Medical Mythbusters – broken bones

you need x-ray specs to see this!

Q: If I hurt my arm or leg but can still move everything, then it’s not broken, right?

A: Wrong!

Bones are long, hard, mineral-filled struts, if you will; kind of like the wood or metal framing inside a house. The connective tissue matrix, or “nails” holding the “struts” together is made up of ligaments, tendons, and strong sheets of fascia. As the framing of a house is attached to insulation and an exterior (a skin), your skeleton is anchored to the rest of your body via a delightfully complicated system of sturdy connective tissue.

As a result of all this connectedness you can breach the support (the bone) and not necessarily have a breakdown in function. Often only a part of the bone is broken (an avulsion or “chip” fracture) and the broken piece isn’t horribly out of place. If the connective tissue matrix isn’t badly damaged odds are you might be able to keep things moving, even if a joint is involved.  The bottom line: It is possible to move a fractured bone.

So how do you know when something is broken? Sometimes it’s obvious: the bone is sticking out of the skin staring back at you or there is a clear deformity of the affected limb.  If that’s the case, by the way, head directly to the emergency room: do not pass go, do not collect $200.

Often, though, the signs are more subtle and you need x-ray vision to evaluate the damage.  Come in to see us and we’ll help you figure it out. We’ll ask you a bunch of questions, poke around to see where it hurts and if we still aren’t sure, we’ll break out our high-tech digital x-ray machine and get a final answer. 

This baby is really cool.  We can look at the x-rays with you on the computer screen right in our office, and while we’re doing that the images are instantaneously zapped over to the radiologists at the medical center to make sure we don’t miss anything. Almost always, we have a definitive answer before you walk (or limp) out the front door so we can make sure you get the proper follow up care.

John A. Vaughn, MD
Student Health Services
The Ohio State University

Medical Mythbusters – 10 Food Myths That Just Won’t Die!

Health.com

Lifehacker has taken a page from the BuckMD playbook and decided to debunk 10 Stubborn Food Myths That Just Won’t Die

Does adding salt to water really change the boiling point and cook food faster?

Is it true that you should never use a wooden cutting board with meat?

Does searing meat really seal in juices?

Check out the Lifehacker article to find out.  And remember, if you have any questions about your diet we have two outstanding Registered Dieticians at the Student Health Center that you can come and talk to.

John A. Vaughn, MD
Student Health Services
The Ohio State University

The truth about antibiotics and birth control!

cmdrc.com

Q: I heard that antibiotics interfere with birth control pills, but I’m on the birth control that gets implanted under my skin – will antibiotics interfere with that too?

A: I’m so glad you asked this question!  This is one of the biggest medical myths of all time; one that gets propagated in doctors’ offices, health clinics, hospitals, blogs, magazines – and OK fine, student health centers – every day.  So now, for the first time ever… in print… online… on this blog… the TRUTH!

The only antibiotic that has ever been shown to interfere with birth control levels and effectiveness is a medicine called rifampin which is used to treat tuberculosis.  Rifampin may also interfere with the birth control patch and vaginal ring so if you are taking it, be sure to use a back-up, non-hormonal (i.e. condom) form of birth control.

There are some other medications that can interfere with your birth control, however, and if you are taking any of them you should always use back-up contraception.

  • Griseofulvin
  • Phenytoin (Dilantin)
  • Carbamazepine (Tegretol)
  • Phenobarbital
  • Topirimate (Topamax)
  • St. John’s Wort (herbal supplement)

But in general, your birth control will not be affected by any run-of-the-mill antibiotic that you might be taking for things like sinus infections, strep throat, urinary tract infections, skin infections, acne, etc.  Some people believe that because antibiotics disrupt the normal bacteria in the gastrointestinal tract, they will interfere with the absorption of the birth control pills from your stomach.  But this is not an issue, and even if it were, it wouldn’t apply to birth control methods that don’t involve swallowing pills like the skin patch or the vaginal ring or Implanon.

Now, there are enough women out there who swear that they have little antibiotic babies running around the house that your health care provider will probably still tell you to use back-up just in case.  And birth control doesn’t do anything to protect you against sexually transmitted infections, so using a condom is a good idea no matter what medications you’re taking.  But you can rest assured that your birth control is just as effective when you’re taking antibiotics as when you’re not. 

