Special Post Tomorrow!

Not feeling well tonight but will have an extra special post tomorrow.

Epiglottitis

Medical Topic of the Day: You lucky people got a topic suggested.  My friend Jen wants to know about Epiglottitis.  So Let's do this.

Off The Top of My Head:  Epiglottitis is the inflammation of your epiglottis.  Your epiglottis is a chunk of cartilage in your throat that prevents food from going into your trachea when you eat.  It does other stuff too but that is the main function.  But what causes it to get all hot and bothered?

That thing.

My Research Today:  Epiglottitis can be caused by many different bacterias most commonly strep and staph.  It is much less common today than it was 20 years ago.

Prior to 1990 the most common cause of epiglottitis was Haemophilus Influenzae or H. flu and also referred to as Hib.  Like you would expect H. flu is a type of bacterial influenzae but not the cause of influenza as it is not a virus.  Typically this bacteria lives in humans without causing disease, however, when it does rear it's head it can be serious.

This has nothing to do with epiglottitis.

Typical 5 year vaccinations cover H. flu.  Most epiglottitis cases involving H. flu effect children under the age of five years old.  Epiglottitis is very serious in children as the swelling can occlude the airway more easily as the trachea is smaller in diameter.  Past and present treatment for children with epiglottitis is intubation and antibiotic therapy until swelling subsides.

In adults the treatment is more forgiving.  Usually just antibiotics and observation.  After the H. flu vaccine was developed cases of epiglottitis in industrialized countries dropped significantly.  It is more common to see epiglottitis in adults caused by strep these days.

Well I hope everyone enjoyed this informative and not fun post.  Have a good night.

Quest To 180:
Meh.

The MAN:
Meh.

Ear Wax

Medical Topic of the Day: Nobody gave me a topic yesterday so I guess we are going to have to discuss something disgusting.  Ear wax.  What is it, does it do anything, and why is it so delicious?

Off The Top of My Head:  I am not sure if it serves a particular purpose but many people's ears are jammed full of it.  The technical term is "cerumen impaction" and I have personally noticed that the level of ear wax in your ear directly correlates with your level of personal hygiene.  Although I am sure other things could cause excessive ear wax.

I'm going to go ahead and say that isn't normal.

I don't think ear wax does anything but I am probably wrong.  My working assumption is that it is mostly a collection of dead skin cells that get trapped in your ear canal.  Let's find out. 

My Research Today:  Technically referred to as cerumen, ear wax is a waxy oil secreted by hair folicles and glands that line your ear canal.  And proving me wrong once again, ear wax serves more than one purpose.

1. It protects your ear canal from micro-organisms and bacteria
2. It protects your ear from particles like dust or debris
3. It lubricates and coats the delicate inner ear skin to protect against water

Typically older ear wax makes it's way to the opening of your canal where it is washed away by bathing. However, a few people can produce too much ear wax for their canal to clear naturally and get impactions that way.  You can also jam it into your ear canal being clumsy with a q-tip, but 99 times out of 100 cerumen impaction is caused by not bathing properly.  Other things that can cause impactions are:

• Hearing aide use
• Ear plug use
• Shoving bobby pins in your ear?  What the tits?  Why is that on the list?

This guy has impactions all the time.

That last one is actually on the list.  Approximately 6% of the population suffers from cerumen impactions and it is a leading cause of hearing loss, ear pain, and tinnitis (ringing in your ears).  Cerumen impaction is actually the most common cause of ear complaint in adults.

There are all kinds of drops you can use to soften and remove ear wax including a popular stool softener, Colace.  It comes in drops so don't go jamming capsules in your ears.  In doctor offices we use a Waterpik with extreme prejudice to blast wax out of your ear and a little spoon thing called a curette.  In fact I thought that was what they made Waterpiks for until I saw one in a dentist's office.

Now with filthy ear attachment!

Well I hope you all enjoyed learning about ear wax and proper bathing habits.  Tomorrow we are going to talk about poop unless someone suggests a better topic.

Quest To 180:
10K steps

The MAN:
I don't even know.

