Why Do Men Have Nipples? Hundreds of Questions You'd Only Ask a Doctor After Your Third Martini

CHAPTER 4. CAN I TREAT IT MYSELF?

I lookat my watch and I can’t believe that it is only 12A.M. I answer the last of the sex questions and quickly scan the room to make sure that my path is clear to the bathroom. I see an opening and rush off hoping to avoid any more questions.

The door is slightly ajar and I push it open tentatively to find our hostess, Eloise, sitting on the edge of the bathtub. Leyner is clutching the massaging showerhead and is directing a cold stream of water on her burned and blistered cheeks. As it turns out, Eloise, ever the impeccable hostess, had joined Leyner and Cinderella in their laboratory to see if they needed their glasses refilled. Leyner then insisted on slathering her with his spicy balm. Little did he know that Eloise had had a deep-cleansing facial peel just a few hours before the party, leaving her skin ultra-vulnerable to any corrosive ointments. It was comforting for me to see that in the heedless anarchy of the moment, Leyner had actually done the right thing and was correctly caring for her burns.

There are two venerable maxims that rule the professional classes. For doctors it is do no harm, and in the world of jurisprudence it is anyone who represents himself in court has a fool for a client. So, if you must be your own physician, do no harm and don’t be a fool.

A patient came to the ER one day for treatment of an infection on her scalp. She had tried to treat it at home by taking the tetracycline for her fish tank. As it turns out, she actually didn’t need antibiotics for her rash. Was this self-medicating ingenuity or insanity on her part?

I wouldn’t exactly call it ingenuity, because the other great idea she came up with was to rub toothpaste on her head. As for the fish tank tetracycline, it seems as though those tablets often contain the same dosage as your over-the-counter tablets, but I certainly cannot vouch for their purity. Logic says to stick with the stuff you get from the pharmacy.

Maybe. A study inJAMA, orThe Journal of the American Medical Association for all not in the know, demonstrated a significant reduction in the rate of urinary tract infections in older people who drank cranberry juice daily. We don’t know exactly why, but the most likely answer is that some chemical in the juice prevents bacteria from sticking to the wall of the bladder. I know some people don’t like cranberry juice, but since urinary tract infections can happen after sex, it’s probably worth it to drink a little bitter cranberry juice instead of smoking a cigarette.

Yogurt may have some role in helping prevent yeast infections, but only when you put it in the correct orifice — your mouth.

Yogurt does have some very interesting health properties. Some women find eating one cup of yogurt a day while taking antibiotics is helpful in preventing the yeast infections that often follow such treatment; however, yogurt alone will not cure vaginal yeast infections that are already in full bloom.

Excessive amounts of earwax can cause decreased hearing or pain, but this is no reason to start lighting your head on fire. “Ear candling,” or coning, involves placing a cone-shaped device in the ear canal and, with the help of smoke or a burning wick, removing earwax. The companies that make these devices claim many other health benefits. The FDA and the Canadian government disagree, and both have come out against these fraudulent claims. In most cases earwax will come out on its own, and if not, you should see your doctor. Avoid these silly products and save the cones for your ice cream.

No. Save the butter for breakfast.

Butter is the wrong thing to put on a burn. It will trap the heat in the skin and prolong the pain. Use cool water instead.

I do have to say that there are some kitchen supplies that may be useful for the pain of a burn, straight from the medical literature in India: boiled potato skins and honey.

Why honey? Honey is sometimes used for its antibacterial effects. Boiled potato skins may seem to be an unusual treatment, but they maintain a moist environment.

The best thing to do when you grab a hot pan is to cool your burn under running water, and only after it has thoroughly cooled, apply an antibiotic ointment. For severe burns you should go to your local ER.

Here is one for all the world travelers. Melatonin may be an effective solution for your problems with jet lag.

