Friday, September 25, 2015

OK, see??!! We knew it.

During the 17 months that I served as Area Medical Advisor for the missionaries in the countries of Ecuador, Colombia and Venezuela, four young missionaries in those 12 missions suffered acute appendicitis, though all did well after surgery.
In the 26 or so months that we have been in the Peru Huancayo Mission, we have already had five cases, the most recent of which occurred several days ago.
The problem here is that at times, the missionaries are serving at some distance from trusted medical care.  For this reason, if we suspect a problem, we get them on the road quickly.
That sounds laudable.  However, as previously noted, the crop of speed bumps or rompemuelles (spring breakers) has been bounteous over the last 15 years.  They are everywhere!
So, you can imagine having a developing appendicitis, having to travel for a couple of hours, and bumping over 58 speed bumps (we counted them en route to that particular town).  Oooff!  When I questioned several of the missionaries afterward, they said that yes, every cruel one of the bumps hurt.
Imagine my  surprise when Paula e-mailed me the link to the following study, cited in the annual "Ig Nobel Prizes:"
And by the way, I am not making this up.  The study was this:
“Pain Over Speed Bumps in Diagnosis of Acute Appendicitis: Diagnostic Accuracy Study,” Helen F. Ashdown, Nigel D’Souza, Diallah Karim, Richard J. Stevens, Andrew Huang, and Anthony Harnden, BMJ, 2012.  By way of the study, it was determined that acute appendicitis can be accurately diagnosed by the amount of pain evident when the patient is driven over speed bumps.
Wow!  We were way ahead of published science here in the Peru Huancayo Mission!  Instead of doing all those silly blood tests, ultrasounds, etc., just drive them over a couple of speed bumps and see how much they yelp!  Simple!
All of this harks back to the Henderson Hamburger Test, which I administered numerous times during my years in clinical practice.  In a suspected case of appendicitis, one merely had to ask the patient whether or not a big, sloppy hamburger with lots of cheese, grease, fried onions and mushrooms sounded good.  
In not one single case in which appendicitis was diagnosed did the patient express interest in such a meal.  If they blanched and looked like they needed to throw up, the possibility was still in the running.  
Like I said, who needs all that other stuff when you've got speed bumps and hamburgers, eh? Oooh!  Maybe give them a hamburger while they are going over a speed bump!
Anyway, we hope your appendix stays healthy, and that your speed bumps are small.  And that your hamburgers are big!  And greasy!
Dave & Paula

Monday, September 14, 2015

From the Department of Duh

You know, sometimes the desire of manufacturers, apartment building owners and others to avoid litigation from potential risks goes a bit too far.  Take this warning sign, for instance: 
Perhaps this was to alert those who are actually 24 feet tall or something.  Or who are blind.  No, wait, it's not in Braille.
This next one makes me think of ways that the gene pool could be chlorinated. 
I'm confused, or perhaps they're confused.  Gives me a headache.
It looks like a joke, but apparently was for real.  Ewww!  Don't put Spot in the Nukerator!
This one made me think a bit, which is, after all, a good exercise.
About once a month, we find it necessary to spend the night at Cerro de Pasco, the mining town at 14,400 feet about which I've written before. 
We live at 11,000 feet here in the higher part of Huancayo, but it still may be from the additional altitude in Cerro that we both have difficulty sleeping.  Because of this, we occasionally use a mild hypnotic (sleeping pill, not hypnotist, although that would be another idea) to get some needed rest.
I was taken aback reading the actual real warning label on the prescription bottle:
Wait!  Whoa!  I need to back off on the booze also?!  And not drive a car in my pajamas around Cerro de Pasco at night?!  And these pills may cause drowsiness?!!  Hey, what are they trying to do with this stuff, anyway?!!!
I feel lucky that I read the label before taking any.
We hope that you, too, heed the warning signs all around us.
Dave & Paula