, while other people can't do it at all and would hurt themselves if they tried. Why can some of us crack our joints but not others? What actually makes that popping sound? And most importantly, is this act going to cause an epidemic of arthritis?

First of all, let me tackle what your joints actualy look like. A joint allows two pieces of bone to move, but without any means of lubrication the bones would grind together, destroy themselves and hurt like hell. So the ends of the bones have cartilage to protect them and help them slide over each other easily. But there's more to a joint than that. The whole joint is completely enclosed in a membrane that contains a slippery, nutrient-rich liquid. The membrane is called a synovial membrane and the fluid is called (surprise surprise) synovial fluid. Together, this creates a joint capsule.

For many years people had no idea what caused our joints to crack. There were many mediocre theories but no real proof. Today, we still have very little proof. But at least we have a solid theory that many people agree on. Let me describe a finger joint to illustrate this. If I pulled on my finger to "crack my knuckle", I am pulling the two bones apart. But the joint capsule is attached to the bones so it also expands. For those of you who remember high school physics, increasing the volume of a chamber that contains a fixed amount of fluid will drop the internal pressure. If I pull on my finger, the pressure of the synovial fluid will become low enough to reach its vapour pressure. When this happens, some of the liquid will evaporate and create a bubble of gas. Dissolved gases will also be released, contributing to the bubble formation. The bubble will quickly collapse on itself after it's formed, creating the characteristic clicking sound.

So why are some people naturally cracky? It often depends on how loose your ligaments are. If you have loose ligaments, it is much easier to move your bones apart and create the low-pressure environment in your joints. Some people with "loose joints" will seem to crack several joints just by blinking (ie Stronach).

Now for the big question. Does cracking your joints cause arthritis? The short answer to the question (from our limited knowledge) is: probably not. Honestly, nobody is 100% sure. Why isn't there solid evidence to determine this? Because there have only been a handful of half-assed studies that looked at this question. The biggest one had a sample size of only 300 people.

Here is what we've learned so far. Most of the studies could not find any link between joint cracking and arthritis. However, people who were habitual joint crackers showed an increase in swelling as well as lower grip strength. But do we know if one causes the other? Some argue that having loose joints predispose you to these problems, and that joint cracking is just a side effect of the laxity of the joints. Who knows? But it seems pretty clear so far that the bones and cartilage are not damaged, and that joint crackers are not more prone to developing arthritis.

One of the doctors I've met here at Queen's told me that (to quote Sloan) if it feels good, do it. If cracking your joints isn't causing you pain, there is an exellent chance that it's not causing any harm, either. There tends to be a general agreement with this idea. And if cracking your knuckles causes a lot of pain, why the hell are you doing it?

Science Fact - Caution: Pamplemousse!

2007-03-13T13:44:00.000-04:00

When I was living in Thornton House back at Mount Allison University, I would rely almost solely on the meal hall for my food. We could get 19 meals each week, but most people couldn't handle eating that much cafeteria food. I am not like most people. The all-you-can-eat cafeteria was heaven to me despite frequently recurring dishes like sloppy joes and beef teryaki.

One of the things that kept me coming back was the grapefruit juice. More specifically the yellow grapefruit juice that has about 1 teaspoon of sugar in 10 L of juice. I would drink 3 glasses of this divine liquid at each meal. That means had 57 glasses of grapefruit juice each week for about 3 years.

Now the pamplemousse is an incredible fruit. It has nutrients like vitamin C, it tastes great (not too sweet), it's refreshing. But it can also be extremely dangerous. It can make many medications too potent or not powerful enough, causing effects that range from the most mild (unnoticeable) to the most severe (death). How could such an innocent citrus fruit cause so many problems? Read on to find out.

To start with, let's talk about drug metabolism. Our liver is the main organ responsible for modifying drugs and allowing our bodies to get rid of them. That's why everything that we eat gets absorbed into a specialized bloodstream (the portal system) that goes directly to the liver before reaching any other part of the body. This is called “first pass” metabolism. All of these chemical modifications are meant to make compounds more water soluble and easier to be excreted. But in terms of drugs this could mean turning an active drug to an inactive one, or turning an inactive prodrug into its active form.

There is a plethora of liver enzymes that metabolize drugs. The major group are the cytochrome P450 enzymes (aka CYP). There are many types of these enzymes, but the CYP3A4 enzyme is able to metabolize the majority of chemicals. We also have this important enzyme in the walls of our intestines to further help the metabolism of things before even reaching the bloodstream. An important concept is that if you mess with one of these enzymes, you are changing the way your body can handle other drugs that require this enzyme. Grapefruit is dangerous because of this.

There is something in grapefruit and its juice (but not other fruits or juices) that screws up the CYP3A4 in our guts. The enzyme can't work anymore and so the cell needs to make new enzyme from scratch before it can do its job again. During this time, many drugs (~60%) will be absorbed differently than you would expect. On average, grapefruit will increase the concentration of drugs 5- to 25-fold by preventing their metabolism in your guts. This can cause serious effects on your body.

Here are some examples of drug/grapefruit interactions that you should be aware of:

Antihistamines - You can mess up your heart rhythm and have a heart attack

Blood Pressure Meds (Antihypertensives) - Higher concentration, so you can get lightheaded and dizzy as well as have a super fast heartbeat

Lipitor (and other cholesterol-lowering drugs) - More potent, so lots of side effects

Caffeine - Increased absorption so you get a super jolt

Viagra - Slower absorption so you don't get the 'kick' you need

Valium, Methadone - Increased concentration in your bloodstream

These are just a few examples of drug interactions with grapefruit. Because of this, you can no longer find grapefruit juice in hospitals or nursing homes. Some may argue that you can use this lovely tasting liquid to reduce the amount of drug you need to take and save $$. The problem is that you can't predict exactly how much the juice will affect drug concentrations.

Here is the take-home message: If you are on medications and don't drink grapefruit juice, don't start now. But if you regularly drink grapefruit juice and have already optimized your drug regimen, don't stop the pamplemousse. This could decompensate for things and also cause bad effects (like having the drugs not work anymore).

Part of Everything

2007-03-13T11:06:00.000-04:00

I love this shirt so much!! You can find other gems like this on engrish.com

Science Fact - Rabid (Hopping Mad)

2007-03-06T22:48:00.000-05:00

The classic 1957 movie Old Yeller was a touching story about how a mischevious stray dog shows up at the family farm and causes havoc, but slowly becomes a useful and lovable part of the family. It's eerie how similar this is to the Pauly Shore movie Son In Law. But unlike Son In Law (sadly), Pauly's character Crawl doesn't get killed with a shotgun.

But why did Tommy Kirk, the actor who played Ernst in another classic movie called Swiss Family Robinson, shoot his beloved ol' yeller companion? The answer is: rabies. Here is a summary of what many people know about rabies. An animal gets bitten by a rabid animal, then it starts going crazy and foams at the mouth, and finally goes around biting people before it dies. This is actually pretty accurate, but let me explain the steps a bit further and discuss what you can do if you somehow get rabies.

First of all, rabies is a virus. It can get into your body through animal bites, but a more common route is simply through saliva, like the time you shared your ice cream cone with that stray dog. Seriously, though, animal licks on an open cut or on the mouth are the most common ways of getting rabies. The virus then hides away for a while (ranging from a few days to a year) before all hell breaks loose.

When the rabies virus decides to get off its ass and do something, it uses our nerves as a subway system to travel to our brain. When it gets to Grand Central Nervous Station it causes tons of problems. This is when the first symptoms appear, like behavioural changes (excitability, fury, confusion), fever, and loss of appetite. The infection quickly progresses, and within a week the person becomes very sick. There is an interesting symptom late in the infection called hydrophobia. The person avoids water, and will gag at the sight or thought of water. Because of this, they have a lot of trouble swallowing, so they tend to drool a lot. Hence the frothy mouth.

The rabies virus does an interesting thing once it reaches the brain. Some of the virus leaves through the nerves again and travels to places that secrete liquid. The most common place is the salivary glands, but some virus can also be found in tears and breast milk. This helps to spread rabies to other hosts.

Now, how serious is rabies? When is the prognosis bad? And what can we do about it? Well, if you have rabies (ie you begin to show the symptoms) it is almost certain that you will die. There is nothing that anybody can do to save you. You will die within a week or two. Crazy stuff. But if you've been bitten by a rabid animal, you can prevent certain death by getting a rabies vaccine. This vaccine can only be used before the virus gets to the brain. After that time it is too late. So if you get bitten by a strange animal and are worried about rabies, get a vaccine right away!! If you're travelling somewhere that has lots of rabies around, you can also get a rabies vaccination beforehand to help protect you.

There was a case of human rabies in Canada last week (the first case in a few decades). This man got it from a bat bite and never bothered to get the vaccine. Let this be a lesson to you all.

So now that you know more about rabies, it makes sense why Ol' Yeller was killed in order to prevent the kids from getting rabies. I'm pretty sure that the farming family didn't have access to a good vaccine at the time, and it would only be a matter of time before the dog suffered through the horrible symptoms and went to the big doghouse in the sky.

Band/Album Names (Pt 14)

2007-03-05T23:36:00.000-05:00

It's that time again! I collected these gems around Chinese New Year from bad movies, PBL research, and an email that my friend Jeffson Chung sent out to our entire class. But I thought I'd end the entire set with a great album name that I came up with a few years ago. Enjoy!