John A. Vaughn, MD (OSU SHS)

Medical Mythbusters – Green Snot!

click to enlarge

ehow.com

sheknows.com

True or False: My snot is green so I need an antibiotic, right?

AFalse!!

This is one of the most tenacious, and frustrating, medical myths out there: that clear snot indicates a viral infection that will clear on its own while green snot automatically means a bacterial infection that requires an antibiotic for treatment. 

This is simply not true! Coming down with a sinus infection is very common this time of year. You may know the symptoms: headache, stuffy nose, nasal discharge, facial pain and pressure, fever, cough and ear pressure. The vast majority of cases are caused by viruses and resolve on their own within 10 days.  The only time antibiotics are recommended is when the infection lasts for more than 10 days, or worsens over 5-7 days.

Many people come to the doctor expecting antibiotics for minor viral infections but keep in mind that not only do antibiotics do nothing against viruses, they are not always benign either. They can have side effects such as upset stomach and diarrhea. More importantly, overuse can lead to resistance, so that if heaven forbid you come down with a serious infection that does require antibiotics in the future, they may not work as well and the infection will be more difficult to treat.

As for the myth of the green snot, microbiologists believe the color comes from enzymes released by your white blood cells (myelo-peroxidases and other oxidases) to break down bacteria and other organisms. These enzymes contain iron, which gives off a greenish color. Also, the longer the mucus stagnates in your sinuses, the more likely it is to look green when it comes out. So when your sinuses are clogged up during a sinus infection, it is more likely to stagnate and appear green, just as your early morning snot will be more green just from sitting in your nose all night. The only kind of snot that deserves antibiotics is purulent (think pus) mucus coming from your nose or throat.

Remember, most of these infections clear on their own with a little TLC. Over the counter products such as pseudoephedrine (“Sudafed”) or my personal favorite, the neti pot are usually effective at alleviating the symptoms while the infection runs its course.   

If your sinus infection has been going on for more than 10 days, or it’s been getting worse over the past week, be sure to contact Student Health Services to be evaluated.

Angela Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

photo: sinusinfocenter.com

Medical Mythbusters – Poisonous Poinsettas!

poinsettapictures.com

True or False: Poinsettias are poisonous to kids and pets.

FALSE!!

This is one of those holiday myths that just refuses to die. It supposedly began back in 1919 when a 2-year-old boy was found dead after eating a poinsettia leaf – it was just assumed that the plant had killed him. However, since that time, many studies have shown that kids (and pets) that are exposed to poinsettia plants do just fine.

The sap of the plant is mildly irritating but according to POISINDEX (the resource used by Poison Control Centers) a 50-pound kiddo would have to eat about 500 leaves to have any toxic effects.  And while I myself have never dined on a poinsettia salad, the leaves are reportedly not very tasty, so it’s highly unlikely that kids or even hyperactive pets would be willing to eat that many! The most common side effects that have been reported from poinsettia ingestions are upset stomach and vomiting, and some people with serious latex allergies have had a skin reaction after touching the leaves.

If you or any of your relatives happen to nibble on a poinsettia (or any other plant for that matter) and you are concerned, you can always call your Poison Control Center at 1-800-222-1222 to speak with an expert.  But in the mean time, go ahead and get decorating for the holidays – with your crazy Uncle Louie coming over to celebrate with his famous High Octane Egg Nog, the plants are the least of your worries!   

Angela Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

Medical Mythbusters – Does gum really stay in your stomach for 7 years?

photo: wikimedia commons

Q: Is it true that swallowed gum stays in your stomach for 7 years?

A:  This myth is definitely false.  The body is very good at digesting material that it can use and passing the rest out in the stool.  It is true that your body is unable to digest the synthetic portion of chewing gum, but it doesn’t stay in the stomach for an extended period of time because the stomach periodically empties into the small intestine.  The gum then moves through the small intestine into the colon and is eventually passed in the stool. 

There are many substances that the body cannot digest that pass harmlessly through our system – for instance, this is why you will often see the outside fiber shell of corn in your bowel movements.  Tougher things than gum will often pass through harmlessly in a couple of days, as any parent of a toddler who swallowed a penny can tell you. 