I need a topic!

Someone give me something interesting to write about.

Inbreeding Part 2

Medical Topic of the Day: Welcome to part two of my series on inbreeding.  Today we get into the nitty-gritty of what makes it so bad.  Lots of technical details ahead.  I hope I don't F this up too bad.

My Research Today:  Inbreeding is defined as the breeding of closely related people or animals especially over multiple generations.  We saw many examples in part one with sister, brothers, cousins, and sometimes even father/daughter, mother/son breeding.  Besides being gross, what makes it go wrong genetically?

Well inbreeding does not cause genetic mutation as many people think.  What it does do is multiply the chance of a mutated recessive gene being expressed.  Recessive genes are traits or mutations that need to be inherited from both parents for the mutation to manifest in the child.  Keeping it in the family reduces the available genes in the pool making it more likely for this to happen.  Look at it like this:

Poor Selena!

So in this scenario we have Justin Bieber and Selena Gomez and they have kids.  Now the Biebs has a Trollism trait that is recessive (marked by a pink dot).  Selena is genetically perfect.  They have four kids: two Biebs, and two Selenas.  Of those four both Selenas and one of the Biebs inherits the recessive Trollism trait.  Now because none of this second generation has inherited the Trollism trait from both parents the trait does not manifest.

But here is where we have a problem because the second generation of Biebs get freaky with their sister.  So with the third generation the likelihood of the child inheriting the trait from both parents is much higher.  Because of this both kids of one of the pairs are trolls and the other pair produces two more children with the recessive trait.

Selena 3 doesn't even have genitals.

Now this is an extreme example but you can see how each generation of inbreeding compounds the chances of a recessive trait manifesting. And we aren't talking about just one thing, we are talking about many traits that could be compounded over time. It gets extremely complicated. To put it in it's simplest terms inbreeding reduces the available non-mutated genes in a family's pool of genes.

You end up with this eventually.
Now SQUEAL LIKE A PIGGY, BOY!

That is all I am going to get into tonight if you want me to get into it more than just tell me. I hope you all enjoyed and understood that. Have a great night and thanks for reading!

Quest To 180:
10K steps

The MAN:
I don't even know.

Double post tomorrow.

Tomorrow we will continue with inbreeding, heh.  It is requiring more research than my typical articles so maybe I will make it three posts instead of two.

Inbreeding Part I

Medical Topic of the Day: Today begins my two part series on inbreeding.

Everyone has heard the term "nature favors diversity" at least non-inbred people have. Look at Tiger Woods: Asian, African-American, great athlete, intelligence, good looks, he has it all. He even has a harem. Do you have a harem? I didn't think so.

Tiger Woods is under the pile of women.

Off the Top of My Head:  Everyone knows that inbreeding is wrong, right?  The Egyptians set a dangerous precedent with their pointy-ass heads.  That shit doesn't happen if you aren't banging your sister is all I'm sayin.  Look a this shit:

Ecephalopathy can't be healthy.

The European and Russian royal families followed the Egyptian's example to a T.  The last Tsar of Russia, Nicholas II, was unable to produce a suitable male heir.  Alexei, his only son suffered from hemophilia, a disease in which his blood did not clot making even a paper cut a life-threatening injury.  This eventually led to Nicholas' overthrow (Sort of, Nicholas was also a terrible leader.) and the original communist party.  That's right, inbreeding leads to communism.  You heard it here first.

The European royal families were arguably worse.  Look at this family tree:

Aww, man, you started with two and ended with one?

European royal families took keeping it in the family way too serious.  Look at that family tree up there.  What you are looking at is the Hapsburg family tree.  The Hapsburg royal families were famous for producing offspring with all kinds of genetic defects including one named after then, the Hapsburg Jaw.  Charles II of Spain did not learn to speak until he was eight and was unable to produce any offspring.  The coroner who performed his autopsy stated that Charles "had a single testicle as black as carbon and a head full of water."

Not real pretty either.

Stay tuned, tomorrow we explore what exactly it is about inbreeding that makes it so bad.  I mean besides the fact that you want to have sex with your own family.

