BUMMER: BURMA AND CHINA?

     The news is depressing these days.   My thoughts go out to the people of China and Burma.   If any good comes of the natural disasters there, maybe it will be that the Chinese government, unlike the cruel dictatorship of Burma (Myanmar), is really throwing every resource it can at helping victims of the quake, and it's assisting, not blocking, foreign aid organizations.   Maybe someone in Myanmar will take note.    It's about time the Chinese government did something nice.

READER QUESTION: DO FEVERS "BREAK?"

     The most important fact I can teach you about fevers is this: You don't have a fever if you have not measured it on a thermometer.   Many patients say things like:  "well, my temperature usually runs 95.6 so for me a temperature of 98.0 is a fever."  Guess what: it's not.  The Good Lord, or Darwin, has determined that a normal human temperature is 98.6.   HE has also decided that you can get up to about 99.1 when you're excited.   If you are over 99.2, on a THERMOMETER, you might be running a fever (there is some disagreements as to the magic "cutoff" number).   But overall, the numbers tell the story, not your theory about what your particular temperature is supposed to be.   Your body temperature is not like your hair- you don't get to tell the rest of the world what you think it's supposed to look like, any more than you get to tell the world what the Pythagorean Theorem means in your particular geometry.   So check your temperature on a proper thermometer and stop lying that you have a fever.

   Once you've done this, if you do have a fever, be reassured: REAL FEVERS DO "BREAK."  If they are caused by a virus, such as the flu, or a bacterial infection that resolves WITHOUT antibiotics, such as a sinus infection or gastroenteritis, a high fever can actually herald your imminent recovery.   That's because a fever is literally your body's attempt to cook the infection out of you- and it's an attempt that is effective more often than not.  Your body is a remarkable system, which is why it knows that a true fever can be measured only by a thermometer, not by your opinion of how hot you are. 

     I hope that was helpful.   I realize that my anger and bitterness today is overshadowing my ability to be a nice, helpful source of information.    But I've tried to stay close to the truth, even though it hurts.   

YOU DON'T KNOW JACK ABOUT COLDS

     It's true- you probably know less about the common cold than you think, and what you do know is almost certainly a load of crap.   Why shouldn't this be the case?   After all, you're not the one who went to medical school.   Doctors don't expect you to know that doctors can't do much to help you with your cold.    But to help educate you, let's run through a few questions in rapid-fire style.   These are questions from real patients:

QUESTION: I thought I had a cold, but it's been two weeks and I'm not any better, so what's wrong with me?

ANSWER: There is no time limit on the common cold.  A cold on AVERAGE last 7 days, but they can be as short as a 48-hour illness or as long as a month, in some cases more.  Bummer.

QUESTION: How do I know what I have isn't bronchitis?

ANSWER: Bronchitis is a cold.  It's just a "chest cold," or a cold with a lot of coughing.  It's still a cold, and antibiotics won't help you.   But watch out for pneumonia.   That can feel like a chest cold, but it will usually give you a fever and it will get worse from day to day.

QUESTION: I've had a cold for a week but I'm leaving on vacation tomorrow and I've got to get better!  What can I do?

ANSWER: Nothing.

QUESTION: How can I keep my friends/coworkers/family from getting my cold?

ANSWER: Stay away from them as much as possible, and tell them to wash their hands with soap and water often; especially when you're around.

QUESTION: Will Vitamin C help me get over my cold sooner?

ANSWER: No.

QUESTION: How about chicken soup?

ANSWER: No.

QUESTION: What will happen if I keep smoking cigarettes while I have a cold?

ANSWER: Either your cold will last longer than it would have otherwise, or you'll get pneumonia, or both.   A cold is a wonderful time to quit smoking!

QUESTION: When should I see the doctor for a cold?

ANSWER: When you think you might have strep throat, an ear infection, pneumonia, or if you have asthma and your asthma symptoms are getting worse.  But don't be shy.   It's your body, and if you're worried about it, see your doctor!

DR. TOFUHEAD NEEDS YOUR COMMENTS ABOUT COLDS:

     I have just scratched the surface with the questions above.  The common cold is a huge topic, and if you're a human you've almost certainly had at least one cold this year.  So do me a favor: if you have questions or thoughts about colds, post them here as comments!

ADDENDUM: JOINT CRACKING

    When asked why joints crack, I summarized by stating, "joints crack because they're joints, and that's what joints do."  As a reader pointed out, I should have added, "they also crack to annoy other people."

A QUICK NOTE: PIERCINGS

    Patients seem shy about showing me their piercings; not that I ask, but they have a way of showing up during a physical exam.   If you have a piercing of any sort, you should know the following:

1) Any doctor who has been in practice for more than 24 hours has seen a load of piercings.  And what ever you happen to have pierced, chances are your doctor has seen it before.