Be Careful The Elephant

It's Today in China

Dark Therapy

My Brain My Cave

And the kicker to end it off:

Amish Homage

Science Fact - Hair Today

2007-02-21T23:49:00.000-05:00

People have been obsessed about hair since the time of the ancient Egyptians (my ancestors). This obsession over a part of our bodies has continued throughout history, whether people grew it long, cut it short, concealed it, dyed it, or wore fake wigs and beards. This fetish has not diminished in the 20th and 21st centuries. Examples of people with great hair from our lifetimes are shown below to illustrate this point.

So what is hair all about? What is it made of? Why does it fall out? Why doesn't it hurt when I get it cut? And most importantly, why don't I need an arm haircut now and then? This is Hanni Darwish coming at you with science and fun, and if you're not careful, you might learn something before it's done. Hey hey hey!!

Hair is mostly made out of proteins such as keratin. This long protein is the substance that "seals off" our skin on our hands and lips, but is absent on mucous membranes like the inside of our cheeks. Keratin is also found in fingernails and the enamel of our teeth.

Hair is dead. Even though it is made from follicles (that are alive) hair is only protein. Hair has no living cells whatsoever, including nerve cells, so you don't feel anything when you cut your hair. Imagine how painful it would be to get a trim or to shave in the morning if we actually could sense our hair the way we sense our fingers. The only consolation to this would be getting some serious anaesthetic (hello morphine!) before a haircut. But keep in mind that if the person sitting behind you in class tugged at your hair, you would feel it because the force would stimulate nerves in your skin and hair follicles.

Because all of your hair is dead, it doesn't get repaired once it comes out of your head. So you should take good care of it, like a favourite sweater that can only be hand washed in cold water. Even though it seems so easy to just throw it in the washing machine, you're going to ruin it pretty quickly. Things you can do to help your hair grow well and keep it shiny and new are:

Treat your hair delicately

Get 7-9 hours of sleep each night

Get enough vitamins

Lower your stress

Stop smoking

Reduce your caffeine intake

Reduce the amount of sugar anf fat in your diet

But wait a second!! Doesn't your hair grow back? Or do you have the same strands of hair forever? Well, every hair follicle can grow about 20 hairs in your lifetime. So one hair grows for a certain amount of time and then falls out before another hair grows. There are two stages of hair growth: anagen and telogen (or to use lay terms, stop and go). Hair growth ranges from a few weeks to a few years, depending on both location and genetics. Once it stops growing, your hair follicle goes into a rest phase for a few months. When it starts growing a new hair, it pushes the old hair out. This is why we lose about 100 hairs each day from our heads.

Now let me finish with another brief word about hair locations. Most of our hair grows at about 1/2" per month, or 6" per year. So if the hair on your head is set to grow for 3 years, the longest you can grow your hair is 18". Likewise, if your arm hair grows for only 2 months it will get to be 1" before falling out, thus keeping your arm hair at an even length and preventing you from requiring an arm haircut. All of these set times are determined by location and genetics, so as long as you are getting proper nutrition your hair will grow at it's normal rate. It is unlikely that you can influence the growth rate by doing external things like eating banana peels, standing on your head, or rubbing your fingernails together.

Snack Attack Motherf**ker

2007-02-19T22:10:00.000-05:00

During an excellent night of partying with some of my old Mount Allison buddies Rico and Rob, I watched some pretty funny videos. The first clip was an up-and-coming comedian named Demetri Martin. Check out a bit of his comedy routine and see if his humour tickles your funny bone. He's no Bill Hicks, but I still dig his jokes.

The other hilarious videos that we watched were more SNL Digital Shorts. We've all seen Dick in a Box, but there are even better ones like Lazy Sunday and the two-part masterpiece series entitled Laser Cats and Laser Cats 2.

Band/Album Names (Pt 13)

2007-02-15T17:24:00.000-05:00

For all you superstitious readers out there, it's time for lucky part 13 of the who-the-heck-knows part series of band and/or album names. Many of these were inspired by either geriatric patients or the circumstances surrounding my encounters with them.

Dancing with Nigel

Short of Breast

The Hub Bub

Start Low Go Slow

Dementia Sandwich

And the best name for an elderly diabetic rap artist:

P. Suga

Eventually someone will take one of these ideas and make it big. Then I'll know that all my effort was truly worth it.

Science Fact - Stretch Armstrong and EDS

2007-02-10T21:31:00.000-05:00

How many people do you know who are double-jointed? They seemingly can bend their fingers backwards with the greatest of ease, or can touch their thumbs to their wrists without screaming in agony. This is foreign to me, as I am one of the least flexible people I know. When I try to touch my toes, everyone around me begins to laugh until a wave of pity silences them.

But what is double-jointed, anyway? Does this mean that someone has twice as many joints? Of course not. Everyone has the same number of joints. It's just that some people can move those joints more than others. This is called joint hypermobility.

Joints depend on ligaments and muscles for stability and movement. If you have really tight muscles and the only stretching you do is to turn off your alarm in the morning (me) then your joint mobility will be limited. With proper stretching you can increase the movement of joints and become more flexible.

Stretching muscles is something that you need to actively do to change joint mobility. But there can be genetics behind hypermobile joints. If your ligaments are too weak/stretchy then your joints won't be held together as tightly, allowing more movement. This is most commonly caused by a genetic condition called Ehlers-Danlos Syndrome (EDS).

People with EDS have a problem making collagen, a strong protein found in connective tissue such as skin, bones, cartilage, and ligaments. The two main symptoms of this condition are hypermobile joints and stretchy skin. Their joints are extra moveable because their ligaments are too lax. The most common joints involved are the fingers, wrists, shoulders, hips, and knees.

The other symptom is soft, velvety skin that can stretch a lot. Once you let go, the skin should go back to normal. The reason for their super elastic epidermis is that the connective tissue holding the skin to the rest of their body is not formed properly.

You may be thinking that this condition has no downsides. Who wouldn't want to be like Stretch Armstrong? Sadly, people with EDS are a bit less than super heroes. They have an increased risk of developing arthritis, and many people suffer from joint pain and dislocations. Their skin is fragile so they get cut more easily and heal poorly. This can be a concern for surgery as the healing process is a lot longer. Bruising may also occur more frequently.

There are three major types of EDS: hypermobility, classic, and vascular. The first two types will experience most or all of the above symptoms. Vascular EDS sufferers, however, can't make collagen in their blood vessels either. People with this (thankfully rare) type of EDS can spontaneously bleed internally and suffer serious consequences. Most of these individuals have their lifespan cut in half because of this problem.

There are a lot of excellent websites for people with EDS. If you're interested in this genetic disorder that affect 1 in 5000, go check them out.

EDS Today
EDS Support Group

Finally, it's been found that certain types of EDS can be helped by taking lots of vitamin C. It makes sense since this vitamin is needed to make collagen and connective tissue. Yet another reason why vitamin C is the best medicine!

The Best 13 kb Ever

2007-02-07T01:03:00.000-05:00

My fantastic roommate Alex just found one of the simplest yet most beautiful animations ever. And to think, the whole thing is just 13 kb!! Check it out, but I warn you that you may end up staring at the hypnotic movements of this joyful creature for hours at a time.

Science Fact - Urochrome

2007-02-05T23:38:00.000-05:00

I was in the bathroom today and was standing over my porcelain throne, releasing the sunny contents of my bladder when something occurred to me. It's funny how many important things happen in the bathroom (this idea is directly taken from Sam's fantastic blog). What happened was that I remembered the question that my friend Erin asked me. To state it in a Jerry Seinfeld-esque way, "What's the deal with urine?" Seriously. Why do we need to pee? Why is it sometimes clear, sometimes yellow? Why do millions of people ingest horse urine on purpose? Stay tuned, all you avid readers and urolagniacs.

The main purpose of urine is to get rid of waste products and excess salts from your body. If you couldn't piss, your waste products would back up into your bloodstream and eventually make your body shut down. This is similar to having your septic tank back up into your pipes and end up contaminating your drinking water. Yummy.

So the bad toxins that we excrete are compounds like ammonia, urea, various medications, and other junk from dead cells. It turns out that some of this dead cell junk comes from red blood cells. Red blood cells have hemoglobin, an iron containing molecule that can transport oxgen all around our bodies. When it gets old and feeble, hemoglobin breaks down into bilirubin. This stuff is sent into your gut and goes out with the rest of the solid waste. So when you pinch a loaf, or drop the kids off at the pool, the brown colour you see in the (hopefully) toilet is due to bilirubin.

But what does this have to do with pee? Well, a little bit of bilirubin escapes the confines of the intestines and goes back into the bloodstream where it is further broken down into urobilins such as urochrome. These new compounds are filtered by the kidneys and enter the urine, turning this watery waste to a beautiful yellow colour.

So why did my grade 3 friend Matthew King tell me that when my pee is yellow I should drink water? It's a little deeper than the reason he gave me ("my mom's a nurse and she said so"). Normally, you will be making and destroying a constant number of red blood cells, so you will be making a constant amount of urobilin. That means your pee will roughly contain the same amout of 'yellow dye' per unit of time. It's all a matter of how much water you mix with it. If you drink lots of water or take a diuretic (aka pee inducer), maybe during a night of drinking or perhaps a coffee-intensive day, then you will dilute the yellow colour and it will look almost clear. If, on the other hand, you are dehydrated and your body doesn't want to lose much water, your kidneys will concentrate the waste products and make a darker yellow pee. So Matt King's mother was right: when you have yellow pee, you should drink water because you are likely dehydrated.