Quest To 180:
10K steps, good workout yesterday though.

The MAN:
I don't even know.

Google shit the bed.

Google shit the bed tonight and I refuse to re-do an hour of work that Google says didn't happen.

Plantar Fasciitis

Medical Topic of the Day:  My good friend Jonny wants to know about plantar fasciitis.  What is it, andv why does it have so many i's for such a short word?

Off the Top of My Head:  Itis indicates a inflammatory process and plantar is the bottom of your foot.  I have had plantar fasciitis before and it is very painful but I do not know exactly what causes it but I am going to assume the pain is caused by swelling of the muscle fascia in your foot.

My Research Today:  The plantar fascia is a thick band of tissue (a ligament) that connects your heel to your toes and forms the arch of your foot. Plantar fasciitis is the painful swelling and inflammation of that tissue. The inflammation is caused by overuse or over stretching of that ligament. It is more common in men and obese people.

This guy probably always has plantar fasciitis.

Plantar Fasciitis can be extremely painful and is worse after rest like when getting up in the morning. The most common symptom is a stabbing type pain in the arch of your foot nearer your heel. Your foot can also feel stiff and be sensitive to touch.
Typically the best treatment is stretching exercises and anti-inflammatories like Tylenol or Motrin.  A physical therapist taught me a trick where you fill a bottle with water and freeze it then roll the bottle in the arch of your foot.  The ice reduces swelling while you gently stretch out your arch.  Some people roll tennis balls on their feet too.

Dilala?  Starts with a D?  It's the only one I can take
and I need 4 milligrams to start with.

There are crazy surgical options like injections in the soles of your feet.  You can also have your plantar fascia sliced which destroys your natural arch and makes it so you can never walk without orthopedic insoles to support your arch.  Luckily it can almost always be treated without surgery it just takes a while, sometimes up to six weeks.

That's probably too many.

Well, I Am done for the night. If you'd like to request a topic, drop me a line.
Interesting aside:  Why does Lindsey Lohan appear on the second page of an image search for Dilaudid?

Quest To 180:
In the pool 30 minutes

The MAN:
I don't even know.

Fibrin

Medical Topic of the Day:  Fibrin, what is it?  What does it do?  How much do you remember from anatomy and physiology II?

Off the Top of My Head:  I dunno.  It probably has fiber in it?

My Research Today:  Defined as an insoluble protein formed from fibrogen which is in turn produced by the liver.  Fibrin is produced through the action of thrombin in response to bleeding.  The action occurs at the tissue level that is bleeding on an as-needed basis.

Fibrin in whitish in color and forms an elastic-like interlacing network of protein strands that lock in platelets. The gradual accumulation of thrombin and platelets create this spongy mass that forms the basis for blood clotting.  The mass formed hardens and contracts which in turn stems the bleeding.

Looks like spaghetti.

Think of fibrin like the hair in a clogged drain.  It catches other stuff until the drain is completely clogged.  That seems like a good analogy.

Like this only less gross and more complicated.

Well short one tonight, suggest a better topic so I have something to write about.  They can't all be winners.  I'm not Charlie Sheen.

Quest To 180:
Meh


The MAN:
Meh

Dysuria

Medical Topic of the Day:  Reader Linda wants to know why it burns when she pees.  So today we are talking about dysuria or discomfort when you pee.

Off the Top of My Head:  Dysuria is a common symptom and I have seen it caused from urinary tract infections, kidney stones, and STD's.  As to the actual mechanism for how it causes discomfort I would guess swelling due to infection but I don't know.  Let's find out.

My Research Today:  Usually burning or stinging in nature, dysuria is any discomfort experienced in the action of urination.  The root cause is inflammation and/or pressure of your urethra by one or more reasons.  There are four most common ailments that cause dysuria:

It probably shouldn't do that.

1)  Urinary Tract Infections.  Usually bacterial in nature, UTI's are much more common in women.  Bacteria introduced to the opening of the urethra tracks into the bladder causing an infection and associated swelling.  Frequent sexual intercourse or poor hygiene can increase chances of a UTI as well as individual physiology in regards to anatomical arrangement.

