Farting Dogs

Bella and Gordy Photo: Rod Moser

I may have reached a new low on Blog topics, so I apologize in advance. As a lifelong dog-lover, I think this is a topic that should be discussed. I am not the only one that feels this way, either. When I put "dog farts" in my Google search engine, there were 340,000 citations. Much to my personal horror, some of those citations were videos! Anyone that has ever owned dogs know that dogs will occasionally clear a room with an eye-watering, gassy ripper. Sometimes the dogs are just blamed by a shifty-eyed man sitting next to him, but sometimes it IS the dog, or in my most recent experience...two dogs.

Dogs have similar gastrointestinal tracts as humans. They eat and intestinal bacteria try to digest and break the food down into fuel. Depending on what is eaten, some foods are just more-gassy. Foods high in sugars, carbohydrates, and slowly-digestible fibers can produce quite a bit of flatulence. Notorious in the gas department has always been beans, cabbage, cauliflower, broccoli, onions, garlic, potatoes, brussel sprouts, milk/lactose, and even pasta. Most people have identified foods that react in this way. This is why we don't feed bean burritos to dogs (or Grandpa) or why it is not a good idea to eat a big bowl of chili before a job interview. Much of dry or even wet dog food has a lot of grains, and most grains fit this gassy category.

Other things that fill our intestinal tracks with gas would be carbonated beverages, eating too quickly, and aerophagia - the medical term for swallowing air. Stomach gas will come out as a belch (eructation), but some of this unwanted air will migrate into the intestinal track where it blends and mellows with the gassy products of digestion.

Gas expands at higher altitudes, so this explains why air travel often causes flatulence. Most questions that I get on the Ear, Nose, and Throat message board involved ear pressure with air travel; not farting. Even with my tinnitus and decreasing hearing, I still hear (and smell) an occasional fart on my travels. The culprits are usually sleeping (or pretending to be sleeping).

I had a farting dog when I was about twelve. He ate mostly what we ate, and his name was Casper - an albino boxer. Not only would he sleep on my bed and lie across my legs to the point I was dreaming I was paralyzed, he was a big farter. Because of that, he spent most of his time sleeping in our basement. My mother was not a big fan of dog farts.

I recently read a National Geographic article on whales and they discussed foul-smelling, whale-farts. On a trip to Baja two years ago, I personally experienced a few of those, although the Mexican tour guide looked a bit guilty in my opinion. There were no dogs around to blame.

So, everyone and every mammal will fart from time to time, although a significant percentage of the human population will deny it. When I was in medical training, I was horrified one day when the lecturing radiologist suddenly stops talking and let out one of the loudest intestinal explosions that I had every heard. Naturally, a fart causes a reaction, and in this case, the reaction was laughter.

"Why are you laughing? Flatus is a normal, human response", he said.

We knew that, of course, but we were not expecting a distinguished member of the medical community to fart in front of the entire class. I hope this is not going to be on the final. Throughout the semester, he would fart at least two to three times per class - loud ones - and pretty much getting the same class response. After a few weeks, we sort of got used to them. I did try to come to class early so I could get one of the cherished seats toward the back. It is one thing to hear a fart. I did not intend to have a multi-sensory experience.

I went to visit my new grandson for the first time this week. I will blog about that "First Encounter" on a separate post. It seems sacrilegious to talk about your grandson and farting dogs in the same story. My new grandson lives with his parents (of course), a cat, and two Boston Bull Terriers: Bella and Gordy, the Farting Dogs.

Babies fart all of the time, much to the amusement of older siblings. Working in medicine, especially pediatrics, I have become accustomed to these random acts of innocence. I have encountered some of the more noxious and odoriferous smells known to man, but these two dogs can quickly clear a room. I am not exaggerating. Not only are they very sociable; jumping all over you, they will randomly fart a dozen or more times every hour. It was unbelievable. I once read that dogs have a sense of smell a thousand times greater than man. If this is true, then why did they not seem to mind the stench?