A few more fast facts about pee:

Taking too much vitamin B can turn your pee bright yellow. Be sure to drink lots of water when you take your multivitamin to help get rid of the excess vitamin B.

As I had mentioned before, the estrogen derived from pregnant female horse urine (premarin) is used by millions of women in North America and is the leading product for hormone replacement therapy. Yikes.

Finally, I would like to pose a question to you male readers. How many of you stand up to pee and how many sit down? I have only recently noticed that the "sit down revolution" is taking place and growing in size. There are pros and cons for both sides, but I'm taking a stand for standing up.

Translation - The Musical

2007-01-31T11:06:00.000-05:00

My friend Crystal showed me this video on YouTube about how mRNA translation was taught in the 70's. It is very reminiscent of Hair (the musical). If you like molecular biology, hippies, and poetry, you'll love this video. It starts with a 3 minute introduction to the process of mRNA translation, so if you already know about it just skip to the good part.

Band/Album Names (Pt 12)

2007-01-30T16:46:00.000-05:00

The newest installment of band and/or album names is sure to be a hit. I have entries to please the math nerd, the med student, and everyone in between. Here they are:

First Fiddle

I Likes

Expert Tease

Bernoulli

Can You Make Claws For Me?

Second Minute

And for all the med students who have examined the respiratory system on patients:

Fremitus (first album: "99")

Sadly, some of my band names for this installment were already taken. I can no longer suggest Fast Forward, nor can I discuss how cool and possibly how close to extinction the term "fast forward" is in our society of CDs, DVDs and MP3s. Next time I will be faster with my posts to aviod this problem. Like 22 years faster in this case.

Science Fact - Carotenemia (Mmmm You Said It)

2007-01-28T11:36:00.000-05:00

There is a fantastic song that Joel and I discovered in our first year at Mount A. It's a song from Spearhead called "Red Beans and Rice". There are so many great lines from this song, but one that stuck was "Your skin will turn orange if you drink carrot juice." Now, Spearhead is known to be a reliable source for scientific facts, but I wanted to find out more details for myself. Is it true that your skin can turn orange? Before I get to that answer, let me talk a bit about vitamin A and beta-carotene.

Vitamin A is important for maintaining proper vision, keeping the immune system functioning, and preventing bacteria and viruses from entering our bodies by strengthening the barriers between us and them (skin, mucous membranes, intestinal tract, etc). So think of vitamin A as being useful for our blood and everything exposed to the outside environment.

There are two sources for vitamin A: animals and plants. Animal sources have the direct, pre-formed vitamin A called retinol. This is found in liver, whole milk, eggs, and butter. Liver is the biggest source of vitamin A by far because that's where animals store this vitamin.

Plants don't contain vitamin A, but they contain molecules that can be turned into the vitamin. These compounds are called pro-vitamin A, or carotenoids. The most common carotenoid is beta-carotene, and one of the biggest sources for beta-carotene is (surprise surprise) carrots! Actually, the best plant source would be carrot juice (aka liquid carrot). But you can get a lot of beta-carotene from other fruits and veggies, especially ones that are bright yellow, orange, or dark green. Some examples would be sweet potatoes, spinach, cantaloupe, and mangoes.

Most people who live in developed countries get enough vitamin A in their diets. But there are still between 250,000 and 500,000 people worldwide who go blind each year because of not enough vitamin A. Drinking too much alcohol can also lead to a vitamin deficiency, partly due to the liver damage you're causing.

On the other hand, there is a serious risk of getting too much vitamin A in your diet. If you get too much in one or two meals you can develop headaches, drowsiness, peeling skin, blurred vision, nausea and vomiting. If you ate one ounce of polar bear liver, you would ingest enough vitamin A to kill you!! That's one less reason to eat polar bears. There are also some serious risks for taking too much vitamin A chronically (consistently over a long period of time) such as osteoporosis, cancer, and liver damage.

Retinol (the animal source) is easy to overdose on, but beta-carotene is safer because if you take too much, your body will slow down its conversion to vitamin A. That means you will have a lot of unused beta-carotene, so it gets stored in your liver. But when you have filled up your liver storage space, the yellowish orange beta-carotene will begin to float around your body and show up in your skin. The process of beta-carotene turning your skin yellow is called carotenemia. You mainly see this happen in the palms of your hand and the soles of your feet.

So to recap, vitamin A is important for maintaining a healthy body, but it's possible to get too little or too much. Also, drinking too much carrot juice (the most potent plant source of beta-carotene) can turn your skin an orange hue. Thanks for the science lesson, Spearhead!!

Green Eggs and War

2007-01-27T11:07:00.000-05:00

After searching the internet for carotenemia (you'll understand what that is in my next post) I came across a website full of old Dr Suess cartoons. We all know Dr Seuss (aka Theodor Seuss Geisel) and the children's books that made him famous, like The Cat in the Hat. It's interesting that he wrote that book using only 220 different words, ones that kids beginning to read would/should know. And after that, he wrote Green Eggs and Ham and won a bet that he couldn't write a book using only 50 words. His creativity and fantastic illustrations made him a superstar in the 50's and 60's, and everyone still knows who Dr Seuss is 15 years after his death.

But the cartoons that I found were quite different than his more famous children's stories. These were single editorial cartoons from World War II, commenting on the progression of the war up until January 1943. If you thought you knew Dr Seuss, think again. Check out these cartoons here. You might see him in a different light.

Science Fact - Too Cold To Snow

2007-01-20T16:17:00.000-05:00

The weather here in Kingston has been pretty good this winter. It's been averaging about -5 to -10°C and we've been getting lots of excellent snow this week. This is in contrast to the past 3 winters in Montreal where we would always get a few agonizing weeks of -30°C where your fingers would freeze in the time it took to brush the snotty ice crystals from the tip of your nose. Surprisingly, though, these arsehole-freezing bouts didn't give us much snow.

But is this very surprising? Could it be that the temperature was too low? Can it ever be too cold to snow?

Well, the temperature alone doesn't directly matter very much. If the other conditions were right, we could have had snow every day in Montreal despite -30°C weather. But there is an indirect link between low temp and little snow. That link is water vapour.

We're surrounded by air (hopefully) right now, and in this air there is a certain amount of moisture. The % of water in the air can range from 0-4%, depending on things like a source for water vapour and (yes) temperature. Hot air can hold way more water vapour than cold air. That's why you often see heat and humidity go together, and why cold winters make your hands and lips become dry and chapped.

So if it's -35 outside (or colder), there is probably so little moisture in the air that there is almost no chance of snow. However, a nice and moisture-filled -5°C day can bring a substantial amount of snow.

Another thing to keep in mind is the atmospheric pressure. Low pressure is associated with precipitation and storms, while high pressure is linked to calm and clear weather. In the winter, high pressure is also linked to colder weather because the skies are clear. Without proper cloud cover, a lot of the Earth's warmth is lost.

So to recap, cold weather is associated with:

Little water vapour

High pressure

Few or no clouds

All of these things contribute to very little precipitation. So, for a few reasons, it can be too cold to snow. Try to notice it this month. What is the temperature when it's snowing? Has it snowed when the temperature is less than -20?

Science Fact - Eggcraft

2007-01-19T22:09:00.000-05:00

Have you ever had a carton of eggs in your fridge for too long? You know it's a long time because you can't remember ever buying them, and so you have no idea if they're any good. The gut-wrenching odour of rotten eggs can turn you off of these tasty ova for quite some time, so is it worth the risk to open one up and find out what lays inside? How long does it take for eggs to actually go bad, anyway? Should bad eggs be a real concern if the carton has been sitting in the back of your fridge for a few weeks? Or more likely, a few months?

Eggs can go bad at room temperature within a week. But unless you live on a farm or have a constant supply of fresh eggs, you'll probably keep your eggs in the fridge. In that case, eggs can last several weeks. However, as time goes by the eggs lose their deliciousness and will be less pleasing to eat, even if they're not considered to be 'bad'. These eggs can still be used to bake with, but there is a good chance that if you have really old eggs you don't bake very often. So how can we tell if an egg has gone bad without risking the release of that characteristic putrid smell?

Luckily for us, there is an easy test you can do to find out if your eggs are suitable for either eating or chucking at passing strangers. You simply put the egg in water and see what happens. Follow the guidelines made up for the witch trials: throw them in water. If they float, they're bad and should be destroyed. If they sink, they were never bad to begin with. And again, luckily for us, good eggs can hold their breath underwater for a very long time so we don't need to worry about killing the innocent eggs.

To do the test, you fill up a mug or measuring cup with water and place the egg inside. If it sinks to the bottom and lays on its side, it's still great. If it stands up on the bottom, it's becoming more stale but is still edible. If it floats, then you should toss them somewhere other than the frying pan.

Why does this happen? Eggs have tiny pores in its shell that can let moisture out and air in. When an egg is laid, it contains a small air pocket and a lot of eggy goo (water, proteins, cholesterol, etc). Fresh eggs with small air pockets will sink when placed in water. As the egg matures, it loses more water while the air pocket gets bigger. When enough air gets inside, the egg will float. This doesn't mean that all floating eggs are bad. It simply means that they are all old, and there is a bigger chance that they have spoiled.

So the next time you have old eggs in your fridge, test them out before you use them. If not, you might end up using them to make banana bread and serving it to your guests before finding out that the rest of the eggs float. Hypothetically speaking, of course. Don't you agree, Marisa?

