Things that make you go “hmmm”: a few medical surprises!
Sometimes (ok maybe more than that) medicine dishes out some surprises. Like this whole peanut allergy guideline change—that’s kind of a surprise, right? Everyone’s chatting that up quite a bit: some excited, some apprehensive, and all the feels in between. I didn’t want to leave out a few other (less new but still) surprises since we’re all feeling that sort of way, so let’s list out a few real quick, just sorta lettin’ you know:
1. A broken humerus (upper arm, 25 cent word) right in the middle of the bone looks quite dramatic on xray—I mean, super broken.
Because when that happens, it is. But guess what? Does it require a splint or cast? Or anything? Well, in nearly all cases that answer is a big fat NO—just an EXPERT clinician to look at your child and the xray and determine that it is in fact a humerus fracture that doesn’t involve the elbow or shoulder. Who knew. We put the child’s arm in a sling for comfort and they get on their way.
2. Similarly, a broken clavicle (collarbone) can look just awful and form an impressive bump at the top of the chest. But what do we do to fix those? Diagnose them correctly and then let them heal. An arm splint helps for comfort. End of story.
3. Lots of kids get significant tongue lacerations, or big gashes in their tongues from falling down and cutting their tongue on their teeth. Not to be graphic but I’ve seen gaping wounds in the middle of a child’s tongue from what seemed like a simple fall. You might be thinking that it must be hard to sew up a tongue, and sometimes it is. But in most cases after someone with solid clinical experience in this area examines the wound and the child, we typically allow those cuts to heal ON THEIR OWN with clean care instructions and a prescription mouthwash. Why wouldn’t we stitch a very deep cut in a tongue? — Food particles can get caught in that germy location otherwise known as the mouth and cause significant infection if trapped by stitches. And they heal beautifully all by themselves. Boom.
On the other end of the spectrum, it’s not always so blasé:
4. If a patient comes in with pain in a testicle it is a time sensitive ALL OUT EMERGENCY to make sure that boy
doesn’t have a twisted testicle (testicular torsion-25c). When a testicle gets twisted the blood supply bringing oxygen to this living tissue can be compromised and the testicle can become nonviable, potentially leaving a male patient sterile. So it’s a pretty big hurry. The stakes are high. If a testicle is truly twisted, there’s typically about a six hour window during which time the patient needs to get that testicle untwisted in the operating room by a pediatric urologist. We do NOT mess around with this.
This is a short list of a few conditions that have caused the MOST surprise for patients in my experience. It’s by no means comprehensive, and I could add to it but I’m thinking that I should let this info dribble out bit by bit in small, digestible portions so that we can all routinely feel the buzz of surprise that reminds us of the amazing awesomeness of the human body. And that medicine will continue to surprise us.