A review of ten studies on the use of melatonin concludes that two to five milligrams of melatonin taken at bedtime after arrival at your destination is effective and may be worth repeating for the next two to four days. This should be done in conjunction with nondrug measures — such as avoiding dehydration and alcohol, engaging in exercise and activity during daylight hours, eating well, sleeping well, and adjusting to the local time schedule — for fighting the dreaded jet lag.

Ice is hardly as dramatic as a carefully placed porterhouse, but it does the same job. There is no magic in the beef, just cold and a little pressure. Keeping your head elevated and avoiding aspirin or ibuprofen, which can affect the ability of your blood to clot, also helps. The best idea is to avoid getting punched in the first place.

There are many home remedies for skin ailments, and I’ve seen patients come to the emergency room covered in all sorts of creams and potions. Some common antizit home remedies people try concocting include baking soda, vinegar, coffee grounds, Mercurochrome (a red substance no longer sold in this country), iodine, hemorrhoid cream, sugar, salt, and toothpaste.

It is commonly believed that toothpaste on zits is an excellent home remedy. There are no scientific studies that I could find on the use of toothpaste for acne but it may work to dry out those troublesome blemishes.

But if you go the toothpaste route, there are some things to look out for. Perioral dermatitis is an eruption of discrete papules and pustules on an erythematous scaling base around the mouth (fancy description for “acnelike”). It occurs almost exclusively in women between the ages of twenty and thirty-five. The cause is unknown, but some people think that fluorinated toothpaste may be a factor.

Fragrance allergies are also a danger with the toothpaste method. Balsam of Peru is an ingredient that has been known to cause allergic reactions and cinnamic aldehyde in toothpastes has also been a common culprit. We say to stick with Clearasil.

In an unrelated but truly bizarre story, one night I was working in the ER and a patient came in with a bandage over her jaw. I asked her what happened and she was very timid in responding. She said she was embarrassed because she had picked her face over and over, which had caused an infection. I tried to calm her, told her that this was common, and asked her if I could take a look. When she removed her bandage, she revealed a 4 by 4-inch hole all the way down to her jawbone. She received some antibiotics and a careful psychiatric evaluation and at no point did anyone say, “Didn’t your mother tell you not to pick at your face?”

As for zit popping, it definitely can lead to some complications. Squeezing pimples can actually push the zit-causing bacteria farther into the skin, causing more redness and swelling. It is also the most common cause of acne scarring.

There is one more deadly complication from zit popping, which is called cavernous sinus thrombosis, a blood clot in the sinus cavity that runs between the sphenoid bone, the large bone at the base of the skull, and temporal bone located near the temple. The real danger zone for zit popping is an area that some people refer to as the triangle of death, an area stretching from the bridge of the nose to the corner of the mouth to the width of the jaw. The veins in this area drain into the cavernous sinus and any severe infection in this area can cause cavernous sinus thrombosis. Squeezing zits in this part of your face can cause an infection and start this dangerous process.

Our friend Kim can do pretty much anything. She was like Martha Stewart before anyone had seen her bake her first cookie. Add to that a rugged edge that allows her to take on any project. She wanted to know the answer to this one, and we realized if anyone could do this, it would be her. She also wouldn’t allow the procedure to interrupt her dinner party.

A cricothyroidotomy (similar to a tracheostomy) is one of the most dramatic procedures done in the emergency room. This procedure is an emergency attempt to relieve a blocked airway. Remember theM*A*S*H episode where Father Mulcahy sticks a pen into some guys throat to help him breathe?

The oyster knife might work too, but definitely avoid trying this at home! Call 911 instead.

We all saw thatFriends episode (c’mon, you watch it, too) when Monica gets stung by a jellyfish. Joey remembers that peeing on a jellyfish sting takes the pain away, Monica “can’t bend that way,” and Joey gets “stage fright,” leaving Chandler to save the day. Don’t believe everything you see on TV.

Most jellyfish stings cause only pain and numbness. The Australian box jellyfish is the most venomous and deadly of all stinging marine creatures. Approximately 20 percent of those stung by the box jellyfish will die. Portuguese man-of-war is also dangerous but nothing compared to the box jellyfish.

