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Category Archives: Medical Issues

Cancer Isn’t a Modern Disease

What is cancer? You know the term and odds are great that you know someone personally who has suffered from a member of this constellation of diseases. But what exactly is it?

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Cancer is basically a genetic disease in that something changes in the DNA inside certain cells and this, in turn, disrupts their normal functions. These changes might result in uncontrolled growth and this can cause problems simply by the tumor’s size and location. The cancerous tissues might obstruct a bowel or a bile duct, or compress brain cells and increase the pressure inside the cranium, or erode into nearby organs of blood vessels. Others changes within these cells might alter their internal workings so that they no longer function as intended or they might produce chemicals or hormones that alter the function of other cells within the body. Cancer comes in many forms.

cancer-cells-growing

What causes cancer? This has been the subject of debate, as well as a tremendous amount of research, for many many years. We have some answers, but there are even more questions. We know that things such as cigarette smoking, exposure to the sun, certain chemicals, and many other things can trigger these genetic changes within cells that can lead to cancers of various types.

Medicine has made tremendous strides in our understanding of cancer and in our methods of early detection, diagnosis, and treatment. There are programs for the early detection of breast and colon cancer and newer treatment protocols have revolutionized the approach to these malignancies. The progress in leukemia and lymphoma treatment, as compared to when I was in medical school, has been nothing short of astounding. 

We often think of cancer as a modern scourge, but cancer is not a new disease. Not by a long shot. It’s been around for many centuries. Evidence for cancers have been found in Egyptian mummies and a recent report from Live Science underscores that.

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Beware the Rabid Dog—-and the Homeopath

Remember the scene in the classic “To Kill A Mockingbird,” where Atticus confronted and shot the rabid dog to protect Scout and her friends? A very dramatic scene and one that had played out in other communities during that era. A rabid dog roaming the streets was indeed a community emergency.

Atticus

But, I don’t remember anywhere in my medical training where the saliva of a rabid dog could be used to treat emotional problems, or anything else for that matter. Maybe I missed that day, though I doubt it.

Homeopath is a word everyone knows. You’ve heard it thousands of times. But, what does it mean? “Homeo” means “the same.” if something possesses homeostasis it means that it remains in a state of stability rather than one of flux or change. It’s static. “Path” means disease or a pathological state. So, homeopathic means a stable state of wellness that is unchanging.

A homeopath is someone who, by definition, practices medicine where nothing changes. No good, no bad, nothing. Homeostatic. Since most of what they do makes no difference, causes no changes in the body, their treatments also cause no harm. Well, except to your wallet. This is what keeps them from being more tightly regulated, or run out of business altogether. 

But that’s not always the case.

Jonah was a four-year-old boy who obviously had emotional if not truly psychiatric problems. He apparently was fearful of werewolves and would crawl around on the floor and beneath furniture and growl at his classmates. Odd behavior for sure. The proper course would have been for him to see a physician in order to determine if there was some infectious process, neuropsychiatric problem, or perhaps drugs involved in his behavior. If none of these were found, then psychiatric evaluation and care should follow.

Instead, he visited a homeopath. One Anke Zimmermann. Apparently, the treatment of choice under Zimmermann’s care was to give the young man a concocted medicine that contained the saliva of a rabid animal. Really? Odds are that this beyond bizarre treatment would do no harm, be homeopathic, but you just never know. The rabies virus is a hardy creature.

Rabies Virus

The key point here is that these types of treatments are neither regulated nor investigated and are far outside scientific thinking or procedure. The take-home lesson is, be careful out there. There are a lot of folks who, under the guise of being a so-called “health care provider,” do crazy stuff.

 
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Posted by on June 19, 2018 in Medical Issues, Uncategorized

 

Yes, You Can Die From A Broken Heart

The term “broken heart” is well known to everyone. From Romeo and Juliet, to shattered romances, to many a teenager’s angst, a broken heart seems to be part of life. Everyone’s been there. But can you die from a broken heart? You bet.

In a very unusual medical condition known as Takotsubo’s Cardiomyopathy, dying from a broken heart can actually occur. Takotsubo is a Japanese octopus trap and is shaped like a dilated and damaged left ventricle as happens in a cardiomyopathy.

Takotsubo Pot and LV

Cardiomyopathy is a big word but when broken down into its components is fairly easy to understand. Cardio means heart, myo means muscle, and opathy means disease. So a cardiomyopathy is a disease of the heart muscle. It often results from coronary artery disease where multiple heart attacks (myocardial infarction or MI) have occurred, damaging the muscle severely. It also can occur after viral infections, certain meds and drugs that are toxic to the myocardium, odd diseases like amyloidosis, some members of the disease group we call autoimmune disorders, and other maladies.

We analyze the pumping function of the heart in many ways. Echocardiograms, CT and MRI angiograms, and with a ventriculogram done as part of a cardiac catheterization procedure. Here a catheter is passed through an artery and into the left ventricle—the heart’s main pumping chamber—and contrast material is injected while a digital video is made. A normal ventriculogram shows the heart squeezing in tightly as the heart muscle contracts.

Normal LVgram

An abnormal one, such as is seen in a cardiomyopathy, will show diminished “squeezing” during the contraction phase (systole) of the cardiac cycle.

