January 18th, 2008 by Dr. Val Jones in True Stories, Uncategorized
Tags: Emergency Medicine, Infectious Disease
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A coworker (we’ll call her Tina) approached me yesterday for what she called “pseudo medical advice.” Apparently she had gone to a local sandwich shop with a friend, and purchased some bottled water to compliment her deli item. As the two sat down at a table and prepared to have a leisurely lunch, Tina twisted off the water top and took a big swig.
To her horror, she had taken a large gulp of what tasted like lemon soda instead. She checked the plastic bottle – it was marked as pure water. She instantly recalled that the bottle top had come off rather easily and she heard no characteristic suction noise as air first entered. She was gripped with fear – could this be a poisoning? Did someone tamper with the bottle to inflict harm on unsuspecting victims?
Tina’s friend advised her to call the Poison Control Center. The woman who answered asked if Tina was having any symptoms – nausea/vomiting, headache, dizziness, abdominal pain… She denied each of these, complaining only of some tingling around her mouth (probably because Tina was so worried that she was hyperventilating). The Poison Control Center recommended that she keep the bottle, call the water manufacturer, and go to the ER immediately if she experienced any symptoms.
Tina asked me if she had done the right thing and if I thought she might have been poisoned. I told her that calling the Poison Control Center was a good idea, and although the thought of drinking out of a stranger’s water bottle is fairly disgusting, here’s what I thought about her actual risk:
1. The most likely scenario is that someone was using the water bottle for their daily drink – refilling it with soda from home and taking it to work each day. They probably left it on a counter by accident and a clerk reshelved it in the cooler. I give this an 80% chance of being the cause of the SNAFU.
2. The second most likely scenario is that some kids wanted to pull a prank and intentionally filled the water bottle with soda to see what would happen when someone drank it. I give this a 19.99% likelihood.
3. The third potential explanation for what happened, which is very unlikely, is that a nefarious random killer is masking poison with Sprite or 7-Up in water bottles around the city. I give that a 0.0001% chance on the high side.
The reason why I don’t think Tina’s drama is consistent with a poisoning is three-fold:
1. Most poisonings are directed towards specific individuals – renegade spies, abusive spouses, unwanted kids, that sort of thing. It’s quite rare for people to bother to try to poison random individuals. In the rare cases where this has happened (take the Tylenol debacle of 1982 for example – where cyanide was carefully planted in non-tamper resistant bottles) the idea was to make the person think that the product they were taking was totally NORMAL. Otherwise, why would the person take the full dose? A water bottle filled with soda is a real red flag.
2. The most common deadly poisons are flavorless and odorless (cyanide and arsenic) so there would be no need to use lemon soda to cover the taste. Styrchnine is incredibly bitter and can’t be covered up easily – anthrax, ricin, and sarin have to be inhaled so they wouldn’t be as successful in a bottle form.
3. Tina had no immediate symptoms. Arsenic poisoning causes symptoms within 2-24 hours of exposure, with abdominal pain, headache, weakness, dizziness being the most common initial symptoms. They are followed by bloody urine, jaundice, and severe abdominal pain. For cyanide, the effects are very rapid – causing confusion, fainting, collapse and potential coma. Again, after 24 hours Tina was completely asymptomatic.
After discussing this with Tina she said she felt much better and she perked up nicely. Then tilted her head thoughtfully and asked, “could I catch an infectious disease from drinking out of someone else’s bottle? Like, could I get herpes?”
“Oh yes, that’s possible. Cold, flu, and herpes viruses can be transmitted from glasses and bottles.”
A look of horror crossed her face.
“Um… well (I tried to save all the reassuring I’d done about the poisoning) it’s probably unlikely… I uh, don’t know how long the bottle was sitting in the fridge, maybe the viruses dried up and died?”
“Well, thanks, Val. I guess we’ll just have to wait and see what happens.”
“Yep. You’ll probably be just fine. Did you have your flu shot this year?”
“Uh, no.”
“Oh, never mind.” I said.
And Tina turned around and left with about the same level of anxiety that she had arrived. We’d just switched poisoning for herpes or the flu. Oh well?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 10th, 2008 by Dr. Val Jones in Uncategorized
Tags: News
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I guess all the enthusiasm from Iowa and New Hampshire have translated themselves into the blogosphere. Not only have I been made a finalist in the Best New Medblog of 2007 award contest, but my alter ego – Mindy Roberts of The Mommy Blog has been nominated for the “Hottest Mommy Blogger” in the Blogger’s Choice awards. Please vote for her when you get a chance. You may remember Mindy from my blog posts about her new book called, “Mommy Confidential: Adventures from the Wonderbelly of Motherhood.” Mindy is a fantastic writer with a terrific sense of humor. I’ve posted excerpts here and here. My favorite one is this:
Will is obsessed with size differentials among animals and the relative strengths and weaknesses of each as they relate to other predators. He wants to know exactly how big everything is so that he can determine how many predators it takes to bring down each type of prey. Among the factors are: height, weight, speed, habitat, how far it can jump, whether it can rear up, whether it can swim, and how sharp the teeth are. Usually he wants to know if, say, 20 wolves can take on 10 tigers, but this morning’s question took the cake. “Daddy, can 10 monkeys take down a zebra?”