The following guideline can be applied to most jellyfish stings: The patient should remove any visible tentacles, using gloves if possible. The area of the sting should be rinsed with household vinegar. The acetic acid of the vinegar can block discharge of the remaining nematocysts (stinging cells) on the skin and should be applied liberally. If vinegar is not available, salt water can be used to wash off the nematocysts.

In laboratory tests, urine, ammonia, and alcohol can cause active stinging cells to fire, which means applying them has the potential to make a minor sting worse, so urinating on a jellyfish sting is both gross and painful.

Oh the pleasure of the forbidden! Those things that you are not supposed to do are always so enticing.

The ears, for the most part, do not require any routine cleaning. Ears are like a self-cleaning oven. With the help of gravity and body heat, earwax will gradually find its way out. If wax appears on the outer ear, a cotton swab may be used. If you can’t help but go in farther, you are risking wax impaction or injury. If you do get wax impacted in your ear, you will be in pain and half deaf. There are over-the-counter preparations that can help relieve wax blockage but warm water in a syringe often works. As a last resort you can see an ear doctor or come to the ER for a good cleaning.

It is not uncommon for us to see patients who have violated these rules and come to see us to remove the tip of the cotton swab that has fallen off inside the ear. Don’t worry, we are prepared. We also remove other things like cockroaches, beads, and pen caps, all of which we’ve pulled out of ears.

Gberg: We need a list of things for the cotton swabs in the ear question.

Leyner: OK.

Gberg: Things that you aren’t supposed to do but can’t resist.

6:05P.M.

Leyner: Picking scabs.

Gberg: I love it when they bring the food to the table and say “hot plate.”

Gberg: Can’t help but touch.

Leyner: That’s good!

Leyner: More…

Gberg: Like Carrie says, “More funny, boys.”

Gberg: Making fun of the editor is one of those things that you are not supposed to do but can’t resist.

Leyner: More funny like, “How do you extract my size 9 old school Adidas shell toe from the rectum of a book editor?” More funny…

Gberg: Should I leave that in?

6:10P.M.

Leyner: Your call.

Leyner: Might be a little harsh.

Leyner: But it’s from the heart.

Gberg: Slightly.

Gberg: A dangerous little muscle, that heart of yours.

Leyner: I’m trying to think of more not-to-do stuff.

Gberg: Talk at a woman’s breasts.

Gberg: Eat your young.

Leyner: Pick chicken pox.

Gberg: You just want to pick stuff.

Leyner: Pop pimples.

Gberg: Talk with food in your mouth.

Leyner: I knew some girls who loved popping each other’s and their boyfriends’ pimples.

6:30P.M.

Gberg: I wish my lady would groom me like a monkey.

Leyner: It’s all in the eating… monkeys combine grooming and eating… that’s the special part… picking insects out of our fur and eating them.

Leyner: Metaphorically speaking.

Gberg: You are at your best when speaking metaphorically.

Leyner: Thank you again.

Gberg: I gotta leave to go to the Knicks game soon.

Leyner: Can we get back at this tomorrow when you get back from the hospital?

Gberg: Let’s try to finish everything.

Leyner: You have to go, right… we’ll talk about it tomorrow.

Gberg: OK, let’s talk tomorrow.

Leyner: I’ll look at the e-mail… and we’ll drive the final stake into the heart of this vampiress tomorrow.

Colonic irrigation claims to help indigestion and yeast infections, control blood pressure, restore pH balance, reduce bad odors, clear colon blockage, induce proper blood clotting, stimulate production of white blood cells, help prevent gallstone production, clean the colon of parasites, help loss of concentration, and aid lung congestion, sinus congestion, skin problems, and nail fungus.

Not a bad day’s work, but not exactly proven, and yes, potentially dangerous.

