You give me fever, eeuh, … really?

Dum, dum, dum, dum – dum, dum, dum. It almost sounds like your heartbeat, doesn’t it. Dum, dum, dum, dum, you hear your heart pumping, sweating like a wrestler’s armpit. Dum, dum, dum, dum, why?

FEVER!
Fever is such a common thing, but even I still have many questions about it. And what a better way to understand love, passion, anger, fever through songs.

Everybody’s got the fever

That is something you all know

Fever isn’t such a new thing

Fever started long ago

 Peggy Lee, what a singer, what a beauty, what musicality. But a medical genius? A Fever specialist? Let’s take a closer look at some of the lyrics:

You give me fever

Okay…? Thanks, but what exactly was given? What is fever? Fever is just a symptom, it’s not a disease.

When your body detects something that doesn’t belong inside it (a bacterium for instance), your body will try to kill it by heat. Imagine Khaleesi with her dragons burning every enemy that gets in her way. Your body … is Khaleesi… Mmm, imagine that… Anyway, your brain will change the set point of your personal thermostat to “kill”, aka about 39 degrees Celsius. This will inactivate/slow down all your “enemies” (bacteria and stuff), giving your immune system time to figure out how to properly kill them. This means that your body feels cold at 37 degrees Celsius, it needs to get to 39! So you’ll shiver and get an extra blanket to get that heat up. As soon as the thermostat is set back to 37, your 39 degrees body will feel insanely hot and you’ll start sweating and puffing and trying to get rid of the heat. This means: time to get back to work!
Can fever be given? It’s possible, if the fever was caused by an infectious disease this can be transmitted. It will take some time before you get the fever though, sometimes longer than a month.

When you kiss me

Definitely a possibility. For instance with EBV, or the “kissing disease” most teenagers go through. Actually because they drank out of each others cups, not because they went around tasting their fellow classmates …

Fever when you hold me tight

I’m still on the virus pathway for this, but with just holding it will be difficult. Unless Peggy Lee actually meant the really “tight holding”, as in “fucking”, then we have some clear ways how to get that fever.

Sometimes however, nobody needed to hold you to get it. No infection, no virus, no bacteria. Sometimes, the brain tries to kill you with a serious system malfunction: an auto-immune disorder. Fever can be one of the first complaints. In these diseases your body actually makes antibodies against your own cells making you very sick and fooling your brain at the same time. Also other nasty diseases like cancer can cause a fever.

Fever! in the morning

Fever just in the morning is tricky. Usually a spiking fever does not care if it’s morning. But still, abscesses can give spiking fever (but you don’t get that from someone else), also Malaria (you’d need a mosquito in between) and tick bite fevers (name says it, you need a tick bite). I don’t know Peggy Lee, this will be harder to blame on your man.

Fever all through the night

Yes, this is clearly possible again. Maybe with the previous statement you meant to say that you have had the fever all through the night, into the morning? And the rest of the day? But yes, Fever at night is terrible. You get these fever dreams, real vivid, sometimes scary dreams. Nobody can tell you what fever dreams really are and why you get them though.

Now you’ve listened to my story

Yes, thanks for sharing

Here’s the point that I have made

Bring it on

Chicks were born to give you fever

Excuse me? Are you saying that chickens are born to make us sick? With some sort of poultry virus? Is this an apocalyptic confession?

Be it Fahrenheit or Centigrade

It’s 2018, we call it Celsius now.
Normally your temperature will be between the 35.5 and 37.5 degrees Celsius. But it depends on how, and especially where, you measure it. Under the tongue your temperature will be lower than in the butt. Furthermore, your temperature is different every moment of the day, depending on the temperature of your surroundings, your activities, even the menstrual cycle. But let’s not make it more difficult than we should.

They give you fever

They? You’re still on the chickens?

When you kiss them

Why would we kiss chickens? If we don’t kiss them, no fever?

Fever if you live and learn

Well yes, if you live, you’ll definitely get fever a couple of times.
And about learning to Staying Alive (aah, nice, new song, different blog however): you can stop fever!
Your over active brain doesn’t know when to stop and will keep turning your thermostat until 42 degrees Celsius in some cases. That temperature is really harmful for your cells. But also “just” 39 degrees Celsius can be harmful, especially for young children. My drug of choice? XTC. Oh, you mean drugs against fever of course, sorry; Paracetamol. But by bringing down the fever, you don’t treat the underlying cause. You’re just treating the symptom. By the time the Paracetamol stops working, the fever will be up again. So never just use Paracetamol for a long period of time if you have fever, try to find the underlying disease and treat that.
Live and learn, baby, live and learn.

