Ask The Doctor – fritzstrobl

Medical Mondays: Amnesia & Amoeba

fritzstrobl Ask The Doctor December 20, 2011May 12, 2016Amnesia, amoeba, amoebic infection, brain-eating amoeba, Dr. Fritz Strobl, memory loss, naegleria fowleri, Neti Pot, wasp stings 0 Comment

Ask The Book Doctor!

This week’s questions come from stories in the news this past week.

If you’re a writer or a fan of books, TV shows, or movies–or even a news junkie–and have a medical-themed question you’d like to see answered in this weekly column, check out the submission guidelines at the bottom!

Q. A recent article in the newspaper featured a British man who, after getting stung by a wasp, had a severe allergic reaction that put him in a coma for week and when he woke up, he lost 20 years of his memory. Can you really get amnesia from an insect bite?

A. If the wasp sting caused a cardiac arrest or severe shock, yes, indirectly. And it could be severe or fatal. But the period of memory loss is highly suspect for being psychosomatic, not real.

Q. I suffer with allergy and sinus issues and have regularly used a Neti Pot, which my physician recommended, as did Dr. Oz on TV. I just read that two people in Louisiana died after being infected with “brain-eating amoeba” from the water used in their treatment. How frightening! Should I be worried? I live in a large city and thought my water was safe? Why are there amoebas in the water and what can I do to protect myself?

Neti Pot for Nasal Cleansing Photo Credit: Aikhan from de.wikipedia.org

A. You must be sure you use pure water in the Neti Pot. Distilled, boiled, or reverse osmosis (RO) water is the best. Naegleria fowleri, the amoeba in question, is normally not a problem to have in drinking water as your digestive system is used to processing many impurities. However, your nose is not equipped to do this. I personally saw a case of this amoebic infection in a young woman who, while water skiing on a stagnant bay, fell face first into the water. There are only about 3-4 cases each year in the US, so it is, fortunately, very rare since it is almost always fatal.

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Attention writers and readers! If you need quick insight/advice on a medical condition that affects a character or impacts a storyline, or are curious about a medical story in the news, please email your question to fritz@fritzstrobl.net. I’ll post two answers here every week!

Due the volume of requests received, I am unable to provide personal responses. Questions should pertain to characters or stories you’re writing, books you’re reading, TV shows/movies you’re watching, or health issues in the news. If you have a question about a personal health issue, please contact your doctor.

Medical Mondays: A is for Apple . . . and Arsenic

fritzstrobl Ask The Doctor December 13, 2011May 12, 2016Ambien, apple juice, arsenic, Dr. Fritz Strobl, medical questions, neurons, synapse, zolpidem 0 Comment

Ask The Book Doctor!

This week’s questions come from recent headlines and stories in the news.

Remember, if you’re a writer or a fan of books, TV shows, or movies–or even a news junkie–and have a medical-themed question you’d like to see answered in this weekly column, check out the submission guidelines at the bottom!

Q. As the mother of active and thirsty preschooler, I was frightened to hear about recent reports that apple juice—one of the most popular choice of juices for young children—contains arsenic. What impact will this have on my child who has consumed apple juice regularly for years? Melanie J.

A. Arsenic is in a group of toxic materials that we call “heavy metals.” It can cause both nerve and brain damage. The nerve damage is often reversible. It is a curious fact that bottled water is given much less testing than city water despite selling at a premium! Similarly, although certain impurities are checked in juice, not everything can be.

A hundred years ago, before the development of other antibiotics, arsenic was used to treat syphilis and was generally effective. So obviously, at some level, it does no grave damage.

Unless your child is showing signs of learning or other problems, I would not be overly concerned. That said, I’d avoid the apple juice until this issue is sorted out.

Ambien — Photo Credit: Healing Resources

Q. I recently read about a young man rendered brain dead after an overdose of pain killers who was later given to moments of awareness upon being administered the insomnia drug, Ambien. How is this possible? Wouldn’t a drug like this, used to induce sleep, have the opposite effect? Stephen R.

