Friday, January 20, 2006

Five Medical Myths

Five medical myths I wish would die a horrible death:
  1. Green mucus = go to the doctor. NOT TRUE. Somewhere, somehow, someone started the myth that while it's ok to have clear or white snot or phlegm, green snot is an ominous sign, and means that you must seek medical attention, quick! In fact, any run-of-the-mill respiratory virus can produce a whole palette of lovely snot shades, from palest ivory to pea-soup green. This has been studied; color of sputum has never been shown to indicate whether an infection is viral or bacterial. (And the vast, vast majority of illnesses that cause you to cough up nasty greenies are viral.) There is a type of pneumonia that can cause rust-colored sputum, but we don't see this much, and in those cases the sputum alone is not the only clue as to what's going on. Yet doctors keep on asking patients about the hue of their snot, and every magazine article about respiratory infections says, "you don't need to see the doctor unless you have green phlegm."

  2. "It's just a virus." And its corollary, "you don't need antibiotics." NOT TRUE. Patients get frustrated when they go to the doctor feeling lousy and are told the above, and they should; they're really sick, and they shouldn't be told they're not. Viruses are bad; viruses can kill you, or at least make you wish you were dead. We don't give antibiotics for them because the antibiotics we have, with the exception of a couple of flu medicines, don't work on viruses, not because you don't "need" them. Believe me, if and when an anti-cold virus antibiotic is developed, we will be using it. (Of course, you won't have to take these hypothetical antibiotics, but then, you don't have to take antibiotics for bacterial infections, either. Yes, you can survive many bacterial infections without antibiotics.)

  3. High blood pressure gives you headaches. NOT TRUE. Studies such as this, this and this have repeatedly shown that this is not true, yet patients and doctors continue to believe it. The problem with this is twofold: patients may assume that if they don't have a headache, their blood pressure must be ok, and patients don't get their headaches adequately treated.

  4. Drinking lots of water is good for you. NOT TRUE. This one really gives me a headache. I think it started because of a misunderstood study long ago that the average amount of water a person uses for the business of existing for 24 hours is equal to about 8 eight-ounce glasses of water. The misunderstanding is that this is not EXTRA water; it's the water that already exists in all the foods and beverages a person takes in during the day. Thirst is actually a wonderful mechanism for telling you how much water you need. Extra water does not benefit you. It doesn't help constipation, it doesn't help your skin, it doesn't benefit your kidneys (unless you have kidney stones), it doesn't help you exercise. Perhaps it helps some people avoid eating and drinking a lot of fattening junk, but this is questionable. What it DOES do is make you pee constantly, and in severe instances can actually kill you. If you're truly dehydrated, you don't need water, you need water plus electrolytes. The water myth is reprinted in every issue of every health and beauty magazine published, so I have little hope of it dying.

  5. Coffee is bad for you. NOT TRUE. People have been trying to prove this for decades, and they haven't been able to do it convincingly. (Which means that there have probably been a lot of unpublished studies that showed no harm.) In fact, there's evidence that coffee may be good for you. Now, plenty of people don't tolerate caffeine well, but for those who do, drink up!
Any myths in your field that you'd like to put to death?

44 comments:

C. said...

Myth: Marketers are useless, BS people trying to make you buy shit you dont need. As a marketing exec, I keep people employed and the company provides a much needed service. Oh and marketing/advertising is by no means glamourous. Hard work and VERY long hours.

nancy said...

Myth: lawyers know about all laws. Just like doctors, lawyers have their specialties. You don’t go to a brain surgeon when you need a colonoscopy, and you don’t go to a securities lawyer when you need a divorce. Even if you are a friend, sibling, or distant relative we are not being jackasses when we say we can’t help you with your legal problem. The truth is that 9 times out of 10 it is not our area and we have no clue what the laws are that relate to your neighbor’s tree that is encroaching on your land.

Question: is the fact that I really do feel like I have less trouble with constipation when I drink more water all in my head?

B.E.C.K. said...

Um, some people put punctuation outside of the quotation marks, think the word "aluminium" is proper, and do silly things with spelling (theatre, colour, etc.). Oh, wait, that's the British. You know, those Brits really screw up the English language! ;^)

Seriously, certain (not all) spelling errors and mispronunciations wear on me. For instance, on a pet site that I visit occasionally, people often claim their dogs are "purebread." Does this mean they're made out of dough? (Don't get me started on "they're" v. "their.") As an editor, I see a lot of this stuff, and although it used to drive me nuts, now I love it...because it's the kind of thing that keeps me in business! :-)

Amie said...

