News of Eyes

What I learned this morning at the optometrist:

1. Introduction: My left eye is slightly more astigmatic than my right, which is a thing that can't quite be corrected for by current contact lens technology.  Not a big deal, I'm still 20/20 with the lenses, and my actual glasses are even better if I really care.
2. Opening: Cataract surgery has gotten really good in the last few years.  It's often quick, relatively straightforward, minimal recovery time (as in hours instead of days), and in many cases includes as a side benefit the equivalent of LASIK correction.  Getting a cataract removed can actually improve your vision significantly.
3. Development: Cataracts are also being detected much earlier than they used to be, which contributes to the ease of treatment-- the less developed they are, the easier they are to remove.
4. Embellishment:  Cataracts can be caused (sort of) by "trauma to the front of the face."  It doesn't exactly cause them per se, but an impact force on the eyeball can sort of prime it, making cataracts slightly more likely to form later on down the line.  All of which leads to:
5. Climax: I have the tiniest infinitesimalest beginnings of a cataract in my right eye, and even tinier such in my left. Possibly caused (as it were) by the air bag in the car accident I was in in '98, or even the soccer ball I took to the face back in...'87?  Maybe?  Somewhere around junior high.  Although I think that hit more on the left, if I remember correctly-- I seem to remember suffering a cut over my left eye from the beveled edge of my glasses.
6. Denouement: It's basically of no more than academic interest.  My previous OD (since decamped for another office) noted it in my file and didn't even bother mentioning it to me.  The current OD saw it on the file, peered into my massively dilated eyes, and said, "Wow, he was really picky."  Basically, I can easily ignore it for the next a decade if not two.

And now back to work, as my eyes slowly regain their previous pupillite proportions.

Ticked off

The thing that I sort of already knew but learned again just now is that the "bad" ticks, the deer ticks that can carry Lyme disease, are really quite tiny, which means that the slightly larger one I just discovered on my ankle is a wood tick, and even if I didn't get all of it out (I'm pretty sure I did but it's hard to tell), it's probably just icky and not medically dangerous.

Death to the Wild Parsnip!

Everyone knows that you should stay away from poison ivy.  Many people even know what it looks like.

Hint:  (image from http://www.wikihow.com/Identify-Poison-Ivy).

Many people have also heard of poison oak and poison sumac, and know to stay away from them as well.  But are you aware of the danger that the wild parsnip can pose?

The stem and leaves of the wild parsnip (essentially the same plant as the cultivated parsnip that we eat) contain chemicals called furocoumarins.  These chemicals are not strictly speaking dangerous on their own, but when they are absorbed into the skin, through contact with a broken plant, they can react to ultraviolet light (from the sun, presumably) and damage the nearby cells, essentially acting as a sunburn accelerant.  The problem is complicated by the fact that the damage typically takes a day or two to show up, so often a victim will just sort of spontaneously develop a burn and have no idea why.

The good news, such as it is, is that the burns aren't even as bad as poison ivy, most of the time.  If it does happen to you, keep it clean and loosely covered.  The blisters will fade pretty quickly.  And of course, if you do manage to recognize the plant, washing yourself off promptly will help a great deal.

Source: http://dnr.wi.gov/wnrmag/html/stories/1999/jun99/parsnip.htm

Bond. Gold Bond.

This has nothing to do with the Bond films, but I was on a roll and figured I'd go with it.

A gold bond is a bond that is backed specifically by gold-- that is, it is repayable only by gold, and only by gold of a specified quality.  This is contrasted with a currency bond, which is repayable in any form of legal tender.  A bond itself is basically a contract that represents a loan, from the bondholder to the bond issuer.  So issuer of a gold bond takes in some money, gives out a piece of paper, and agrees to repay the loan (usually with interest) with gold.

The specification of gold rather than any other currency meant that it was typically offered only by companies that had access to a reliable source of gold, for example mining corporations.  It's somewhat akin to investing in gold (essentially trading money for a promise of gold), so when the price of gold is relatively stable compared to the currency at large (as during a recession), it can become a very attractive proposition.

This impression of reliability and value helps explain why it was chosen in 1882 as the name of a popular concoction of menthol, zinc oxide, and various binders and fillers, often applied to people's sensitive bits.

Bordetella

I always (somewhat foolishly, in retrospect) assumed that bordetella, also known as kennel cough, was named that because that's the environment where dogs tend to contract it.  When they're boarded, right?

Yeah, I know.  It's actually named after Jules Bordet, a Belgian microbiologist.  And strictly speaking, it's not even the name of the disease-- it's actually the genus of bacteria containing one of the culprits that cause kennel cough.  So I was wrong in all sorts of clever ways.  Huzzah!

