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Snot – So what have I got Sinusitis? Cold? Allergies?

Snot.  We all have it and we all hate it.  What is it anyway?  Why different colors?  When should I be concerned and see a doctor?

Snot is basically a dead warrior white blood cell (WBC) and an invading foreign body locked in a deadly embrace.  The WBC engulfs it and kills it then dies itself.  I know sad huh?  Your body makes different WBC to fight different types of invaders.  Neutrophils to fight bacteria, Lymphocytes to fight viruses, and Eosinophils to fight off allergies.  As the dead bodies pile up in your sinuses, nose, lungs, or ears they clog up with snot and have to be removed to clear the battlefield.  We notice it most when we have an overwhelming infection or allergies but even on a daily basis we all make up to 1 quart everyday. We mostly swallow it and don’t notice.

Now why the different colors?  Neutrophil WBC have a green hue enzyme inside them so when they kill bacteria it shows up in the snot.  Lymphocyte WBC that kill viruses have a yellowish enzyme so the mucus is yellow.  Eosinophils don’t have any colored enzyme, so you guessed it the snot is clear.  Brown or rusty colored snot is from dried out nasal tissue that has cracked and made very small blood vessels bleed slightly.

So how do all these viruses and bacteria get inside me to begin with?  Well in the USA we are the handshaking-est, hugging-est, kissing-est, people in the world.  Sadly even when we are sick.  We just don’t seem to mind sharing everything with others.  Also wearing masks in public is just not fashionable.  In Japan where they bow and wear masks in public, infection rates are far below what they are here.

The rule of thumb we providers follow is this:  If sudden symptoms all at once out of the blue it is either a virus or allergy. Why? Because viruses and allergens hit you full force they don’t have to divide and reproduce like bacteria.  If any sudden fever, body aches, or yellow colored snot then it’s a virus and not an allergy  Viruses hit you hard, fast, and usually you get better by day 3 and infection gone by 5th day.  Allergies also sudden symptoms but no fever, no body aches, and snot is clear with sneezing.  Symptoms do not improve until allergen out of air.  That leaves bacteria which gradually worsens and can last for weeks.  Fever and body aches start days later and worsen if body can’t kill off bacteria.  We try not to start anyone on antibiotics until the 7th day of an infection because we know then probably not a virus.  We worry about over use of antibiotics creating a resistant super bug.

Now some will say I got sick suddenly then got better and then got worse again.  What’s with that?  Probably a virus or allergy but it weakened your immune system and a bacteria snuck in while body defenses distracted with 1st invader.  People with allergies get 4 x more colds or sinus infections than those who don’t have allergies because they are making this clear wet warm snot in a dark place just begging for a virus or bacteria to cling to it and feed on protein of dead WBC.

So thank goodness for snot.  It means your body is doing its job well.  Enjoy.

Bored Medical Submariner – Oh oh

In my Navy days on a Trident Submarine I was the one and only medical person on board.  I would often be very bored because crew so healthy.  Dangerous combination boredom and the only medical person.  I noticed one day that the brand of pyridium (a urinary anesthetic) looked very similar to the multi-vitamins all the crew asked me to provide them.  Pyridum turns urine bright fluorescent orange.  So one day I put 1 Pyridium capsule in every bottle of multi-vitamins.  At the start of the patrol when we were underway I gave a lecture on health and just added in the lecture that one of the first signs of HIV was your urine would turn bright orange.  Hey no other medical person to correct me and no internet for crew to check.  I then passed out bottles of multi-vitamins and sat back and waited.  Didn’t take long but one by one I started having crew members come to me all in a panic worried that they might have HIV.  I’d then get to play, examine them, practice my blood taking skills, and then later assure them they didn’t have it and also let them in on my practical joke.  They thought it very devious and some would hover near the sick bay door to see others panic and how they secretly come see me.  No one ever gave the ruse away and it never got old….uh, for me that is.

FEVER – Your friend?

Fever is helpful!