Woodstock and Rehab

2007-01-19T21:20:00.000-05:00

There are two sexy artists that made it to my ears this January, and I'm really digging both of them. The first one is Amy Winehouse, a boozing vixen with a jazzy and slighly dirty voice coupled to music reminiscent of decades-old soul music. Check out some of her songs (like Rehab) on this website.

The other singer is Alice Smith. She's a bit more mainstream, but has a killer voice that my friend Dan considers "like Fiona Apple with more soul." Her song Woodstock is the most poppy, but damn is it ever catchy!!

Science Fact - Shots of Water

2007-01-14T12:22:00.000-05:00

People often say that everything is good in moderation, and that even the most benign things can be harmful if you take too much. In medicine there is a famous saying from Paracelsus (1493-1541), a Swiss physician, that when translated reads "All things are poison and nothing is without poison, only the dose permits something not to be poisonous." Another way to state this is that every substance can be a cure and poison, depending on how much you give someone.

There are many examples of Paracelsus' mantra. Chemotherapy is very toxic, but in the right dose it can specifically kill cancer cells and thus be a great cure. Some antihypertensive drugs can lower your blood pressure, but if you take too much then your pressure will drop dramatically and you won't be able to push blood around your body, ultimately causing death. Morphine can relieve pain very well, but if you overdose on morphine you can lower your breathing rate to the point where you don't get enough oxygen.

Now there is a recent case of a normal substance becoming a poison in California. A woman died after drinking too much water too quickly. This is called water intoxication. It may seem bizarre, but there is good science to back up why it can be dangerous. If you drink more water than you can get rid of (peeing, sweating, breathing, etc) then it will build up in your blood and cells. You are essentially diluting all of your body fluids, so the concentrations of electrolytes needed to keep your body running properly are all messed up. If the concentrations of sodium and potassium are off, your nerves won't work well and your heart may beat irregularly (or not at all).
Read the article for more info.

So if you're going to drink your 8 glasses of water a day, don't drink them all at once.

Christmas Box

2007-01-08T15:03:00.000-05:00

I'm sure many of you have seen this SNL clip with Justin Timberlake, but after watching it and laughing my ass off I thought I should post it anyway.

Check out some other SNL clips: Schmitt's Gay Beer, Lettuce Help, and The Lunch Lady.

Angina's Tough (Brother What a Night it Really Was)

2007-01-03T20:40:00.000-05:00

After receiving some great questions about my last post, I've decided to keep the cardiac theme pumping along with this second installment. As for you silent readers out there, keep in mind that many of my ideas for posts come from you. So keep the comments flowing!

The #1 cause of death in the US is heart disease, followed closely by malignant cancer. But what is heart disease? Is it just another term for heart attacks, or does it mean having a sad, sick heart?

Well, heart disease is a super general term that covers almost anything you can think about happening to your heart. There are many sub-categories that make up heart disease, including ischaemic heart disease (not enough blood to the heart), cardiovascular disease (stuff affecting arteries and veins like atherosclerosis), and hypertensive heart disease (caused by high blood pressure), to name a few. So heart disease is really any condition that increases the risk of making your heart work badly or not at all. This wide definition may be the reason why heart disease is the #1 killer.

So then what is angina? Is it another name for heart disease, or does it have anything to do with mangina? Nope. Angina is a symptom and not a disease, although certain types of heart disease can cause angina. But what exactly is angina? It's when not enough blood/oxygen is getting to your heart, so it cries out in pain. This isn't as severe as a heart attack because you're not killing the muscle, but it can definitely lead to an myocardial infarction if ignored for too long.

Some people with angina may feel a high pressure choking sensation in their chest after walking several city blocks, but feel better after resting a few minutes. In this case, maybe the coronary arteries are being blocked off a bit with cholesterol (atherosclerosis) but can still allow enough blood to flow under resting conditions. However, once you put more stress on the heart and increase it's need for oxygen, you no longer have a sufficient supply to keep it running smoothly. The heart muscle will scream for you to stop walking before it dies, causing the strangling feeling and the pain. This extreme discomfort will stop you from moving long enough for your heart to "catch it's breath".

Check out information about risk factors for developing heart disease here and here. Oh, and bonus points for anyone who can tell me what band and movie inspired the titles of the first and second installments of cardiac health, respectively.

Science Fact - Heart Attack Man

2007-01-02T23:15:00.000-05:00

Everyone knows what a heart attack is, right? Or do they? When I was growing up I understood it as something that happened to your heart that messes it up for some reason, possibly leading to death but maybe not. My old definition wasn't very enlightened or scientific, but I knew enough to understand the seriousness of heart attacks and the lifestyle behaviours that could increase your risk. Now I know a lot more about heart attacks such as the causes, the various effects on the cardiovascular system, and how to treat someone who may be having a heart attack.

Before we dive headfirst into the cardiac world, I want to point out how many of us replace vague notions with more solid science as we get older. Good examples of this replacement are:

1. Realizing that meat is not a separate part of an animal, but is in fact muscle (thanks Morgan).

2. Understanding that bugs have organs similar to ours and are not just filled with yellow goo.

3. Watching a movie and realizing that the two people lying naked on a bed are doing more than just kissing.

So now what is a heart attack? The medical term is myocardial infarction (MI). Let's dissect this term: myo = muscle, cardiac = heart, and infarction = death or injury due to a lack of oxygen. Put together, we see that an MI is when heart muscle dies because there isn't enough oxygen getting to it. If you kill part of your heart, it won't work as well. Furthermore, the rest of the heart will have to work even harder to keep up with the body's demand. This added stress will make it more likely that your heart will poop out. Bad stuff all around.

What causes an MI in the first place? Wel, anything that would reduce or stop blood flow to the heart. And not the inner chambers of the heart (the atria and ventricles), but the outer blood supply that feeds the actual muscle. These vessels are known as coronary arteries. To illustrate this idea, think about a water pump. If you reduce the water flow inside the pump, it can still work. But if you cut the electricity that's actually 'feeding' the pump, then it stops working.

Things that can trigger myocardial infarctions are:

Overexertion - Too much stress (physically or psychologically) for your heart to take, leading to a constriction of blood vessels and an increase in blood pressure. These two things can trigger an MI. If you're normally a couch potato, don't decide to get up and immediately run a marathon. Build up to your desired level of exercise.

Blood Clots - A blood clot can form in your coronary arteries, or it can form somewhere in your body and then travel into one of your coronary arteries. The result would be the blockage of blood flow and ultimately MI. If instead it travelled to your brain, that would be called a stroke.

Atherosclerosis - An atheroma is a build-up of junk (cell debris and cholesterol) inside the walls of your arteries. This is referred to as the 'hardening' of your arteries. The diameter of the arteries will shrink, making it harder for the heart muscle to get a proper blood supply. Furthermore, if the inner wall of the artery breaks open (possibly due to an increase in blood pressure) then this junk can block the blood vessels.

Before I wrap this up, I'd like to point out that myocardial infarctions are not the only things that can go wrong with your heart. Most people call everything a heart attack, but there are three main conditions that make up our classic idea of a heart attack. They are (1) myocardial infarctions, (2) cardiac arrest, and (3) ventricular fibrillation. Cardiac arrest is when your heart stops beating, and I shouldn't have to mention that it's pretty serious. Ventricular fibrillation, or V-fib, is when your heart is not contracting normally so it doesn't pump blood well. This can also lead to cardiac arrest. For people in V-fib, it is crucial that you do something to get their heart back on track, something to stop the fibrillation. That's why we use the shocking machine, otherwise known as a 'defibrillator'.

Funny Bones and Other Humerus Anatomical Terms

2006-12-22T17:45:00.000-05:00

While learning about the human body inside and out, I began compiling a list of anatomy terms that I thought were pretty funny. These words either sound funny, remind you of something funny, or are just plain stupid. You decide where each term belongs.

Hanni's Top 10 Funny Anatomy Terms:
An ordered list in no particular order

Sartorius

Uncus

Sacculation

Infundibulum

Buccinator

Wharton's Jelly

Spinalis

Epoöphoron

Supinator

Alcock's Canal

If you can think of any other funny terms to share with me and the millions of other readers, please keep us posted.

Phased Out

2006-12-15T19:15:00.000-05:00

Our class just finished the last of three exams. And not just any exams. These were designed to shatter your ego, make you puke with horrible disbelief, and then kick you in the ass once you're bent over hurling. They probably weren't as bad as I'm making it sound, but this was the feeling everyone shared right after each exam.

Most of us in med school are used to doing quite well on our exams. We would do some hard work beforehand and then walk into the exam with unparalleled confidence. This was definitely not the case here.

First of all, we had at least 13 different topics to study for, ranging from pharmacology to public health and from ethics to anatomy. It's hard to learn all of this, but more importantly it's hard to feel confident about everything because as soon as you finish reviewing one topic you forget one of the others. It's plain frustrating.

Secondly, it was upsetting to see that a lecture that was cancelled and never taught to us was still tested. And not only that, those sections made up almost 10% of our exams. Think about that: we've had over 200 lectures, and the one lecture we weren't taught contains so many questions. Again, it's frustrating.

But the bright side is that marks don't matter too much anymore. There's no more fighting for the top mark, or trying to keep your GPA above a 3.8, or crying when you see a B- on your midterm. At Queen's there are three categories: honours, pass, and fail. And frankly, it doesn't affect you whatsoever if you get honours vs a pass. So even though the exams were stressful, the only thing that matters is that we show a decent understanding of the material. If it scares you that your future doctors are banking on a marginal pass to succeed, rest assured that the distribution of marks usually switches when we're graded on actual hospital-patient experiences. Don't be worried about the person who scrapes by in med school, because they could be one of the best doctors ever. This is what we're all thinking right now...