I love this post! :D I haven't worked in six years, and when I did work it was in computers. Everything I was an expert in is now obsolete.

Anonymous said...

Well, there seem to be some funny assumptions students have, like I would care about the layout of their paper or not notice if the margins are 5 inches wide. Not up to taking on the myths right now! I suppose one myth is that someone who has a Ph.D. is really smart and someone who has a Ph.D. from an ivy league school is really, really smart. It's the professors themselves who believe this. Academics have a need to create very sharp hierarchies of ability and value when none exist.

I too love this post. I think I knew most of them. I knew drinking too much water will kill you and thank God that coffee isn't bad for you. Not that that would stop me. There seems to be some conflicting evidence on whether too much coffee causes miscarriages (or caffeine causes birth defects) but it was a moot point for me because I simply could not stop drinking it. How else can you pull an all nighter when you are pregnant?

The most absurd thing of all folk medical wisdom: If baby's poop is green, baby is allergic to whatever he/she is eating. This one is rampant on the internet! All these women on internet sites discussing the poop of their babies! It would be only funny except they then go on to deprive them of certain foods or put them on medications.

The pregnancy ones--those I'd love to see. I'd read one thing (e.g., stress hurts fetus) Dr. would tell me another thing (stress doesn't matter). I'd get confused.

When pregnant, you can't ignore all the internet information since the OB won't see you through most of your first trimester. Then, absurdly, in your 12th week or so, they give you this big sheet of things you weren't supposed to do weeks and weeks ago. So where do you turn during those weeks without a doctor? (God forbid to those sexist 'What To Expect Books') If you are me, you turn to folk wisdom and the internet. Don't eat blue cheese, etc.

Mignon said...

Thanks, ozma, for saying 10 or so things I was thinking (especially calling bullshit on "What to Expect").

Myth: Engineers are boring know-it-alls. Okay, this one is true, but really I think it's because there is a lot of undiagnosed autism in the hard-science fields.

DoctorM, I thought the myth about green snot was that it indicated the sickness was on its way out... is that closer to true?

A Peach said...

Are you serious about the water thing? It doesn't help my skin? It doesn't help me lose weight?

I *force* myself to drink at least 60 oz. of water per day... so if it really isn't helping anything...

Margaret said...

One myth in my field is:

"The President FINALLY signed the Appropriations Bill, so now we can spend money."

Just because he signed the bill, it DOES NOT mean we have money!!

Margaret said...

Oh, I forgot. I'm a Budget Analyst for Uncle LeRoy.

Anonymous said...

DoctorMama,

I just recently stubled across your blog and I'm really enjoying it. Closest thing I can think of to a myth in my field (I'm a mechanical engineer dealing with machine design, i.e. nuts and bolts, building stuff out of metal, and that sort of stuff): When I was planning my wedding I posted to a wedding message board. People kept saying, "don't let your husband" (it was always the husband) "get a titanium wedding ring. If he ever has to have it cut off on the emergency room, they won't be able to cut through it because the titanium is so strong!" Now, I don't know what cababilities emergency rooms have, but one can certainly cut tintanium with out too much in the way of specialty equipment. My husband (also an ME) made his tintanium wedding ring in our garage, and that certainly involved cutting metal.

By the way, I do have a medical question for you.

(Don't worry, I'm not going to ask you for medical advice.)

Your discussion of septum reminded me of something I was wondering about the other day. Is there a scientific/medical term for "boogers"?

Anonymous said...

MYTH -- All lawyers are scum-sucking and greedy, and don't want what's best for their clients. Depsite what Hollywood and personal injury lawyers would have you believe, the majority of lawyers out there are genuinely nice people who have a healthy respect for the law and do NOT enjoy the overly litigious nature of the American public. It drives me crazy when people make assumptions about this because NOT all lawyers want to sue just because they can, and not all lawyers prey on the innocent.

carolinagirl79 said...

Nancy, Right on, sistah. I'm a lawyer too. No I don't know any judge who can help you fix a ticket, nor do I know the grounds for divorce in Kansas, or if your aunt in Iowa's will is valid.