Patients look at me weird when I tell them fever is normal, healthy, and welcome.  When I ask them not to take any Tylenol or Motrin and not use cool baths to lower their fever they think I am nuts.  It goes against everything they’ve been taught by parents, teachers, school nurses, and media.   But before you pick up a stone and yell “Blasphemy!  Stone him!”  Let me say fever really is an effective weapon your body uses to fight infection.  Fever is an indicator that either a bacteria or virus has entered and trying to do damage to body cells.  So the  hypothalamus (gland at base of your brain) turns up the thermostat knowing that most bacteria and viruses can’t stand as high temperatures as the body cells can.  Truly a fever of 102 degrees is very helpful in killing millions of the invading organisms.  Die suckers die!  The immune system actually works better in higher body temperature.  Most normally healthy children and adults can tolerate temps up to 103 and 104 respectively for a short time (1-3 days).  It takes a lot of energy for the body to raise its core temperature so eating and drinking extra are essential.  So even the phrase from Chaucer, Canterbury Tales, “Feed a cold, starve a fever” is wrong.  Now use common sense here.  If you have fever and can’t stand the body aches then take Motrin that works better on achiness.  If the fever is too high and you’ll know mainly by the  lethargy ( just lying there exhausted not able to eat or drink) then give Tylenol for the fever.  But if you can eat and drink okay then allow the fever to continue unabated.  You’ll actually get better faster with a fever than continuing to try to tamp it down.

Marine vs Snake

I was assigned as the Hospital Corpsman (a Navy name, Army calls them medic) to a US Marine Corps Combat unit in 1st Marine Brigade, now get this in Kaneohe, Oahu, Hawaii for 5 years.  Tough tough duty.  We went on a joint exercise with Australian Marines in Australia.  One day one of my marines runs up to me and says doc I need the anti-venom snake kit.  I said it won’t help you much without me knowing what type of snake and who got bit.  He said nobody yet but here is the snake.  He had an Australian Eastern Brown venomous snake’s head held by his hand and the entire snake was wrapped around his forearm and it was mad!  I jumped back about 5 feet and said are you nuts!  What to do, what to do?  So I got a pair of pliers (the longest pair I could find) and clamped its mouth shut while another brave marine wrapped metal wire around it’s mouth then we unwound the snake from the arm and chopped it’s head off.  Man oh man was I scared.  I think I smacked him (the Marine not the snake) in the head a couple times I was so pissed off.

All Red Eyes are not “Pink Eye”

Mom’s say “Don’t tell me he doesn’t have “Pink eye” just look at him!”  They bring in their babies with red eyes and want an antibiotic ointment or drops to kill this bacteria that their kid got from some despicable unsanitary person.  But a lot of time it isn’t bacterial conjunctivitis “Pink Eye” at all.  They get upset at me when I tell them antibiotics not necessary.  They feel helpless and want something done.  That’s when I explain it could also be Viral, Allergy, or Mechanical irritation conjunctivitis.

So what’s a person to do?  How can one know which one they’ve got?  So to save you a trip, an insurance co-pay, and your time, let me try to break it down for you.

Now this is Pink Eye

Bacterial Conjunctivitis “THE TRUE PINK EYE” usually produces a thick yellow-greenish discharge of pus that affects usually one eye at first but then both eyes.  The eyelids are almost always matted together with crusty dried snot looking material in the AM when they wake up.  Can last longer than a week, starts slow and gets progressively worse.  Stays locally in eyes, doesn’t affect nose or ears.  Antibiotic drops or ointments work wonders real quick.  Very contagious when in contact with discharge.  Have fun keeping their hands away from their face.  Lots and lots of hand sanitizer might help.

Viral Conjunctivitis can be part of the flu or a cold or all by itself.  It produces a whitish thin watery sticky discharge  that stretches between two separated fingers(yea like you are going to touch it to find out).  Short lived better by 3rd day and gone by fifth.  Symptoms start  wham bam all at once and get better quickly.  Antibiotics do not help …got to ride the storm out.  Very contagious to contact with discharge or any air coming out of their nose and mouth.  An unfashionable “hey look at me I’m sick” mask would help a lot.

Allergic conjunctivitis has intense itching of the eyes and copious thin clear watery tearing.  It can be associated with sneezing and clear snot or present by itself.  Can last months depending on what allergic to.  Starts quickly and does not abate as long as allergen in air.   Allergy eye drops or allergy pill medications help.  Not contagious to anyone else.  Check out this website to see what allergen in air in your area.  http://pollen.com/allergy-weather-forecast.asp

Mechanical Irritation Conjunctivitis comes from contact lenses in wrong, to chemical splashes, to smoke in eyes.  Immediate painful eyes making you want to keep them shut.  Tearing like allergies.  With flushing or moving to filtered air usually clears up within a day.  Other than flushing, cool cloths, and murine not much to be done.  Not contagious to anyone else.

Vitamins

Man I spent hours typing up everything I know and then looking up and typing  a whole lot more about what I didn’t know about vitamins.  This was very good project for me because I learned a lot.  A lot of work went into this so you better just darn well read it all.  Look up at top right and you will see a dark blue tab with white lettering that says simply “Vitamins.”  Enjoy.  I am taking a break.