Of course, if you swallow something that is too large to fit through the various valves and tubes in your guts, it can cause an intestinal obstruction.  So if you swallow a large amount of gum in a relatively small amount of time it can theoretically clump up into a large mass of indigestible substance (called a bezoar) that can get trapped in your GI system.  This medical emergency is very rare, but believe me – it if does happen, it’ll take a lot less than 7 years for you to figure out something ain’t right.

So the next time you’re at a fancy restaurant with a cloth napkin and nowhere to put your gum, you can swallow it with confidence.  Despite what the “old wive’s tale” says, it’ll be out of your system in a day or two.

Adam Brandeberry, Med IV (Ohio State College of Medicine)

John A. Vaughn, MD (Ohio State Student Health Services)

Medical Mythbusters – Mosquito Bites!

A tasty treat!

True or False:  Mosquitoes find some people more ‘tasty’ than others.

A:  True!

Female mosquitoes need our blood to develop fertile eggs. When they bite us, they deposit a tiny bit of saliva into our skin. This saliva contains proteins that cause an allergic reaction. Individuals have different levels of reaction to these proteins; that’s why some people don’t seem all that bothered by the bites and others – like me – itch like crazy.

Researchers have discovered that mosquitoes actually do find some people tastier than others.  They haven’t yet discovered exactly what attracts them, but they do know that it involves genetics, chemicals on our skin, and carbon dioxide.  About 1 in 10 of us has just the right combination of those ingredients to whet the little buggers’ appetites!

So how do we keep them away? 

There are a few ways you can protect yourself. Wearing long sleeves and pants definitely help, but I know that can be very appealing on a warm, humid summer night.  Fortunately there are many useful mosquito repellants on the market such as DEET, picaridin (Cutter Advanced), and metofluthrin (DeckMate).  Some people swear by natural oils such as citronella, eucalyptus, cedar, peppermint, lemongrass, and geranium.  People used to believe that Avon Skin-So-Soft repels mosquitoes, but turns out it only keeps them at bay for about 10 minutes.

So what can you do once you’re bitten?  

Topical steroids such as hydrocortisone cream (generic, Cort-Aid) can help with the inflammation and itching.  Calamine lotion or baking soda paste (3 teaspoons baking soda and 1 teaspoon water) applied several times a day may also help. For more extreme itching, an over-the-counter antihistamine pill such as diphenhydramine (generic, Benadryl) or loratadine (generic, Claritin) is often very helpful.  Diphenhydramine can make you very drowsy, so it’s useful at bedtime when the itching is keeping you awake.  Loratadine is non-drowsy so is better for daytime use.

Angela Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

Medical Mythbusters – Eating late at night makes you fat!

TRUE OR FALSE: Late night snacks make you fat

A: FALSE!

Weight loss is one of those topics on which medical myths abound – in fact, one stroll through Barnes and Noble will show you how many people are making a mint by promoting them. One of the ones we hear all the time is that eating late at night makes you fatter than eating earlier in the day.  Fortunately for those of us midnight snackers, new research has shown that this is total bunk. While technically speaking our metabolism slows down a little bit at night, the simple truth remains: if you eat more calories than you burn, you’ll gain weight and if you eat fewer calories than you burn, you’ll lose weight – no matter what time of day it is.  

Granted, if you find yourself taking a big bowl of ice cream to bed every night, or indulging in nightly wine & cheese, you’re going to pack on some pounds, but no more so than if you had that bowl of ice cream for breakfast.  

It’s probably still a good idea to avoid eating late at night.  Eating right before you lie down puts you at an increased risk for acid reflux, a condition in which food contents and digestive acids from the stomach splash back up into the esophagus causing an uncomfortable burning sensation in the chest (“heartburn”).  If that occurs, be sure to let your health care provider know.  And leave the Oreos alone unti the sun comes up…

Angie Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS) 

Medical Mythbusters – sexual positions!

I’ve been lucky enough to co-faciliate some sexual health information sessions with our friends over at Student Wellness.  They’re great – students write down any question they have about sexual health, we collect them and answer all of them for the group.  I love these sessions because after we sift through the obvious jokes (“Why do I mack so many b—-es?”  I don’t know, maybe they’re attracted to your maturity?...) we get to some questions that are obviously important to students but are just too embarrassing to ask in person.  These questions are usually the ones that involve a lot of medical “myths” and you know what that means… time for some medical mythbusting! 

Q: Can a woman get pregnant if she’s on top?