Colonic irrigation (CI) is a procedure in which very large quantities of liquids are infused into the large intestine, or the colon, via the rectum through a tube. The purpose is to detoxify the body through the removal of accumulated waste from the colon. This may involve the use of twenty or more gallons of liquid. Liquids used in colonics may contain coffee, herbs, enzymes, or wheatgrass.

The machines used for colon therapy are illegal unless used during conventional medical treatment. Colon therapy also can be dangerous. Complications include bowel perforation, heart failure from excessive fluid absorption, electrolyte imbalance, and several outbreaks of serious infections. One case linked to contaminated equipment caused amebiasis, a parasitic infection, in thirty-six people.

11:50A.M.

Leyner: This book is going to ruin both of us. The editor will probably get a huge promotion and we’ll end up in the subway wearing fedoras and playing Andean flute music.

Gberg: Andean flute music sounds appropriate for the theme music in a colonic ad.

11:55A.M.

Leyner: Why are people so interested in colonics?

Gberg: Seems insane to me.

Gberg: Who says it’s supposed to be clean, that is, your colon?

Gberg: I sounded like Yoda there.

Leyner: Me too… part of the wonderful Judeo-Christian legacy of self-loathing… you know… how we’re essentially filthy inside.

Gberg: Putrefaction.

Gberg: I feel like I am rotting inside today.

Leyner: That’s right… If you can’t have a dirty colon… c’mon.

Gberg: Good title for a pop song.

Leyner: Sounds good for Prince.

Gberg: Imagine Britney Spears singing the Mark Leyner version of “If you can’t have a dirty colon… c’mon.”

Gberg: Great video too.

Leyner: I love tracking the doings of aging rock stars.

Gberg: Some celebrity colonoscopy cameos.

12:00P.M.

Leyner: Rod Stewart’s become the new Jim Nabors somehow.

Gberg: What is he up to now?

Gberg: I read something on Page Six about Elton John injecting himself with lamb’s urine to lose weight.

Leyner: Rod’s singing duets with Dolly Parton, Gershwin ballads, and children’s songs… and doing an album with the Wiggles next — wouldn’t surprise me.

Gberg: They also said “Michael Jackson reportedly used to keep his weight down with lots of self-administered enemas, but later needed a tampon to control ‘embarrassing leakage.’”

Leyner: How do you get a lamb to pee in a cup?

Gberg: That is going to be my next job after the book — catheterizing lambs.

Leyner: Jackson should let himself get fat like Elvis did.

Leyner: Is that true about Elton John and lamb urine?

Gberg: Page Six, my friend. Check the New York Post. Isn’t everything in the newspaper true?

Leyner: Yes…

Gberg: Maybe we can add the lamb’s urine question in as an urban legend.

Leyner: Doesn’t something have to be in the public subconsciousness for more than a day to qualify as an “urban legend”?

Here’s one from the June 2004New England Journal of Medicine. A cream containing an ingredient of human breast milk appears to be an effective treatment for stubborn warts. The key ingredient of the cream is a compound called alpha-lactalbumin-oleic acid. Its Swedish creators have nicknamed the cream HAMLET, for Human Alpha-lactalbumin Made Lethal to Tumor cells.

This may lead to other areas of research as certain types of warts or human papilloma virus (HPV) can be linked to cervical cancer.

No word yet on whether Starbucks will be introducing a tall-decaf-breast latte.

I love a good Western and nothing could be more bad-ass than biting into a snake wound and spitting out the venom. Of course this would be followed by some whiskey and a good gunfight.

Unfortunately, this is no longer an accepted practice. Sucking at a snakebite is not only ineffective but could lead to an infection at the wound site.

According to the American Red Cross, these steps should be taken after a snakebite:

1. Wash the bite with soap and water.

2. Immobilize the bitten area and keep it lower than the heart.

3. Get medical help.

Toxicology experts might also suggest applying a tourniquet loosely above the bite to prevent the venom from spreading. This must be done with caution, as the tourniquet itself can cause problems if it cuts off the blood flow entirely.