Photo: Rod Moser

They have even taken the dogs to see veterinarian specialists to no avail. The dogs are on a special diet (including duck!) and take special anti-fart food additives. Nothing works. One of my son's proud possessions is an air purifier (one of those expensive ones that are not supposed to really work). I now know why he needs it. There are cans of room deodorizers all over the place, including special ones that are sold for dog farts. If these were my dogs, they would be eating activated charcoal, attached to a catalytic converter, or spending a considerable amount of time outdoors. This was a real learning experience for me.

Inhaling dog farts cannot be healthy, but surprisingly, they have not been proven to cause tumors or respiratory problems. Or, do they? My son was diagnosed a few days ago with left lower lobe pneumonia. Is there a connection? If people can try to blame autism on vaccinations, then I can claim that dog farts cause pneumonia. I worry about my little grandson. He does seem to cry a lot. Can we really catch something from dog farts (other than nausea, of course)?

Farts are composed mostly of nitrogen with a little carbon dioxide. The rotten egg smell is hydrogen sulfide. The flammable gases of methane and hydrogen are also produced in varying amounts. For those of you that have not witnessed the fine art of lighting a fart - a memorable experience from my undergraduate years - it does work. You can get a little blue flame, not unlike a gas stove. My son and his wife had a lot of perfumed candles burning. Hopefully, there will not be an explosion.

I only had one patient over the years that specifically made an appointment because of farting. She had one of the original intestinal bypass surgeries for weight loss and no one really warned her about foul-smelling flatulence as a side-effect. We were able to help her using bismuth subgallate. I suggested this as a remedy for the farting dogs, but I don't really know if this is safe or will even work.

Probiotics used to restore intestinal balance are the new buzz word at the natural food stores. Perhaps, probiotics or some combination of digestive enzymes will help these dogs. Again, I don't know. We use simethicone in babies (and adults) to control gas but I don't think this will help with the odor. Simethicone does make larger gas bubbles smaller, so maybe a smaller dog fart will be more tolerable. If these were my dogs (unlikely), I would be actively experimenting on finding a cure.

My son and his wife love their dogs (obviously). For the health of my new grandson, I will continue my research. Maybe I will call my congressman to see if the new economic stimulus package has funding for research in this area.

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When You Don't Have Health Insurance (or Money)

Millions of people in the U.S. do not have health insurance, and more and more are losing their insurance when they lose or change jobs. When you have limited financial resources, priorities rapidly shift to the essentials, like food and shelter. Getting medical care tend to be low on the list. Nearly every day, someone will tell me that this will be their last visit due to insurance or financial constraints.

I tend to be highly sympathetic and do the best that I can to hold down costs, often by putting down a lower billing code and making sure to order only tests that are absolutely essential. When prescribing medications, I will look for samples (becoming increasingly scarce) or only use the less-expensive generics. I am often embarrassed by the costs of medical care. As a salaried employee of a large, health organization, there is little that I can do to

I am definitely less sympathetic when I know my patient has not changed expensive habits, like smoking, drinking expensive coffee, and eating out instead of packing a lunch. When someone asks me to bill them for their small, insurance co-payment and I notice they have a pack of cigarettes sticking out of their purses, I tell them how I feel. I am getting too old to let these "teaching moments" slide.

Setting reasonable priorities is not something that all people know how to do. And not all people are proactive and resourceful when it comes to trimming their personal budgets or finding affordable care.

Things you CAN do

1. Unless you have a true emergency (life-threatening) condition, stay out of the emergency room. If you have a primary care problem, like a sore throat or earache, this would be the most expensive way to get treatment. Call a few urgent care facilities (aka "Doc in the Boxes") for prices. They are certainly less-expensive than the ER.


2. Check your area for free clinics, or clinics that charge a sliding scale. There are fewer and fewer of these around, but sometimes you will be lucky.


3. Many counties have Public Health Departments that offer free or discounted medical services, especially immunizations.