Phase 2a, here we come!!!

Science Fact - Scratch That

2006-12-11T11:06:00.000-05:00

We all know about the great combinations of spaghetti and meatballs, or Mario and Luigi, or even gin and tonic. But these pale in comparison to one of the ultimate duos in the history of the world. I'm talking about itching and scratching. Many people take this combination for granted, but I can think of no better pairing than this. Imagine what life would have been like if the match-up was itching and coughing, or kissing and scratching. It just wouldn't work. So what is itching all about, and why do we scratch an itch?

Before I start, I need to make one thing clear. You cannot itch a bug bite. You scratch it. The bug bites is what itches you. I hate when people say "I need to itch my nose" because it makes no sense. Get it straight.

Now, let's use the classic example of a mosquito bite for our itching example. Some of the saliva of the mosquito gets into our arm and causes an immune response. The area swells a little bit and becomes red. This is due to histamine, a chemical that makes your blood cells leaky and causes fluid to build up in your tissue. Why would you want to make your capillaries leaky? Because you want to make it easier for white blood cells to pass through the blood vessels and into the site where the foreign 'enemy' is hiding.

So why does scratching a mosquito bite make it grow even bigger? Because when you scratch your bite, you are 'popping' certain white blood cells called mast cells that contain thousands of histamine granules. The more you scratch, the more mast cells you destroy and the more histamine your release.

Back to the original idea. Why do we scratch an itch? There are two reasons. First of all, when we itch there is usually something on our skin that is irritating us. It could be an ant crawling around, or some dandelion fluff, or someone sitting behind you in class tickling the back of your neck with a piece of hair. Scratching is a primitive response designed to find and remove those stimuli.

But in the case of mosquito bites, we can't get rid of the cause by scratching. So why do we do it, and why does it feel so good? By scraching that area, you're telling your brain that you know where the irritation is and that you're doing something about it. But more importantly, you are replacing the annoying itch sensation with something else. Even if you're hurting your arm while scratching a bug bite, it feels good because the itchy feeling is masked by the new sensation (pain). The only problem is that once you scratch it you are releasing more histamine, causing more swelling and more white bllod cells to enter the area, and thus more itching. But, hey, it feels so good doing it!!

Band/Album Names (Pt 11)

2006-12-06T12:05:00.001-05:00

It's been a while since I've had a list of band or album names for you all. The truth is that I wrote down some good ones over the past month, but would keep on losing the lists. So after cleaning up my room (an improvement from 'landfill' to 'disgusting mess') I located a few of these album names in waiting.

Who Said Baby?

Spun & Woven

Alien Place

Back to the Bottom

I Surmise

And my favourite name of the season (and a candidate for name of the year):

BEDMAS

NES Trash Talk

2006-12-01T14:29:00.000-05:00

How many of you have owned a nintendo during your childhood? Now I'm talking about NES, not Nintendo 64 or even SNES. You know, old school NES video gaming with the rectangular controllers and the game cartridges that you needed to blow into before they would work. To me, this is the epitome of video gaming.

Now, how many of you have gotten so pissed off at any of the numerous shitty games made for the NES? Angry enough to swear at the TV, the game cartridge, and the makers of the stupid game? Probably. But none of you have ever gotten as angry at NES games as the Angry Nintendo Nerd.

This guy has made about 20 videos that tear apart games such as Double Dragon III, Top Gun, Karate Kid, and TMNT. He even does a review of the Power Glove**. Go check him out on YouTube and find a game that you recognize. Then be prepared for a in-depth analysis coupled with a whole lot of swearing.

But my favourite of all is his first video where he trashes Castlevania II: Simon's Quest. This was one of the first NES games we ever owned, and even though I have very fond memories of this game I get a big kick out of this guy's review. Shireef and Osama, definitely check it out and you'll agree.

There were many awesome games for the original Nintendo, but you can't deny that there was a lot of crap, too. Now our generation has a spokesperson to tell the world this. And its only 20 years too late.

** For an original look at the Power Glove in all its glory, check out this clip from the unforgettable movie The Wizard.

Science Fact - Menses Away!

2006-11-30T00:13:00.000-05:00

I want to appeal to my women readers between the ages of 40 and 60 (and believe me, the number is skyrocketing), so I put together a little info session about menopause. It's not that these mature readers need a lesson about what's happening to their bodies. Far from it. If your body was about to experience what these brave women go through, you'd probably have collected information from the time you turned 29. Rather, by educating others about menopause I hope that I can spread a bit more understanding and compassion for our mothers, grandmothers, aunts, and friends.

Let's start with the basics. Menopuase means the stopping of menses (menstruation). At some point in a woman's life, usually somewhere around 51 years old, their periods will have become irregular and eventually disappear for an entire year. This is the definition that we use today for menopause. But the several years that lead up to this point can also be considered early menopause or perimenopause, so you may feel many of the symptoms of menopause even if you had a period (although a bit irregular) this month at age 44.

Why does menopause occur? It's all about estrogen. And your ovaries, the primary organs that produce estrogen. As you reach a certain age, the function of your ovaries gets worse and worse. This means you will produce less and less estrogen in your body. When the level of estrogen becomes sufficiently low, there is not enough drive to keep menstruation going. So it stops.

The symptoms of menopause come from a lack of estrogen, not from a lack of menses. What many women experience are:

Weight gain

Hot flashes

Insomnia

Night sweats

Mood swings

Short-term memory loss

Fatigue

Osteoporosis (thin bones)

And all of my fellow Queen's med student will remember the GU video dealing with this last symptom:

Vaginal dryness

Overall, this natural part of aging is a pain in the ass. If these were side effects for a new drug, it would get pulled from the market unless the benefits were phenomenal. And I hardly think that middle age is fantastic enough to outweigh the adverse effects.

So what can be done to manage the horrible symptoms of menopause? One popular treatment is hormone replacement therapy, or HRT. The attempt of HRT is to replace the estrogen in your body so you don't feel so crappy. One of the biggest names in HRT is Premarin from Wyeth Pharmaceuticals. It was originally developed in Quebec near Montreal and has been the leading HRT supplier in North America for over 50 years. Sound good, right? Especially considering that premarin stands for pregnant mare urine. All you need is some horses, get 'em preggers, and let the money whiz in (after a purification step, of course). How can you lose? 14 types of horse estrogen for one low price!

Does it work? Well, sort of. It has been shown to reduce hot flashes, night sweats, and vaginal dryness. That's a good thing. But the therapy has its own side effects like headaches, irritability, and bloating. Oh, and the reported benefit of fighting against osteoporosis is wrong because after you stop HRT your bones become as thin as they would have normally become at that age.

Then there are some more serious concerns about HRT, too. A gigantic study was done recently called the Women's Health Initiative where HRT use was assessed. It was supposed to last 8 years, but they stopped it after 5 years because they felt the health risks of HRT outweighed the benefits. So what were those health risks? To start with, you immediately have an increased risk of blood clots. On top of that, the use of HRT would increase your risk for heart disease and breast cancer.

Personally, I'd stick with hot flashes. Or better yet, I would find a better alternative to help with the symptoms. Things like improving diet, exercise, herbal remedies, and (for you pharmaceutical-crazy readers) SERMs.

An interesting menopause fact is that about 400 years ago, there was almost no menopause. Wait a minute! Does this mean that we're causing menopause because of our bad diet or pollution or UV rays? Nope. It's actually caused by us living long enough to outlast our ovaries. So there's one more problem we've created by increasing our life expectancy.

Finally, if you're like me (male) you may feel a bit left out of the many wonders of menopuase. But don't worry, we have our own version!! It's called andropause because we slowly reduce our production of androgens like testosterone.

Science Fact - I Huffed and I Puffed...

2006-11-23T20:02:00.000-05:00

A few days ago I slept through my alarm and woke up 10 minutes before class started. The biggest problem was that I live 10 minutes away from my second home, classroom B139 in the basement of good ol' Botterell Hall. On any other day, I would have just slept for another 30 minutes and then make it to the next class. But on this day we had MSR, a course where patients come in to tell us about their condition, followed by a 2 hour class discussing the details of that condition. If I missed the first part, I would have to miss everything. So I ran. And I ran like the wind.

I made it to class on time, but the first 5 minutes were spent breathing heavily in the back of class, despite my attempts to stay relatively quiet. The more I tried to slow down my breathing, the more I needed to gasp for breath. I was upset with my body's natural breathing drive at that time, but I knew that it was for the best that we rely on such a mechanism. So what is this mechanism and why couldn't I stop panting in the back of class?

We have several chemoreceptors in our circulatory system and brainstem that control our breathing rate. They indirectly measure the amount of carbon dioxide in our blood and decide whether to make us breathe more or less. If we have too much CO₂ in our bodies then our lungs will work harder to get rid of it, and vice versa.

My early morning sprint to class caused my muscles to work really hard and produce lots of carbon dioxide. I still had high CO₂ levels when I got to Botterell so my brain was making me breathe more to eliminate this waste product. If I tried to keep quiet I would turn red, get hot and gasp for breath because I would be increasing the concentration of CO₂ even more.

An interesting side note: carbon monoxide poisoning. CO can bind to hemoglobin in your blood and prevent oxygen from binding. The result is that you don't deliver enough oxygen to your body. A significant exposure to CO can cause you to become unconscious and eventually die.

