April 21, 2003
Today is the day to see how much Taco Bell you can eat in an hour.
Lent is over, so "A Tale of Two Catholics" has finally wrapped up here.
The Doctor is in! She will have some studying to do in the near future, so if she doesn't get to your questions, don't take it personally. She's just becoming an even better Dr. Hot Pants. If you do have any questions for her, just send me an email with the subject line reading "Hot Pants."
And before we start off with the questions, I have another classic quote from Dr. H. Pants.. Last week, I asked her if she was enjoying the warm weather. Her reply:
"I would like to point out that I 'enjoyed' the weather
today by forcing a demented old lady who still cooks special pork chops for
her husband, who has been dead for three years, into a nursing home despite
the fact that she would probably rather die than go there. And then I spent
six hours in a bar."
Ask Dr. Hot Pants: Issue #2
Dear Dr. Hot Pants,
Seriously, what is it about drinking water while having a spoon placed horizontally in your mouth that stops hiccups? What's the science behind that?
-Anonymous
Hiccuping is still a great medical mystery, and the sheer number of "cures"
recommended is probably the best evidence that none of them are guaranteed
to work. No one is really sure why we hiccup from an evolutionary perspective,
but physiologically it has to do with a spasm of the diaphgram, which is the
main muscle of inspiration. When you hiccup, the sudden contraction of your
diaphragm forces air into the lungs. At the same time the glottis (a flap
of tissue at the upper end of the trachea) suddenly closes, blocking off the
air and causing the noise. Hiccups start in the phrenic nerve that innervates
the diaphgram, and hiccuping may also be induced by stimulation of the vagus
nerve which innervates the glottis. Because of that, most of the hiccup cures
that have sometimes worked depend on either stimulating the back of the throat
and with it the vagus nerve-- that would include drinking water with a spoon
in your mouth-- or interrupting normal breathing in attempt to cut off the
diaphragmatic spasm. Of course, a lot of these cases are not really "cured"--
it's just that by the time you go through all the motions, the hiccups have
subsided on their own. In severe cases where hiccups won't go away, a doctor
might prescribe an antispasmodic like baclofen, or even crush or sever the
nerve involved! And sometimes even that won't work, and you will end up like
the famous Charles Osborne, who hiccuped nonstop for 65 years. As a side note
I think it worth noting that there have been reports of hiccups that have
been cured by sex, and even the worst sex is probably better than having a
catheter stuck down your pharynx via your nose. I recommend trying that first
if possible, and then maybe trying the spoon and water thing after.
Dr. Hot Pants,
Do you believe in the validity of a BMI scale? Isn't it conceivable that some people will always fall outside of the "acceptable" range just based on body type (i.e. big-bonedness?)
M.M.
Personally, I am not a huge fan of any sort of body mass index for the same
reason that I am not a fan of those body fat pincer things at the gym-- I
strongly disagree with fostering an unnatural obsession with weight and thinness.
That said, many serious diseases including hypertension, type II diabetes,
and coronary artery disease are strongly linked to obesity and among ways
to determine total body fat, so the BMI is probably one of the best available
methods. It does have certain limitations in that it tends to overestimate
body fat in people with a lot of lean muscle mass and it tends to underestimate
body fat in older people and people who have less muscle mass. But I think
it is crucial for people to understand that the value of the BMI lies not
in determining whether you are "fat", and I am completely against
the idea of standardizing ideal body weight-- which in reality varies widely
from person to person. The BMI is only useful when considered along with other
factors like waist circumference and other risk factors present like increased
LDL cholesterol, decreased HDL cholesterol, family history, cigarette smoking,
physical inactivity etc. Having a BMI that places you at "overweight"
may not mean that you should lose weight. And even if it is recommended, a
small weight loss can be enough to significantly lower your risk of disease.
Dear Dr. Hot Pants,
Instead cups...what are your thoughts?
-On the Rag, I mean, Cup
The truth is that I have very mixed feelings about the Instead cup. People
have been trying to market similar products since the 1930's, with a scary
version attached to a wire and clearly designed by a man invented as early
as 1867. For more history of menstrual cups I would highly recommend the Museum
of Menstruation, which is an actual
web site. As far as the Instead cup goes-- well, at least it is not made
out of rubber like the earlier versions. And it does have certain advantages
over pads and tampons. It is less messy and far longer lasting than a pad,
and less drying and theoretically safer to use for longer periods of time
than a tampon. And if you have a problem with string, then this cup is probably
for you. The Instead people claim that their cup is better in every imaginable
way, which is probably not true. You still shouldn't use the cup if you have
an IUD or have recently given birth, and although it is "approved"
for use up to 12 hours I expect most people find they will have to change
their cups far more often. The cup is not going to get lost inside of your
body, but I am not convinced that it is going to mold perfectly to every cervix
(and every one is different) or that getting it in and out is not going to
be fairly complicated. Unlike the Instead people, I do not recommend using
the cup even if you don't have your period (seriously, why would you even
want to?). And as far as their claims that you can have safe and clean sex
with the cup in-- well, you should probably make sure that your sexual partner
is very comfortable with your body fluids first in case there is any mishap.
And remember that it will NOT prevent STD's or pregnancy. The sex thing is
probably the one truly clear-cut advantage over the tampon for people who
want to have sex during their period. And users have reported less leakage,
especially of more solid tissue clots which may not be well absorbed by a
tampon. My main problem with the cup, and this is a theoretical objection
because I haven't actually tried it, has to do with inserting it and even
more so, taking it out. I'm sure that it works out just fine once you are
used to it, but there is a high potential for serious leakage until you are
used to it, not to mention the very real possibility of accidentally sticking
your fingers in the cup while trying to remove it. I guess my advice would
be to make sure your hands are very clean before you go and use this thing,
and then maybe try a practice run or two before things get urgent. And then
let me know what you think! Because now I am very curious....
--Dr. Hot Pants