4. Many uninsured and non-working people qualify for state-run insurances like Medicaid but never bother to check their eligibility. Children, especially, will benefit from this.


5. Find a good primary care provider or solo practitioner. Medical professionals who work for themselves set their own charges and have the ability to charge less or nothing at all. You will be surprised how many dedicated professionals will find a way to help you out during these tough economic times.


6. Ask for samples. Although pharmaceutical samples are also becoming increasingly scarce, even a few days of medication to get you started will reduce your overall health costs.


7. Ask for a generic prescription or for an alternative choice of medications known to be less expensive. Although medical providers often do not know what prescriptions cost at the various pharmacies, most will have a good idea if they are giving you an expensive one or a reasonably-priced alternative. Generics are just as good for a fraction of the cost. If your doctor wrote for a brand name, your pharmacist can substitute a generic equivalent in most instances.


8. Don't be shy about shopping around for a better price on your prescriptions. Call the pharmacy, read your prescription to them (if the writing is legible!), and ask how much it will be. Many large, chain pharmacies have huge medication discounts for certain commonly-used prescriptions. A prescription that costs $60 in one pharmacy may only be $18 at another.


9. Ask for a discount. A $75 office visit may only be reimbursed by insurance companies for a fraction of that cost. So, why should you pay more simply because you do not have health insurance? Even fees vary among private medical practitioners, so call around.


10. Be creative in your available resources. I am often surprised that people can afford to buy beer or cigarettes, but they don't seem to have money left for their own medical care. A one pack per day person would save over $150 in a month - a savings less-costly than of an average office visit.


11. If you have a credit card, most medical offices will charge your visit to the card, giving you up to a month to come up with the cash.


12. If feels good when you help someone, so if you are in serious need, it is okay to ask family or friends to help you out. Remember, you are asking for help to get medical care, not to buy a new toy. By helping you, they will feel better.


13. If you are a member of a church or synagogue, many will help the less-fortunate with reasonable, but unexpected medical costs. It doesn't hurt to ask for help. I have seen local churches buy glasses for children, or provide medical appliances for the elderly. Don't forget to thank others who help you, including God.


14. Practice medical self-care. The first-step in staying healthy is taking care of your self and practice healthy habits. Don't smoke. Don't take recreational drugs. Don't drink and drive. Always wear seat belts. Exercise and maintain a healthy weight. These things do not cost a dime.


15. If you have lost your job and are looking for a new one, try and find employment that will offer health benefits for you and your family.

Ten Things you should NEVER do

1. You should never ignore potentially-serious symptoms simply because you do not have the resources. Not only can your condition become worse (and more expensive to treat), you are potentially putting your life in jeopardy. If you feel you need medical care, find a way. You really can't die now and pay later.


2. Don't ignore preventative care, like mammograms and pap smears for women or prostate exams and PSA tests for men. And, keep up with your preventative dental visits.


3. You should never take someone else's medication. Every person and every disease is different.


4. You should never take expired or suboptimal (sub-therapeutic) dosages of leftover medications from prior prescriptions unless specifically instructed to do so by your medical provider. For instance, by not having a complete course of antibiotics - about ten days worth - it may not be possible to eradicate an infection. You may also create a resistant bacterial strain that is more difficult to treat.


5. Many people resort solely on alternative medicines, such as homeopathic remedies, vitamins, or herbs. Most are not scientifically proven by clinical trial, and any response may be merely anecdotal. It is okay to try them, but if you are not improving, you may need traditional medical intervention.


6. You should never smoke. Smokers have considerably more cancer-fears than other people. People who smoke worry that sore throats, lymph node enlargement, or chronic cough may be something serious. Sometimes, they are right - all the more reason NOT to ignore long-standing symptoms.


7. Don't rely solely on online health information sites (including WebMD) in an attempt to diagnose (and treat) yourself. Online health experts have no way of examining you, reviewing your medical history, or treating you based solely on your posting.


