Yittz's Clinic!!

[Han Solo]

Hello Doc, What kinda med do u put on BURNS?? I mean after the skin fallen off. Neosporin??

Creams with moisturizing properties and Silver (SSD) to prevent infections, are commonly used.

Han Solo

[LuNaR]

I have the same habit myself.

The question that you need to ask yourself is that - when do you bite your finger nail?

When you are nervous or when you have nothing to do?

Doing things that occupies your fingers helps.

Han Solo

i usually do it when im bored, but its like a habit, sometimes i dunt even kno im biting my finger and soon its gone before i know wat happened.

[Sparky]

Hey Doctor Han, I have a question. How unhealthy is it to skip lunch? I know skipping breakfast is pretty bad. Despite the fact that I'm a health nut and exercise freak, I've been so busy lately I've been skipping lunch to do work. Does this have any really bad long-term effects? I do snack, so it's not like I'm only having two meals a day. Is there any reasoning behind the set three meals a day, or did people just like the number three?

[Han Solo]

Hey Doctor Han, I have a question. How unhealthy is it to skip lunch? I know skipping breakfast is pretty bad. Despite the fact that I'm a health nut and exercise freak, I've been so busy lately I've been skipping lunch to do work. Does this have any really bad long-term effects? I do snack, so it's not like I'm only having two meals a day. Is there any reasoning behind the set three meals a day, or did people just like the number three?

Others will probably correct me, but i don't really see any great reason that your schedule can be unhealthy, as you snack in between. A heavy dinner (like what i usually have) is unhealthy though.

Han Solo

[Aphraeleiss]

Congrats HanSolo

Hey I've got a question: I often get this itch after shower like back, shoulder hip thighs. After i scratch it the the skin becomes slightly raised and red. Is this just an allergy thing. In my Haem rounds today, there was something called aqua-something, relating to itchiness after shower, associated with pancythaemia. I was wondering whether that's the condition i have (aquawhateva) and why does increase RBC cause itchiness.

I think you're referring to aquagenic pruritus but what you have does not sound clinically significant. As for pancythemia - I think you're referring to polycythemic rubra vera - pancythemia refers to increased cells across all myeloid and lymphoid cell lines. Polycythemia is specific for a few select cell lines - more detail in the article below. The itch is related to histamine release from mast cells as these cell lines are also increased. It is not primarily caused by hyperviscosity due to erythropoeisis.

http://www.emedicine.com/ped/topic1848.htm

On second thought I don't think it's the water. Do you get it after you wash your hands even? If not that I suggest you look into changing your body wash.

To Han Solo: we're lucky to get to eat at all during the day - I won't be complaining about being unhealthy with a heavy dinner. All I can say is I'll be working parttime starting next year to maintain my health and sanity. At least until I get on a training program I actually like.

[duguxiaojing]

Hello Han,

I have a question....I made a bet with my brother that I could finish the meal that made Morgan Spurlock(?) in super size me puke. The meal consists of 42OZ's of coke, half a pound of fries and a double quarter pounder with cheese. I need to expand my stomach by next sunday!!! Ive already started drinking alot of water...but im curious to know if you can offer any other advice?FYI, I can finish a large coke, quarter pounder and large fries(all Canadian sized though =() with realitive ease...but im stuffed after...I need to increase my capacity by a decent amount withing 9 days.

Thanks in advance.

[Han Solo]

To Han Solo: we're lucky to get to eat at all during the day - I won't be complaining about being unhealthy with a heavy dinner. All I can say is I'll be working parttime starting next year to maintain my health and sanity. At least until I get on a training program I actually like.

I guess that i'm pretty lucky right now with my current rotation doing a RMO Anaesthetics in a small hospital: 4 days a week, no weekend, no on-calls.

But i remember last year, if i'm working on weekend and forgotten my breakfast, i could have worked from 0730 to 2200 without anything on board, and have the first meal at 2230.

So Aphraeleiss, guess surgery is not in your long term plan? Those guys works crazy hours.