If someone is unconscious from CO poisoning, they can be brought to hospital and put on a ventilator. But here's the kicker: if they were given 100% oxygen to help with oxygen delivery in the bloodstream, their breathing rate would be very low and they would be kept on a ventilator for a long time. The reason for this is that pure oxygen would be too pure and so would lower the drive to breathe.

It would be much better to get their breathing rate higher at the same time as supplying O₂. This way they can get rid of more CO. So what should they be given? A mixture of oxygen and CO₂. This would supply the much needed oxygen to their body while triggering a big increase in breathing rate to remove carbon monoxide.

So don't just give someone oxygen if they're hardly breathing. Give them carbon dioxide, too.

Libraries and Swimming Pools

2006-11-22T20:44:00.000-05:00

Here are a couple of YouTube video clips that made me laugh this week.

The first one is about all of the things we do in a pool that would seem extremely weird anywhere else. They may not all be things that will make you laugh out loud, but you can relate to everything. Come on, who hasn't pretended to drink tea while sitting on the bottom of a swimming pool?

The second video is a strange but highly amusing Japanese gameshow called Silent Library. With events like "slapping machine" and "old man bites tenderly", how can you pass this up?

Science Fact - Staying Alive

2006-11-10T00:13:00.000-05:00

This is a follow-up to last week's post about fevers at the request of my main man Joel. Hopefully this sequel goes over better than Staying Alive did in 1983.

Ok Joel. Now that you've waited patiently beside your computer while constantly pushing ⌘-R for the past week, I've finally been able to answer your questions.

1. Do other animals get fevers? If so, what is the boundary between animals that get fevers and those that don't?: Many other animals actually get fevers when they are sick. In humans, raising our body temperature will both stimulate the immune system and make it more difficult for infections to grow. The same thing happens in other animals, so it makes sense that they would also bump up their core temp to fight off an unwanted microbe. Thus, other animals can and do get fevers.

Now which ones are able to do this fancy thermal trick? Well, all of the warm-blooded animals. Warm-blooded creatures such as ourselves have a body temperature of about 37°C. Because we can all get viral and bacterial infections, we use the simple and effective method of developing a fever to help fight off these bad guys.

What about cold-blooded animals? Do they get the evolutionary shaft when it comes to fighting off infections? Not quite. Some cold-blooded animals actually use their environment to give themselves a fever. For example, lizards are known to go into the sun to warm up more than usual during an infection, raising their body temperature enough to get all of the benefits of a fever. I hear that some insects do this too...
2. Did an increase in immunity during a fever first occur by chance and then get reinforced through evolution?: Actually, stimulating the immune system is seen as the primary reason for a fever. If the temperature is higher then chemical reactions occur more quickly, more white blood cells are produced, and they can find the infection faster and more effectively.

Screwing up the growth of microbes with high temperatures is also important, so it would be difficult to argue that this occured by chance too. Th two reasons for getting a fever suport one another and are closely related. Since these two factors are so connected and intertwined, it's best to think that they both occur at the same time during a fever, and that it has always been that way.

Girls's Costume Warehouse

2006-11-06T23:37:00.000-05:00

My roommate Alex just showed me this hilarious video. It's by far the best Halloween commercial to ever hit the airways. Or at least the fake airways.

If only this was on TV when I was young...

Science Fact - Saturday Night Fever

2006-11-02T01:28:00.000-05:00

There are many types of fevers in this world. Some are medical, while others are not so scientific. For example, you can have rheumatic fever, hay fever, cabin fever, yellow fever, spring fever, Scarlet fever, or saturday night fever.

The type that I want to focus on is the normal "I'm sick and my temperature is high" fever. This is called pyrexia in medical terms. You may also hear doctors talk about a febrile response to an infection or drug, meaning you react by getting a fever.

It's interesting to note that getting the flu or having a bacterial infection will not cause your body temperature to rise by accident. Your body will raise its own temperature in order to get better more quickly. This may not sound logical to you, but once I outline what happens during a fever and why it might be beneficial during an infection, it should all make sense.

Let me begin by explaining how temperature is regulated in your body and how a fever occurs. Normally, the hypothalamus (master gland) sets your body temperature at about 37°C much like a thermostat in your home. If you get too hot like when you exercise a lot, you sweat a lot and turn red (blood vessels enlarge and come to the surface). This allows you to lose heat and return to the optimal temperature. If you get too cold, you turn pale (blood vessels shrink) and you start shivering. Muscle movement creates heat, so these two things will help raise your temperaure.

When you have a fever, the hypothalamus/thermostat gets set higher to 38 or 39°C. When you want to warm up to then newly set temperature, your blood vessels shrink and you begin to shiver. This is the "chills" part of a fever. Once you reach the desired level, you switch gears to release some of the excess heat. So now you're sweating and flushed. You can either strictly maintain this temperature and stay in the fever state, or you can cycle back and forth between chills and fever.

Now we get to the big question: Why the heck do we make our bodies go through this much discomfort and (some may argue) danger?? If we had the choice, why don't we skip all of this? Well, there are two main benefits of raising our body temperature during an infection:

1. Hard Times for Enzymes: Viral and bacterial enzymes work best at 37°C (like ours) but they become really bad at doing anything if the temperature is raised just a little bit. You can see this on the picture over on the right. By increasing your body temperature, you are making it difficult for the infectious agent to attack you or reproduce. You also make them weaker and thus easier to kill.
2. Calling All Leukocytes: An increase in body temp triggers the acquired immune system. A lot more white blood cells will be made, along with more antibodies and other things to help the immune system fight off infections.

These reasons make fevers seem more useful and less annoying. So if you have a mild fever due to illness, don't try to suppress it by using cold packs or medication because you would be preventing this natural mechanism of killing the infection more effectively. Remember, though, that if your fever become too high (>39°C or >102°F) it can cause bodily harm. In that case, go see a doctor.

P.S. This science fact is my 100th post!!!

Wing It

2006-11-02T01:18:00.000-05:00

My medical buddy Steve Chapman showed me a great website recently. The Wingit Film site has a collection of short, creative, and very funny films that he made with his friends during undergrad. Take a few minutes to check them out. And if you watch The Assignment you can see Steve in all his acrobatic glory (no stunt doubles were used in the making of this film).

Steve (soon to be Steve MD)

A Trip Down CBC Memory Lane

2006-10-29T14:11:00.000-05:00

Growing up in Canada without cable TV forced me to watch a lot of CBC. Some was good, some was bad, but all of it contriubuted to our Canadian identity. If you were in the same situation as me in the '80s , then you'll not only recognize these characters but will want to check out the show intros for sentimental reasons.

Science Fact - High C's

2006-10-26T00:11:00.000-04:00

I am one of many people who take vitamin C supplements to stay healthy. But (like many people) I didn't really know how vitamin C actually works to make me healthier. So a number of questions came to my mind. Why do we take vitamin C supplements? Do we really need it? What about other animals? Can we take too much? What was the nickname of 18th century British sailors? All of these questions will be answered shortly, so read on.

Vitamin C deficiency has plagued our species for thousands of years. It took us a while, but we managed to figure out that fresh fruits and vegetables helped to prevent scurvy. Centuries later around 1930, vitamin C was "discovered" and proven to be the chemical that prevented scurvy.

Because we cannot make or store vitamin C (aka ascorbic acid), we can run out of it easily. When we don't get enough vitamin C in our diet we can get scurvy, a disease that makes you fall apart. Vitamin C is important in making collagen and thus connective tissue, so a lack of this vitamin (scurvy) can cause several bad effects including (in order of severity):

Easy bruising

Loose teeth

Fragile blood vessels

Massive internal bleeding

Death

People who did not have access to fresh fruit would be at serious risk for getting scurvy. The majority of these people were sailors. Many sailors in the 16th, 17th, and 18th centuries died of scurvy when traveling far distances such as across oceans. Fortunately, it was discovered that citrus fruit could prevent this horrible death. In 1747 the British navy began to fill their ships with limes to stave off scurvy during long voyages, and soon the British sailors were known as "Limeys".

We now know that humans need vitamin C, but what about other animals? Surprisingly, most animals and plants can make their own vitamin C. The only exceptions are humans, apes, guinnea pigs, fruit bats, and a species of trout. All other animals can synthesize vitamin C in their bodies.

So if we need to eat vitamin C in order to live normally like other animals, how much do we need? Health Canada and the FDA suggest around 100 mg/day, but this is pretty small compared to other estimates. Linus Pauling, one of the greatest men in our history (you'll hear more about him soon), advocated taking between 3 and 18 grams of vitamin C each day. Other sources back up Pauling's ideas, but go further to say that if you're really sick you should take up to 300 g!!!

You might think this amount of vitamin C is extreme, but keep 2 things in mind. First of all, you can't overdose on vitamin C because it's so water soluble. You just pee out any excess vitamin. And FYI, vitamin C has one of the lowest toxicities of any compound known to medicine. Secondly, think about our friend the mountain goat. Normally this goat makes 13 g of vitamin C each day, but if it's stressed out, hurt, or sick it will make over 100 g. So when you compare this info with our 100 mg recommended daily intake, you may wonder why we're only asked to get a tiny amount. I've been wondering that too...

Finally, some quick information for you about our friendly neighbourhood vitamin.

Studies have shown that vitamin C can reduce the length and severity of colds, but NOT the frequency. So you'll get sick just as often, but you will recover a lot more easily.

