Monday, June 29, 2015

Medical Mondays: Water, The Poison We All Drink

Ever consider water as a means of sickening your characters in a novel? Yes? Well then, this post is for you. :)

Have you ever heard someone say, "Oxygen is poisonous. After all, 100% of humans who breathe it will eventually die."

Well, the same could be said about water. Except water can kill a heckuva a lot faster if the situation is just right (or wrong, rather). We're talking about water intoxication.

That's correct. Water can intoxicate you, and I do mean in a toxic way. It's also known as water poisoning, or the medical term, dilutional hyponatremia ("low salt in the blood").

There are several situations in which one can become seriously sick or even die from water intoxication.

  • Endurance athletes: Think of marathoners who collapse at the end of a race and need hospitalization. When you're sweating a lot of salt water, your body *thinks* it needs to retain fluid because you're sweating and exercising, AND you're drinking large quantities of pure water, it's a perfect set up for this condition. 
  • Heat Stress: It's a hot day. You're sweating buckets and drinking huge amounts of water to compensate, and then you get a headache...and confused...and pass out. Yep. 
  • MDMA use: Also known as "ecstasy", this street drug not only causes body temperatures to rise (hyperthermia), but users drink a lot of water because of it. On top of it, MDMA can cause the body to secrete a hormone called ADH (antidiuretic hormone) which slows down the ability to urinate out the excess fluid. 
  • Really Stupid Challenges and Games: I'm a huge non-fan of all those internet challenges and games. Like the Cinnamon Challenge, or the choking-somebody-until-you-pass-out challenge. Well, there's also a water drinking challenge, and guess what? People die. This unfortunate woman died after a radio contest was held to see if people could drink large amounts of water and not pee. This 12 year-old died playing water poker where she had to drink a glass of water if she lost a hand. 
  • Psychiatric Illness: All doctors learned about this in medical school. It's called psychogenic polydipsia, in which a sufferer feels compelled to drink water constantly. 
  • Accidental/Unintentional: Babies can become water intoxicated because it takes relatively little water compared to their body size to make them ill. Adults can drink too much water for the wrong reasons (for example, they get nervous before a medical test, or are trying to dilute their urine before a drug test, or are trying to suppress their appetite and drink too much water too quickly). 
  • Torture: Enough said. 
So what is the mechanism of water intoxication? Basically, a healthy pair of kidneys can clear about a liter of water per hour. If you overdue this and drink too much and too fast and retain more water than your body needs and can get rid of, your blood sodium will start to become dilute. 

When this happens, your body cells (which contain a healthy, well-regulated amount of sodium) start to take in water to try to even out the sodium concentration discrepancy between what's inside the cell, and what's outside. So cells start to swell. Like your brain cells. Which is really, really bad. 

Symptoms include headache, confusion, irritability, muscle cramping and twitching. When it's worse, nausea and vomiting, coma, seizures, brain damage, and death. 

How much can kill you? Drinking 3-4 liters of water too quickly could make you hyponatremic. The lady in the water drinking contest drank about six liters of water in a three hour period before she died (that's just over one and a half gallons of water). 

For all of you out there who are now pushing away that glass of water in abject fear and horror, don't! Remember--drink to satisfy your thirst, use common sense to stay hydrated, stay cool, don't do stupid internet challenges, and you won't end up on one of my Medical Mondays posts. :) 

Also, don't use Ecstasy. Bye now!

Monday, June 15, 2015

Medical Mondays: Hello Mummy! (Corpse Decomposition, Part 2)


Boy, it's been a while since I did a Medical Mondays. A few days ago, I received a question on Facebook that prompted me to revive the blog, Frankenstein-like, with a zap of inspiration.

For those of you who are new to my blog or Medical Mondays, here's the short of it. I'm a doctor of Internal Medicine with a background in biology and neuroendocrine research. When I started writing fiction back in 2009, I started blogging but didn't know what to blog about. After all, everyone had a writing journey story to tell. What did I have to add to the mix?