Many thanks to Cooper and Emily at The Motherhood who have posted a request for folks to vote for my blog in the blog award contest. It’s so great to be loved by MOMs!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 9th, 2008 by Dr. Val Jones in Uncategorized
Tags: Cancer, Hospitals, Medicare, News, Research, Weight Loss
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I’m so excited and honored to have been nominated – and now selected as a finalist – for the “Best New Medblog, 2007” award! Thank you MedGadget team! If you’d like to vote for me, please go to this page. The winners will be selected based purely on quantity of votes. The polls are open until midnight, January 20th.
I’ve also collected the best posts from 2007 below so you can get an overview of what my blog is like – where else can you join a weight loss group, read weekly round ups of the best posts from medical experts, stay in touch with breaking medical news, and have a generally cathartic experience with true health stories?
The Best “Feel Good” Posts
A Baby’s Life Is Saved – a young mother forces a doctor to reconsider his diagnosis, saving her baby’s life.
Do the Right Thing– a young intern fights to save the life of a patient that everyone else has written off.
The Wounds of Childhood– how I might have made a difference for a little girl who was marginalized.
Medicine: Face-to-Face– the story of how I treated a child for the same injury I had at her age: being mauled by a dog.
Informed Consent and the Animal Guessing Game– my reflection on the emotional side of consenting for a procedure.
Thanks to Surgeons– a heartfelt tribute to the surgeon who saved my life.
Fly the Ball– the life and times of a Pakistani doctor who builds a successful career in the US.
The Best Infuriating Posts
The Last Straw: My Road to a Revolution– the true story of a child with cerebral palsy who died because he was denied a wheelchair part by Medicare.
The Benefit of the Doubt– how my friend was labeled as a drug seeker and mistreated in the ER.
VIP Syndrome: A No-Win Situation – the story of how a young man with “connections” demanded and received inappropriate and expensive medical tests, leaving the doctors holding the bag.
The Case of a Predator in the Hospital– how one drug user managed to game the system, wreaking havoc on her fellow patients.
Don’t Believe Everything You Read in a Medical Chart– the story of how a misdiagnosis resulted in a patient being wrongly labeled as a drug seeker.
The Real Dangers of Pain Medicine – a woman who died of opiate induced constipation.
The Best Sad Posts
The Scream– how a cavalier end-of-life decision destroyed a family member.
The Size of Unhappiness– a reflection on America’s obsession with thinness.
Baking Cookies– that’s all I could do as a doctor in Manhattan on 9/11.
Unencumbered by Prognosis– my dear friend handles her diagnosis of stage 4 colon cancer with optimism and grace.
Alzheimer’s Dementia: A Life Lived In Reverse– the story of my grandmother’s dementia and her slow mental decline.
The Best Humorous Posts
Conversations at the Spa– the true story of my recent trip to a high end spa in California.
Kids Say the Darndest Things– these are some pretty good ones.
The Christmas Miracle– a “miraculous” icicle forms on a Christmas tree and pandemonium ensues.
Medical Haiku– some irreverent poems I created a few years ago.
Is that Your Real Skin?– the silly conversations that arise when you’re really pale.
Dudes– a quick look at how men perceive a new hairstyle.
The “Perfect” Wedding– the story of how my hair was transformed into an alien head on my wedding day.
The Best Healthcare Policy Posts
Why I Worry about a Government Sponsored Single Payer System – previous experience with government rulings make me distrustful of population based healthcare savings initiatives.
Pay for Performance: More Red Tape without Improved Quality of Care – the title pretty much sums this post up.
Are Physician Salaries Too High? – compare them to health insurance and corporate executive salaries.
Concierge Medicine for the Masses?– my physician is part of an “off the grid” movement in healthcare.
Rationing Healthcare and the Emperor’s New Clothes – I take a look at some of the funding allocation decisions being made by the government.
End of Life Care: Healthcare’s Big Ticket Item– I explore some of the high costs of end-of-life care and the ethical dilemmas that rationing it creates.
Posts That Make You Go…Hmmm
My First Day as a Doctor– it was a baptism by fire.
The Great Unveiling– who are we deep down inside?
Night Float in the Hospice– what it feels like to care for the dying.
Dying with Dignity– I refused to practice intubation on a deceased patient as his family members waited for news in the next room.
Face Transplants: Ethical Dilemmas– should they be covered by health insurance?
The Man Who Couldn’t Speak– a strange diagnostic dilemma solved by a doting mom.
The Best High Brow Posts
Cancer: Do We Really Understand It?– a wonderful post by guest blogger Avrum Bluming, questioning if we really do know as much as we think we do about this formidable foe.
Hormone Replacement Therapy: A Critical Review– another wonderful post by Dr. Bluming.
