Thursday, November 10, 2005

Doctor, how should I pick my nose?

And now, a public service announcement.
Yesterday, I received a most unusual email: the usual litany of symptoms, followed by an ecstatic elegy to female breasts. The letter-writer found this blog through my other website, The Medical Consumer's Advocate, my professional home on the web. This blog receives a few dozen hits a day from the Advocate, but most of those visitors run away screaming. At any rate, they usually don't gush over the glories of mammae. Doubtless this fellow had read my Sociobiology of Boobage post and felt he'd identified a kindred spirit. Let me be clear about this: this blog isn't about me. Think of these posts as performance pieces, and the writer, a stand-up comic. These are characters I play, nothing more. I'm not obsessed with boobs no matter what that emailer might think. I'm an ass man all the way. This fellow's letter served to remind me that my blog receives tons of traffic from the Advocate. Today's post is for you poor, unsuspecting newbies who came here expecting, I don' t know, perhaps some sappy sentiment a la JAMA's regular feature, A Piece of My Mind. Screw that. Let's talk bodily secretions.
Doctor, can I use Q-tips?
Sure. While you're at it, you can get drunk on Thunderbird and clean your loaded handgun. I don't mean to suggest you'll blow your brains out with Q-tips; that takes true talent. No, my point is that you're an adult. You're old enough to accept that there are risks to everything you do. For my patients who insist on cleaning their ears with Q-tips (cotton tip applicators, for you Europeans), I give the following guidelines.
  • Pay attention. I've had two patients perforate their ear drums by putting a phone to their "loaded" ear. Each one had forgotten about the Q-tip hanging out of his ear. (Yup. Both were guys.)
  • Make sure you're alone, and I mean alone. One of my patients sustained a traumatic perforation when his dog jumped up on the sofa with him at just the wrong moment.
  • Don't wait until your ears are full of wax. You know how they used to stuff cannon balls into cannons? Same idea.
  • But don't use Q-tips too frequently, either. Daily use, particularly aggressive daily use, can lead to the "itch-scratch" syndrome. The more you itch, the more you scratch; the more you scratch, the more you itch. It took a dermatologist to think that one up. Anyway, trust me, you don't want to go there.
Have more wax questions? Check out my Ear Wax FAQ. One of the warnings on that page bears repeating here: folks who have a history of ear disease should not mess with their ears. Go see an ENT and find out how best to care for them.
Doctor, I have trouble hawking up my phlegm.
First let me say that mucus gets a bad rap. Mucus is your best friend. Without mucus, your nose would fill with up with dry, dirty boogers, your sinuses would be perennially infected, and sex would be a dry affair. 'Nuff said. Nasal mucus is like the sticky stuff on a No Pest Strip. It traps nasty particles including dust, bacteria, viruses, and fungal spores, immobilizes them, gets them out of your nose and into your throat, where you can swallow them and let your stomach do what it does best: kill stuff. No, you don't want to get rid of mucus altogether, but I won't blame you if you'd rather hawk it up than swallow it. How can you manage tenacious phlegm?
  • Increase your fluids. The current recommendation (thanks to our nether buddies, the urologists) is that a healthy adult should drink 80 ounces each day of non-caffeinated, non-alcoholic beverages. You don't have to give up caffeine or alcohol, but you cannot count these drinks towards your total.
  • Treat underlying sinus or allergy conditions. Tons more I could say about that.
  • GARGLE, but be careful what you gargle with. Most mouthwashes do more harm than good, thanks to their alcohol and detergent content. Check out my page on gargling and nasal douching for more information.
Doctor, how should I pick my nose?
Oh, admit it. You do it. Maybe you get all dainty with the corner of a tissue, but I'll bet when no one's looking, you're up there to the second knuckle. (Try it some time. It's as fun as squeezing college students into a phone booth!) Let me explain why you shouldn't pick your nose.
  • Nose bleeds. Emergency room and ENT docs hate nose bleeds. Be kind to us.
  • Folliculitis. Lots of hair follicles inside your nostrils. You know how you like to pluck the hairs out? Don't do it. Hair follicle infections hurt like hell and are potentially lethal. I'm not joking.
  • Impetigo. This is a nostril infection with the bacterium Staphylococcus. Nasty, painful, crusty, and it can last for years.
  • Septal perforation. I'll bet you thought septal perforations were reserved for coke addicts. Well, guess again! Most spontaneous perfs are found in lifetime nose-pickers.
If you simply must do this deed, do it with a moistened Q-tip, and be gentle.
Today's blog was brought to you by the letter I.
As in, I ain't got bupkes, so I decided to write a medical blog.
Day 2 of nothing added to my NaNoWriMo total, but tomorrow is the start of a three-day weekend. Catching up should be a piece of cake. As I mentioned in the comments below, I had a hectic day. I got home late, made dinner, ate it, and before I knew it, The Daily Show was on. More goodness tomorrow, fiends, especially since I got all these secretions out of my system.
Other people's ear wax is my bread and butter.


Blogger Jona said...

Right, I'll hand out the Q-tips to my offspring and explain how they should be picking their noses (this could cost me a fortune ;o))

11/11/2005 05:38:00 AM  
Blogger Douglas Hoffman said...

Just make sure they don't run through the house with Q-tips shoved up their nostrils, screaming like banshees.

One lesson I've learned as an ENT: kids love shoving crap up their nostrils.

11/11/2005 08:27:00 AM  
Blogger mm said...

I'm so glad I'm a woman with dainty, short, blonde nostril hairs that are all self-plucking.

I can't wait for the post about the lethal nose-hair follicle infection.

11/11/2005 08:35:00 AM  
Blogger Douglas Hoffman said...

Ah, but then I would have to tell you about the Danger Triangle.

Time to stop procrastinating . . .

11/11/2005 08:40:00 AM  
Blogger Robyn said...

Hey Doug- I don't have a sense of smell. I ran severely high fevers as a baby, and one doc I talked to thought the fevers burned out my olfactory. Plausible?

My son will be so disappointed that he can't run with Q-tips. :(

11/11/2005 11:03:00 AM  
Blogger Douglas Hoffman said...

Not necessarily due to the fevers, but the viruses, Robyn. That's one of the most common ways people lose their sense of smell -- a simple cold or flu. Head trauma will do it, too.

Sorry to hear it. Have you lost all sense of smell?

11/11/2005 01:29:00 PM  
Anonymous deedeldum said...

Gee, just found this whilest looking at Nose you answer questions as well as raise them?

A Nosemans hiliday may not be what the doctor ordered.


11/11/2005 01:33:00 PM  
Blogger Robyn said...

Pretty much, Doug. I can't smell bread baking or steak on the grill or flowers, but neither can I smell skunks or vomit or diapers. If you have to be without a sense, that's the one.

Of course, my sense of taste is dulled as a result. I'll get a mouthful of milk before I know it's gone bad. Raw veggies all taste the same. Strong sweet or salty is all I can taste.

11/11/2005 03:13:00 PM  
Blogger Douglas Hoffman said...

I suspect you don't miss it since you lost it as a baby -- similar to the way blind or deaf people adapt better if they've lost their sense early on.

Ever try zinc? I've seen it work once in fifteen years. Still . . .

11/11/2005 04:11:00 PM  
Anonymous cheap rs gold said...

I don't have a olfaction. I ran seriously great fevers as a child, and one doc I discussed to believed the fevers burnt off out my olfactory.
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