2) Doctors know that if you have a piercing, that does not mean you are a drug-user or prostitute.    We know that people from all walks of life have piercings.

3) Generally speaking, piercings are not a health hazard in any way.  When done correctly, they do not cause or transmit any diseases and they do not usually cause any health problems.

4) If you're worried that your piercing may be infected, don't go back to the place that pierced you.   Go to a doctor.  We know how to treat infected piercings.

5) Many pierced body parts do NOT seal up again if you take out your piercing for good.  So don't pierce anything unless you can live with having a hole there forever.

FINAL QUESTION: WHAT HAPPENED TO THE PICTURES?

ANSWER: My brother Randy used to do the pictures, but he has some crazy projects at work going on.  After putting in 14-18 hours at work, he needs to sleep and he can't stay up all night adding pictures to the blog.   In the near future I'll figure out how to get my own pictures in the blog, or maybe Randy's work schedule will lighten and he can add his pictorial expertise again.  

But never fear, sooner or later Dr. Tofuhead will have pictures in the blog!

IT'S ROUGH OUT THERE

      It's been a tough week for Dr. Tofuhead.   I have to be honest: the situation in Myanmar has got me down.  The massive catastrophe there, and the fact that the leadership of that country would like it to continue, has left me drained of enthusiasm.    After all: who cares what I have to say about radishes when tens of thousands of people are dying?

      I suppose life goes on.   But in my life, the kid has been sick, I've been up for 3 days straight with little sleep, and a late frost wiped out my meticulously planted eggplant and tomato garden.       So I have nothing to offer my readers today, except a request: think positive thoughts for the people of Myanmar.   I'm sure they are good people, victims of a disease that is all too pervasive in this world- oppressive dictatorship.   They deserve better.  

A GREAT DAY FOR MOTHERS, BUT NOT THE LAKERS

     I hope all you mothers had a great day; a better day, at least, than the L.A. Lakers did.   Today the Lakers really looked vulnerable, and at this point Dr. Tofuhead will officially have to predict that the Los Angeles Lakers will NOT be your championship team this year.

     But who really cares.   After all, today was about mothers.   What did I do for my special mother today?   Nothing that unique...flowers, breakfast, a card, and some fun time with friends.  What more could a mother want?

FOOD OF THE DAY: RADISHES

     I don't know a ton of people who love radishes.   I'm not sure why this is the case; I really think these colorful and fun little roots have a completely crisp, lively taste.    I always think of them in the spring because they are the first garden vegetables that are ready to eat- and though store-bought radishes are fantastic, it certainly is fun to pull a few from the garden and eat them moments later.   Relatively ignored in the United States, radishes are everywhere in Asia and Latin America.   The massive Daikon radish is used both raw and cooked in Chinese and Japanese dishes, and the more familiar red radish is frequently found in soups, stews, salads, and as a condiment south of the border.   I think the best way to eat them is to slice them thin and sprinkle them on a fresh summer salad, or to sprinkle them on a spicy Mexican soup such as posole or menudo.

RADISHES: BENEFITS

-For their size, these things are loaded with an impressive amount of vitamin C.

-Reputable nutrition web sites note that radishes have "anti-inflammatory" properties, much like garlic.   I am not sure how they determine this; but sounds good to me!

-In addition to Vitamin C, they have significant fiber and B vitamins.

-They keep for up to 2 weeks in the fridge.

-Probably the easiest of all vegetables to grow, and they go from seed to harvest very quickly.

-If you buy them, they're cheap.

RADISHES: DRAWBACKS

-A bit acidic.   If you are in the middle of a case of heartburn, have a Tums, not a radish!

-I can't think of any other drawbacks.

QUESTION OF THE DAY: WHY DO MY JOINTS CRACK?

      I asked this question to a colleague who knows a ton about sports medicine.   His answer: "Because they're joints.  And joints crack."   

      Obviously, that's a bit of a "smart ass" answer- but if you think about it, it's true.   Almost all joints CAN crack, whether they are healthy as can be or worn to shreds.   Arthritic joints crack and the cracking hurts; that's because any event within an arthritic joint can hurt.   Healthy joints crack and it feels good; that's because healthy joints are healthy and they don't cause pain.  The point is that the cracking of a joint generally has nothing important to tell you about the health, function, or alignment of that joint.    

       I have heard numerous explanations from orthopedists about why joints crack- some say there are small air bubbles in the joint fluid bursting, others say that tendon fibers crack as they slide over each other, but most say that there is no good explanation.   But all the doctors I've talked to agree: there is nothing unhealthy or abnormal about joints cracking.   So if your joints crack, DON'T WORRY ABOUT IT!

MOTHER'S DAY: TIME TO GARDEN

    As Nurse's Week comes to a close, Mother's Day is just beginning.   If you're a nurse and a mother, you're pretty much kicking 110% ass right now.   If EVERYONE isn't giving you flowers, you better start slapping people.