You can train your body to metabolize vitamin C more quickly when you take lots of supplements. So if you're ever taking a bunch of vitamin C, don't stop suddenly. Your body will metabolize the small amount you get in your diet too quickly and make it easier for you to get sick. Slowly reduce your supplementation instead.

Vitamin C increases iron absorption. This is great if you're anemic, but it's dangerous if you have too much iron (iron overload or haemochromatosis).

Remember that vitamin C is your friend, especially when you're sick or stressed.

Sticky Lyrics

2006-10-22T12:35:00.000-04:00

I'm sure you know the feeling of hearing song lyrics that seem to stick to your thoughts long after the song is over. Here are a couple of lyrics that have stuck in my head this week. Feel free to share any of your own "sticky lyrics" with everyone.

Bright Eyes - Lua

"We might die from medication, but we sure killed all the pain"

Iron & Wine - Passing Afternoon

"There are things that drift away like our endless, numbered days"

Band/Album Names (Pt 10)

2006-10-22T12:21:00.000-04:00

We're up to 10 installments of band/album names!! That's quite a milestone, though I would rather hit the "first band or album name actually used by somebody" milestone. Someday, Hanni...

Rogue Raisin

The Sniffles at Night

Dancing for Two

Touching Two Hours

And for all of you anatomy enthusiasts, here's a band name that was inspired by the forearm and hand:

Extensor

It's The Law!

2006-10-19T20:42:00.000-04:00

I am currently taking a short break from posting/reality as I get swept up in an academic/social/political/personal tidal wave, but here is something to keep you all afloat in this crazy ocean we call life.

My law student roommate (roommate-in-law) Alex showed me this video. You don't need to be a lawyer to appreciate it, but it wouldn't hurt (Dan). I laughed a lot because it reminded me of many dates I've been on as a wild and promiscuous youth.

Make sure you take good notes.

Science Fact - Turkey and Tryptophan

2006-10-08T14:24:00.000-04:00

This Thanksgiving weekend, many of us will be gathering with friends and family around a turkey-centric feast. And many of you will enter an uber-lethargic state afterwards, sitting on the couch and watching football with a glazed look in your eyes while your unbuttoned pants make the statement that 4 helpings of turkey and mashed potatoes wasn't such a good idea.

I was taught that the reson why you get so darn sleepy after a Thanksgiving dinner was due to tryptophan. Let me elaborate for my non-biochemistry readers. Tryptophan is an essential amino acid, meaning that we can't produce it ourselves so we have to get it in our diet. It is a precursor for many proteins in our body, but more importantly it is necessary for making chemicals in our brain like serotonin (aka 5-HT). Serotonin plays a major role in your mood, appetite, and sleep. It's thought that high levels of tryptophan would make more serotonin, causing you to fall asleep.

Tryptophan

So how does this all relate? Well, turkey is very high in tryptophan. It's believed that if you eat a lot of turkey then the tryptophan will make you sleepy. Hence, the post-Thanksgiving dinner nap that is oh so common.

But here's the real info behind the myth. Tryptophan will only induce sleep when you have a lot of it on an empty stomach. If you ate a big piece of turkey all by itself, you could feel a bit tired. But if that tryptophan is competing with the other 27 things that you ate during the meal, there is a very low chance that this amino acid will cause any effect.

What is the most likely reason behind the popular holiday naps? Insulin. I don't know about you, but when I eat a Thanksgiving meal I'm eating tons of carbohydrates. Think about it: mashed potatoes, stuffing, bread (especially Little Breads), pop, pie, and an assortment of cookies. Not to mention beer. All of these are loaded with carbs, and I tend to go overboard with ALL of them. Insulin will induce a drowsy feeling, and the insulin rush after a meal like this is the grandaddy of all insulin rushes. Couple that with alcohol, and you're out for the count.

So remember, we get sleepy after Thanksgiving dinner because we eat too damn much!

Pop Locking Midget

2006-10-05T00:06:00.000-04:00

My recent obsession with funny asian videos on YouTube has led me to yet another gem. Not only is the video great, the commentary by John Robe is hilarious. I know I should be posting original content, but this is just too good to be kept to myself. Check it out!

What a Thrill

2006-10-04T00:50:00.000-04:00

If you thought that Bollywood remakes of old American music videos couldn't get any better, then you are in for a surprise. Move over, Michael. There's a new Thriller in town tonight.

El Presidente

2006-10-01T15:03:00.000-04:00

We had our class council elections this week, but everything was extremely rushed. Couple that with little warning of the election schedule, and you have a serious event that zooms past you in the blink of an eye. But although we were only given 48 hours to find out the available positions, give speeches, and vote, I think our class did quite well.

I went to a meeting on Wednesday to hear past council members explain how fun/stressful/boring their positions were. During that time, I found out that several people wanted me to run for president. So I thought "What the hell. I want to be involved in some way, and being the president would definitely get me involved."

The speeches were the next morning. I was the 2nd one to speak and it seemed to go over pretty well. But really, how can you go wrong when you mention malpractice, guacamole, and wearing women's lingerie all in the same speech?

The rest of the speeches were great. I haven't laughed that much in a long time. My favourite was Eric who ran for Sports Rep. He thought there was nobody to contest the position, but at the last minute Steph joined the race, forcing Eric to make a speech. He detailed how he was not a likely candidate (glasses, weak upper body), and then proceeded to wow us with a magic trick involving a disappearing loonie. Brilliant. Unfortunately, his speech wasn't enough to get him the position.

Everyone voted during the next 24 hours, and on Friday afternoon I found out that I was elected class president!! So now I'm trying to figure out how to be presidential. Any suggestions?

Science Fact - Check the Appendix

2006-09-30T10:18:00.000-04:00

Many of you know that we have an appendix, but you might not be clear on its position and structure within our body. Before I entered med school I knew that my appendix was somewhere in the "belly" region, but that was it. So now that I've learned more about our semi-useless friend, I wanted to enlighten you readers as well.

First, let me go over the basic (and I mean very basic) gastrointestinal tract from beginning to end. If we were a piece of chocolate chip muffin, we would start with the mouth, and then travel down the esophagus to the stomach. After swimming around in acidic, enzyme-rich liquid we pass into the small intestine. Now the small intestine has 3 parts: duodenum, jejunum, and ileum. The first section is where most digestion occurs. The next 2 are where absorption of nutrients occurs. Then we enter the large intestine, beginning with the cecum which quickly becomes the colon (a long mofo). From there we go into the rectum and anal canal, finishing up in the toilet (hopefully). For more details on digestion, check out an earlier post about lactose intolerance.

The appendix is located where the small and large intestines meet. That is, it's connected to the cecum. Another name is vermiform appendix because it looks wormy. The average appendix is 10-20 cm long, about as long as your Johnson (if you have a Johnson).

Your appendix is found in the lower right quadrant of your abdomen. To find the exact position, find these two landmarks:

1. Anterior superior iliac spine (ASIS) - find the right side of your pelvis, then go to the front of the upper part of your pelvic bone.

2. Umbilicus (belly button).

Your appendix is about 1/3 of the way from your ASIS toward the umbilicus. Now you know what could cause pain in that specific area of your abdomen.

There is a sensitive part of the appendix called the McBurney's point. So the next time you overhear somebody mention that their McBurney' point is tender, you will know what they're talking about. This happens to me all the time.

BTW, does anybody know what the appendix does for us?

Eggs Erroneous and Golden Girls

2006-09-27T00:29:00.000-04:00

I was going to write a quick note about Ernest (Ernest Goes to Camp, Ernest Saves Christmas, Ernest Scared Stupid, etc) because frankly he hasn't been in the media spotlight enough during the 21st century. Eggs erroneous was a major part of my favourite Ernest movie, and my childhood couldn't have been the same without the entertaining idiocy of Jim Varney's antics.

However, when searching for a good picture of Ernest, I stumbled across a blog that made me laugh out loud at one of his posts. If you've ever watched Golden Girls and Who's The Boss (raise your hand high, Shireef) then you will love the connection made. Check it out.

That's the story of how I went from Ernest to Blanche in 1 step.

Art and Anatomy

2006-09-25T23:57:00.000-04:00

One of the great things about my medicine classes at Queen's is that we learn about history. Now I've never taken a history course in my life, but for some reason the "History of Medicine" classes are super interesting. Maybe it's the fact that I'm learning the background of medicine and, more generally, science which I love. Or maybe it's taught by one of the best professors of our time. Either way, I thoroughly enjoy it.

During the first week we learned about the history of anatomy. It was not surprising that dissecing humans was frowned upon long ago, but there were a few people who did what they could to learn all about the human body. In 150-200 AD a man named Galen would hang around coliseums to observe the mutilated bodies. He would direct the dissection of animals, but would sit back and let barbers and 'lowly surgeons' cut into the beasts. With the knowledge he gathered, he published a book of "human anatomy" that had many blatant errors, but was accepted as the truth for over a milenium. Throughout this time, human anatomy was still considered a questionable (if not sinful) field of study, for if you were found cutting into a dead body you would be severely punished.

It wasn't until the Renaissance that anatomy came into the forefront. And it was artists that made this transtition happen. A famous man by the name of Vesalius started doing animal dissections himself instead of telling others what to do. He published an amazing book that challenged some of the older (and wrong) views of human anatomy, and made it more accessible by creating beautiful and somewhat disturbing drawings of the human body being stripped away one layer at a time. Vesalius is known as the father of human anatomy.