I also thought the water/constipation thing was valid in my own experience..but I ain't no doctor.

Anonymous said...

myth: artists are all flakes with no business sense. Yeah right - that's why none of us make any money from our work... wait a minute - some artists, lots of artists make livings from their work and how can that be?? There's my pet peeve assumption that people make about my field.

Shirky said...

dude, my field is not interesting enough to have myths but I dearly love hearing falsehoods (especially medical) BEAT DOWN. Especially when it makes my life easier...fuck drinking all that water, the bubbler is on the other side of the building!!

how about the weather causes colds and flu? My MIL still believes this...her daughters, doctors, can't disabuse her of it.

Anonymous said...

Coffee also lowers your risk of developing diabetes. Good stuff. However, my Mom drinks literally a pot a day and then takes Ambien to sleep... go figure! Everything in moderation, right?!

http://www.hsph.harvard.edu/press/releases/press01052004.html


Love your blog. It makes me laugh, and has so much I can relate to as a PA and a mom of a 10 month-old.

thumbscre.ws said...

Huh... knew most of these, but the water one's new to me. Wish I'd known it when I was pregnant and feeling guilty for being unable to down 64 oz. a day. I believe that was one of the "What to Expect" gems... HATE THAT BOOK!. My mom claims that when mucus starts to taste sweet, that means whatever bug you've got has migrated into your lungs. I've always found it kinda doubtful.

I second (third? fourth?) the lawyers' comments. I do tech stuff for a law firm, and the majority of lawyers are nice, decent people, especially considering the enormous stresses which are so prevelant in the profession.

I wish the tech support industry had a slightly better reputation in general (not a whole lotta myths, other than, "MY HAIRDRESSER FORWARDED ME THIS WARNING ABOUT A VIRUS WHICH WILL CAUSE MY PC TO DEVELOP BIRD FLU AND DIE DO YOU GUYS KNOW ABOUT IT????). I'm good at what I do, which is handle any and all technical problems hurled at me (from Palm Pilot to PC to "server on fire") and get harried lawyers up, running and charging $500 an hour again. And yet there's soooo much bad support out there that people often speak disparagingly of "the help desk".

Anonymous said...

One of the most pervasive myths about medical editors is...well, there are no myths. We are blissfully fact-based and hidden from public view. Can editors ever read a menu, brochure, or sign without noticing the flagrant abuses of the English language? No, we cannot.

Anonymous said...

So I'm curious to know whether you think antibiotics are prescribed too frequently. It seems like a lot of doctors I've been to assume that I have come to see them (with respiratory problems whose viral or bacterial nature is unclear) in hopes of getting antibiotics. And they give me the prescription so that I will go away and stop bothering them.

On to the myth question. I think there are a lot of language myths that need to be taken out back and shot. Two that spring to mind are that you shouldn't end a sentence with a preposition and that you shouldn't split an infinitive. I have seen infinitives torn so far asunder that by the time you get to the verb you forget that there was a "to" attached to it, and I do fix those. But there's no point in removing a tidy adverb sitting contentedly amidst the verb it's modifying. I can't even pretend to understand the preposition thing. I suspect that elementary school teachers with control issues had something to do with the problem (or nonproblem, as it were).

Oh yeah, and lots of educated folks think that you need to put a hyphen between a prefix and the root word, especially if they have a prefix-root pair that don't normally appear together. But if one were to try to write that way consistently, you'd end up with stuff like pre-fix and tele-vision, which would get annoying pretty quickly. Just close 'em all up unless the root word is a proper noun.

Feral Mom said...
This comment has been removed by a blog administrator.
Anonymous said...

Oh, man, b.e.c.k., are you male or female? Either way I want to marry you because YES, with the punctuation and such.

And Leslie, ha, yes indeedy.

And Bihari--I know can you believe I'm catching hell from Husband about thimerisol even now with Little Child? Nobody is autistic in this house except for maybe him.

and Molly my blog's tagline is not grammatically correct, and I put it up anyway. It's accurate. Heh.

DM--your place is the new place to GO for the discussions...pretty cool.

Feral Mom said...

Oops, I can't type. Let's try that agagin: I love this post, especially the bits about coffee and water. Whenever my mom comes to visit, every time I turn around there's a giant tumbler of water in my coaster. Well, and a tray of bacon and toast loaded with chunks of butter. Is butter by any chance good for you? What about alcohol?

