I say to thee, Achoo!

Gerardus Cremonensis, Wikimedia

BuckMD is delighted to welcome Sarah Kernan to our blog. Sarah is a PhD student in medieval studies here at The Ohio State University. Her area of specialization is late medieval French and English food and cookbooks. Now, it might not seem like medieval cookbooks and student health have a lot in common. Wrong. Read. Learn. That’s why you came to college, after all. -Victoria Rentel MD

As a medievalist, my mind often wanders to daily life in the Middle Ages.  With cold and flu season upon us, I have been thinking about how people in the Middle Ages tried to stay or become healthy by eating right.

Just as people today turn to nutritional information in books or online, literate people in the Middle Ages turned to books of health and nutrition advice called “regimens of health” and “dietaries.”  One extraordinarily popular regimen of health was the Regimen sanitatis salernitatum, a twelfth-century poem about hygiene and diet dedicated to the king of England.

Eating right in medieval Europe meant balancing four bodily humors – blood, phlegm, yellow bile and black bile.  Each of these humors had a combination of hot, cold, moist, or dry characteristics.  Imbalanced bodily humors could be balanced by foods which contained opposite characteristics.  Ingredients were often selected for their humoral properties.  Foods that could potentially be dangerous to eat, such as eel – an extremely cold and moist fish – could be remedied and balanced by a warming and drying sauce containing ingredients such as pepper or garlic, rendering it healthy for consumption.

Medieval cookbooks often contained recipes called “sickdishes” for foods that could be easily eaten and digested by picky eaters, convalescents, or someone suffering from a nonspecific illness.  These dishes contain more sugar, nuts, and chicken than regular recipes. The chicken and nuts – especially almonds – had balanced humoral properties similar to the balanced humors of a healthy human.  Sugar was thought to purify blood.  It was the most common item in sickdishes, but rarely was an ingredient in regular food preparations.

Strange combinations of food were thought to restore health and wellness to the sick.  I am, however, comforted to know that my sickdish of choice, chicken noodle soup, would have been approved by medieval physicians.

Sarah Peters Kernan

kernan.7@buckeyemail.osu.edu

Blanc mengier d’un chappon: An Invalid’s White Dish of Capon

Cook a capon in water until it is well done; grind a great quantity of almonds together thoroughly with the dark meat of the capon, steep this in your broth, put everything through the strainer and set it to boil until it is thick enough to slice; then dump it into a bowl. Then sautee a half-dozen skinned almonds and sit them on end on one half of your dish, and on the other half put pomegranate seeds with a sprinkling of sugar on top.”

Terence Scully, The Vivendier: A Critical Edition with English Translation (Totnes, England: Prospect Books, 1997): 291.

The Ulcer Rap

You could spend the next 3 minutes reading about the risk of developing stomach ulcers from taking too much non-steroidal anti-inflammatory medications (NSAID’s), or you could just watch this “music video” made by an actual doctor rapping about ulcers courtesy of The ZBlogg.

 

We use NSAID’s all the time for aches, pains and fevers.  Odds are you’ve taken one within the last year, either alone or as an ingredient in one of those multi-symptom cold and sinus medicines.  The most common NSAID’s are ibuprofen (Motrin, Advil, Nuprin) and Naproxen (Aleve). 

These medicines really work well, but like all medications they have side effects, and one of the most serious – as ZDoggMD so eloquently points out – is ulcers in the stomach lining that can cause you to bleed internally. 

So if you need to use these medications, use as little as possible.  And if you develop fatigue, abdominal pain, black or tar-like stool, or bright red blood in your stool while taking them, make sure you get checked out right away.  In fact, if you need to take them that much, you should probably get checked out anyway.

And don’t worry – we don’t rap at the Student Health Center.

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

Pertussis, People and Passion

Dr. Kendrick and Dr. Eldering

Dr. Hugh MacDonald

The story of how the pertussis vaccine was developed may sound like a dry history lecture, but it actually has all the trappings of a modern day thriller – a gritty tale of underdog heroes and heroines who overcome overwhelming adversity through tenacious persistence and personal sacrifice to save thousands of lives!  So pop up the corn, and read on.

The pertussis bacterium was discovered in 1906, but initial vaccines didn’t work very well.  Children were dying by the thousands.  Sparked by the epidemic plaguing their Grand Rapids community in 1932, Dr. Pearl Kendrick and Dr. Grace Eldering, research bacteriologists at Michigan State, determined to develop a pertussis vaccine.  

After their day job of water and milk analysis, Drs. Kendrick and Eldering gathered specimens from children in their homes, often at night by the light of kerosene lamps, and distributed bacterial culture plates to local physicians.   

Despite the harsh conditions and shoestring budget, they developed precise methods of preparing vaccine; established sterility, safety, and effectiveness tests; and even conducted well-controlled field trials.   In 1936, Eleanor Roosevelt visited their lab and was instrumental in increasing their personnel and funding.   Kendrick’s and Eldering’s vaccine went on to virtually eliminate all fatalities from pertussis.

At about the same time, Dr. Hugh MacDonald, a physician in Skokie, Illinois, developed his own version of a pertussis vaccine and actually tested it on his own family!  He gave his wife Edith and two of his sons the vaccine in February of 1933, and then in June he sprayed the pertussis bacteria into their noses!  I’m guessing there was no IRB back then…

Dr. MacDonald then quarantined his family in an apartment for the summer.   Within two days, his unvaccinated children developed a cough that became progressively worse.   The vaccinated children did not cough at all.  The family survived the summer, and their story was told to the world through newspapers and scientific journals.  