2)  Kidney Infections:  Also called pyelonephritis, kidney infections are caused mainly by advanced UTI's or kidney stones.  The infections are more serious with stones that obstruct your ureter or renal ducts as the infection has no natural outlet and can track into your blood stream causing sepsis.

3)  Urethritis:  This is swelling of your ureter typically caused by any one or an assortment of STD's including chlamydia and gonorrhea.  Urethritis can also be less commonly caused by irritants like spermicides or bubble baths.

No, that happens WAY later but you should always be suspicious.

4)  Vaginitis:  Guys don't have to worry about this one cause you need a vagina.  Vaginitis is vaginal swelling caused by infection or irritation.  Anything from douches to STD's can cause vaginitits but yeast infections are probably the most common reason.

So to answer your question, Linda, it burns when you pee because you are probably gross.

No wonder, Linda.

Have a good night everyone, and remember, if you want to ask a question just send an email!

Quest To 180:
11K steps.


The MAN:
Meh

Hemorrhoid Cream

Medical Topic of the Day:  My friend <name redacted> wants to know about hemorrhoid creams.  How, they work, what is in them and is it a good topping for salads?  So let's explore this topic.

Off the Top of My Head:  Typically hemorrhoid creams contain active ingredients to reduce swelling, numb the effected area or both.  But before we get into the cream contents, let's define what a hemorrhoid is.

My Research Today:  Hemorrhoids are enlarged veins near the surface of your skin by the rectum and anus.  They become swollen due to increasing pressure applied to them by straining or other pressures like pregnancy or constipation.  Most typically they are caused by straining when trying to poop.  There can be two types of hemorrhoids, external and internal.  For the simplicity of this article we will be focusing on external hemorrhoids.

Hemorrhoids in production.

The main mechanism through which most hemorrhoid creams work is though vasoconstriction.  Vasoconstriction is the process of your arteries or veins constricting or getting smaller.  Without getting into specifics of blood chemistry the effective agents in the cream act on the smooth muscles that line the walls of your blood vessels.  There are all kinds of vasoconstirctors that work by different means but that is essentially the end result.

Topically applying the cream to the affected hemorrhoid is ideal as you are applying a vasoconstrictor almost directly to the inflamed vein.  Hemorrhoid creams come in different formulations and flavors.  Most commonly the active ingredient is phenylepherine also found in over-the-counter decongestants.  Also commonly found in hemorrhoid creams is witch-hazel which is a natural astringent and pramoxine which is similar to lidocaine to numb the area in question.

Many people have heard the old wive's tale of putting Preparation-H under their eyes to reduce puffiness and swelling.  And you can do that but it is just gross, unless you live in Canada.  That formulation of Preporation-H was un-shelved from stores in the US in 1955 but the original formula is still sold in Canada.  Leave it to filthy Canadians to put ass cream on their face.

Filthy Canadians

The pre-1955 formulation contained some sort of live yeast cell extract called Biodyne.  Classified by the FDA as a wound healing agent, Biodyne speeds healing by increasing oxygen to cells through something something complicated something.  How exactly that reduces hemorrhoids or swelling around the eyes is a subject of debate but there is some merit to it.

No, it totally is.

Anyways this article is getting too long, I hope I answered all of your questions, <name redacted>.  Have a good night!

Quest To 180:
3 miles today.  13K steps.

The MAN:
Meh

Coccyx

Medical Topic of the Day:  This is probably the last in the series of misunderstood and/or abused, neglected and otherwise ignored body parts.  Today we are looking at something as fun to say as it is to talk about.  The coccyx.

Off the Top of My Head:  That little guy at the end of your tailbone, the coccyx, is all that remains of the tail of our ancestors.  It is sorta pointy, and does not seem to serve much purpose other than to easily break when we fall on our ass.  But does it do anything beneficial?  Let's find out.

