What happens when a smoker stops smoking?

When a smoker stops smoking:

In 8 hours, their oxygen level is back to normal.

In 24 hours, their risk of having a heart attack has decreased.

In 2 weeks, lung function has improved 30 percent.

In 10 years, the risk of having a stroke decreases by 50%.

In 10 years, the risk of lung cancer has decreased to the same as non-smokers!


Normal Lungs:               Smoker’s Lungs:



Can you make the diagnosis?

Doug is sitting in a meeting, when he notices a twinge of back pain.  He notices the pain seems worse on the left side.  He tries to ignore it.

Soon however the pain is much worse, and is radiating from his back to his groin.  He becomes nauseated and sweaty, and excuses himself from the meeting.   Doug makes it back to his office and tries to work.  He keeps shifting around in his chair to find a comfortable position, but the pain keeps getting worse.  Soon he is not sure he can even drive himself home because the pain is so bad.

What is causing Doug’s pain?

  1.  Muscular back pain
  2. A kidney stone
  3. Appendicitis
  4. A urinary tract infection




If you picked 2.  A kidney stone, you are correct!

Twelve percent of men and seven percent of women will get a kidney stone in their lifetime. Your chance of having a kidney stone doubles if you have a family member who has had one.  The average kidney stone is about 5 mm (0.2 inches).  Most kidney stones will pass on their own, but some need to be removed.

Patients who have kidney stones usually describe it as severe 10/10 pain that starts on the back on either the right or left side, and often radiates to the groin.  The pain is often associated with vomiting.

Muscular back pain usually has a subtle onset, and is more general low back pain though it can radiate to the legs.  It is not usually associated with nausea or vomiting.  Appendicitis pain usually starts in the mid-abdomen and then moves to the right lower side, and is often associated with vomiting.  Patients with appendicitis often want to lie very still however, and not writhe around like patients with a kidney stone.  A urinary tract infection usually starts with flu-like symptoms, and has burning with urination and fever.  A urinary infection that spreads to the kidney can also cause back pain.

Kidney stone:

kidney stone

How much radiation are you getting?

We all know that radiation exposure may increase the risk of getting cancer.  How much  radiation are we getting when we get an x-ray or a CT scan?
In the United States, the amount of radiation the average person is exposed to has doubled, because of increased use of x-rays and CT scans.  Medical imaging studies have rapidly increased in recent years, and 68 million CT scans are now performed a year in this country (in 1980 only 3 million were performed).  Ten percent of the CT scans are performed on children.
CT scans account for half of the radiation dose that the public receives, and are thought to be the cause of .4% of current cancers in the United States.  For every 10,000 CT scans performed, one case of leukemia and one brain tumor would be expected to occur due to the radiation exposure.
Here is the dosage of radiation we receive from some common imaging tests:
Dental x-rays:  1.5 millirems
Chest x-ray:  10 millirems
Abdominal x-ray:  60 millirems
Mammogram:  72 millirems
CT scan head:  200 millirems
CT scan chest:  700 millirems

Does aloe really work?

Aloe is a cactus-like plant that grows in tropical climates around the world.  Aloe has been used in ancient medicine since the 16th century BC.  It was called the “Plant of Immortality” by ancient Egyptians.

What has Aloe been used for?

Toothpaste:  A study published in General Dentistry reported that Aloe is as effective as toothpaste in fighting cavities.  Aloe also contains compounds called anthraquinones, that can heal and reduce pain in the gums through an anti-inflammatory effect.

Laxative:  Aloe has a strong laxative effect.   Aloe is widely used in other countries for constipation.

Sunscreen:  Studies have shown that Aloe may protect the skin from UVB photodamage, and may even protect the skin in patients undergoing radiation treatment.  Aloe can help reduce the pain of sunburn.

Wounds:  Some studies have found that Aloe improves circulation and helps heal wounds.

Infections:  Aloe gel has properties that can help fight bacteria and fungi.

Keep in mind, that the studies on Aloe have been small and some studies have had contradictory results.  Also, some patients are allergic to Aloe, so a small test area should be performed prior to widespread use.



Can you make the diagnosis?

Shelly is very excited to be on her first cruise.  She has been enjoying the sun, food and drink on the ship as she heads to the Caribbean.

On the third day of her cruise, she feels a bit under the weather, and doesn’t want to eat breakfast.  Then her stomach becomes unsettled, and she feels nauseated.  Next she begins to have diarrhea, but the worst is still to come.  She begins vomiting repeatedly, and spends the night on the floor of her cabin bathroom.

What caused Shelly’s illness?

  1.  Appendicitis
  2. Gallstones
  3. Too much alcohol
  4. Norovirus


If you chose 4. Norovirus, you are right!

Norovirus is also called “the winter vomiting bug”, or “the stomach flu”.  We often hear about it sweeping through schools, nursing homes, and cruise ships.

Norovirus causes vomiting, diarrhea, and stomach pain.  Fever and headache can occur.

How do you get Norovirus?  It is transmitted by “fecal-oral” route, which basically means a person who has the infection touches food or other objects without adequate hand-washing after going to the bathroom.  Then another person consumes the food, or touches an object and then touches their mouth, contracting the virus.

Norovirus symptoms usually last 1-3 days.

While most people with Norovirus recover on their own, complications can occur such as severe dehydration.

Patients with Norovirus should try to take smalls sips of fluid, rest, and frequently wash their hands.

There are 685 million cases of Norovirus a year, and 200,000 deaths worldwide from the virus.  In 2018, there were 11 cruise ships that had Norovirus outbreaks.

The infection is named after Norwalk, Ohio, which had a very large outbreak in 1968.

Appendicitis usually starts with vomiting, and patients develop pain that moves to the right lower portion of the abdomen.  Gallstones cause pain in the right upper portion of the abdomen.  Both appendicitis and gallstones often cause vomiting, but diarrhea would be an uncommon symptom.  Alcohol can cause vomiting, but would be unusual to cause such significant diarrhea.


What is a ruptured disc?

We’ve all heard people say they have a ruptured disc in their spine, but what does that mean?

A disc is a rubbery cushion that is between the spinal vertebra:


The disc is like a jelly donut.  The outer portion of the disc is thick and tougher.  The inside portion is soft material like jelly.

When a person has a back injury, such as from lifting a heavy object or twisting the back while lifting, the outer portion of the disc can rupture, and the “jelly” can be forced out of the disc.  That is a ruptured disc.  Then the ruptured disc and “jelly” can irritate the nerves coming out of the spine.

Sometimes a rupture disc can heal by itself over time.  But if a ruptured disc is accompanied by severe pain, pain down an arm or leg,  is accompanied by weakness or numbness, then surgical intervention may be required.

MRI of ruptured disc pushing on spine:



Who invented cocaine?

John Pemberton was born in Knoxville, Georgia in 1831.  As a young man, he excelled in chemistry, and decided to go to medical school.  After graduation, he opened his medical practice, as well as his own drug store, in Columbus, Georgia.

During the war,  Dr. Pemberton served as a lieutenant colonel in the Confederate Army.  In 1865 during the Battle of Columbus, he sustained a saber wound to his chest that almost ended his life.

During Dr. Pemberton’s recovery he was given morphine for his pain, and soon became addicted.  He decided he would try to find a painkiller to cure his addiction, and began extracting cocaine from the coca plant.  Soon he had concocted a mixture of alcohol and cocaine that he took to Atlanta, Georgia to sell.

Dr. Pemberton named his new patented drink “Coca-Cola.”

Originally, the recipe called for five ounces of coca leaf per gallon, which was later reduced.  By 1904 both cocaine and and alcohol were removed from the formula.