Han Solo

[Han Solo]

Hello Han,

I have a question....I made a bet with my brother that I could finish the meal that made Morgan Spurlock(?) in super size me puke. The meal consists of 42OZ's of coke, half a pound of fries and a double quarter pounder with cheese. I need to expand my stomach by next sunday!!! Ive already started drinking alot of water...but im curious to know if you can offer any other advice?FYI, I can finish a large coke, quarter pounder and large fries(all Canadian sized though =() with realitive ease...but im stuffed after...I need to increase my capacity by a decent amount withing 9 days.

Thanks in advance.

Can't help you- the bet sounds pretty dumb, imho.

But for your unhealthy pursuit, these links may help:

http://www.wilmingtonstar.com/apps/p...09/-1/yourlife

http://eatthisbook.com/?cat=2

http://en.wikipedia.org/wiki/Takeru_Kobayashi

Han Solo

[big master]

Hello Han,

I have a question....I made a bet with my brother that I could finish the meal that made Morgan Spurlock(?) in super size me puke. The meal consists of 42OZ's of coke, half a pound of fries and a double quarter pounder with cheese. I need to expand my stomach by next sunday!!! Ive already started drinking alot of water...but im curious to know if you can offer any other advice?FYI, I can finish a large coke, quarter pounder and large fries(all Canadian sized though =() with realitive ease...but im stuffed after...I need to increase my capacity by a decent amount withing 9 days.

Thanks in advance.

Wow! i remember one time my brother n i planned to finish all the value meals of mcdonalds from 1 to 10 n see who could eat more

[Aphraeleiss]

I guess that i'm pretty lucky right now with my current rotation doing a RMO Anaesthetics in a small hospital: 4 days a week, no weekend, no on-calls.

But i remember last year, if i'm working on weekend and forgotten my breakfast, i could have worked from 0730 to 2200 without anything on board, and have the first meal at 2230.

So Aphraeleiss, guess surgery is not in your long term plan? Those guys works crazy hours.

Han Solo

Hmm, to be honest my personality and dexterity are probably most suited to being a surgeon. I've already taken two years off and I'm still better at procedures than those who're at the same stage of training but haven't had any time off. Unfortunately the hours don't agree with me. Anesthetics is next on the list, but I've been getting alot of pedantic crap from them so it's kinda putting me off. I think I better stick to my forte, which is skincare. Unfortunately there's like zilch chance of getting an accredited spot until I start currying favor with the dermatology department so I'm working parttime and devoting my time to "research" until I get a spot starting next year. I hope I make attending by the time I hit 35. Otherwise I'll just quit.

Yeah, I'm still in the days where I'm called to theatre to do nothing apart from stand around as a retractor holder, unable to leave because the surgeon just likes human retractors, and have to stay back on the wards to finish what I wasn't allowed to do in the morning, missing lunch maybe at least 3 out of 5 days a week, not including weekend shifts. Try getting consults at 4pm. What I'm most unhappy about is that I've got sick patients on the ward that need attending to, and I'm made to drop everything. If something happens the surgeon says to just call a MET call and let them deal with it, which I find very annoying. It's not like I'm actually doing something useful by standing there in the OR. And I don't eat breakfast at all, so it's more than likely I'll only have 1 meal a day most of the time.

[Han Solo]

Hmm, to be honest my personality and dexterity are probably most suited to being a surgeon. I've already taken two years off and I'm still better at procedures than those who're at the same stage of training but haven't had any time off. Unfortunately the hours don't agree with me. Anesthetics is next on the list, but I've been getting alot of pedantic crap from them so it's kinda putting me off. I think I better stick to my forte, which is skincare. Unfortunately there's like zilch chance of getting an accredited spot until I start currying favor with the dermatology department so I'm working parttime and devoting my time to "research" until I get a spot starting next year. I hope I make attending by the time I hit 35. Otherwise I'll just quit.

Unfortunately, dermatology is even worse than anaesthetics to get in, as their selection criterias are more opaque.

Being female(?) helps, and does currying favors with the department.

Last year, the 2 trainees selected in my hospital in melbourne, are young females who are in their second year, and neither actually did dermatology as part of their rotation (!!) but apparently has good connections with the dermatologists.

And what do you meant about pedantic craps from the anaesthetists?

