Why Do Men Have Nipples? (9 page)

My wife’s “friend” once told her that eating pineapple made you smell good “down there.” The friend had heard this from a call girl. It doesn’t get more evidence based than that.

There is, however, no scientific research on this sensitive subject. People do believe that you are what you eat, so what you ingest, ladies, can affect the smell and taste of your womanly secretions. Foods that are often mentioned as having the potential to cause problems “down there” are asparagus, garlic, and curry.

CAN A WOMAN EJACULATE?

There have been many claims about female ejaculation, but this was always dismissed as urination during intercourse. More recent evidence has found that higher levels of a compound, prostatic acid phosphatase, has been found in patients who claim to have female ejaculation. This compound is also found in high levels in male ejaculate and originates in the prostate.

Researchers have taken an anatomic approach to the issue of prostatelike components in female ejaculate. They believe that if women ejaculate a fluid that is not urine, then it must be coming from someplace other than the bladder. The most likely source was thought to be the female paraurethral glands or Skene’s glands.

Autopsy tests of Skene’s glands have found substances identical to those found in the prostate. Some experts now call these glands the female prostate. So, it seems highly likely that some women can, in fact, ejaculate, but causing that to happen may be as tough as finding the G-spot.

WHAT IS A HICKEY?

A hickey is a bruise that forms when a person sucks and lightly bites an area on another person’s body, causing the blood vessels under the skin to break. It is also a badge of honor for horny fifteen-year-olds all around the world.

CHAPTER 4

CAN I TREAT IT MYSELF?

I look
at my watch and I can’t believe that it is only 12A.M. I answer the last of the sex questions and quickly scan the room to make sure that my path is clear to the bathroom. I see an opening and rush off hoping to avoid any more questions.

The door is slightly ajar and I push it open tentatively to find our hostess, Eloise, sitting on the edge of the bathtub. Leyner is clutching the massaging showerhead and is directing a cold stream of water on her burned and blistered cheeks. As it turns out, Eloise, ever the impeccable hostess, had joined Leyner and Cinderella in their laboratory to see if they needed their glasses refilled. Leyner then insisted on slathering her with his spicy balm. Little did he know that Eloise had had a deep-cleansing facial peel just a few hours before the party, leaving her skin ultra-vulnerable to any corrosive ointments. It was comforting for me to see that in the heedless anarchy of the moment, Leyner had actually done the right thing and was correctly caring for her burns.

There are two venerable maxims that rule the professional classes. For doctors it is do no harm, and in the world of jurisprudence it is anyone who represents himself in court has a fool for a client. So, if you must be your own physician, do no harm and don’t be a fool.

CAN YOU TAKE THE TETRACYCLINE MEANT
FOR FISH TANKS?

A patient came to the ER one day for treatment of an infection on her scalp. She had tried to treat it at home by taking the tetracycline for her fish tank. As it turns out, she actually didn’t need antibiotics for her rash. Was this self-medicating ingenuity or insanity on her part?

I wouldn’t exactly call it ingenuity, because the other great idea she came up with was to rub toothpaste on her head. As for the fish tank tetracycline, it seems as though those tablets often contain the same dosage as your over-the-counter tablets, but I certainly cannot vouch for their purity. Logic says to stick with the stuff you get from the pharmacy.

DOES CRANBERRY JUICE CURE URINARY
TRACT INFECTIONS?

Maybe. A study in
JAMA,
or
The Journal of the American Medical Association
for all not in the know, demonstrated a significant reduction in the rate of urinary tract infections in older people who drank cranberry juice daily. We don’t know exactly why, but the most likely answer is that some chemical in the juice prevents bacteria from sticking to the wall of the bladder. I know some people don’t like cranberry juice, but since urinary tract infections can happen after sex, it’s probably worth it to drink a little bitter cranberry juice instead of smoking a cigarette.

WILL YOGURT CURE A YEAST INFECTION
IF YOU PUT IT “INSIDE”?

