The Body Odd

See ghosts? There may be a medical reason

fitlist — Thu, 29 Oct 2009 21:57:00 GMT

By Diane Mapes

Spooky footsteps, faint figures, the feeling of being watched – these unsettling signs of a ghost are as familiar to us as the goose bumps on the back of our arm (or neck).

But are there physiological explanations for those things that go bump in the night?

Absolutely, says Joe Nickell, a senior research fellow for the Committee for Skeptical Inquiry, an organization that promotes scientific inquiry and critical investigation of paranormal and other extraordinary claims.

“I’ve investigated haunted houses, inns, theatres, graveyards, lighthouses, castles, old jails, and even office buildings,” says Nickell, who’s researched stories of ghosts, vampires, werewolves, sea monsters, psychic phenomenon and other unusual phenomenon for 40 years. “And I’ve never found a paranormal explanation.”

Cbs Photo Archive / Getty Images file

Barney Fife (played by Don Knotts), Gomer Pyle (Jim Nabors) and Andy Taylor (Andy Griffith) investigate a haunted house in an episode of "The Andy Griffith Show."

Instead, Nickell says “ghosts” are often the result of pranks, environmental phenomenon, or physiological conditions such as sleep paralysis and the hypnogogic and hypnopompic hallucinations that accompany it.

Dr. Priyanka Yadav, a sleep specialist at the Somerset Medical Sleep for Life Center in Hillsborough, N.J., says sleep paralysis occurs when there’s a disconnect between mind and body while people are going in or coming out of REM sleep.

“It seems like you’re paralyzed, which naturally occurs when you’re sleeping,” says Yadav.

“But this somehow happens while you’re awake. It can last from a few seconds to a minute or two and is often associated with hypnagogic hallucinations, things you might see when trying to fall asleep or hypnopompic hallucinations, things you see when you’re trying to wake up.”

Yadav says these “waking dreams” can involve serpents, spiders, intruders, and yes, even ghosts and are often associated with feelings of dread.

“Some people have visions where they feel something is trying to strangle or choke them or they have a sense of impending doom,” she says. “They’ll often see someone coming into their room and they’re not able to move or talk or scream or do anything.”

Nickell says the phenomenon, which has been suffered by humans for centuries, also explains both the demonic visitations people reported during the Middle Ages as well as today’s reports of alien abductions.

“People [who report hauntings] will often tell you that they just went to bed or will say they woke up at 2 in the morning,” he says. “They’ll tell you they couldn’t move. That’s enough to diagnose it right there. It’s extremely common and very, very often the simplest and best explanation for a ghost.”

But it’s not the only explanation. Ghostly sightings can also be brought on as a result of a psychotic state, drug use, sleep deprivation or temporal lobe epilepsy. He says a “ghost” can also be an illusion produced by the brain, particularly when a person is tired.

“Someone will be doing some routine chore like polishing the furniture – they’ll be in a near-reverie or daydream state – and they’ll see something out of the corner of their eye,” he says. “They’ll turn and their mind will fill in the blank – they’ll see a Civil War soldier or a ‘gray lady’ -- and then it will promptly vanish.”

Nickell says studies have shown that people who are tired or are performing mindless tasks are more susceptible to these visions and, again, it’s a body thing, not a disembodied thing.

“It’s a trick of the eye,” he says. “Your eyelid will twitch or an insect will fly by and this will trigger a momentary welling up of a mental image. It’s like a camera’s double exposure for just a brief moment.”

Carbon monoxide poisoning – and the hallucinations that can occur with it – is another possible explanation, although Nickell says he’s never encountered this scenario.

Others have, however. In 1921, the American Journal of Ophthalmology published a case study involving a couple who moved into a house and promptly began to suffer headaches, listlessness and strange auditory and visual hallucinations (footsteps, mysterious figures, strange sensations, etc.). Their symptoms were finally traced to a faulty furnace.

A more recent case in 2005 involved a woman who was found delirious and hyperventilating after seeing a “ghost” while taking a shower; respondents discovered a new gas water heater had been improperly installed, flooding her house with carbon monoxide.

More spooky Body Odds
Real-life vampires? People who are allergic to the sun
Can you really be scared to death?
Can hair truly turn white overnight from fright?