Han Solo

[Aphraeleiss]

Cancelling surgery because day of surgery bloods weren't done - granted it's a renal patient but a quick blood gas would've shown hyperkalemia - for dialysis patients the creatinine is bound to be high anyways. If they'd checked it earlier that morning I would've done the bloods very quickly - I was not given specific instruction to do it, and most patients don't get day of surgery bloods in the first place. The patient had never been hyperkalemic, was on alternate day dialysis which is why I've always done alternate daily bloods on this particular patient since I know her very well. If they'd even bothered to talk to me, but hey, I'm the insignificant RMO. Or look at the cumulative blood results ... whatever. We all want to cover our own asses so no point arguing. You may not agree with me anyways.

I figure anything that's worth doing is competitive, so probably no point worrying about it. Just keep trying. Life goes on in any case. My bestie just got an accredited spot as an anesthetic trainee and he's PG-Y4, so it's only one year later than the theoretical minimum. He was working an unaccredited job last year but that just served to build up his experience and pave the way.

There's just no freaking way I'm moving again because of this job. If I move it'll be because I want to try something new, not because a job is dictating my life. So sick of it.

Off to China for 3 weeks on holiday. Finally, a real break. Will be MIA for a while. Have fun!

[duguxiaojing]

Can't help you- the bet sounds pretty dumb, imho.

haha...well I finally did the conversion of 42 ounces into ML and it is quite a bit...but the money is already down, so cant back out even if i wanted 2

Thanks for the links anyways.

Wow! i remember one time my brother n i planned to finish all the value meals of mcdonalds from 1 to 10 n see who could eat more

Damn...safe 2 assume that you didnt finsih?

[ghostdarTeal'c]

Hi Dr Han, seeing the thread i think its only appropriate i convey the problem here.....hope you can help me with this....

im not quite into exercise, but the job im in now require perfect health and stamina. the thing is, i cant exercise without having a splitting headache afterwards if my last session is more than three days apart. im still studying, so these headaches are really troublesome.....say, my last running session was three days ago, and then this morning i had to go for PT (that's compulsory, and just in case you dont know, PT is Physical Training), so right now im having the headache, like something is pushing into my head, my neck hurt and stuff, well, you know what i mean. sure i take panadols, but i dont want to rely on those too much....NOTE: i have a lecture in three hours so basically i have to take the pills either way....oh yeah, and i dont have migraine....the same happens if i start running again after three-day break, altho PT is more demanding than the usual evening run, i still get the headache.....

im just wondering whats wrong with me, cuz i dont see my friends having the same problem, and theyre much lazier than me when it comes to exercising.....and i dont like going to the doctors, not quite fond the hassle of going there ....

So, do you have any idea what's wrong with me?

[big master]

Damn...safe 2 assume that you didnt finsih?

nahhh...we never actually continued the challenge coz we were quite stingy and decided it was too expensive too eat all those:P but i sure would like to try it still someday

[KJ]

Doc,
Once in a while, I would accidentally bite my lip while chewing. Now, that would smart for a minute, and that's fine. But, a day or two afterwards, I would develop some sort of blister or sore in that spot. It's not very big, maybe 1cm in diameter, but it hurts like heck for 3 or 4 days. What can I do to treat it or ease the pain? I've tried rinsing my mouth with salt water, but it only helps for a couple minutes. Other than that, I have no ideas except to wait it out, which takes 3 or 4 days, but sometimes up to 6. Any ideas?

[Han Solo]

Doc,
Once in a while, I would accidentally bite my lip while chewing. Now, that would smart for a minute, and that's fine. But, a day or two afterwards, I would develop some sort of blister or sore in that spot. It's not very big, maybe 1cm in diameter, but it hurts like heck for 3 or 4 days. What can I do to treat it or ease the pain? I've tried rinsing my mouth with salt water, but it only helps for a couple minutes. Other than that, I have no ideas except to wait it out, which takes 3 or 4 days, but sometimes up to 6. Any ideas?

Wait it out, or try Bonjela cream on it.

Han Solo

[ghostdarTeal'c]

Aww...doc, you havent replied on my prob in post #494......thot you were busy or something....

if it's not in your field thats okay....but gimme a hint or something, k?

