Grey's: A Fish Swam Up Your What??

Last night's episode of Grey's Anatomy -- with the fish swimming up the guy's penis --may sound like total craziness, but in this case the writers were pretty much right on.

The moral of the story? Reconsider that spontaneous skinny dip -- at least if you're headed to the Amazon.

When Seattle Grace's chairman of the board showed up at the hospital unable to urinate and with testicles the size of "grapefruits," all the attending physicians competed against each other to wow the Chief.

But the Chief showed them. He was the one that figured out the chairman (who Christina graciously referred to as a VIP -- very important penis) had a fish lodged in his penis.

The candiru fish is a freshwater fish found in the Amazon. It's notorious for swimming up the penis, particularly when a man urinates in the water. The candiru is also known as the toothpick fish and vampire fish of Brazil (because it sucks blood from its victims).

The candiru usually attaches itself inside another fish by following the stream of water from the gills and winding its way into the fish. It apparently also has an affinity for a urine stream and that's how it finds its way into the penis.

Once in the urethra, the fish lodges itself in there by the use of spines on its surface. No big deal, right? Sounds awful but just yank the sucker out. It's not quite that easy.

Once the fish's spines are stuck in the urethra, there is really no way to get it out of there without extensive surgery.

In the Amazon, one traditional treatment was to amputate the penis since surgery was so expensive. Another native treatment involves the Xagua plant and the Buitach apple. These two plants reportedly kill and dissolve the fish.

Without treatment, death is common due to overwhelming infection in the body, called sepsis.

Thankfully, Grey's VIP had "some of the best surgeons in the world" on the case -- at least that's how the Chief put it. It was really the chief and an unknown urologist that saved the day and the VIP.

And although his heart acted up a bit during the surgery, he came through just fine. Well, that's all relative. He won't be wowing his wife or girlfriend in the bedroom any time soon.

Related Links:

• Travel Health Risks: Germs
• Malaria Risks On Long Tropical Travels
  

technorati tags: greys, greysanatomy, candiru, candirufish

House: She's Dead, House

There are two things about this episode that you may think are odd:

1. people die from staph infections
2. very few doctors get training in how to deliver bad news

Okay, maybe one more: House and Foreman killed someone.

House and his ducklings missed a simple but systemic staph infection looking for some grander disease, again favoring either an autoimmune flavor or cancer.

Staph, or its full name staphylococcus, comes in many forms, including infections in your skin, hair follicles and body. Some have names you know: boils, toxic shock syndrome, and impetigo.

Staph infections are caused by bacteria, and those with compromised immune systems are most at risk of death. Lupe, our patient this week, nicked her back with a bra hook and the sore got infected. It spread inside her body, attacked her organs, and she became very sick.

But it was the dose of radiation that really sealed her fate. Usually staph infections are treated with antibiotics, which work in conjunction with your body's immune system to beat the infection. Radiation suppresses white blood cell count, the soldiers in your body that fight sickness.

So if you kill your body's natural defense system, or suppress it, or if the disease is resistant to antibiotics that can help your immune system, you can die from a simple staph infection - especially if your doctor doesn't think its staff, but cancer, and gives you radiation.

Now, here is the second thing that may shock you: doctors don't always get training on how to tell folks they'e doing to die, well sooner than they expected.

Setting aside that maybe your actions hastened a patient's death, (because frankly I don't see how anyone could be prepared for such a situation) I personally was surprised to find out that interns don't take a course, or at least get a few lessons, in how to deliver such a devastating blow to someone they are caring for.

"In general, doctors aren't trained to deal with dying," says Dr. Brunilda Nazario, one of our medical editors. "Residency programs do not have this listed as part of the core curriculum. However, there are ongoing developmental courses that are taken to help communication skills to address end-of-life to patients and family members. These usually deal with death and dying, and deal with the psychological, social, cultural and religious issues."

Tell us your experiences in getting bad news from your docs. How did they handle it?

Related Topics:

• WebMD Video: How to Stop Staph Infection
• WebMD Video: End of Life Decisions

Technorati Tags: House, HouseMD, endoflife, staph

House Act Your Age, Mr. Handy

It's an unusal story.

Fortyish man loses wife to brain cancer and is alone to raise two, young children. Man meets kids young school teacher and falls for her. Man needs male enhancement cream to help him... um... firm-up his relationship. Man accidentally spreads the cream around causing his significant others to grow lip hair, begin menstruation, grow pubic hair, have nose bleeds, stroke out, flirt with Cameron, and attack Chase.

Okay, it's not so unusual. It's House.