Other environmental explanations for ghostly phenomenon include low-frequency sound waves (infrasound), said to cause feelings of nervousness and discomfort and vibrations in the eye which can produce illusions; fluctuations in the electromagnetic field, which can purportedly interact with the brain, causing dizziness, hallucinations, and other neurological symptoms (paranormal buffs often point to these fluctuations as proof of a ghost’s existence) and inconsistent lighting and temperature, which in certain circumstances can unconsciously “spook” human beings.

So can a person build their own “haunted” house by incorporating these elements?

In a May 2009 paper in the journal Cortex, psychologists from Goldsmiths College in London wrote about their attempt to do just that. They then asked 79 participants to spend 50 minutes inside their “haunted” chamber.

Contrary to Hollywood expectations, no one died or was driven hopelessly insane, although “many participants reported anomalous sensations of various kinds” which the researchers attributed not so much to the experimental conditions but to one other common explanation for ghostly experiences: “suggestibility.”

Real-life vampires? People who are allergic to the sun

fitlist — Wed, 28 Oct 2009 14:47:00 GMT

By Bill Briggs

Let’s start by driving a stake into the heart of some olds myths. People with sun allergies aren't really restless creatures of the night. They are not undead – although they may feel that way after, say, watching a marathon of the sun-drenched bikinifest “The Hills.”

While sunbeams don’t turn their skin sparkly like the vampire characters in "Twilight," one brief exposure to solar rays may send them screaming back to their dark places or, at least, to the doctor’s office.

Who are these people who dread the daylight? Chances are you know one.

American Academy of Dermatology

Bumpy rash caused by sun allergy

By some estimates, 45 million Americans – most of them northerners – are so hypersensitive to ultraviolet light that the first splash of spring sun causes itchy, red rashes or patches of small, red bumps to flare on uncovered areas of their chests, backs, upper arms, bellies or shoulders. They have a common condition called polymorphic light eruption (PLE), found in about 10 to 15 percent of people in North America.

There's another more rare condition linked to sun sensitivity called porphyria, sometimes known as "the vampire disease." Porphyria is an incurable, inherited disorder that affects the nervous system and skin. Symptoms include burning blisters and swelling of the skin when exposed to the sun, along with severe cramping, paralysis, and sometimes psychosis. Some historians blame porphyria for the madness of King George III. It's also often a favorite disease of TV shows, making an appearance in "House," "Scrubs" and, most recently, ABC's "Castle," where a character diagnosed with porphyria believes he's a vampire and sleeps in a coffin.

Vampires and TV plotlines aside, polymorphic light eruption is by far the most common type of sun allergy. Despite the "Twilight"-esque creepiness of its name, the disorder is generally harmless. PLE typically vanishes on its own in a few hours or a few days.

To soothe a PLE rash, a doctor may prescribe a topical cortisone cream or an oral steroid like prednisone. After an initial exposure to the warmer, intense beams of spring, PLE often goes dormant again for a year. Doctors says PLE does not seem to make one more susceptible to skin cancer.

“It’s more common in fair-skinned people, but it can happen in any race,” said Dr. Susan M. Rabizadeh, a dermatologist with the Cedars-Sinai Medical Group in Los Angeles. “There is probably some genetic susceptibility – it can run in families. It’s sort of like an allergy. We see a fair amount of it because it is so prevalent.”

PLE is more common in women, especially younger women – who just happen to be the main lovers of popular romantic vampire fantasies.

Has the confluence of pop-sensation and skin-popping sun rash evoked any “Twilight” chatter among Dr. Rabizadeh’s patients?

“You mean, that they might be vampires? No,” Rabizadeh said with a laugh. “No, it hasn’t come up.”

But there are some mysteries about PLE that researchers enjoy sinking their teeth into.

The disorder seems to appear more frequently in people from higher northern (or higher southern) latitudes and less often in those who reside in more tropical climates. In Australia, for example, only about 5 percent of residents show PLE symptoms. It’s likely that people who live near the equator become slowly desensitized to the allergy-like condition through daily exposure to harsher UV rays. For patients who develop only mild PLE breakouts each spring, Rabizadeh said she encourages them “to just get a little sun exposure – protected with sunscreen – every day so that they can build a tolerance to it.” Doctors call that process “hardening.”