Head Lice – Growing problem

Growing problem. Darn pests are getting resistant to the poisons we apply to scalps. Why you ask? Because people don’t follow instructions. People have such complete trust in the medication they do not do this one simple thing. They do not use the nit comb every day to remove the nits. Nits are baby lice eggs composed of a super hard shell. You can tell a nit from dandruff because a nit is attached to hair shaft and very hard if not impossible to pull off whereas dandruff comes off easily. In fact usually the hair will detach from the head before the nit casing will come off. No medication can penetrate a nit casing. Sorry they can’t. So one dutifully uses the poison (yes they are all very toxic that’s why more 2 applications cause for alarm) which kills the lice, then 3-5 days later the nits hatch and the baby lice are exposed to a weak concentration of the poison emitted from it still being released from absorbed skin and their immune systems figures out an antidote to the poison so even later at full strength it can’t kill the little buggers.

Now one look at my picture will tell you I have never had head lice. If sunlight can touch ones scalp you won’t get head lice. Lice can’t stand the sun. That’s why they love the nape of the neck and behind the ears the best. Once when examining a patient’s scalp, my head was to close, and a lice jumped onto my bald head (They can jump 6″). It must have said “Yikes!” because it immediately jumped back onto child’s head. Hmmm wonder if that is why I get all the head lice patient’s and not my fellow female providers? As a last resort I’ve had to counsel shaving a child’s long tresses off because they have had so many lindane poison applications it is making them toxic and sick.

So use the nit combs. It is probably more important than the medication. I dare say if one used just the comb and never used the medication they would be lice and nit free. I hope this helps.

Rectal Exam – Once in my lifetime

I have been doing rectal exams for 38 years.  Uh professional rectal exams you sickos.  Only once in all this time have I had this happen.  A man came in for a prostate check.  Now why God had to put the prostate up where the sun doesn’t shine I do not know, why not the front right lower abdomen just under skin so one can check it oneself?  But I digress.  So I gloved and lubed and inserted my right index finger into his anal area.  I don’t feel anything.  Not the anal ring, no hemorrhoids, not the prostate, nothing.  I start to pull my finger out and the man crys out “Oh oh I got to poop!”  My finger comes out completely encased in a turd.  No wonder I couldn’t feel anything.  I drop the glove into red lined trash can.  I tell him, “don’t worry, I took care of it for you.”  Has never happened since.  Poor guy had to endure me doing the exam a second time.  Ah everything was where it was supposed to be.

Soda Pop – Dangerous stuff

Now I am not standing in my ivory tower and pointing fingers at anyone. I have been addicted, yes I use the word addicted, to soda pop for 50 years. I was once off it for over 2 years before I imbibed again. Currently been off of it for almost 5 months now.

This is a sad truth. More Americans drink soda than water. Some of my patients don’t drink any water. Some moms say that can’t get their kids to drink the stuff. Soda pop is called a “soft drink” but it is not very soft on the body. Soda pop is some dangerous stuff. So what’s in a can of soda that is so bad?
ACE-K: A Synthetic sweetener. 200 times sweeter than sugar. Adversely affects brain.

Aspartame: (Nutrasweet) Known neurotoxin, converts into formaldehyde at 86 degrees (I know you drink it cold but it warms to your body temp of 98.6 really fast). Not wise to embalm yourself while still alive.

Caffeine: Sympathetic nervous system stimulant (Fight or Flight chemical). Exhausts adrenal gland and causes anxiety. Depletes your B vitamins especially B1. B Vitamins help cells grow, especially nerve cells.  Also a diuretic which takes even more water out of your body

Carbon Dioxide: The bubbles! Natural waste product our body makes. Breaks down bone by interfering with calcium absorption. Causes arthritis.

Glycerol: Wood resin, Wood alcohol. Elevates Liver enzymes.  Revving up the liver is bad.  Can cause liver damage like cirrhosis.
Lake dyes: (Blue, Green, Red, Yellow) mixed to give soda specific color. Known carcinogens (cancer causing).
Natural Flavors: Bogus claim. They are citric acid, gum acacia, potassium sorbate (are preservatives),sodium citrate, and sodium polyphosphates. These chemicals disrupt blood cell size and shape, the RBC can’t give off as much oxygen.

Polyethylene glycol: Used as anti-freeze and in oil solvent.  Irritates inner blood vessel lining creating plaque that can dislodge and cause stroke or heart attack or pulmonary embolism.
Phosphoric acid: Interferes with calcium getting into bone. Makes them brittle.

In Heaven, when I see Doctor John Pemberton, the pharmacist from Atlanta, Georgia who in May 1886 first shot carbon dioxide into a sugary syrup, and created Coca Cola; I am going to walk up to him and punch him in the stomach.