Such creams actually exist and purchased at certain pharmacies that compound many of the sex hormones and the doses vary, says endocrinologist, said Dr. Brunilda Nazario, one of our medical editors.

However, the cream takes time to work.

"While the hormone can be used as a cream, it is unlikely to act this quickly to help maintain an erection for that extra standing ovation period," Dr. Nazario said.

"Erections are caused by an increase in blood flow to the penis and while testosterone works to enhance sex drive it doesn't act this quickly. The sustain erection may have simply been caused by his own manual stimulation, " she said.

Dr. Nazario says over-hormonal exposure -- for you and your loved one -- is a real issue.

"One real issue with using this route of application is that the female is exposed to testosterone cream as well and vaginal absorption is extremely efficient," Dr. Nazario said. "If he regularly uses male hormone cream on the penis for vaginal sex with a female partner, this will lead to unwanted side effects for her. This might include unwanted facial hair, increased muscle mass, deepening of the voice, and other masculine characteristics."

Editor's note: Ewww.

So the moral to this tale is, when your sex life is flaccid, don't reach for a cream, grab the phone and reach out and touch your doctor for prescriptive pick-me-up.

Related Links:

• Less Sleep Lowers Testosterone
• Erection Problems
  

Technorati tags: House, HouseMD, erectile dysfuction

Grey's Are You Smarter Than Denny?

Did you notice that the X-ray behind Jeffrey Dean Morgan -- the guy that plays Denny in Grey's Anatomy -- was upside down during the entire episode of last night's show?

Denny walked us through three years of highlights -- some funny, some not so happy, and some... well, just very Grey's.

Wondering how many people picked up on the wrong side up X-ray made me think about another one of my favorite shows -- Are You Smarter Than a 5th Grader? The combo of shows makes for a good Thursday night.

The editors at WebMD love that show so much we decided to do our own version -- Smarter About Health Than a 5th Grader?

But first, another little quiz about one of the biggest story lines on Grey's.

What does LVAD stand for? Well, if you know that one, I give you an honorary MD.

In case you didn't catch it, the wire Izzie cut that led to the early demise of her fiance was connected to Denny's LVAD. It struck me that they throw that name around quite a bit without really telling you what it is. Like in the scene last night where every intern -- well, except for Alex -- says they cut Denny's LVAD wire.

It stands for left ventricular assist device. (check out this article to see how an LVAD is connected to the heart). I won't bore you with a long explanation of what it does, but for those who care, it's an electronic device that helps the heart pump. It's most commonly used in people with heart failure to keep them alive while they wait for a heart transplant.

OK, now back to something a bit easier. In Thursday's episode of 5th grader, one of the health questions was:

True or False? The small intestine is longer than the large intestine.

Oh, and my favorite question in WebMD's online version of the game is the million dollar question.

If you eat just one candy bar a day in excess of your calorie needs, in a year you will put on how many pounds?

You don't have to wait for a commercial to find out the answer. Just check out WebMD's story and test your health knowledge. Then think twice about that next Snickers.

By the way, the small intestine question is true. The small intestine is about 22 feet long, compared to 5 feet for the large intestine. But the large intestine is bigger around. Hence, the name.

Here's to your health!


Related Links: Heart Transplant Patient Education

Technorati Tags: greys, greysanatomy, smarterthanafifthgrader, heartdevices, LVAD

What Grey's Doctor Are You Most Like?

I'm Miranda... Who Are You?

I'm a perfectionist and expect nothing less from everyone around me. OK, there's possibly some truth to that.

My family is my rock. Well, I do talk to my family every day and spend more time with them than friends.

I learned all these finer personality points from a quiz called Grey's Diagnosis: Which Character Are You Most Like? The show was a rerun last night and on a topic I had previously blogged about so I figured, why not?

The quiz, which assesses personality traits to determine which Grey's character you're most like, delves into issues such as your relationship with your parents, how you deal with a crisis, and what you think makes the perfect date.

But being George or Alex-- or any other McDoctor-- isn't an option.

This quiz was not meant for guys. How do I feel about motherhood? That's a toughie. But I chose the "rewarding but stressful" category and I bet many moms out there would agree.

I'm still having trouble embracing the Miranda in me. Does Grey's knows something about my personality that I don't. I'll look on the bright side. I could have been Cristina. Scary. She's only chilly doc.

Ok, you guys are probably tired of me bashing the storylines on Grey's, so I won't irritate you with any further thoughts about Grey's Cosmo-like diagnosis of my personality.

Hopefully they'll have a great medical situation for me to expound on next week.

technorati tag: greys, greysanatomy, greyquiz, webmd