CPR

According to some studies of the outcomes of patients in need of resuscitation who have had CPR performed on them (as opposed to a defibrillator or whatever), approximately 3 percent had what I would call a "favorable" outcome, living at least another month.  Another 3 percent also lived, but in what is commonly referred to as a vegetative state, and a couple percent further had an outcome somewhere in between, not quite as bad as the second group but not really in good shape.  The other 92 percent just died.  Other studies are slightly more optimistic, but only slightly.

This is in sharp contrast to the way that CPR is promoted, and even more so compared to the way that it is portrayed in the media, where it has a roughly 75% chance of completely saving a person's life with no major ill effects.

On the plus side, some of the things they're doing with automated defibrillators (the ones that you see in public buildings) are pretty amazing.  So hopefully, CPR will slowly become a less and less necessary skill.

Primary source: http://www.radiolab.org/blogs/radiolab-blog/2013/jan/15/bitter-end/Secondary sources:  http://www.nejm.org/doi/full/10.1056/NEJM199606133342406    for study on media protrayalshttp://www.ncbi.nlm.nih.gov/pubmed/2751179?dopt=Abstract   for one study on survivability

Blood types

While my blood type (AB negative) is neither the most useful to blood banks (O is the best) nor the least (AB positive blood can basically only be given to other AB positive recipients), I can take some small bizarre pride in knowing that it is the rarest-- only about 1% of Caucasians have AB- blood, compared to the 37% who have O+.  Of course, there are other classification systems that use other characteristics of the blood, so that's not a full picture of what's going on in my veins, but it's still interesting.

Pizza Dog

Many of those who read this blog have already heard in other places, but we had a bit of a scare Christmas night.  Our dog managed to sneak into the kitchen while we were video chatting with my wife's folks (it's the future!) and gulp down an entire pizza's worth of raw dough that was completing its final rise, such as it was (I'd been having trouble with the yeast--more on that later).

Our first reaction was, "Oh, that darned dog," and a certain degree of frustration on my part because it was Xmas night and we didn't have a lot more food on hand and nothing was open, but fortunately my wife thought to check the Internet to see if we should be concerned.  Subsequent consultation with the emergency on-call vet and vet hospitals confirmed that we should indeed.

You see, raw bread doughs in general (not just pizza) have yeast in them, which, since they've yet to go into the oven, are still doing their yeasty thing.  To wit; fermentation.  This has several effects in a dog's stomach.

First, it produces carbon dioxide.  This can cause distention and bloat in a dog, bloat meaning not simply the sort of belchy sort of condition that humans get but a severe overstretching and possibly twisting of the stomach, which Wikipedia says is fatal roughly a third of the time without surgery, depending on circumstances.

Second, the yeast also produces alcohol.  This can make the dog very drunk, since it's right there in the stomach lining.  This is much less likely to be fatal, but dogs are smaller than we are, and alcohol poisoning is still possible.

Finally, the fermentation process can also produce some toxic by-products.  Most of them evaporate or are otherwise negligible in a finished baked good, but in a dog's stomach, they're just kind of sitting there being toxic, and that's not good either.

So we had to schlep him down to the emergency 24-hour vet hospital (Which we now know the location of! Bonus learning!), and they induced vomiting.  Fortunately, it was a small batch of dough, and not a lot of active yeast (see earlier comment), so we were all fairly confident that he'd be fine.  A couple of hours of observation later, we were cleared to take him home, and at this point he's probably forgotten all about it.

This post has nothing to do with Sandy

Last weekend (9 days ago) I had a small accident, wherein I needed to stop our dog very quickly from chasing a squirrel into the street.  Sadly, all I had with which to attempt this task was my voice (only moderately effective at this point), the rope to which he was attached, and my bare hands.

So now I have minor rope burns that are finally starting to heal.  But over the course of the last week, I have learned that in 2009, Johnson & Johnson (not an S. C. Johnson company) discontinued the sale of their immensely popular First Aid Cream, which irks me no end.  When I go into a drug-type store now, all I see are antibiotic creams (unnecessary and possibly harmful in the long run due to overuse of antibiotics), "burn sprays" (overkill, and hard to apply to the webbing between my fingers anyway), and various aloe-type gels, which I'm not sure are safe to apply to broken skin.  This is annoying-- all I want is something I can rub onto a wound that will moisturize, soothe, and seal it/protect it a bit from the environment.  And there really isn't anything on the shelves that matches that.