Well, it turned out that I was doing a too-good job of keeping my medical career and my creative side completely separate. I realized, hey, I have a way to give back to the writing community.

I can do medical consults. For free. 

So I told my writer friends I'd help answer their fictional medical questions to help them make their stories more accurate, or at least find the right diagnosis or situation to fit their plot needs. But sometimes, I'd just blog about interesting science or biological randomness just to spur imaginations. (in fact, it was one of my own posts that gave me the idea for the main character in CONTROL.) And voila, Medical Mondays was born.

Since then, I've been happy to help out lots of authors, some of whom were my blogging buddies way back when, like Theresa Milstein, Angela Felstead (this is her question!), Stina Lindenblatt.

I've also consulted with newer friends, including Elle Cosimano (Nearly Gone), C.J. Flood (Infinite Sky), Mindy McGinnis (A Madness So Discreet), Megan Miranda, Tara Sullivan (The Bitter Side of Sweet), Emma Pass, Sarah Fine, Justina Ireland, and more but I'm forgetting the whole list!

So what questions did I get? Take a glance at the tab up yonder and see what I've blogged about before. :)

So here's today's question: Are there body parts that would keep for centuries and not rot? 

*cracks knuckles*

*hopes that readers have a strong stomach*

So a few years ago I blogged about corpse decomposition and what happens under relatively normal circumstances, including which body parts decompose the fastest and slowest. Sometimes, under ridiculously good conditions, it can decay super fast (if you have a strong stomach, check out this video of a pig decomposing underwater. Yep, they videotaped the whole thing and it's so utterly gross and I couldn't look away while gagging quietly).

Today, we'll talk about why things might slow down and be preserved for longer than expected. Consider this part deux.

So. Why would a human body NOT decompose? 

1. Lack of moisture. Like in the poor pig demonstration above, moisture is decomposition's friend. It allows a good environment for bacteria to go to work dissolving a corpse. Without it, the body turns into (forgive me) a sort of human jerky. Bacteria have a lot of trouble breaking down desiccated flesh (which is why jerky is so good for camping, since it won't rot easily. I am sorry jerky lovers, but you are eating mummified food. Yep.)

The Egyptians used to augment the dryness of the environment when creating mummies by using natron--a drying salt found locally that was stuffed into and packed around corpses to dry them out.

Other famous mummies include the Saltmen, who accidentally died in salt mines in Iran and were found 2200 years later, complete with intact pork tapeworm infections.

2. Temperature. Most of us are lucky to have the brilliant technology of the refrigerator and freezer at our beck and call. Not only do they keep food fresh longer, they are also fantastic for mummification. (Lydia is not a serial killer. Please repeat this. The only thing I mummify in my fridge is long-forgotten Laughing Cow cheese.)

There are a lot of mummies found due to their being pretty much flash-frozen and sort of freeze-dried upon death. These include the famous mummies of the Inca and the 500 year old Greenland Qilakitsoz mummies.

3. Acidity. In the fight against decomposition, a low pH is good. We all know that acid is great at preserving. Hello pickles.

The Bog men are famous for their startingly well-preserved bodies. Tollund Man is one of the most famous. In the peat bog, the lack of oxygen, cold temperatures, and high acidity (despite the moist environment) could even preserve facial expressions.

4. Chemical Preservation. So this sort of includes the embalming practices of ancient Egypt and numerous other cultures, but it also includes the more modern methods of using preservatives like formaldehyde to embalm corpses. Sometimes brandy works great! (Vice Admiral Horatio Lord Nelson). In other circumstances, people have asked to have their body parts preserved and mounted, doll-like and thoughtfully arranged, for visitors (Jeremy Benthem).

More recently, the plastination of bodies has made its rounds on display around the world and as a means of academic anatomical study. (I can't help but mention that there was a questioning of the ethical issues surrounding these display exhibitions: see this NPR article.)

So there you go. If you need body parts in your novel to last a LONG time, use some of these methods above to pickle, freeze, or dry out your corpse in question.

Fun times, people. Fun times. This is what you get for hanging out with writers.

And sorry to make your stomachs churn!