So if you haven’t already, be sure to get the pertussis vaccine.  Getting a shot may not be as dramatic as CSI Skokie, but you’ll be saving lives just the same.  And we won’t even have to lock you in your apartment all summer.

Jo Hanna Friend D’Epiro, PA-C, MPH
Student Health Services
The Ohio State University

Ride with the Pelotonia Student Team

Buckeyes Riding to Beat Cancer!

Did you know that 1 in 2 men and 1 in 3 women will be diagnosed with cancer?

Help change this startling statistic by riding with us on August 21st in Pelotonia! Pelotonia is a grass roots bike tour with one goal: to end cancer. In its inaugural year, Pelotonia raised $4.5 million for life saving cancer research at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute.

Thanks to our generous sponsors, every dollar raised by riders goes directly to cancer research.  As a Buckeye, the registration fee is waived and your fund raising minimum is only $500. All funds must be raised by Friday, August 13, 2010.

Every rider will receive a Pelotonia rider jersey, goodie bag, food, drinks, entertainment, transportation and overnight lodging at Ohio University if they do the two-day ride.  Ohio State students also get a 10% discount and another 10% re-contribution towards your fundraising at Roll: bike stores. 

To register, visit here and contact pelotoniastudentteam@gmail.com about submitting the completed registration form!

Thanks and Go Bucks!

Flash mob at Union! See President Gee dancing!

Two days ago, a group of Ohio State students broke out into an “impromptu” dance number at the new Ohio Union.  President Gee stopped by with Brutus and danced along with his fellow Buckeyes.  If you’re a fan of dancing, singing, Glee or Journey, check out this video.  Technically, it has nothing to do with your health – or Student Health Services for that matter – but seeing President Gee dance has got to be good for treating the Wednesday “Hump Day” blahs!

Go Bucks!

And the Oscar goes to… your testicles!

This week is Testicular Cancer Awareness week – because nothing else says “spring is here” like grabbing your package – so to follow-up on our posts about the L.A.N.C.E. of testicular cancer (parts one and two), Student Health Services has created our very own movie about how to talk to your friends about testicular cancer!

After you watch the video, be sure to check out this really cool website to learn how to do a testicular self exam and take their poll that asks that all important question – “How many times a day do you touch your balls?”

We hope it’s often (OK… not too often… and not that… you know what we mean… get your mind out of the gutter) and regularly.  And if you notice something that shouldn’t be there, or feels different than it did the last time you checked, make sure you come in to see us so we can check it out!

Victoria Rentel, MD

John A. Vaughn, MD

A little Vitamin B won’t hurt me, right? Ask the Mona Lisa.

Click to enlarge

Patients have asked me for years to diagnose things over the phone (and now the internet).  And okay, sometimes it works; once you’ve had a bladder infection, for example, it’s pretty hard to mix the symptoms up with anything else, and I can get a pretty clear picture of what is going on without actually seeing you.

But more often than not, I want to see you. Nailing down exactly what ails you is much easier in person, where the nuances of your posture, color, ability to carry on a conversation, and innumerable other visual clues are right there in front of me.  Lots of things that I can diagnose with a quick glance – rashes, for example – are practically impossible for you to explain over the phone, unless you’re fluent in dermatology-speak and are comfortable with statements like, “I have fluctuant erythematous macules with scaly, raised satellite lesions and non-tender indurated papules.”

To prove my point, let’s steal a page out of Yale Medical School’s playbook and hone our observational skills on a famous work of art.  Ladies and gentlemen… I give you the Mona Lisa!

Look at her picture for a few seconds.  Now try and tell me exactly what is going on with her.  Evoke an accurate picture in my mind.  Is she happy?  Sad?  Tired?  Anxious?  Make it good enough that I can feel comfortable prescribing medication, ordering lab work or knowing exactly what kind of radiographic study to get.  Give it a shot and post it as a comment.  It’s not easy!

We’re visual, us humans.

Which reminds me.  I was tickling my eyeballs with a stroll through the world wide web today and chanced upon a serious visual gem, something I will refer to myself – and refer patients to – over and over again.  This particular image organizes the evidence for vitamins and other nutritional supplements in a unique and visual manner. It’s beautiful. It’s clean. It’s referenced (PubMed and Cochrane, for those of you keeping score). I love it. It’s the iPod of nutritional supplementation knowledge. Take a look for yourself. It’s from the always fascinating Information is Beautiful blog.  Enjoy and share with your friends over a lovely cup of green tea, which, as you can see, might actually do you some good!

Thanks to Life in the Fast lane for the head’s up.

Victoria Rentel, MD (OSU SHS)

photo: wikimedia commons

Test Your Patient Safety IQ

Student Health Services is voluntarily accreditated by The Joint Commission, an independent organization that reviews the quality and safety of care in hospitals, ambulatory care facilities, nursing homes, and other sites across the country. 

The Joint Commission is sponsoring Patient Safety Awareness Week, March 7-13, and is offering you a Patient Safety IQ Quiz. The quiz is a fun way that patients can test their knowledge about how to prevent infection, what they need to know about their medicines, how to talk to their doctor, and other important safety tips.

The direct link is http://www.surveymonkey.com/s/Patient_IQ_Quiz. Everyone who takes the quiz will be entered in a drawing to win one of 20 of The Joint Commission’s patient safety books, “You: The Smart Patient” or the new “The Smart Parent’s Guide.” The quiz contains 11 questions and will be available through March 13.

Have fun!  BuckMD