CMP LVgram

An odd form of cardiomyopathy is Takotsubo’s Cardiomyopathy. In this circumstance, extreme emotional upset changes the physiology of the heart muscle in some fashion and leads to it being “stunned” or damaged. The actual mechanism for how this happens is not known but the result is a significant weakness of the heart muscle, which, in turn, can lead to heart failure and death. It is not common, but it is real.

This is likely what happened to Joanie Simpson and perhaps the famous actress Debbie Reynolds.

 
 

Metal Pica: Hmmm, That’s Good—-Or Not

 

Pica is the persistent and compulsive eating of substances that have no nutritional value. Things like dirt (geophagia) or rocks (lithophagia), ice (pagophagia), paint chips, hair (trichophagia), paper (Xylophagia), metal, almost anything.

In the South, clay pica, more so in the past than now, still occurs. Red clay dirt is seen as having health benefits. It doesn’t, and in fact, the clay can bind iron, remove it from the body, and lead to significant anemia.

X-Ray of Geophagia

And oddly, ice pica can be a sign of iron-deficiency anemia. If someone says they feel the need to munch on ice constantly, a search for anemia is in order.

Metal pica is not common but cases do pop up from time to time. Kids swallow coins and paper clips and pieces of aluminum foil because kids do goofy stuff. But some people consume metallic objects in large amounts and, as should be obvious, this has significant health concerns. I mean, a belly full of metal can’t be good.

Such is the case with a 52-year-old man from whom surgeons removed over 100 pieces of metal.

 
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Posted by on March 19, 2018 in Medical Issues

 

The Mystery of Chopin’s Heart

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Did Frederic Chopin die from Tubercular Pericarditis? And what the heck is that anyway?

Pericarditis is an inflammation has occurred of the pericardium, the sac that contains the heart. Most often it is due to a viral infection but there are many others causes. One of the worst is tuberculosis (TB).

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Tubercular Thickening of the Pericardium

 

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X-Ray Showing Thickened Pericardium
(White ring around heart shadow)

Tuberculosis has wreaked havoc in humans for centuries. It has been found in Egyptian mummies and has devastated entire populations. Treatment didn’t appear until the 20th century and in recent years new, more malignant forms have appeared. Even after several millennia, it remains a difficult medical problem.

It attacks the lungs and slowly destroys the tissues, leading to cough, fatigue, weight loss, and muscle wasting—-the reason it was called “the consumption.” It, at times, literally consumed the sufferer.

When it spreads to the heart, particularly the pericardium, it can quickly become deadly. A thick viscous fluid collects in the pericardial sac, compresses the heart, and interferes with its function as a pump. This fluid can also solidify into a leathery trap around the heart so that even survivors of the initial infection can suffer severe, long-term problems that we term constrictive pericarditis—-the encasement restricts cardiac filling and thus effects pumping.

Recent studies suggest that this is what happened to Chopin. His heart took a strange and convoluted journey. He had requested that at his death that his heart be removed and returned to his native Warsaw, Poland. When he died in Paris in 1849, his heart was indeed removed, placed in a crystal jar, and encased in a stone pillar at the Holy Cross Church in Warsaw. In a recent examination, researchers found evidence that suggested he had suffered from TB pericarditis.

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Holy Cross Church

 

Getting Lost in Your Own Home

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What if you couldn’t navigate your own home? What if your child is calling for you in another room, but you can’t figure out how to get there? You just might have Developmental Topographical Disorientation (DTD). Some resort to making detailed maps of their home just to navigate life.

An odd neurological condition for sure.

The Atlantic article: https://www.theatlantic.com/health/archive/2015/05/when-the-brain-cant-make-its-own-maps/392273/

New Scientist article: https://www.newscientist.com/article/dn25578-mindscapes-the-woman-who-gets-lost-in-her-own-home/?full=true&print=true#.U4neU16aGzA

Medical Daily article: http://www.medicaldaily.com/getting-lost-what-happens-when-brains-gps-mapping-malfunctions-245400

 
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Posted by on January 11, 2018 in Medical Issues

 

Peanut Butter Can Kill You

 

Peanut butter can be deadly. If you’re allergic to peanuts.

Our immune system protects us from all sorts of bad things – – bacteria, fungi, and viruses. Our bodies recognize these foreign invaders and the immune system immediately goes to work manufacturing antibodies against the intruders. These antibody signal for help and pretty soon white blood cells show up along with their buddies known as mast cells. These cells release an array of chemicals that help damage the invaders, which are then consumed by the white blood cells. And life goes on.

But sometimes the immune system overreacts. It produces a massive amount of chemicals that can cause a drop in blood pressure, a tightening of the bronchial tubes, a leaking of fluids within the tissues and, most deadly, the lungs. We call this overwhelming reaction anaphylaxis. It is typically immediate and severe.

Such a reaction happened to Miriam Ducre-Lemay. She was allergic to peanuts. Her boyfriend had apparently eaten a peanut butter sandwich and had given her a good night kiss. Then everything went off the rails. She suffered an acute anaphylactic reaction and by the time paramedics arrived it was too late. This illustrates that it only takes a very small amount of an antigen (in this case the peanut oils in the peanut butter) to initiate a severe anaphylactic reaction.

 
 
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