Fever! till you sizzle

I’ll interpret this like being delirious and raving of fever. At one point your brain can get so confused about the higher temperature that you get into a fever delirium. No worries, nobody is going crazy yet. Once the fever is down, the raving stops.

What a lovely way to burn

I strongly disagree. I’ve had my share of fevers and in no case did I ever think “what a lovely way to burn”. Sorry Peggy. I am not agreeing with her, but that’s ok, it’s the 21^st century.

Glad we got that sorted out.

 

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Hepatitis, easy as ABC

Most people only know of Hepatitis from their travel vaccinations stamp collection, but you probably also knew that Hepatitis affects the liver. Well done. But Hepatitis is so much more. It is such an interesting disease. If it was a Popstar I would sing all her songs. Let’s look at some nice things about this fascinating disease.

1. Inflammation of your liver

The latin name for liver is Hepar, and -itis is something we glue after everything to indicate it’s inflammated (colitis = inflammation of intestines, conjunctivitis = inflammation of eye, wapitis = two or more North American deer with large much-branched antlers). Hepatitis means you have an inflammation of your liver. This can be due to a virus (a viral hepatitis) but also by alcohol. If you want to be left alone the morning after the GT-mayhem don’t say you are hungover, no, you’ve got something “far more serious”: you’ve got a starting alcoholic hepatitis.

2. There are 5 viruses that cause viral hepatitis

There is A, B, C, D and E. They all cause the inflammation of your liver, but all in different ways. It’s not like when you learn how to swim that you get your A diploma first, then B, etc. These viruses can sneak up on you when you least expect it and all at the same time.

Hepatitis A: is transmitted fecal orally
Or in plain language from poop to mouth. Hence the true meaning of “being shitfaced”. If you don’t wash your hands after doing number two on the toilet or if a chef in a restaurant doesn’t do it, this virus can enter your mouth via the food that you eat. It gives you symptoms almost always and for about one month, some people get severely sick though. Sad thing is, we can’t really treat it, you just have to lie in bed and wait while turning yellow (you turn back to your normal color in the end). We do have good vaccinations though!

Hepatitis B: transmitted sexually or via blood.
It can also be transmitted from mother to child during pregnancy. Very sad for the child so we need to avert this. This is actually what I’m currently researching. A lot of times the infection becomes chronic and gives no symptoms for years. It does lead to liver failure and can cause liver cancer. We have medication to suppress the virus but most of the times the patients need to take medication their entire life. Better to prevent with some vaccinations! In most vaccination programs, Hepatitis B is part of the immunization of all children. All medical personnel are already obligated to get vaccinated, because there have been numerous outbreaks in history where an infected surgeon transmitted the virus to patients and vice versa.

Hepatitis C: transmitted via blood.
Mostly intravenous drug users are prone to infection, but also men who have sex with men are at increased risk if they do stuff with their anus or put stuff in their anus. Luckily, we recently got really nice medications to treat this infection! Keep stuffing your anus, we’ve got your back! Well, figuratively…

Hepatitis D: transmitted through contact with blood or other body fluids…
However only in patients that are infected with hepatitis B virus. Without B, no D. 

Hepatitis E: transmitted via consumption of contaminated water or food.
Experts are still unsure of the real impact of this virus in a person. It appears as if more people are infected without having symptoms. There are vaccines available, but until we know the exact burden of this disease, we probably won’t regularly distribute them.

3. Beware: an inflamed liver can stop functioning. The dangers of having Hepatitis

I still trap many medical students with asking them what the functions of the liver actually are. Here we go, the main functions:

• detoxification of your blood. Yep, that alcohol you have been drinking is being processed by your liver. If you’re shitfaced regularly (aka alcoholism), your liver has to work so hard detoxifying you blood that it affects the function to do so. This makes you confused or worse.
• production of clotting factors. Without your liver making these, you would bleed through all your pores and in your brain and everywhere.
• production of glucose. Without your liver, you have no back up storage of glucose which is our main fuel. You would have to eat all the time, best excuse for Secret Eaters: I have an infection, I must eat. 
• bile production. Your blood cells get renewed every so often and their dead bodies are taken from your blood by your liver and made into bile. This stuff makes your poop brown. Without your liver this will stay in your blood turning you yellow as big bird and your urine brown.
• breaking down of hormones. Without a functioning liver, hormones like estrogen will not be broken down. This will result in men having boobs. And men shouldn’t have boobs… fact.

There you go, easy as ABC. Just remember to get all your vaccinations and limit your visits to poop-eating/fisting/vampire parties. You should be alright on the viral hepatitis issue.