My Research Today:  The coccyx is a small triangular bone forming the lower most part of the spinal column.  It comprises between three to five fused or "ankylosed" vertebrae and is all that remains of the vestigial tail in tail-less primates.  It is possible for some individuals to have up to five non-fused bony segments that comprise their coccyx.

Like all of the vestigial organs we have examined, the coccyx is not without utility as it provides a very important attachment points for muscle structures near our ass.  Speaking of your ass, part of your gluteus maximus is attached to the coccyx.  The coccyx also supports the position of your anus and anchors your pelvic floor aiding in defecation and continence.

Not with your coccyx you didn't!

With all those attachments and support your coccyx can cause any number of issues if it is fractured or otherwise damaged although a fracture is usually just painful.  The coccyx can be extracted if needed as long as special accommodations are made for the attachments.  Women have a greater chance of breaking their coccyx because they have a broader pelvic seat.

In Kim's case it is 20 times more likelier.

Well, that is all I feel like typing tonight.  Type at you later.

Quest To 180:
Sorta been slacking this week.  Not really over-eating though.  I gotta get back on track.

The MAN:
Meh

Wisdom Teeth

Medical Topic of the Day:  Our series of misunderstood body parts of dubious utility continues today with your wisdom teeth.  If you still have them that is.  Why do we have them when they usually need removed and cause so much discomfort?

Off the Top of My Head:  By the time wisdom teeth emerge there is little room in your head to accommodate them.  Hence they are typically extracted causing pain, discomfort, swelling and more pain.   They suck.

Look at them sitting there doing nothing.  WTF?

My Research Today:  Wisdom teeth are any one of your four third molars that emerge between the ages of 17 and 25.  Oddly enough "wisdom teeth" are supposedly named for the "age of wisdom" that exists between those ages.  Or maybe the person that coined the term was exceedingly sarcastic.  17 to 25 year-olds know exactly dick.

Wisdom.

It is very common for wisdom teeth to be misaligned when they begin to emerge which is what creates the necessity for removal.  The teeth become impacted causing pain and swelling sometimes leading to infection or abscess.  There are four main types of wisdom tooth impaction.  Get ready for some big words.  The most common is Mesioangular impaction (1), the second most common is Vertical impaction (4).  Distoangular impaction is rare and I have no pic for it but it is angled in the reverse of (1).  Horizontal impaction (3) is very rare and extremely unfortunate because you will need an oral surgeon with a scalpel.

Whichever way they become impacted they need removed as they can cause damage to your existing molars even if they do not become infected.  Sometimes the teeth will have to be broken into pieces to be extracted.  Wisdom teeth extraction is not a gentle procedure.  Dentists and oral surgeons go to work on those sonsofbitches with extreme prejudice.  It's like Seal Team Six kicking down the back door of your mouth, son, they will not leave empty handed.

Not pictured:  Dead wisdom teeth and terrorists.

Luckily you only have to have the procedure done once.  And extraction is much more pleasant than the alternative of infection.  Dental infections are extremely painful and can be deadly.  Your body will wall off infections into an abscess but if an infection of your tooth gets out of control your jaw bone can get infected. It is also a short sort trip to your brain from there.  I have seen both and most people don't look as nice with a piece of their jaw removed or an extra hole in their head.  So cowboy-up and don't be a pussy, just get it over with.

Tools of the trade.

Some people are sort of lucky and have properly aligned wisdom teeth which become functional healthy teeth. The position make them difficult to clean and care for and cavities develop. I, for example have all of my wisdom teeth but I also have fillings in all of them and a root canal in one of them. All of the work back there sucked donkey D.

Anyways, have a good night. Is anyone tired of this series yet? If you want it to change then recommend a topic.

Quest To 180:
11K steps. Feeling better today, trying to get back in it.

The MAN:
Meh

Not feeling well.

Not feeling so great today.  I will probably wait until tomorrow to start a new topic.

Plica Semilunaris

Medical Topic of the Day:  Our series of misunderstood body parts of dubious utility continues today with the plica semilunaris.

Off the Top of My Head:  I don't even know what that is.  In Latin it means "the fold of half of the moon." It has something to do with your eyeholes I think.