A. In neurology, we have to be open minded (no pun intended!). The brain is the most complex organ in the body by far. Not designed by man, its function is still more mystery than it is known fact. Neurons don’t synapse (connect) to other neurons physically; rather, they stop just short of touching. They “talk” to each other by discharging a neurotransmitter (chemical) that then causes a reaction in the second neuron. There are a number of these chemicals that we know about, but almost certainly more that we don’t. In this case, and perhaps 10% of what is called “minimally conscious” or vegetative, improvement will be seen. On rare occasions, it can be dramatic.

We don’t know how this happens, but it is, at times, how progress is made in medicine. Ambien (zolpidem) affects the part of the brain that modulates sleep and wakefulness. With damaged connections, then are many possibilities as to why it might work. The original case was actually misprescribed. But remember—penicillin resulted from a botched experiment too.

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Attention writers and readers! If you need quick insight/advice on a medical condition that affects a character or impacts a storyline, or curious about a medical story in the news, please email your question to fritz@fritzstrobl.net. I’ll post two answers here every week!

Medical Mondays: Diabetic Neuropathy & Gluten Sensitivity

fritzstrobl Ask The Doctor November 28, 2011May 12, 2016celiac disease, diabetic neuropathy, Dr. Fritz Strobl, food allergies, gluten sensitivity, Medical Mondays, medical mysteries, medical questions, peripheral neuropathy, wheat allergies 0 Comment

Ask The Book Doctor!

If you’re a writer or a fan of books, TV shows, or movies and have a medical-themed question you’d like to see answered in this weekly column, check out the submission guidelines at the bottom!

Q. I’m working on a novel and my main character is a middle-aged police detective who is diabetic. Family members who are diabetic often complain about getting pains in their feet and I figure that since crafty detective work entails being on one’s feet, I’d like to know more about how to integrate these symptoms into my character’s life. Can you tell me more about what causes this type of foot pain and how it is alleviated? Karen B.

A. Diabetes is the single largest identifiable cause of peripheral neuropathy. Sufferers generally complain of numbness and burning because the nerve endings–usually in the feet–don’t work as well. Modernmedications for alleviating the pain include gabapentin and pregabalin. Your character would likely walk with his feet a bit further apart and be somewhat unstable in the dark because he would have trouble feeling his feet.

Q. As the holiday season is upon us, I’ve seen an overwhelming amount of information on TV and in magazines dedicated to gluten free cooking and products for those sensitive to wheat. I don’t recall this being a health issue over the last 30 years, but it suddenly seems like more and more people have wheat allergies today. What’s this all about? Jeffrey S.

A. Gluten sensitivity has been recognized only in recent times. Once thought to be interchangeable with celiac disease, a spectrum of diseases has been identified in which gluten sensitivity is a factor. In addition to the obvious gastrointestinal symptoms, there may be more distant effects, including some that are neurological. Estimates vary, but 5-10% of Americans may be affected. Why are we often allergic to food? We can create antibodies to anything, including to ourselves, such as in autoimmune disease. One theory is that the wheat we eat today is much different than the grain our ancestors consumed. So, although wheat may be nutritious and more productive per acre, it may not be without side effects.

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Attention writers! If you’re working on a book, script, or article and need quick insight or advice on a medical condition that affects a character or impacts a storyline, please email your question to fritz@fritzstrobl.net. I’ll post answers to two questions every Monday on this blog!

Due the volume of requests received, I am not able to provide personal responses. Questions should pertain to characters or stories you’re writing, books you’re reading, TV shows/movies you’re watching, or health issues in the news. If you have a question about a personal health issue, please contact your doctor.

Medical Mondays: Trichinosis and Morgellons Syndrome

fritzstrobl Ask The Doctor November 21, 2011May 12, 2016Dr. Fritz Strobl, Morgellons syndrome, trichinella, trichinosis, undercooked pork 1 Comment

Ask The Book Doctor!

Another question from fans of ITW’s “The Big Thrill” along with a contribution from a reader of this blog (thanks!). If you’re a writer or a fan of books, TV shows, or movies and have a medical-themed question you’d like to see answered in this weekly column, check out the submission guidelines at the bottom of this column!