For me, I’ll try to find a way to reduce mother to child transmission here on the Myanmar-Thai border in order to get rid of Hepatitis B for once and for all!

Syphilis, a social disease

Napoleon Bonaparte, Al Capone, Adolf Hitler, Friedrich Nietzsche and Vincent van Gogh. All well-known men that seem to be unrelated in every way. But on closer look we understand that they all changed the world as we know it. And no, not always for the best. I am indeed talking about Nietzsche with his endless nagging about the apparent relationship between the Apollonian and Dionysian juxtapositions in one’s endless struggle trying to create order in one’s chaotic life, … , you know what I mean. But what these men also had in common, they all suffered from Syphilis. Probably not a big shock, looking at the title of this blog. Can we maybe state that, to change the world, you might need a nice little psychosis due to neurosyphilis?

Syphilis is a disease that has been amongst us for many years now and used to be referred to as a “social disease”. Now don’t be afraid, you can still like a Facebook post, play Monopoly with friend or even go to a birthday party. Just wear a condom when you are doing it! You know why? Because unlike what my patients try to convince me of, you don’t get Syphilis from a toilet seat. Syphilis is an STD.
We now know that the bacterium Treponema pallidum thrives through intense relationships of mucous membranes from different persons, or to state it in plain language: penises, vaginas and anuses having fun with each other. The bacteria end up in the blood leading to rashes on your skin, festers on the already mentioned penises, vaginas and anuses and could lead to severe neurological problems… now take a look at the list of names again…

Back in the Middle Ages they didn’t know what the cause was. To investigate the disease and see if it maybe was blood transmittable, some clever men (always those guys) started a “very ethical” study amongst prostitutes, by far the most social people in that time. The researchers found some ladies with syphilis and took their blood. This blood was then given to another group of prostitutes, let’s call them the “I am really not volunteering for this” ladies. All the IARNVFT-ladies got injected with the infected blood and became ill. Voilà: the clever men knew Syphilis was blood transmittable. That’s what you call empirical research.

Unfortunately for them, there was no cure. One of the treatments that was practiced from the 11 century onwards was using Mercury. It wasn’t a cure, merely treating some symptoms if any. The Mercury was rubbed on skin, patients swallowed it, it was vaporized or applied in a plaster. For your reference, using Mercury as a medicine is probably comparable to taking 13 XTC pills, swallowing them away with detergent and smashing yourself on the toe with a hammer. Not something to look forward to. Another idea was to induce high fever in neurosyphilis patients using a Malaria parasite. This led to some patients death but also for the Nobelprize in 1927. Imagine you are paralyzed and psychotic and then getting Malaria, I wouldn’t be the biggest fan.

So, what did they know: Syphilis was blood transmittable, it gave you severe neurological problems … and there was no cure from getting sick after a social event! And if there’s no safe cure, people try crazy stuff to think of ways to prevent it. Flashback to 1717. An English doctor Daniel Turner was sitting in a bar, had some drinks and saw some beautiful ladies. He felt his manhood swelling and he knew he couldn’t resist the action. As a doctor he knew that the last thing on his wish list was getting Syphilis, so with his almost exploding man parts he jumped out of the bar, ran into a greenfield, saw a sweet little lamb … and butchered it. He immediately wrapped the sheep’s intestines around his penis, ran back to the bar and started a social intercourse event with one of the remaining lovely ladies. And guess what? He didn’t get Syphilis. In fact, he didn’t catch any STD. Daniel Turner, through his act of explosive desperation changed our lives drastically, the Condum (old English for hide) was born! To his great disappointment however, not everyone was enthusiastic at the time. We get that now because there probably wasn’t an ultrathin condum or one that glows in the dark or had funky flavours (unless you really like intestine flavour of course… not judging).

Luckily, in 1928 Alexander Flemming opened his window to start the discovery of Penicillin and a cure for Syphilis and many other diseases was finally there. But don’t think you can live like the Prince of Bel-Air. Syphilis is back in the game. After the start of the HIV pandemic, people became more scared about free sex with everyone they met and started either using condoms or having less contacts. This resulted in a huge drop of all STD’s, hooray! But HIV is not so terrifying anymore. That’s of course good news but people are getting back to their old habits, thus increasing STD rates and also Syphilis rates. That’s crazy, almost like … already have … some severe neurological problems … because of Syphi… probably not.
Ok, you can have sex with as many people as you’d like, even at the same time for all I care, but please take care of yourself and wear protection, it’s not a sheep intestine anymore!

My personal takeaway: I do want to change the world, but I’ll try to do this without Syphilis… I’ll try.