Why do we fart more on an airplane?

What changes happen to our body when we are traveling on a plane?

Traveling on a plane at 35,000 feet is the equivalent of being on an 8000 foot mountain.  At the same time, the humidity is on a plane is lower than being in the desert!

Here are some of the changes that occur to our body when we fly:

-The reduced air pressure decreases our oxygen level by 6-25%.  For healthy passengers this is not a problem, but can cause difficulty for those with lung or heart problems, as well as the elderly.

-Our vision can be affected by the reduced oxygen level, causing our eyes to feel strained.

-The sensitivity of our taste buds decreases by up to 30% due to the low air pressure and low humidity on the flight.

-Our sense of smell also decreases, which can cause food to taste bland.

-The change in air pressure can cause increased flatulence (farting).  When we fly, the gases in our digestive system expands by 30%, resulting in this problem. Planes often have charcoal filters to reduce the odors.

-Our skin dries out by 37% from its baseline, which leads to itchiness.

-Studies have shown that our immune system can be affected by the change in air pressure, making it more likely for us to become sick after flying.  In addition the re-circulated area spreads bacteria and viruses throughout the plane.



What percentage of people don’t wash their hands after they use the bathroom

After using the bathroom, 10% of people don’t wash their hands at all!

Studies have shown that 15% of men and 7% of women don’t wash their hands after using the toilet.

For those who do wash, 33% don’t use soap.

It’s even worse for school students age 8-17, as researchers found that 89% don’t wash their hands.

Because of the lack of hand washing, researchers have found that that the doorknobs of bathrooms harbor such bacteria as streptococcus, staphylococcus, E. coli, salmonella, and campylobacter

So what can you do to prevent infection in a public bathroom?  After washing your hands, use a paper towel to open the door when you exit.  If possible in an office setting or public building, the housekeeping staff should frequently wash the doorknobs to prevent the spread of infection.



Can you make the diagnosis?

Robert is supposed to go out with his friend for dinner, but he feels a bit under the weather, so he calls and says he has to cancel.  He feels like he is getting the flu.  He had a headache and feels feverish.

Robert decides just to take some Advil and get into bed.  His friend who he cancelled dinner with decides to swing by just to check on him.  It is hard for Robert to get out of bed, but he lets him in.  He tells his friend how badly he feels, and shows him a rash he is getting.


What should Robert’s friend tell him to do?

  1.  Take more Advil and go to bed
  2.  Make an appointment with his doctor
  3.  Take a Benadryl
  4.  Go to the Emergency Department



If you guessed 4.  Go to the Emergency Department, you are right!

Robert has meningococcal infection.  Meningococcal disease is caused by the bacterium Neisseria meningitidis.  This infection can lead to severe illness and death if untreated.

Symptoms include fever, headache, neck stiffness and a purple rash.

There are 2,600 cases of meningococccal infection a year in the United States.  It has been reduced with vaccination against the infection.

If caught early, meningococcal disease can be treated successfully with antibiotics.

Advil may help the fever and pain, but Robert has a severe bacterial infection.  It cannot wait for treatment, and he should not wait to see his doctor for a regular appointment.  Benadryl can help allergic rashes, but this rash is from bacteria.

Does tryptophan really make you sleepy on Thanksgiving?

We often hear that it is the tryptophan in turkey that makes us sleepy on Thanksgiving, however turkey actually has the same amount of tryptophan as chicken, and less than many other foods such as eggs, cheese, or even sunflower seeds!

Tryptophan is an amino acid that is present in proteins.  Tryptophan is considered an essential amino acid, as we have to have it to sustain life.

Tryptophan is found in many foods such as poultry,  chocolate, milk, yogurt, cheese, eggs, and nuts.

So why do we get sleepy on Thanksgiving?  Any big meal that contains tryptophan and lots of carbohydrates can make us sleepy, not just turkey.  Also, the combination of taking a break from hard work, as well as alcohol, are likely contributing factors.



How many calories does the average person eat on Thanksgiving?

The average American eats 4500 calories and 229 grams of fat on Thanksgiving day.

Here’s the breakdown on some of our favorites:

Bread stuffing, 1 cup – 350 calories

Turkey, 4 slices – 320 calories

Gravy, 1/2 cup – 100 calories

Mashed Potatoes, 1 cup – 237 calories

Green bean casserole, 1 cup – 350 calories

Cranberry Sauce,  1/4 cup – 110 calories

Biscuits, 2 – 340 calories

Sweet potatoes, 1 cup – 285 calories

Pumpkin pie, 1 slide – 320 calories


Can you make the diagnosis?

Jeremy checks into the Emergency Department for left shoulder pain.  He tells the triage nurse that his shoulder started hurting that morning.  He had been riding his bike to work and hit a pothole.  He thinks his stomach hit the handlebars before he hit the ground.

What should the triage nurse do?

  1.  Tell Jeremy that the E.R. is really busy, it will be a couple hour wait to be seen.
  2.  Triage Jeremy as a high priority, he may have a signficant intra-abdominal injury



If you guessed 2. Triage Jeremy as a high priority, you are right!

When a patient has a history of a trauma or injury to the abdomen, and then complains of left shoulder pain, it can be from  “referred pain”, due to the innervation of the abdominal organs.  The referred nerve pain causes the left shoulder to hurt even though the shoulder is not injured.

In this case, Jeremy has a ruptured spleen.  It is common from patients with a ruptured spleen from trauma to complain of left shoulder pain due to referred pain.  Most patients will also have abdominal pain when examined.

When a spleen ruptures, it is an emergency.  While some patients can be managed non-surgically, there are also cases that result in significant bleeding and must be treated with a surgery.

Ruptured spleen that has been removed at surgery:



How long will drugs show up on a urine test?

Many jobs require drug testing for future or current employees.  How long do common drugs stay in our system?  Here are some common drugs and the average duration that they can be found on testing:

Alcohol:  3-5 days in urine, 90 days in hair

Meth:  1-3 days in urine, 90 days in hair

Cocaine:  2-4 days in urine, up to a year on hair

Benzodiazepines (valium, Xanax, etc):  10 days in urine, 90 days on hair

Morphine:  2-3 days in urine, 90 days on hair

Heroin:  3-4 days in urine, 90 days on hair

Methadone: 3-4 days in urine, 90 days on hair

Marijuana:  7-30 days in urine, 90 days in hair