[Han Solo]

Hi Dr Han, seeing the thread i think its only appropriate i convey the problem here.....hope you can help me with this....

im not quite into exercise, but the job im in now require perfect health and stamina. the thing is, i cant exercise without having a splitting headache afterwards if my last session is more than three days apart. im still studying, so these headaches are really troublesome.....say, my last running session was three days ago, and then this morning i had to go for PT (that's compulsory, and just in case you dont know, PT is Physical Training), so right now im having the headache, like something is pushing into my head, my neck hurt and stuff, well, you know what i mean. sure i take panadols, but i dont want to rely on those too much....NOTE: i have a lecture in three hours so basically i have to take the pills either way....oh yeah, and i dont have migraine....the same happens if i start running again after three-day break, altho PT is more demanding than the usual evening run, i still get the headache.....

im just wondering whats wrong with me, cuz i dont see my friends having the same problem, and theyre much lazier than me when it comes to exercising.....and i dont like going to the doctors, not quite fond the hassle of going there ....

So, do you have any idea what's wrong with me?

Sorry for the late reply.

Excluding migraine, there are a few potential causes of exercise- induced headache.

1) Exercise (or exertional) induced headache.
Benign in nature.
It is usually pusatile in nature, lasting from 5 min to 48 hours.
It is brought on or occuring after exercise
It tends to occur in particularly hot weather or high attitude.
Prevention such as ergotamine may be useful.
Usually treated with non-steroidal anti-inflammatories such as indomethacin.

May occur in 1 in 100 people.

2) Cervicogenic headache

Cervicogenic headache, which is linked to problems in the muscles, joints and nerve structures of the spine in the neck. The symptoms include episodes of blurred vision. Treatment is aimed at resolving the cervical spine problems.

3) Hypertension induced exertional headache

This isn't an official classification.
However, in exercise, the blood pressure tends to rise in conjuction with the rise in heart rate. Some studies has soon that rise in blood pressure is associated with headache.

4) Cardiac cephalgia.

In subset of people who have ischemic heart disease, they may develop headache but not chest pain or discomfort. This headache is secondary to reduced heart circulation, and is relived with the use of nitrates.

5) Cough-associated headache.

Straining as in cough or certain exercises such as weight lifting has been associated with headache. This subset of headache is associated with congenital Arnold-Chiari malformation in the brain.

In short, Most of the common exercise induced headaches including exercise induced migraine are benign in nature. Up to 50% of professional atheletes in some contact sports experiences exercise induced headache.

However, some experts recommends that patients with such symptoms such at least have some neuroimaging in forms of CT or MRI to exclude possibilities such the aforementioned Chiari malformation, aneurysm or other obvious causes. This is especially true if the headache is severe in nature and is associated with other neurological signs and symptoms such as weakness or numbness in one side of the body, or changes in the nature of the headache -- i.e. worse onset, persistent, associated with nausea or waking up in the morning with headache.

Lastly, some british doctors working with children who have exercise induced headache tried to treat their patients with head cooling- wrapping cold towels on the head.

Suggested links/resources :
http://www.bbc.co.uk/health/ask_the_...hessport.shtml
- General discussion of exercise induced headaches.

http://216.25.100.131/upload/CT_Clas...n_no_print.pdf
- Classification of headache by the International Society of headache

http://www.blackwell-synergy.com/doi...0.2003.03076.x
-Case report of Arnold-Chiari malformation in a patient with a history that is suggestive of cough-exercise induced heache and the potential importance of ensuring that patients has further investigations.

http://bjsm.bmj.com/cgi/reprint/39/2/e10.pdf
-Studies of exercise induced migraine/headache in Aussie-rule players in Australia.

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
- Exercise --> raised blood pressure --> headache?

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_DocSum
- Case report of patient with ischemic heart disease who has headache.

Han Solo

[Han Solo]

Aww...doc, you havent replied on my prob in post #494......thot you were busy or something....

if it's not in your field thats okay....but gimme a hint or something, k?

Give me some time to read up. , especially since i'm interested in other fields of medicine.

Anyway, my answer is posted above.

Han Solo