Unfortunately, most of the myths about librarians are true--we DO prefer sensible shoes and often tie our tresses into buns behind our granny glasses. There's a contingent of librarians that try to be all lipstick-y, pierced and stylish, of course, but they are ruining it for the rest of us--librarianship should be the last bastion of the unfashionable. (Also, if we get too stylish, there's no need to undo our buns, take off our glasses, and unleash the sex kitten underneath--how else are librarians ever gonna get laid?) Here's a myth I can dispel: we don't know what you checked out last month or how often you've had overdue books--most library software erases that data every month for privacy and intellectual freedom purposes.

Anonymous said...

Here's one that I wish would die a horrible, painful death: all Ph.D. students in science are there because they couldn't get into medical school. I decided long before even taking the MCATs that med school was not for me. Never even came close to applying. Yet everyone always hears that I'm getting a Ph.D. in pharmacology and assumes it's because I didn't get into med school.

My husband is a lawyer with his own practice and the idea that all lawyers make lots of money makes me chortle out loud.

And I really laugh when people say that "He's a lawyer and you're going to have a Ph.D? You guys are going to be rolling in it!" I want to teach. Just teach. If we ever become wealthy, it will be because of the inheritance that we receive from some as-yet-unknown wealthy distant relative.

Anonymous said...

For reals with the water? MY GOD. Now the interns who sit next to the bathrooms think I have some bizarre urinary tract problem going on FOR NO REASON because I drink so much water that I'm in and out of there pretty much every five minutes. That's it! I am drinking less water from now on. And THAT is a New Year's Resolution I can stand behind.

Anonymous said...

Ok, here's a couple myths about photographers. 1. all we do is push a button and 2. we make a lot of money because we charge $15 for a photo that only costs 35 cents to print at the Wal-Mart. When I go out for a photo shoot, I bring between $8,000 and $15,000 worth of equipment, somehow it has to be paid for. For every hour I spend photographing your children, I spend two hours processing the proofs, hours that I'd like to be paid for, plus my assistant needs to be paid. And I don't send my photos to the Wal-Mart, although Wal-Mart does a good job for your snapshots, I send mine to my professional lab, which is one reason why my color is great and my images pop.

Also, scanning your professional prints is illegal and stealing from the photographer and if you want your kids teeth whitened, take them to the dentist. I can make them bright white in the photo, but then it doesn't look like your kid. (This is a big request in senior photos -- I don't mind taking out acne but the teeth are getting out of hand.)

Liz

DoctorMama said...

Some excellent myth-busting. I'm certainly getting some larnin'.

nancy & ccg: re constipation -- I always say, just about anything can be true for any one person, but when it's been studied, increasing fluid intake did zippo. And I won't go into detail here, but physiologically, it makes no sense.

beck: purebread? Really? Made out of dough -- too funny.

ozma: the pregnancy stuff really burns me up too ... especially the attitude that "well, just in case, you shouldn't [do / eat / take] anything!" Making everyone feel guilty or scared over things that have never been shown to do any harm. And What to Expect -- I flipped through that at the bookstore once, and it seemed like every problem they mentioned, their advice was, essentially, suck it up. You couldn't have pried my coffee away from me when I was pregnant. It was amusing how many people at work (not doctors) would gasp when they saw my thermos and say "You're not drinking COFFEE, are you?"

bihari & mfa mama: the funny thing is, the thimerosal has been taken out of pediatric vaccines, even though it never was shown to be a problem at all. But people are still freaking out about it.

shirky: the weather myth? Impossible to eradicate, and not worth it -- arguing with grannies about whether to wear a sweater is a losing, losing battle.

molly: yes, too frequently indeed. In fact, for an otherwise healthy person, antibiotics should never be prescribed for upper respiratory infections (including "bronchitis"), very rarely for sinusitis, and never for a sore throat, unless it's strep. A lot of doctors try to claim that they hand out antibiotics because "the patients want it," and that is NOT TRUE. Yes, there are patients who pressure for them, but I've been on the patient end of it like you -- I've had prescriptions SHOVED at me. Arggh.

feral: good news: alcohol -- good for you, in "moderation." Wink, wink. Actually we've discovered over the past 10 years or so that a ton of people we thought had cirrhosis from alcohol actually had hepatitis C, and the alcohol was just adding to the mix. (Also: you CAN have a beer when you're on medication for a positive PPD/latent tuberculosis.) Butter? well -- here's a myth-buster: margarine is not better for you than butter -- in fact it's worse for you, and equally fattening.
Your info about library records is very cheering!