8. The same goes for being diagnosed (or treated) by your non-medical friends and relatives...don't do it. Just because people have similar symptoms or experiences, in no way implies that it is applicable to your case.


9. Don't rely solely on phone advice by your doctor or advice nurses. They can only make medical decisions based on what you have told them. Most advice will most likely be conservative. Don't expect to be definitively diagnosed and treated on the phone.


10. Never use the ER as your primary care medical facility. The ER is for life-threatening situations or medical conditions that cannot wait until your regular medical office is available. ER medicine is the most expensive care you can receive. Find a good family practitioner.

As an optimist, I know things will get better. We need to take care of ourselves...our families...and find time to help others. Together, we will get through this economic crisis.

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It's a BOY!

Ellis Moser and his Proud Parents

Of course, we knew he was going to be a boy months ago. There are few surprises in obstetrics anymore, unless of course, you are having a litter of septuplets that end up to be octuplets at the time of delivery. New parents are very excited when they spot the weenie on the ultrasound. In the old days, we had to wait until the baby was born to know what parts they wore. When I saw pregnant patient in those days, I would always guess the sex of their unborn baby. Surprisingly, I was right 50% of the time.

Since I am no longer in family practice, I really miss that aspect of medicine - informing a woman that she is pregnant. I would always ask during the exam, as I waited for the pregnancy test results, "What will be your reaction, if I tell you that you are pregnant today?" If they said they will be elated, I was happy. If they indicated that this would not be the best news, I would prepare myself. The greatest part of family practice was diagnosing a wanted pregnancy, and then having the privilege of watching that little baby grow up. The downside of family practice is that someday that baby may grow up and get pregnant and that this event was not anticipated.

Last Thursday, my daughter-in-law was induced about ten days before the due date. I was a little suspicious about this planned, early induction thinking the OB was just trying to get the delivery out of the way before Super Bowl Sunday. The delivery was uneventful and the baby was fine. I heard him screaming over the cell phone when I got the news. His name is Ellis.

We are glad our new grandson (my first biological grandchild) was healthy and glad he was just one, and not one of eight. I haven't seen him yet (just email pictures), but we are driving down in a few weeks when things quiet down a bit for the official "Ellis Meets the Grandparents" event. I desperately need to hold that little boy.

I talked to my son last night and the new father said that the baby cries from midnight to about three AM. I am quasi-sympathetic, because my son did that, too. Night shift with a new baby is a rite of passage. It helps to toughen up the new, sleep-deprived parents. Fortunately, both parents (and the new grandmother) are there to help him get through this initial transition.

I am glad that this wasn't a C-section. I always sympathize with the baby in this situation. Here you are...kicking back in your little dark room, when all of a sudden; a gloved hand reaches in, grabs you by the neck and pulls you out into a brightly-lit room full of noise and confusion. In my opinion, this is equivalent to me sitting in my reclining chair, when all of a sudden; someone rips a hole in the ceiling, reaches in and pulls me out. That would freak me out. I would much rather take my sweet ‘ol time "walking down the hall".

California, my adopted home state, is famous for alternative medical practices, like re-birthing experiences. I can't say that I would want to go through that again, although my memory of my first birth is nil. I am not really sure how they conduct that rebirthing thing, but I fear they may have some artificial vagina that you crawl through or something. Since I don't like caves, this would not be particularly appealing to me. I am here now. That's all that matters. I don't see how rebirthing is going to really help me in my life at this point. The "Curious Case of Benjamin Button", I am not.

I stared at those pictures of my new grandson and saw my son as a baby again. I was flooded with those wonderful memories. When you look at the face of a new baby for the first time, you see the future. A little boy with your same last name will be growing up, playing baseball, graduating college, and if you are fortunate enough to live two more decades or so, you may experience the eyes of another generation when he becomes a father. Babies represent newness and life, but sadly, they also remind us older folks that our clock is running down. I am not really worried about that clock; I am just going to enjoy the moment - the moment that I became a grandfather, and all of the years to come.

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