A: There are lots of myths surrounding sexual positions, and they invariably have to do with the probability of getting pregnant and determining the sex of babies.  I’ve heard them all: women can’t get pregnant if they’re on top; using the rear-entry position (“doggy style”) will improve the chance of having a male baby; lying on the left side during sex will lead to female babies while lying on your right side will lead to males, etc. 

These myths have been around for a long time.  In previous centuries, French noblemen even went so far as to have their left testice removed in order to produce a male heir!  Others took the less drastic – but I would imagine only slightly less painful – route of simplying tying it off.  Nowadays, the explanations sound a little more scientific – male sperm are faster than female sperm, yada yada yada – but they’re all still just as bogus… especially this one.

So, to answer this question… YES, YES, YES a woman can get pregnant if she’s on top.  This myth relies on the old “theory of gravity” defense: if the woman is above the man, then any sperm that is ejaculated upward will quickly fall back down like the water in a fountain and never reach the cervical opening.  

But the problem is that the vagina is a potential space.  Think of a balloon.  When it is deflated there’s no space at all inside of it but it can expand to hold a large volume of air.  When you let the air out, it collapses back down.  The vagina is the same way: it expands to accomodate the penis during sex and when the penis is withdrawn, the walls collapse right back down.  So any sperm left behind will be pressed right up against the cervical opening thereby maximizing the opportunity for conception.  (Not to mention the fact that if the woman is lucky enough to have an orgasm, the vaginal walls undergo a series of contractions that also help push the sperm towards the cervix).   

So ladies, please don’t fall for this one.  Like most of these sexual myths, they were invented a long time ago by guys who didn’t necessarily have your best interests at heart.  Whether you’re upside down, sideways, hanging from the ceiling or doing 100 jumping jacks after the fact, you can still get pregnant if you don’t protect yourself properly.  If you have any questions about how to do that, feel free to come in and talk to the experts in our women’s services – they’ll give you the real story.  

John Vaughn, MD – Ohio State Student Health Services

Medical Mythbusters – Poison Ivy!

poison ivy

rashes caused by poison ivy

Now that we are in the dog days of summer, an old friend is rearing it’s ugly, leafy head.  Yes, it’s poison ivy season, my friends, and while most of us think we know all there is to know about this itch-inducing plant, there are some medical myths lurking around it that need to be busted! 

First, the facts:  Poison ivy, poison oak, and poison sumac plants are all coated with a colorless oil called urushiol.  After contact with urushiol, about half of us will develop intense itching, swelling, and skin redness. Then, we will develop fluid-filled blisters that are often arranged in a line or streak.  (See photos)  The symptoms are usually most severe within 1 to 14 days after exposure to the plant, but can occur up to 21 days after exposure if someone had never been exposed to urushiol before.

Technically speaking, poison ivy usually resolves within 1-3 weeks without treatment, but without something to control the itching they will be the longest 3 weeks of your life.  A group of medications called antihistamines are very good at reducing the itching: diphenydramine (Benadryl) is good for night time because it makes you sleepy and loratadine (Claritin) and cetirizine (Zyrtec) are good for daytime because they don’t.  Oatmeal baths, calamine lotion and hydrocortisone cream are also sometimes helpful, but the best way to knock out the rash and itching is to see your primary health care provider to get a prescription steroid treatment.  Sometimes you can get by with just a shot, but that often does’t last long enough (1-2 days) so you can take a course of pills over a couple of weeks.

Now, on to the myth…

TRUE OR FALSE: Poison Ivy is contagious

FALSE!! 

Poison ivy is not contagious and can not be passed from person to person.  Only contact with urushiol will cause someone else to get poison ivy – the fluid that leaks from blisters does not contain the oil and can not cause symptoms.  Once you’ve washed the urushiol off of your skin (and clothes and fingernails and gardening tools and pets…) you can not spread poison ivy to someone else or yourself.  The rash sometimes appears to be “spreading” from one part of the body to another, but this is because blisters develop at different rates in different parts of the body – any real spreading that went on happened before you realized you had the urushiol on your skin.  This explains why poison ivy has such an unfortunate predilection for our privates.  Please believe me – if you’ve been weeding in the yard, or camping in the woods, make sure you wash your hands before you go to the bathroom as well as after…

John Vaughn, MD – Ohio State Student Health Services