Liz -- I hear you -- my stepdad did a lot of work as a wedding photographer, and those people drove him nuts. And this was before the white teeth fad.

DoctorMama said...

Oh, forgot:

mignon: yeah, usually once things turn green they're almost over. (And this is EXACTLY when people get prescribed antibiotics -- so it's no wonder that they think later, "hey, that z-medicine knocked it right out of me!")

thumb: that is one weird-ass theory on your mom's part!

And Kate: medical term for boogers?
Um, we call it "nasal discharge," actually. Yummy.

Dr Sarah said...

Oooh, here's another one from medicine - "You shouldn't let people sleep after a head injury". Which is why I ended up seeing a lot of overtired kids when I worked in A&E (sorry - that stands for 'Accident and Emergency', and you'd call it the ER, I believe). Parents would bring their children in after a bump on the head, wait for hours, and tell me triumphantly when they finally got seen that they hadn't let the child sleep because they knew that you Weren't Supposed To sleep after a head injury.

There is, in fact, nothing harmful about sleeping after a head injury. The danger is that if you've had a severe enough injury to cause bleeding inside the skull, you could be slipping into a coma while people around you assume that you're just asleep. However, there's no need to _keep_ someone awake to avoid that danger. It's fine to just wake them up (oooh, I'm so glad I got permission to use that split infinitive! Thanks, Molly!) at regular intervals to check that they're still rouseable. (Unless it's quite a nasty bump - several feet onto concrete, say - I wouldn't even bother with that. I didn't with my child when he recently fell off a chair onto his bed just before bedtime.)

Anonymous said...

Ohhhh...I'm in the midst of horrible catch-up grading. The myth I'd like busted is that your professor won't really notice if you just scribble something random and turn it in as a first draft because you're such a good writer...YOU ARE NOT THAT GOOD...

Also the immunization thing--my husband INSISTS that I ask about the thimerosal...last time the doctor said "before I go and look this up, what are we going to do if it turns out the shot does have that, or one of the antibiotics from the list he gave you...?" And I said "We will give him the shot anyway because I'm not relying on herd immunity to protect my kid from polio and I will tell Husband that you looked it up and the shot did not have any of that stuff in it." And he said "Okay, I looked it up and the shot does not have any of that stuff in it. Now you can truthfully tell Husband that I said so." And we both vibrated happily for a moment, reveling in the mutual understanding, and gave the baby the shots and got on with our days. It really burns me, people trying to peg autism, etc. on something unrelated except through coicidental/anecdotal correlation like immunizations...you might as well say that drinking apple juice causes hyperactivity, I mean hey every hyperactive child in America has probably been exposed to apple juice, right? All of the ones that are prone to repeat ear infections, too. We should do a study and find out exactly what goes into that apple juice, I mean jesus look what it's doing to America's youth...

Anonymous said...

I actually believed a couple of these. Thanks for debunking. Now, I'm off to Starbucks.

I work in marketing so there are really no myths or misconceptions to speak of. We're a pretty boring bunch.

Unknown said...

oh thank you! as a health coordinator for a preschool program, i'm so very happy to hear your "green snot" view. i could not even begin to count how many teachers call me to send a child home because they have green snot and no other symptoms of illness.

i was surprised to read about the hbp and headaches - hubby has hbp and when he doesn't take his meds and his bp is up, he does have headaches. well, that and he's a total ass, too. any research on that?

great post!

Anonymous said...

Many, many parents think there are strict rules about starting various solid foods for babies. I get asked about this almost every day. "When can I give him Stage 2 foods? Should his juice be 1/3 water or 1/2 water? White grape or apple juice? Noodles? Chicken? What if I give him fruit and he won't eat vegetables anymore?" Etc, etc. For the most part, feeding a baby is just common sense, but parents need a lot of instruction and reassurance.

I also hear various myths and potential solutions for getting baby to sleep through the night. Really, none of them work, and babies will just sleep "through the night" when they are ready.