The person then needs to be transported rapidly to an emergency room. Antivenin is available for a variety of different snakes. Other treatments include antibiotics and surgery.

Of the estimated one hundred and twenty different types of snakes found in the United States, about twenty are poisonous. Most bites occur in the southwestern part of the nation, but they even occur in New York City. In New York State there are three species of poisonous snakes, the timber rattlesnake, the massasauga rattlesnake, and the copperhead. In the city, however, most bites occur from snakes that are kept as pets.

Doctors are known for using complicated words that make them sound either extremely intelligent or really out of touch with what most people can understand. The medical word for hiccups, singultus, is a perfect example of when physicians sound ridiculous.

Hiccups are caused when the diaphragm becomes irritated and pushes air rapidly up in such a way that it makes an irregular sound.

Some things that irritate the diaphragm and cause hiccups are distention of the stomach from food, alcohol, or air, sudden changes in gastric temperature, or use of alcohol and/or tobacco in excess. Hiccups also can be caused by excitement or stress.

While most cases of the hiccups last only a few minutes, some cases of the hiccups can last for days or weeks. This is very unusual, though, and it’s usually a sign of another medical problem, such as injections near the diaphragm, hiatal hernias, severe gastroesophageal reflux disease (GERD), or a tumor irritating the nerves in the chest. Hiccups lasting longer than one month are termed intractable or incurable. The longest recorded attack of hiccups is six decades. Doctors sometimes use the antipsychotic drug Thorazine to treat intractable hiccups.

If you don’t want to go the antipsychotic route, you could try one of these simpler but unproven cures:

1. Breathing into a paper bag.

2. Drinking out of a cup from the side opposite your mouth.

3. Holding your breath.

4. Eating a teaspoon of sugar.

5. Sucking on a wedge of lime or lemon.

6. Drinking a glass of water with a straw while you plug your ears with your fingers.

7. Pulling the top of your hair for one to two minutes.

8. Placing a cotton swab in the roof of your mouth and gently rubbing.

9. Pulling hard on your tongue.

For those of you who were watching TV in 1970, you may have seen episode 8 of the first season ofThe Partridge Family when a skunk finds its way onto the family bus and turns the Partridges into stinkers. Reuben remembers that tomato juice can remove the skunk odor, so the family bathes in it. All is well until the family dog gets them covered again. Without time to take another tomato bath, the band plays their concert at a children’s hospital from inside a glass-enclosed operating room. That’s great TV.

The major molecules that make skunk spray smell are sulfur compounds. It is a common belief that tomato juice removes the smell, but there is no scientific evidence to support this claim. The tomato juice probably just tricks the nose into not recognizing the skunk smell through the overpowering red gravy scent. One recommended treatment for pets is one quart 3-percent hydrogen peroxide, one cup baking soda, and one teaspoon mild dishwashing detergent. People can try the same, but be careful; the peroxide can have a bleaching effect.

Parsley was used in the past in medicinal recipes for cure-alls, general tonics, poison antidotes, and kidney and bladder stone relief. Parsley is rich in vitamins and minerals, particularly vitamins A and C. It is also said to be rich in antioxidants. Parsley also can relieve bad breath, although there are no medical studies linking it to halitosis. It is good to note that there are two varieties of parsley: curly-leafed and flat-leafed, which has the stronger flavor. Therefore, the flat-leaf kind is better to cure your chili dog breath.

There doesn’t appear to be a great deal of research on the role of milk as a sleep aid. Milk is certainly a simpler alternative to prescription sleeping pills or drinking so much you just pass out, and there are several theories as to why it might work. Milk contains tryptophan, the same ingredient that makes everyone sleepy after Thanksgiving dinner (see food coma question on page 44). The warmth of the milk can have a minimal effect on your body temperature and sometimes make sleep a little easier. Milk also contains melatonin, which is a natural sleep aid. One company, Night Time Milk in England, even sells milk from cows milked at night when the melatonin is increased. The milk is marketed as a sleep aid, proving that people will buy anything today.