Q. I understand that pigs are engineered so well to collect, absorb, and harbor poisons, toxins, and pollutants that they can kill and eat poisonous snakes with their venom without harming themselves. Additionally, I hear they harbor trichinella spirella roundworms, which can cause debilitating trichinosis and can survive temperatures close to 500 degrees Fahrenheit, and the AIDS-like heat resistant porcine endogenous retroviruses. Are there any studies confirming the danger to human health by consuming pork? Could a deadly poison be manufactured from the hodgepodge of toxins found in pigs and then after giving a human the deadly concoction can the fatality be attributed to eating pork? Elvis S.

A. Pigs are interesting creatures. Wild pigs can eat snakes but are not immune to the venom. Smaller pigs will die from snakebites, but a 1500-pound pig is so massive that there simply is not enough venom to kill it. Trichinella spiralis is the most common of the eight roundworm species in the United States and most prevalent in pigs. Heating to 145 degrees kills all forms of trichinella instantly. So, when cooking pork, an internal cooking temperature of 165 degrees for at least 15 seconds is recommended. On the other hand, although freezing kills T. spiralis, it will not kill T. nativa, found in the Arctic in polar bears and other wild game occasionally brought back by hunters (a warning to Arctic hunters–polar bear liver is toxic!). Fortunately, mild trichinosis in most people is harmless and asymptomatic. But if, after eating pork, you experience severe gastro-intestinal issues that last more than three days or sudden swelling, particularly around the eyes, contact your doctor.

Q. Where do you think Morgellons syndrome originated from? Deb D.

A. Morgellons syndrome has not yet been accepted as a real disease. The term was coined to refer to something that Centers for Disease Control (CDC) refers to as “unexplained dermopathy.” Those purported to have it generally complain of disfiguring sores and crawling sensations on and under the skin. The CDC is currently investigating whether Morgellons should be classified as new disease.

As to its origins, Morgellons was discovered and named by Mary Leitao, a medical lab technician, whose son developed unexplained sores that contained different colored fibers. When doctors were unable to diagnose the condition, she founded the Morgellons Research Foundation, which was fostered by other self-identified sufferers.

Some physicians, as well as the Mayo Clinic, which conducted a study, concluded that Morgellons was simply a form of delusional parasitosis, a form of psychosis exhibited by patients who are convinced that there are parasites crawling on or below their skin, when, in fact, they may be imaginary. The Morgellons Research Foundation itself has not yet been able to pinpoint the source of the condition and its symptoms. This is still being researched and studied.

Medical doctors did not invent the human body and are challenged and intrigued when new or unique clusters of symptoms arise. As with any “new” condition, there can be many misdiagnoses, consideration given towards mental illness, or other conclusions that leave physicians simply baffled. The door remains open on this one for now.

Medical Mondays: Dengue Fever & Autonomic Nervous System

fritzstrobl Ask The Doctor November 14, 2011May 12, 2016ANS, Autonomic Nervous System, brain, Dengue fever, Dr. Fritz Strobl, mosquitoes, tropical diseases 0 Comment

Ask The Book Doctor!

Today, I’ll be answering questions posed to me via The Big Thrill–the International Thriller Writers online newsletter. If you’re a writer or a fan of books, TV shows, or movies and have a medical-themed question you’d like to see answered in this weekly column, check out submission guidelines at the bottom of this column!

Q. How common is dengue fever becoming and is it something to worry about living in South Florida? Susan P.

A. Dengue fever, also called “breakbone fever,” is a viral illness characterized by high fever, headache, rash, muscle, and joint pain. It is spread by mosquitoes, but has not been seen in American mosquitoes since the 1930s. It is most common in tropical areas of SE Asia and Africa. Although 100 million people get dengue fever yearly worldwide, only 25,000 die. It is estimated that 80% of those infected have mild or no symptoms. (By comparison, seasonal influenza in the US kills about 30,000 per year.) There have been a few recent cases of dengue fever in the Florida Keys, but like the other cases noted in the state, they were likely acquired outside the United States. No American recently diagnosed with this condition has died when treated by a doctor, so the risk is very low, although some suffer hemorrhage or shock. Common sense precautions are always advised, so if you (or anyone around you) exhibit these symptoms, it’s best to consult with a doctor.