Yogurt may have some role in helping prevent yeast infections, but only when you put it in the correct orifice—your mouth.

Yogurt does have some very interesting health properties. Some women find eating one cup of yogurt a day while taking antibiotics is helpful in preventing the yeast infections that often follow such treatment; however, yogurt alone will not cure vaginal yeast infections that are already in full bloom.

DOES CANDLE FLAME REMOVE EARWAX?

Excessive amounts of earwax can cause decreased hearing or pain, but this is no reason to start lighting your head on fire. “Ear candling,” or coning, involves placing a cone-shaped device in the ear canal and, with the help of smoke or a burning wick, removing earwax. The companies that make these devices claim many other health benefits. The FDA and the Canadian government disagree, and both have come out against these fraudulent claims. In most cases earwax will come out on its own, and if not, you should see your doctor. Avoid these silly products and save the cones for your ice cream.

IS IT SMART TO PUT BUTTER ON A BURN?

No. Save the butter for breakfast.

Butter is the wrong thing to put on a burn. It will trap the heat in the skin and prolong the pain. Use cool water instead.

I do have to say that there are some kitchen supplies that may be useful for the pain of a burn, straight from the medical literature in India: boiled potato skins and honey.

Why honey? Honey is sometimes used for its antibacterial effects. Boiled potato skins may seem to be an unusual treatment, but they maintain a moist environment.

The best thing to do when you grab a hot pan is to cool your burn under running water, and only after it has thoroughly cooled, apply an antibiotic ointment. For severe burns you should go to your local ER.

DOES MELATONIN WORK FOR JET LAG?

Here is one for all the world travelers. Melatonin may be an effective solution for your problems with jet lag.

A review of ten studies on the use of melatonin concludes that two to five milligrams of melatonin taken at bedtime after arrival at your destination is effective and may be worth repeating for the next two to four days. This should be done in conjunction with nondrug measures—such as avoiding dehydration and alcohol, engaging in exercise and activity during daylight hours, eating well, sleeping well, and adjusting to the local time schedule—for fighting the dreaded jet lag.

SHOULD YOU PUT A STEAK ON A
BLACK EYE?

Ice is hardly as dramatic as a carefully placed porterhouse, but it does the same job. There is no magic in the beef, just cold and a little pressure. Keeping your head elevated and avoiding aspirin or ibuprofen, which can affect the ability of your blood to clot, also helps. The best idea is to avoid getting punched in the first place.

WILL TOOTHPASTE GET RID OF ZITS?

There are many home remedies for skin ailments, and I’ve seen patients come to the emergency room covered in all sorts of creams and potions. Some common antizit home remedies people try concocting include baking soda, vinegar, coffee grounds, Mercurochrome (a red substance no longer sold in this country), iodine, hemorrhoid cream, sugar, salt, and toothpaste.

It is commonly believed that toothpaste on zits is an excellent home remedy. There are no scientific studies that I could find on the use of toothpaste for acne but it may work to dry out those troublesome blemishes.

But if you go the toothpaste route, there are some things to look out for. Perioral dermatitis is an eruption of discrete papules and pustules on an erythematous scaling base around the mouth (fancy description for “acnelike”). It occurs almost exclusively in women between the ages of twenty and thirty-five. The cause is unknown, but some people think that fluorinated toothpaste may be a factor.

Fragrance allergies are also a danger with the toothpaste method. Balsam of Peru is an ingredient that has been known to cause allergic reactions and cinnamic aldehyde in toothpastes has also been a common culprit. We say to stick with Clearasil.

IS IT DANGEROUS TO POP ZITS?

In an unrelated but truly bizarre story, one night I was working in the ER and a patient came in with a bandage over her jaw. I asked her what happened and she was very timid in responding. She said she was embarrassed because she had picked her face over and over, which had caused an infection. I tried to calm her, told her that this was common, and asked her if I could take a look. When she removed her bandage, she revealed a 4 by 4-inch hole all the way down to her jawbone. She received some antibiotics and a careful psychiatric evaluation and at no point did anyone say, “Didn’t your mother tell you not to pick at your face?”

