Ask Our Doctors: Am I Doing The Right Thing?

Elective Amputation

Body Integrity Identity Disorder is a psychological condition in which an individual requests an elective amputation. People with this condition experience the persistent desire to have their body physically match the idealized image they have of themselves. A person with BIID typically wants one or more of his or her limbs cut off. “What’s wrong is any doctor who would do that,” Dr. Lisa says. “We are first, do no harm, so that’s just wrong.”


“I don’t think there’s any doctor out there who would just have a patient come in and will say ‘OK, we’re going to fix you up, we’re going to cut your leg off,” Dr. Ordon says.


Sometimes, however, doctors have no choice because people who suffer from BIID will self-mutilate themselves to the point that amputation is necessary. Dr. Travis says that one man with BIID put his legs in dry ice, causing frostbite. “It’s sort of self-destructive behavior,” Dr. Ordon says. “It’s related to Munchausen (syndrome), which we’ve all heard about. We don’t know exactly what’s going on, but a form of obsessive-compulsive behavior, maybe some depression.”



Flu Shots During Pregnancy

Flu shots are recommended for many people, but should pregnant women get them as well? Dr. Lisa advises pregnant women in their second and third trimesters to get them, especially during flu season. “A woman’s immune system, when she’s pregnant, it’s supporting two people,” Dr. Lisa says. “She’s going to get a lot sicker than just you and me.”


“What’s nice is if the mom gets the flu shot, she gets those antibodies against the flu, passes those to her baby, and then when the baby is born the baby will have those antibodies for about the first six months or so,” Dr. Jim says. “For when they can’t get the flu shot, it will protect the baby.”


Dr. Lisa warns pregnant women against using any flu vaccines made from live viruses, such as the nasal-spray vaccine.



Is Caffeine OK During Pregnancy?

Is that morning cup of coffee or an afternoon soda while pregnant putting your baby at risk? Caffeine is a stimulant and diuretic which increases your blood pressure, heart rate and frequency of urination, reducing body fluid levels, and can lead to dehydration. All of those are potential dangers to pregnant women and their babies. “What you put in your body goes directly to the baby,” Dr. Lisa says.


Caffeine crosses the placenta, and since the baby’s metabolism is still maturing, it cannot fully metabolize or handle the amounts of caffeine you may consume. “It is a stimulant, so it’s going to do what it would do in your body the same as it will do in the fetus’ body,” Dr. Lisa says. “The information out there is that you shouldn’t drink coffee because it may cause birth defects. There are no studies that show it causes birth defects in humans.


“There are also no studies that show that it affects the growth of the baby at all,” Dr. Lisa adds. “We do know that after a certain amount it can affect the baby, but we’re not sure in what ways. The recommendation, right now, is that you can have one cup or less than 100 mg. So one cup of coffee is fine, as long as it’s not one of those big, giant bowls.”



teething time

Is your child teething? Dr. Jim shares his recommended teething remedies for your little one.BLOG...

Does Whiskey Ease Teething Pain?

Avery from Burlington, North Carolina e-mails The Doctors because her baby is teething, and she wants to help her feel more comfortable. Avery has tried to rub the baby’s gums, and her mother even suggested rubbing whiskey inside her child’s mouth! “That’s one of those old wives’ tales,” Dr. Jim says. “Back in the old days, people used whiskey, alcohol, all sorts of stuff to numb lots of different pains, but don’t use it for teething!”


Dr. Jim explains that soft, rubber teething toys and biscuits, bagels, popsicles and frozen, wet washcloths are all safe, healthy options to give a teething baby. He advises against rubbing aspirin, vitamin C, and of course, alcohol, on the baby’s teeth. “A good ol’ dose of Tylenol or ibuprofen, those are good things to help with the pain,” he adds.


Too Clean

Keeping your house clean is important, but sometimes keeping it too clean puts you and your family at risk. Many common cleaners contain dangerous chemicals such as ammonia, formaldehyde and bleach. They can cause eye, skin and respiratory irritations, kidney and liver damage and even cancer and death. According to the U.S. Poison Control Centers, a child is accidentally poisoned every 30 seconds, and more than 50 percent of all poisonings occur at homes with children under 5 years of age.


“If you use bleach to clean something, yeah, you’ll rinse it off afterwards, but there’s a lot of residue, chlorine residue, that will stay on the floor, in the bathtub or even on your dishes,” Dr. Jim says. “If your baby goes crawling on the floor, they’re going to be getting exposed to that chlorine, and I’d be really careful with that.”


Ridding your home of all germs may even hurt your immune system. “Pediatric literature has studied this,” Dr. Ordon says. “You need a certain [number] of germs and natural things in the environment to stimulate your immune system. And if you don’t get it, you’re going to start getting sick.”


You can still keep your house clean without using harmful chemicals. A vinegar, water and rubbing alcohol mixture makes a useful window cleaner, while combining olive oil and lemon makes a substitute for furniture cleaner!


“A little bit of cleaning, being sanitary, is important,” Dr. Jim says. “But cleaning all day long, you don’t want to be doing that.”



Birth Control Pill Benefits, Risks

Debbie from Park City, Utah has used birth control pills for the past 10 years and asks The Doctors in an e-mail if being on the pill for so long has any side effects.


“So many women think that birth control pills are just bad,” Dr. Lisa says. “But they’re used for so many really helpful things, and they have a lot of health benefits. Birth control pills can decrease ovarian cancer by 40 to 80 percent. It can decrease benign breast disease.


“People do not know all the actual benefits of being on the birth control pill,” she adds.


While the pill does have many positive effects, it also comes with some risks, such as a slightly increased risk of blood clotting, liver disease and breast cancer. “The only one associated with prolonged usage is cervical cancer,” Dr. Lisa says. “These are things that women should think about when going on them, but there are so many health benefits, and they can stay on them and derive all those benefits.”



A Safer Smoking Alternative?

Smoking hookah -- a water pipe used for smoking fruit-infused tobacco -- is customary in the Middle East and is gaining popularity in the United States. “It tastes good,” Dr. Jim says after trying a hookah. “I don’t smoke, and I’ve had a few puffs of this and it doesn’t seem to irritate the lungs. It’s not making me cough. I would definitely think that this is better for me than cigarettes.”


“I have to say, as a second-hand receiver of the smoke, it doesn’t smell like regular smoke from a cigarette,” Dr. Travis says. “It smells fruity; it doesn’t make you want to cough. Usually if I’m around people at a coffee shop who are smoking, I want to go to the end of the room. But this actually smells quite nice.”


Many people think it is a safer alternative to smoking cigarettes because they believe the water filters out toxic chemicals, when, in fact, it does not. According to a World Heath Organization advisory, a typical one-hour session of hookah smoking exposes the user to 100 to 200 times the volume of smoke inhaled from a single cigarette. Even after passing through the water, tobacco smoke still contains high levels of toxic compounds, including carbon monoxide, heavy metals and carcinogens.


“You still have all the effects of the tobacco, and it can be potentially cancerous,” Dr. Travis says. “This is not one of those things you can harmlessly smoke after a long day.”

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OAD 2/03/09