DocTalk

BR. One might have to be a little deranged to be an offensive lineman, spending the whole game hitting and getting hit.

Warming the body's core is important in trying to prevent hypothermia, but the body will sacrifice things like fingers, toes and ears to keep warm blood flow to the brain, heart lung and kidneys. Not covering the extremities gives the body an extra reason to not send blood their way.

In sub zero weather, the time exposure to develop frostbite may be less than 30 minutes. As well, the recommendatin is not to freeze and refreeze body tissue because of the damage that occurs. One thaw per injury is plenty for the body.

The fans will suffer most. They'll need to bundle up and snuggle close on the metal bench seats of Lambeau. Hopefully, they'll avoid alcohol, since the combination of cold and beer is not a good one for bopdy temperature regulation.

Thanks for reading!

 

I thought Philip Rivers played pretty well when i was watching the game on Sunday, but I was blown away when I read that he had had arthroscopic surgery less than a week before. For those of you who have experienced the postop pain and swelling, the crutch walking and your constant icing buddy, the Cryocuff, you know that walking and biking is tough and running doesn't happen. But playing in the AFC Championship game? Just no way. How can this not be the medical story of the weekend.

www.MDdirect.org

 

Sometimes it seems that I benefit from the sorrows of others. But then I remember that perhaps we can all learn from those times when illness and injury strike. Unfortunately, PTI's normal format was interrupted by Michael Wilbon's heart needing a little attention. The show continues with guest hosts, but it's just not the same. I wish Mr. Wilbon a quick recovery and a return to the stage where he enterains us all.

Meanwhile, more on heart disease on the website

www.MDdirect.org/blog

 

The Super Bowl made for good watching but not much stuff of emdical interest, until Fox cut to a shot of a bunch of bananas sitting o nthe Giants bench. How can I resist. This week's web entry talks about dehydration, low potassium (hypokalemia), muscle cramps and the lowly banana.

Some potential opportunities may be in the wings, but details have yet to be worked out. Thanks for reading.

 

DocTalk....

I have read in many places where people who have had bariatric surgery (the actual stomach-"stapling" reduction) have eventually gained all their weight back.

Can you explain this? The stomach size has been reduced by 90 percent in the surgery. I have heard that it can be stretched out, but to a point where you can gain all the weight back?

 

Bariatric surgery in its various forms, creates a smaller stomach pouch. The success rate is quite good since eating habits have to chance. The tinier stomach causes the sensation of fullness earlier. Learned behavior of smaller meals can be overcome by higher calorie intake.

Obesity is a lifelong disease that requires vigilance. Research into the chemicals that signal the brain to stop eating may bring better options than surgery. Ghrelin stimulates hunger and attempts are being made to develop a ghrelin blocker. As well, obestatin is an anti-hunger chemical in the body only discovered in the past couple of years and it may show promise.
http://www.sciencemag.org/cgi/content/abstract/310/5750/996

 

Great stuff.... thanks.

 

I can't watch the replays of Joe Theismann's broken leg; I don't know why it is constantly aired. And though it was just yesterday, I feel the same way about Richard Zednik getting his neck sliced open.

At least it's an opportunity to talk about penetrating neck injuries. Most happen because of stabbing or gunshot wounds, but now we can add skate blades as potential lethal weapons.

www.MDdirect.com/blog

 

Um, I have a question.

Say you're really stupid, and when you're on your elliptical you drop you iPod, and when you get down pick up your iPod, you weight shifts and the back pedal digs deeply into your leg and causes a black bruise the size of your forearm and swells a little. .

And then say, a week later that the bruise really hasn't really healed at all your leg is starting to feel tired all the time.

Could there be a bigger problem here than just a bruise?

 

Are you asking if Apple is the root of all evil?

There are two backs of your leg: above the knee in the hamstring muscle group and below the knee in the gastroc group. If either is damage enough to bruise (that is bleed significantly), then muscle inflammation will make it "tired" or weak as healing continues. Unlikely that anything is terribly damaged, otherwise there would be issues with range of motion issues in the kne or ankle.

With that amount of bruising, you may find that by gravity, there will bebruising that collects around the ankle and heel in a couple of days after the injury, as blood tracks down the muscle and tendon planes.

 

For those of you who are interested, It's been just a little over a year since I began writing an online column more or less weekly. I am amazed that many of you have chosen to read it. I'm also thankful for those who have contacted me for medical background information for professional and personal use.

This week, the topic talks about the medical conference. For those of you who didn't know, I was in Florida last week trying to learn about the latest stuff in Emergency Medicine. Too sad that in the five days I spent on Amelia Island, I spent an hour on the beach, no time in the pool and too much time in the classroom. Contact me if you want to know the details.

Otherwise, there is more on the website.

www.MDdirect.org/blog