E. said...

Myth about English teachers: that we are all on the lookout for people to make grammatical errors in casual conversation. (Hence, the hated comment "You're an English teacher? I better watch what I say! Heh, heh!")

Fact: I don't give a shit if you use "ain't" (which is a word, by the way, though it may not be one you want to use in academic writing, except maybe for a very a particular effect), and I won't jump on you if you split an infinitive or put a preposition at the end of a sentence (neither of which "rules" are actually valid anyway - it's best to choose the phrasing that is the most concise and elegant and not create sentences up with which Winston Churchill would not have put).

And if you correct my grammar in casual conversation, I may kick you in the shin.

Anonymous said...

Myth: Having a great lawyer automatically means you'll get a great settlement.

Not True. Sometimes the facts are just the facts and the greatest lawyering in the world isn't going to make you whole. Poo happens.

Anonymous said...

Please, please, please make this into a whole post (not just in the comments). I almost missed a bunch of great info!

DoctorMama said...

I'm trying to think of a way to put all of this together in a user-friendly format! Way too busy at the moment (with some good stuff and some less good stuff), but I hope soon.

carolinagirl79 said...

Yeah, Erin, couldn't agree with you more. Most of the cases I've seen, with the exception of some criminal cases, probably would have gone the way they went with the best lawyer in the world, or a mediocre one.

Shirky said...

my wife puts a little orajel on the crypt before either poking with a qtip or using a syringe from the dentist (from when she had her wisdoms out) to gouge/flush the stones away. She still feels it but the gag reflex is suppressed.

Orange said...

Afrindiemum and shirky, I'm not a doctor, but for the love of god, people who manufacture lots of tonsil cookies should just get their tonsils out! Sure, it was some of the most miserable pain ever during the week after my tonsillectomy (as an adult), but I lost about 8 pounds and bought some really cute pants. (Doctormama, there were only so many rounds of antibiotic treatment I was willing to take, and who wants a chronic low-grade infection in their body? Not I.)

Anonymous said...

Those electric scooters advertised on tv wreak havoc in my life. I'm an occupational therapist, which means I'm a wheelchair therapist, and people constantly see those ads and think those scooters or power wheelchairs are exactly what grandma needs. In reality those things often are bad for people because they are used by people who would benefit from propelling a wheelchair or walking. Recently I had a family member irritated with me for saying that because she doesn't want to push a wheelchair anymore. Also, those commercials make it appear it is easy to get funding for those things, and in reality it is not easy. Only people with certain conditions will be covered by insurance. I have actually had people scream at me for refusing to recommend one.

My mother laughs everytime I glare at the scooter section of Walmart, but this is a true pet peeve for me.

Linda said...

Myth: If you "just relax" you'll be pregnant in no time. Or, if you "just adopt" the same thing will happen.

Yah. I'd like to see that myth go.

Anonymous said...

Oh love the post AND the comments. So very glad about the water thing! YIPEE!! I've been saying that for years... to just go by your thirst level. Surely cavemen didn't carry around 64oz jugs of water?

Here's my myth buster that I deal with all the time at work.... Having an alarm system will not prevent a break in. You will not stop an experienced criminal. You will however get an insurance discount and a possibly a lovely step-by-step account of the break-in (depending on the quality of your system)

Melissa said...

Here are myths I'd like to bust about Canadians (and these are all based on actual questions asked of me when I lived in the US)

- we do not all like hockey
(in fact I hate it and I cannot ice skate either)
- I do not have an igloo (I have never even seen one)
- I have never eaten back bacon
- I do not drink beer
- and I do not live in the wilderness/forest/mountains
Toronto has 5+ million people and is the 4th largest city in North America.

I could go on....

Love the post and reading all the other comments!

Dawn said...

For the Early Childhood Professional:

"You need a degree to do this? Why? Can't you just Love children?"


Yeah, right after I do your gallbladder surgery, cause you don't need no stinkin degree for that either...

Anonymous said...

Medical myth 1: That Asthma is just "over-reacting", it isn't a real disease.

Medical myth 2: That neo-nates and babies don't need pain medication.

Medical myth 3: That you can talk about a sick or handicapped child like they aren't even there - they won't notice.

Medical myth 4: That Hearing Impaired people are all profoundly Deaf and don't hear anything.

Drives. Me. Bananas.