    In Denver, Mother's Day is also the day you can be assured with 95% certainty that you are beyond the last of the killing frosts; the bane of early spring gardeners.  That means: it's time to plant!

    People in NYC, SF, and other large cities often assume that because they don't have a yard, they can't garden.   Nothing could be farther from the truth.   You can grow almost any vegetable in a container- which means that your porch, your front steps, even your windowsill can be a source of fresh, home-grown food.  And if you think vegetables are easy to grow, you should try growing cooking herbs.  There is nothing like cooking a dish using fresh herbs you have grown yourself!

    My college buddies were the ones who taught me that gardening and healthy eating were inextricably linked- I hope I can convince my (handful of) readers of that.   Today's blog is dedicated to them!   I'm signing off to give some TLC to my baby tomato and eggplant seedlings...

DRINK WATER? YOU MAY BE ON 56 MEDICATIONS YOU DON'T KNOW ABOUT

In March the Associated Press released results of an investigation into the contents of municipal drinking water in 24 major cities. The results were rather concerning: in all areas studied, municipal tap water was found to have trace amounts of pharmaceutical medications and their metabolites. These were present in extremely low amounts, but at present we just don't know if small amounts of these drugs can have health consequences for humans. Animal studies are not reassuring: many aquatic animals, such as fish and amphibians, have demonstrated severe physical and reproductive abnormalities in response to pharmaceutical concentrations even LOWER than what's in our own drinking water. In Philadelphia municipal tap water, small amounts of 56 pharmaceutical drugs were found! Even if the amounts of each drug are incredibly small, we just don't know what this veritable stew of drugs might do when present in large combinations. So far, it doesn't look like much, but scientists acknowledge that we might not have reached the tipping point yet, which could occur as the number of drugs and drug metabolites in our water increases (as it is likely to do).
As you may know, bottled water is not going to be the solution. First, many commercial bottled water manufacturers ADMIT they are just selling bottled tap water. Second, the EPA is starting to get concerned about hormone analogs that leach into water from polycarbonate, the clear plastic that is used in the vast majority of beverage bottles. Bottled water, in fact, may be MORE hazardous to your health than your city's tap water.
So what to do? There are no great answers yet, until we find better ways to dispose of medications and improve wastewater processing- but there is a good compromise. I recommend drinking municipal tap water, but filtered through a Brita filter into a pitcher. The filter/pitcher combo is sold at Target and innumerable other home and garden stores, and the filter in these things contains activated charcoal. Activated charcoal not only can bind heavy metals and industrial contaminants, but it does an impressive job soaking up pharmaceutical drugs. Incidentally, activated charcoal is what we'll pump into your stomach if you come into the Emergency Room with a drug overdose. It works to neutralize huge quantities of drugs in human stomachs, and it can work to soak up most, if not all, the drugs in your drinking water.
SUMMARY:
1. use your tap water to drink.
2. filter it through a Brita filter first.
3. to make it portable, put it in a METAL OR GLASS reusable drinking bottle to take with you.
4. DON'T FORGET to change the filter in your Brita pitcher! Most people I know actually DON'T do this enough. I recommend every 3 months.
5. if you have a medication to throw away, DON'T flush it down the toilet. Seal it in a plastic bag and put it in the trash. It's less likely to get into the water supply this way.

IT'S TV WEEK: AMAZON WANTS YOU TO SIT ON YOUR ASS

I was just kindly notified by Amazon.com that it's "TV Week." That means DVDs of all the most popular serial TV shows, which are rarely worth watching more than once, are now on sale at cut-rate prices. The timing seems atrocious. After all, it's Spring: the sun is shining, the birds are chirping, and the days are long. There are bike rides to be taken and gardening chores to do. Why would anyone want to be sitting on their ass indoors watching a recording of a sitcom or TV drama? Everyone know what they should be doing this time of year: sitting on their ass indoors watching the NBA Playoffs!
But seriously: none of us should really be watching anything. We should be out doing things. I'd love to be out playing basketball, but I only have one move, the "fade-away airball." But I don't let that stop me from getting some calories burned. I mean, do I really need to stay off my bike so I can watch the "Orlando Magic?"
If you are somewhat addicted to watching playoff basketball, like I am, try this exercise:
1. Look at the physiques of the players- preferably the ones that are NOT from Europe, where apparently razor blades are not in common use.
2. Then strip down to your underwear, and look at YOUR physique in a full-length mirror. Don't pull your underwear up over your gut- be honest with yourself.
3. If you notice a large discrepancy, it's time to turn off the TV and go get more exercise.
4. Repeat steps 1-3 until the NBA season is over and you are on your way to looking like LeBron James (or Serena Williams if you are a woman).