Q. Which system of the body is responsible for regulating the activity of all body systems? Dennis M.

A. The brain, specifically the Autonomic Nervous System (ANS), gets the credit since the brain is the body’s main computer and the other systems are linked to it, such as the cardiovascular and respiratory systems. For example, the ANS helps regulate blood pressure. When we stand up from a lying position, the brain is instrumental in managing arterial and cardiac connections so that blood flow is maintained. Most organic systems are semi-autonomous. The lungs won’t work at all without the brain, but the heart has its own natural pacemaker. Other organs like the liver and the spleen however, are minimally affected by the ANS.

Please note: Due the volume of requests received, I am not able to provide personal responses. Questions should pertain to characters or stories you’re writing, books you’re reading, TV shows/movies you’re watching, or health issues in the news. If you have a question or concern about a personal health issue, please contact your doctor.

Medical Mondays: Ask the Book Doctor

fritzstrobl Ask The Doctor November 1, 2011May 12, 2016amyloidosis, fiction, Information, laudanum, medical questions, medicine for writers 0 Comment

**The Book Doctor Is In**

Today, I’m pleased to be launching a weekly column on this blog devoted to answering medical-related questions writers have been asking that pertain to characters or stories they are writing, books they are reading, or TV shows/movies they are watching. Since my medical background and cases inspire ideas for my own books, I would like to help other writers and readers understand more about common and unique medical maladies.

Q. I am writing a book that is set in 19th Century New England and my lead character suffers from insomnia and stress. From books I’ve read, it seems that doctors in that era frequently prescribed laudanum to alleviate these symptoms. Can you tell me more about this drug and its side effects? Vicky, NYC

A. Laudanum is also known as tincture of opium. It is 10% opium and 90% alcohol, usually with a flavoring added to mask its bitter taste. Obviously the 180 proof had an effect outside the opium. It was probably invented in the 16^th century and its name comes from the Latin laudare, to praise. Laudanum has strong analgesic properties and was used for many purposes ranging from menstrual cramps to colic in babies. It was used recreationally as well. By the 19^th century, laudanum was in popular use without a prescription. In addition to characters in novels, like Sherlock Holmes, it was used by authors themselves, among them Sir Arthur Conan Doyle, John Keats, Edgar Allen Poe, Lewis Carroll, and even Charles Dickens. Laudanum has side effects that are typical of most narcotics, such as dependence, withdrawal, sedation, constipation, and death (from overdose). In the 20^th century it was removed from the over-the-counter market, along with the cocaine in Coca-Cola!

Q. I’m a big fan of the TV show, House. Almost every week, when Dr. House and his team of experts are trying to figure out their patient’s baffling medical condition, “amyloidosis” is often suggested as a possible diagnosis. What exactly is amyloidosis? Stuart, Jersey City, NJ

A. Amyloidosis is a rare disease caused by an abnormal protein called amyloid being produced in the bone marrow. Abnormal antibody proteins can create amyloid deposits that build up in the bloodstream and damage any organ. They frequently affect the heart, kidneys, and nervous system. There are various forms and because it is rare and difficult to diagnose, amyloidosis is generally incurable. Symptoms can range from changes in color/texture of skin, swelling in ankles and legs, numbness in hands or feet, fatigue, and shortness of breath–symptoms indicative of a variety of other illnesses. I check for it in my patients because it can cause peripheral neuropathy. Not thought to be contagious, one of my neurology professors, who studied it extensively, performed numerous biopsies on patients who died from it, actually (and sadly ironically) died from it himself! Those of us who do procedures always eventually stick or cut ourselves while treating patients. The movie Puncture deals with some of the dangers of modern medicine.

Attention writers! If you’re working on a book or script and need quick insight or advice on a medical condition that affects a character or impacts a storyline, please email your question to fritz@fritzstrobl.net. I’ll post answers to two questions every Monday on this blog!

Please note: due the volume of requests received, I am not able to provide personal responses, nor can I answer questions regarding personal health. If you have a question or concern about a health issue, please contact your doctor.