As for zit popping, it definitely can lead to some complications. Squeezing pimples can actually push the zit-causing bacteria farther into the skin, causing more redness and swelling. It is also the most common cause of acne scarring.

There is one more deadly complication from zit popping, which is called cavernous sinus thrombosis, a blood clot in the sinus cavity that runs between the sphenoid bone, the large bone at the base of the skull, and temporal bone located near the temple. The real danger zone for zit popping is an area that some people refer to as the triangle of death, an area stretching from the bridge of the nose to the corner of the mouth to the width of the jaw. The veins in this area drain into the cavernous sinus and any severe infection in this area can cause cavernous sinus thrombosis. Squeezing zits in this part of your face can cause an infection and start this dangerous process.

IF SOMEONE IS CHOKING AT A DINNER
PARTY, CAN YOU DO A TRACHEOSTOMY
WITH AN OYSTER KNIFE?

Our friend Kim can do pretty much anything. She was like Martha Stewart before anyone had seen her bake her first cookie. Add to that a rugged edge that allows her to take on any project. She wanted to know the answer to this one, and we realized if anyone could do this, it would be her. She also wouldn’t allow the procedure to interrupt her dinner party.

A cricothyroidotomy (similar to a tracheostomy) is one of the most dramatic procedures done in the emergency room. This procedure is an emergency attempt to relieve a blocked airway. Remember the
M*A*S*H
episode where Father Mulcahy sticks a pen into some guys throat to help him breathe?

The oyster knife might work too, but definitely avoid trying this at home! Call 911 instead.

DOES URINATING ON A JELLYFISH STING
STOP THE BURN?

We all saw that
Friends
episode (c’mon, you watch it, too) when Monica gets stung by a jellyfish. Joey remembers that peeing on a jellyfish sting takes the pain away, Monica “can’t bend that way,” and Joey gets “stage fright,” leaving Chandler to save the day. Don’t believe everything you see on TV.

Most jellyfish stings cause only pain and numbness. The Australian box jellyfish is the most venomous and deadly of all stinging marine creatures. Approximately 20 percent of those stung by the box jellyfish will die. Portuguese man-of-war is also dangerous but nothing compared to the box jellyfish.

The following guideline can be applied to most jellyfish stings: The patient should remove any visible tentacles, using gloves if possible. The area of the sting should be rinsed with household vinegar. The acetic acid of the vinegar can block discharge of the remaining nematocysts (stinging cells) on the skin and should be applied liberally. If vinegar is not available, salt water can be used to wash off the nematocysts.

In laboratory tests, urine, ammonia, and alcohol can cause active stinging cells to fire, which means applying them has the potential to make a minor sting worse, so urinating on a jellyfish sting is both gross and painful.

WHY IS IT BAD TO INSERT COTTON SWABS
IN YOUR EARS?

Oh the pleasure of the forbidden! Those things that you are not supposed to do are always so enticing.

The ears, for the most part, do not require any routine cleaning. Ears are like a self-cleaning oven. With the help of gravity and body heat, earwax will gradually find its way out. If wax appears on the outer ear, a cotton swab may be used. If you can’t help but go in farther, you are risking wax impaction or injury. If you do get wax impacted in your ear, you will be in pain and half deaf. There are over-the-counter preparations that can help relieve wax blockage but warm water in a syringe often works. As a last resort you can see an ear doctor or come to the ER for a good cleaning.

It is not uncommon for us to see patients who have violated these rules and come to see us to remove the tip of the cotton swab that has fallen off inside the ear. Don’t worry, we are prepared. We also remove other things like cockroaches, beads, and pen caps, all of which we’ve pulled out of ears.

Gberg:
We need a list of things for the cotton swabs in the ear question.

Leyner:
OK.

Gberg:
Things that you aren’t supposed to do but can’t resist.

6:05
P.M.