Friday, February 29, 2008

Happy February 29th!

It only comes around once every four years, so savor it. I never knew the leap year had such an interesting story until I heard about it on NPR the other day. How all this business started was that the world used the Julian calendar from the first century, until people noticed that the date Easter was celebrated (the vernal equinox) kept drifting slightly forward, since the calendar year (365.25 days) was just a little longer than the time it took for the earth to circle the sun. That meant people were one calendar day forward every 128 years. Pope Gregory XIII found that unacceptable, so created a new calendar (the Gregorian calendar), which we use today. He kept most of the Julian calendar, but added the rule that years that are divisible by 100 are not leap years. However, years that are divisible by 400 are leap-years. (The 400 rule overrides the 100 rule, apparently.)
A couple cool factoids arise from all this:
1. February is so short because Caesar's son Augustus was a brat, and wanted his month to have as many days as his father's (July), so they rearranged a bunch of days, the end result being that February has fewer days than all the other months.
2. The Russian and Greek Orthodox calendars still use the Julian calendar, so Easter falls later for them than on our (Gregorian) Easter.
3. The whole world didn't adopt the Gregorian calendar at the same time. When it was adopted, 10 days were cut out so they could start fresh. Most of the world cut the 10 days in 1582, but Russia held out until 1918. Alaska cut the 10 days when it was purchased from Russia in 1867. Can you imagine the confusion of losing 10 days? And of having different areas be so off from one another? Think of all the birthdays that got thrown off!
The moral of this post being: Who knew calendars could be interesting and cool? And savor today a little more, cause you won't see it again for a while. :)

Thursday, February 28, 2008

Nec fasc./Flesh-eating bacteria/Chompers

"Necrotizing fasciitis. Explain...with pictures please."
Many names for one nasty disease. Necrotizing fasciitis is a type of deep tissue infection. (Fascia is the stuff between and around all your organs and muscles and blood vessels. Fasciitis is an inflammation of the fascia. Necrotizing means it kills cells and tissues.) It's caused by toxins that are produced by certain strains of bacteria, the most common of which is Group A Streptococcus (Group A strep is also known as Strep pyogenes and as GAS). There is no one type of bacteria that causes nec fasc. The bacteria destroy the deep tissue of the body, and it's fatal if not treated quickly and effectively.
Keep this bacteria away from me, please.
You might have toxin-producing GAS all over your skin right now, for all you know. (sleep tight!) But people who carry bacteria on or in them don't necessarily develop infections. Certain people can develop infections after surgery, or because they have breaks in the skin (like with eczema), or because they have a weakened immune system. Only very rarely do people actually develop necrotizing fasciitis.
So how do I know if I have it??
There are no specific symptoms, which makes it a bugger to pick up. And it progresses rapidly and is fatal if not treated quickly enough. Initial symptoms are similar to those of a soft-tissue infection, such as pain, swelling, or redness. But the infection doesn't always occur where the bacteria get in (like an open cut on your hand). They can travel around your bloodstream and set up shop anywhere they'd like.
A rapidly fatal disease with nebulous symptoms sounds like a nightmare to diagnose.
But that's what makes medicine fun! Sometimes you can put on your monacle and play Sherlock.
This sounds familiar...where have I heard of nec fasc before?
It's in a 'Scrubs' episode, where JD correctly diagnoses his patient with it (which he calls "Chompers") after watching a Friday night TV special on it. There was a recent article in The Boston Globe Magazine about a woman from central MA who developed this infection after having a C-section, and is now a quadruple-amputee (yes, you read that right). You can read about her amazing story here.
What about those pictures?
No way am I posting pics here. Google image "necrotizing fasciitis" at your own risk.
So how do you treat it?
Surgery! All of the dead and infected tissue has to be cut out, along with a margin of healthy tissue. Plus some potent antibiotics. Still, the mortality rate is 30%.
That's gross.
Yes. It is.

Antje Duvekot

I thought this would be a good time to extoll the virtues of my newest (as of last fall, anyway) favorite singer. Her name is Antje Duvekot, and she's a German-American folk singer who lives in Somerville. I saw her a few weeks ago with a friend, and she was fantastic live. You can listen to some of her songs here. Though the Indigo Girls continue to hold the #1 spot in my heart, this chick is coming pretty close. You might have heard her in the new Bank of America ads (that show different pictures of the earth). You can read more about her on her website. I hope you like her stuff!

Wednesday, February 27, 2008

Post Questions here

If you have random/fun/burning medical/health-related questions you'd like me to attempt to answer, please post 'em here. Thanks!


At the request of Ms. Dennen: a photo to brighten up the blog. (Taken by her, of course.) Let's see if I'm computer-savvy enough to successfully post a photo....

Medical FAQ

So what does ringworm look like?
It looks like a reddish ring on the skin. Like this or this. It can also be lighter than the skin color. The border is usually slightly raised and red, and the center is flat and lighter (so if you run your finger over it, you can only feel the edges). It can be found in areas of lighter hair growth, or, alternately, it may be in an area with some hair (like the forearm) but have no hair growing within the ring.
So it's a worm infection?
Nope, it's a fungal infection. Unclear etiology of the name ringworm, however, except that it's in the shape of a ring.
How do you get it?
Any type of contact with kids'll do it.
Ew, get it off me!
You can use any topical (meaning you put it on your skin) over-the-counter antifungal, like Monistat.

Jazz Music (aka Culture! Right here in Worcester!)

So last night some friends and I decided to do something cultural (not quite making our quota of one Worcester-based cultural event per rotation, but close enough), and went to Mechanics Hall to see the Monterey Jazz Festival on their 50th anniversary tour. Although it was never fully explained why or how a festival can go on tour with 6 individual musicians, it was an awesome concert. The sax/flute player was 82 (!) years old, and the trumpet player just won a Grammy. We also felt very grown up (and thus like imposters) by drinking wine and schmoozing with members of the Worcester District Medical Society before the show. Until one of us (she remains nameless) (but not me) fell asleep during the show and then we collectively whined about the coat check line afterwards. Then I felt we were acting our age(s).


Well, I've been thinking about starting a blog for a while, but, as so often happens, it remained a pipe dream until Natalie inspired me to do it. Even if this blog has only one reader (hi, dad!), I still think it'll be a fun thing to keep up for a while, especially if I'm traveling next year. While this is not intended to be a medically-themed blog, its creation was partially inspired by near-daily phone calls and emails I get from friends and family asking various random medical questions, most of which I don't know the answers to. So I thought it would be fun to 1. find the answers, and 2. post them up here, because maybe other people will be wondering what ringworm looks like, too.
Enjoy! And thanks for visiting. :)