It is that thing apparently.

My Research Today:  The plica semilunaris of the conjunctiva is a small lose fold of bulbar conjunctiva on the inside corner of your eyes.  It is all that remains of the nictitating membrane of our ancestors.  But what is a nictitating membrane?

That is super sexy right there.

You know when cats lick each other's eyeballs?  You ever wonder why their eyes don't get all jacked up from that?  It is because they have a third eyelid which is translucent and can be drawn across the eye to moisten and protect it.

Amphibians, fish, birds, reptiles, many of them have nictitating membranes.  Primates, not so much; only the calabar angwantibo has them.

That is a calabar angwantibo.  It is less
exciting than I thought it would be.

Fun fact:  When I was a kid I once stuck the eraser end of a pencil in my eye and jammed it between my eyeball and my orbit. It was an accident but it hurt like hell.  No one believed me but it really happened.  I let go of the pencil and it just stuck there.  I had to pull it out.  A nictitating membrane would have come in handy.  It is a shame we don't have them anymore.  To be honest it is lucky I can even see right now.

Right in there.  Still don't know how I did that

Well, that was fun.  Have a good night.

Quest To 180:
9K steps.  Tried to get into the pool tonight but it was like 93 degrees.  It was...not refreshing.


The MAN:
Meh

The appendix

Medical Topic of the Day:  Neglected and misunderstood parts of the body are continued tonight with your appendix.  Why do we have it and what purpose does it serve.

Off the Top of My Head:  An organ in the right lower quadrant of your abdomen the appendix is most well known due to the illness of appendicitis which is an infectious swelling and potentially fatal emergent condition.  Most people at least know one other person that has had to have their appendix removed.

I have seen many cases of appendicitis and while it usually presents the same there can be unusual cases.  For example I know it is possible for your appendix to be rather long stretching across abdomen or other wised misplaced.

My Research Today:  Technically called the veriform appendix it is a blind-ended tube that sits at the junction of the small intestine and large intestine and connects to the cecum.  The word veriform means "worm-like" describing the shape.  Dr. Alfred Romer once referred to the appendix's chief importance as the financial support of the surgical profession.  Most experts consider the appendix a vestigial organ at best and a liability at worst.

Sorta looks like a worm.

Vestigial organs or structures are any diminished structure that previously had a greater physiological significance in an evolutionary ancestor.  Vestigial structures are not necessarily useless and typically serve some rudimentary or secondary function.  Wings on an ostrich are technically vestigial but you couldn't call them useless as the ostrich can use them to scare predators and flick away pests like insects.

Can still ruin your day without wings.

Leonardo da Vinci was famous for disections.  He assumed the appendix existed to accommodate excessive gas in the cecum as to not rupture your intestine when you fart.  That is probably not the original or secondary function of the appendix though.  In herbivorous mammals the dead end of the appendix is designed to increase cellulose fermentation aiding in digestion of plant material.  Humans however cannot digest more than a few grams of cellulose an hour so the appendix would be minimally effective in this function for us.

Leo's drawing of an
appendix.  It's one
of those sqiggly lines.

There are all kinds of theories and ideas about what true purpose the appendix but the subject is constantly debated.  The one thing I can tell you is this:  There is a 7% chance of getting appendicitis in your lifetime.  That is 7 people in 100.  It is quite a significant figure and nothing to fool around with.  Appendicitis is fatal if not treated.

Treatments vary.  In the European Union with socialized medicine they just give you a big bolus of antibiotics and hope it goes away.  80% of the time it does go away with antibiotics.  In the US we say "fuck that" and we just cut that mo-fo out.  That's how we do.  Go big or go home.  There is 100% chance you don't have appendicitis without your appendix.

'nuff said.

So ultimately what does your appendix do?  I don;t know, and neither does the medical community.  It is somewhere between probably something and maybe nothing.  Personally, I like those odds.  Have a good night and remember:  Never neglect or short-count any part of your body.

Quest To 180:
9 mile bike ride, 10K steps.


The MAN:
Meh