Since then, the dissection of cadavers has become more condoned than ever before. Luckily, I am past the stage where bodies were in short supply. If I started at Queen's about a century ago I would have to find my own body to bring to class, either by asking various families or robbing a grave.

CEGEP Tragedy

2006-09-14T22:10:00.000-04:00

It was difficult for me to believe what I read about yesterday in the news. I'm sure we have all heard by now that Montreal's Dawson College was struck by tragedy when a 25-year-old man began shooting random people as he entered the building. This has been extremely shocking and life-shattering, especially for the victims of the attack. My heart goes out to them.

When I was living in Montreal, I quickly found out that Dawson was one of the best CEGEPs around. For those of you who are unfamiliar with CEGEP (Collège d'enseignement général et professionnel, or "College of General and Vocational Education" in english), it's a college where students usually go after grade 11 and spend about 2 years studying in semi-specialized programs. Once this is completed, these students often enter university in the 2nd year of studies.

One of my friends in my old research lab has a daughter who entered CEGEP this year. He and his daughter tried very hard to get into Dawson, and finally managed to get her enrolled. It's extremely unfortunate that after all of their hard work, this tragedy strikes a few weeks into the program. I pray that she was one of the lucky ones who got through this ordeal unharmed.

My hope is that Dawson College, Montreal, and Canada can recover from this devastating act and move forward.

Science Fact - Cutting Around to Cut Out Infections

2006-09-10T21:59:00.000-04:00

The topic of circumcision is not usually brought up around the dinner table, nor is it discussed much in school. But it's surprising how many males are circumcised in North America and around the world, both for religious/tradition and hygienic purposes. Now there is evidence that circumcision has one more benefit: offering some protection against HIV.

Let's begin at the basics of circumcision. During this procedure the foreskin of the penis is cut off, leaving the head to be exposed. This practice has been done for a long time, some say before recorded history. However, it didn't reach english-speaking countries until the early-to-mid 1800s. Back then, it was suggested to cure the dreadful masturbation epidemic. Here is what one doctor wrote in 1903:

"It (self abuse) lays the foundation for consumption, paralysis and heart disease. It weakens the memory, makes a boy careless, negligent and listless. It even makes many lose their minds; others, when grown, commit suicide.... Don't think it does no harm to your boy because he does not suffer now, for the effects of this vice come on so slowly that the victim is often very near death before you realize that he has done himself harm. It is worthy of note that many eminent physicians now advocate the custom of circumcision..."

Since then, people realized that masturbation is fine. Either that, or that not even circumcision could stop a teenage boy from "self-indulging".

There has been some debate about the benefits and risks of circumcision, but in general it is believed that the "snip-snip" leads to better genital hygiene. A study that was mentioned a few weeks ago states that circumcised men had a 60-70% lower risk of contracting HIV than uncircumcised men. This makes sense because the skin covering the head of the penis becomes thicker and tougher, preventing viruses from entering the body easily. Here is another great article discussing how circumcision can be a significant tool in the arsenal against AIDS.

There were some warnings that come with the new study, namely that circumcision should not be seen as a substitute for condom use and safe sex. My response to this warning: no shit.

Band/Album Names (Pt 9)

2006-09-10T12:26:00.000-04:00

Just a quick band/album name update. I don't want to forget these gems:

Manubrium

Synch or Swim

Bicycle Built For 2

That Chick Was In The Dudes'

And possibly this year's favourite:

Some Kid's Grandma

The Medical Queen

2006-09-09T14:20:00.000-04:00

I finally found a chance to breathe since arriving in Kingston for the beginning of medical school. So instead of breathing, I thought I'd update you all on my crazy adventures in the world of medicine.

First of all, let me summarize my time leading up to the big move:

(1) I frantically worked on experiments in the lab so that my paper could (possibly) be published. The revisions were a bit annoying to do, but as long as my paper gets published in Oncogene it will have been worth it.

(2) I passed in my thesis on Friday afternoon (September 1st). Talk about last minute.

(3) My apartment was slowly packed up in between times of drinking during the weekend.

(4) Brad A. helped me move my things to the booming city of Kingston, arriving at 7:30pm on Sunday.

I had 1 day to unpack, meet my new roommate who is beginning law school here, and visit a friend whose mother was in the Kingston General Hospital (KGH). Then the craziness began...

Our class of 100 was packed into a classroom at 8:00am, and quickly met most of the faculty while receiving their congratulations. Then it was time for banks to woo us with their "best deals" on a line of credit, not to mention giving us the first of many free lunches. After that, we got into small groups of 10 (known as our DOC groups) and had a "Meds Olympics". Our team was good, but not great. Thankfully, nobody cared too much about winning so we all had a good time. One of the only things we did win was the tug-of-war match that was featured in both the local newspaper and the Queen's orientation slideshow that was brought to my attention by the recently married Rob F (way to go Rob!!!) in a recent post. You can all marvel at how amazingly muscular I've become (ha ha ha).

The rest of the week was jam-packed with events like fancy dinners, barbecues with the Dean of Medicine, anatomy classes, initiation events featuring our group in women's lingerie, hungover anatomy labs at 8:30am where we explored the thoracic cavity of cadavers, etc. I finally managed to sleep in this morning until 9:30am. That felt so good.

I'll keep you all posted in the next few days about my medical endeavors. And don't worry, I'll be posting lots of new and interesting science facts really soon.

High on Grass

2006-08-30T19:41:00.000-04:00

The sky is unfolding
Tear for tear
But you can call it what you want

I have been diggin the Joe Grass CD I got from Heather V this summer. It's a mix of folk, blues, and good ol' East Coast emotion. Every time I listen to it I'm blown away, especially when track 3 (Bones) comes on. The only bad thing is that it's so damn hard to find the album in stores.

For those of you who are interested, Joe Grass grew up in Moncton NB and has been touring around Canada for several years now. He's currently touring with Stuart MacLean and the Vinyl Cafe. I think he's in Montreal right now, playing in a number of small venues around the city.

I actually had a chance to meet him once or twice at Jack, Jim, and Seth's loft in Montreal. He's a great guy and a wicked guitar player. If you're able to see him play in a town near you, don't hesitate. You'll be pleasantly surprised.

Band/Album Names (Pt 8)

2006-08-29T19:37:00.000-04:00

Yet another installment of soon-to-be-famous album names!

English in Sheep

In With Food

Oh That Belly

Orange Line

And last but not least:

De Lish

And Then There Were 8

2006-08-25T01:27:00.000-04:00

Today was a sad day for Pluto. The so-called 9th planet from the sun doesn't fit the new guidelines for being a planet, so it has been demoted to "dwarf planet". Now I'm all for having specific guidelines for what a planet is, but I feel badly for the little runt of the litter that is no longer a member of the only family it ever knew. It's like growing up with a mother and 8 brothers and sisters, and then in one day you find out that you were adopted and are being sent off to live with your crazy dysfunctional biological family. You know, the one that looked similar to you but didn't have the important status you had because of your last name. So now that you know the truth, your self-confidence has plummeted.

It makes sense for Pluto to be upset. Who is really going to make a model of the dwarf planets of the solar system for a science project? Now all of its street credit has disappeared. It's as if he was a guest star on a popular TV show, but was instantly forgotten as soon as they cut him from the cast.

But there's a silver lining here. Instead of being the farthest, smallest, and coldest planet of the bunch, it has become one of the best dwarf planets ever. And it's the only dwarf planet ever to be considered a true planet (or "classical planet") for part of it's known existence. Not just for a few months or years. We're talking 76 whole years of planet status. That must make all the other dwarf planets pretty jealous.

So I say good luck to our fallen soldier, and best of luck in your next life.

Science Fact - Testicular Feminization

2006-08-22T21:37:00.000-04:00

I thought I'd start the science facts with a bang this time. What better way to do this than to talk about ambiguous genders?

Testicular feminization, or more properly called androgen insensitivity syndrome (AIS), causes a genotypic male to 'become' a female. Let me elucidate this phenomenon for everyone. You may be born with an XY genotype (note that the Y chromosome is what makes me and roughly 50% of the population male), but you don't have any testosterone receptors in your body. That means that androgens (like testosterone) are produced but your body can't respond to them at all. As you grow inside your mother's womb, the lack of testosterone's influence will make you develop into a female.

Once you hit puberty, your testicles (which are undescended inside you) begin to produce a lot of androgens. But your body still can't respond to these hormones, not even to lower the amount of testosterone produced in a negative feedback mechanism. What it can do, however, is convert testosterone into estrogen. Thus, you will probably develop voluptuous breasts and have very little body hair. What you will not experience is the menstrual cycle (bonus!!), as you do not have a uterus.

I'll try to answer some FAQs about testicular feminization here:

Do people with AIS have a penis? - Depending on the severity of AIS, people may have a small and malformed penis or (for those with complete AIS, also known as CAIS) may not have any penis whatsoever.

What about a vagina? - Some people, often with CAIS, have a small vagina about half the depth of a normal vagina.

Are people with AIS fertile? - No.

Can you have this and not know it? - This can happen, but it's usually apparent either at birth (weird penis) or at puberty (no period).

So let me end this with a 'rumour' about someone famous with this syndrome. The sexy Jamie Lee Curtis is said to have AIS. If you've ever seen True Lies and have enjoyed the striptease scene, remember that at the DNA level she could be just as manly as me. Or as Arnold Schwarzenegger. But screw it. I still think she's hot.