Good Science Makes Bad Television– a series on research methodology and why the public should care about it.
The Power of Magical Thinking– describes how to recognize snake oil salesmen.
What You’ll Learn in Pre-Med Classes– a rant about how irrelevant some of the course work is that is required for admission to medical school.
What the Heck is a Rehab Doc?– the history of my medical specialty: PM&R.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 5th, 2008 by Dr. Val Jones in Uncategorized
Tags: Cancer, News, Parenting, Relationships, Research, Technology, Weight Loss
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Welcome to 2008’s first edition of Revolution Rounds, my biweekly round up of the best Revolution Health expert blog posts. Not surprisingly, there’s a decidedly New Year’s theme in this collection of posts. If you’re looking to stick to a New Year’s resolution, be sure to check out the Revolution Health groups section of the site. Whether you’d like to lose weight, quit smoking, or improve your relationships – there’s a group of like minded souls out there resolving to do the same!
Health tips
Dr.
Stacy has 20 New Year’s resolutions for kids. She has even organized them
by age group for you.
New
Year’s resolutions are more likely to succeed if you follow this advice. Mira Kirshenbaum has some great tips for adults.
Would
you like to lose weight effortlessly? Sandra
Foschi suggests that good sleep habits can contribute to
weight loss.
Reading
the right blog could save your life. Dr. HJ Lenz describes how one woman
learned about certain treatment options from his colorectal cancer blog, and it
changed her life.
Would
you like to stop snoring? Dr. Steve Poceta
has some excellent tips.
The best treatment for autism may not be a drug, but human caring.
Robin Morris discusses the findings of some recent research.
Do
you struggle with jet lag? Dr. Vivian Dickerson has some suggestions for
reducing your symptoms.
Pedometers
can encourage increased exercise. Dr. Jim Herndon suggests that a pedometer
might be an excellent addition to your weight loss resolution!
In
case you need another good reason to quit smoking: Dr. Mark Perloe reminds
us that smoking a pack a day can increase the risk of erectile dysfunction by
40%.
Think
you know how to insert eye drops? Think again. Dr. Jackie Griffiths has
some special advice for those of you who need eye drops regularly.
Did you know?
San
Francisco’s mayor has proposed a soda tax. Dr. Jim Hill explains that this
money is unlikely to put a dent in the obesity epidemic.
In
some cultures childhood epilepsy is treated by burning the feet with hot coals.
Dr. Jide Williams describes this horrific practice in rural Africa.
Snowblower
injuries are still quite common even though manufacturers have been working for
over 30 years to make the machines safer. Dr. Jim Herndon explains.
It
is possible to create embryos for the purpose of treating certain diseases, not
strictly for procreation. Dr. Mark Perloe discusses some of the ethical
dilemmas associated with stem cells.
Fitness
is more important than fatness. Dr. Vivian Dickerson explains.
Excess
weight in childhood is linked to adult heart disease. Dr. Jim Hill suggests
that fitness and weight control should begin early to promote good health in
adulthood.
Many
physicians need to work on their empathy. Dr. Mike Rabow explains that
younger physicians may be more empathic than older ones.
Your
emotional state can dramatically affect your physical health. Dr. Joe Scherger discusses this mind-body connection.
Demanding
parents may cause their childrens’ teachers to burn out. Dr. Stacy Stryer
describes this unfortunate phenomenon.
Skim
milk consumption may be linked to prostate cancer. Dr. Julie Silver raises
the question of whether or not skim and low fat milk are over-rated in their
health benefits.
You
don’t need both eyes to have good depth perception. Dr. Jackie Griffiths,
Revolution Health’s ophthalmologist, explains.
Newer
isn’t automatically better. Dr. Mike Glode bemoans the fact that we have
the tendency to rush after the latest medical technology without stopping to
analyze the cost benefit ratio.
Personal Stories
One
woman had an unpleasant surprise on her 40th birthday: a massive
stroke with left hemi-neglect! Dr. Olajide Williams describes the event
with poetic language.
Laughter
is the best medicine. Dr. Stacy Stryer describes how she puts this axiom
into practice in her family.
Dr.
Julie Silver was prompted by her daughter to become one of Charlie’s angels.
You’ll have to read the post to get the reference.
Vitamin
hawkers exaggerate their product’s benefits without recourse. Dr. Mike
Glode describes one interesting example of this phenomenon.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
December 17th, 2007 by Dr. Val Jones in Uncategorized
Tags: News, Technology
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It’s time for the 4th annual Medical Blogger awards… nominate your favorites at MedGadget:
This competition
is designed to recognize the very best from the medical blogosphere,
and to highlight the diversity and excitement of the world of medical
blogs.
The categories for this year’s awards will be:
— Best Medical Weblog
— Best New Medical Weblog (established in 2007)
— Best Literary Medical Weblog
— Best Clinical Sciences Weblog
— Best Health Policies/Ethics Weblog
— Best Medical Technologies/Informatics Weblog
— Best Patient’s Blog
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