After surfing Amazon's product reviews, I was informed of two things: to wit, 1) that a popular replacement is manufactured by Ambix Laboratories, a company that does not seem to have a web presence and about which I can find only limited information, and 2) that the old first aid cream apparently had a beeswax base, which may in part explain its disappearance since the price of beeswax has apparently skyrocketed (possibly due in turn to colony collapse disorder).

Formication

I appear to have contracted a (very mild) case of what I have learned is technically called delusional parasitosis-- the irrational belief that there are bugs crawling on one's skin.  Our household has recently been fighting an minor infestation of extremely small ants (possibly odorous house ants), which seem completely uninterested in all of the ant traps we've strewn around.  And once you've discovered ants crawling on your head a couple of times in a row, I think it's only reasonable that you might develop a bit of a twitch.

Regain Rogaine

The hair "regrowth" medication minoxidil is marketed in the US (primarily) under the name Rogaine.  However, the original name pitched by the ad team was actually Regaine.  The FDA shot that name down, though, since they thought that it was possibly fraudulent marketing (making promises it couldn't always keep).  McNEIL-PPC, Inc., the owners of the trademark, was forced to change it for domestic distribution.  Outside of the US, it's still mostly marketed as Regaine, since the rules are different, and (I guess) McNEIL-PPC, Inc. always liked that name better.

Histamines

I had been under the impression that histamines were produced by the body as a result of an allergic reaction-- hence, the use of antihistamines such as loratadine or diphenhydramine (the main ingredients of Claritin and Benadryl, respectively).

Turns out this is not, strictly speaking, the case. Histamines are produced as a result of an allergic reaction, but they can be produced by other causes as well. According to Stedman's Medical Dictionary, histamine is "A vasodepressor amine derived from histidine by histidine decarboxylase and present in ergot and in animal tissues. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, and a vasodilator (capillaries and arterioles) that causes a fall in blood pressure. Histamine, or a substance indistinguishable in action from it, is liberated in the skin as a result of injury. When injected intradermally in high dilution, it causes the triple response."

Yeah, I didn't understand much of that either.

Wikipedia is a little clearer:  histamines are produced by the body as part of an immune response, which can be prompted by a variety of things, although allergens are the most common.  When absorbed by the four types of histamine receptors, the histamines produce inflammation, which (depending on the location and type of receptor) will in turn produce the itching, swelling, runny nose, bronchoconstriction (tight airways), etc. that we associate with allergic reactions.  They are also involved in other parts of the body in gastric acid and neurotransmitter production.

An interesting side note is that antihistamine drugs don't work by stopping the production of histamines, as a literal interpretation of the name might suggest.  Instead, they flood the receptors that would otherwise absorb the histamines, thus preventing the reaction from completing.  So instead of being anti- histamine production, they're anti- histamine reaction.

Proton Pump Inhibitors

One of the most widely sold (according to Wikipedia) medications in the world is the proton pump inhibitor, commonly sold under trade names such as Prilosec or Prevacid.  Its basic effect is to reduce the amount of acid produced by the stomach, to alleviate chronic heartburn caused by stress, diet, or in my case, random unexplained Act of Deity.  Seriously, my doc couldn't figure it out at all.

Anyway, that's what it does, but how does it work?  What is a proton pump, and why should it be inhibited?

Proton pumps are not exactly mechanical pumps, the way your heart is a mechanical (although also biological) pump.  Instead, they are a specific class of proteins found in cell membranes that move protons chemically from one side of the membrane to the other.  Since protons carry a positive electric charge, this creates an electric potential that typically can be used as a reservoir of energy-- sort of like a biochemical capacitor.  This stored energy can be used by the body's cells for a variety of functions.

When you take a PPI, it specifically targets a class of cells in your gastric system, the ones responsible for producing gastric acid.  In this particular case, the protons moved by the pumps are not being used to store energy-- instead, they are being used to provide the extra H⁺ ions that are used to create acids (those of you with some high-school physics no doubt already realize that an H⁺ ion is in fact just a proton, and those of you with freshman chemistry may recall that acids are sometimes defined as proton donors, i.e. substances with extra protons).  So with these proton pumps "inhibited," not nearly as much acid is formed, taking production back down to more or less normal levels (since heartburn is typically caused by overproduction in the first place).

And voila!  Life goes back to more or less normal.  Side effects are pretty minimal (occasional headache or fatigue are common), although there are some minor risks with long-term use-- hypomagnesemia (an easily treatable deficiency of magnesium), or minor risk of vitamin B₁₂ deficiency (not really an issue for anyone on a typical American diet).