For a small number, PLE causes blistery rashes that are much more severe, longer-lasting and spread over larger areas of the body. For those patients, the prescription usually involves low doses of a special band of ultraviolet light called UVB (which induces vitamin D production in the skin) and a plant extract called psoralen (which helps absorb UV rays).

“Both are done at the doctor’s office. They take the plant extract an hour before they get narrow-band UVB light treatment,” Rabizadeh said. “Those patients receive the treatments three times a week for however many weeks it takes to get their reactions to go away – anywhere from a month to three to four months.”

Although lengthy, the regimen of fake light and plant extract is typically needed only once a year – in the spring, just as the days begin to grow longer.

Can you really be scared to death?

fitlist — Tue, 27 Oct 2009 22:19:00 GMT

By Diane Mapes

Turns out Mom was right yet again. You can scare yourself to death, although not necessarily by watching Halloween horror movies.

Dr. Martin A. Samuels, who studies the sudden death phenomenon, says some people do have the potential to suddenly drop dead from fright.

“It’s a relatively uncommon thing, but it does happen,” says Samuels, chairman of the department of neurology at the Brigham and Women’s Hospital in Boston. “You can even find references to it in the Bible.”

Not to mention Edgar Allan Poe’s “The Pit and the Pendulum,” Sir Arthur Conan Doyle’s “The Hound of the Baskervilles” and even recent headlines (“Robber scared grandmother to death”).

How can a person literally drop dead from fear?

It has to do with our normal fight-or-flight response, says Samuels, which sends adrenaline to various parts of the body whenever there’s a life-threatening situation. The heart rate increases, the muscles get ready for action, digestion slows, and so on.

Unfortunately, these large doses of adrenaline can also do damage to our organs, particularly the heart.

“The release of the stress chemical adrenaline and related substances from the brain and the nervous system can cause damage to many organs,” he says. “It can cause the heart to stop or go into an abnormal rhythm and cause death.”

And it doesn’t just happen to people.

“It can happen to any animal with an advanced nervous system like ours,” says Samuels.

"Rabbits, squirrels, dogs, cats, rats, birds. Racehorses have a high rate of sudden death.”

It's relatively rare, he says, and only happens in a few people for every million. “If you think about it, our species wouldn’t have evolved to this level if it happened in large numbers.”

Known among his colleagues as the “death doctor,” Samuels has spent 30 years collecting stories of sudden death. Fear or acute stress led to an increase in sudden cardiac deaths in New York after 9/11, he says, as well as in the first Gulf War, among people who “huddled in their basement thinking missiles containing poison were landing on them.”

While people with a predisposition to heart disease might be slightly more susceptible, Samuels says he’s seen cases involving people with no heart disease whatsoever as well as cases involving kids.

“It could happen to anyone at any age,” he says “There’s no way to tell in advance who would be at risk. I’ve seen children who have died on amusement park rides, young people who have had a gun held to their head and dropped dead. It’s not necessarily people with heart disease.”

Nor is it always fear that causes people to succumb. Samuels says both men and women have been known to die suddenly from grief, shock, happiness, anger, excitement or passion.

“I have one case where a golfer hit a hole-in-one and suddenly died,” he says. “And a guy who rolled a 300 bowling game and was so elated he dropped dead. One man – who was resuscitated – got so excited about a fumble while watching a Pittsburgh Steelers game that he fell over dead.”

Sudden death among sports fans has even been studied.

In January 2008, the New England Journal of Medicine published a paper which examined the relation between emotional stress and the incidence of cardiovascular events during the 2006 World Cup in Germany. Researchers found that “viewing a stressful soccer match more than doubled the risk of an acute cardiovascular event” and concluded preventive measures were urgently needed “particularly in men with known coronary heart disease.”

Sudden death can also be caused by superstition, says Samuels, pointing to the work of Walter Cannon, the Harvard psychologist who first wrote about the fight-or-flight response.

“He collected cases involving people who had been cursed or had a hex put on them and then died,” he says. “He referred to this as ‘voodoo death.’ As long as you believe it, you can put yourself at risk for having something like this happen.”

Can hair really turn white from fright?

fitlist — Mon, 26 Oct 2009 16:48:00 GMT

The phenomenon of hair turning white from fright (or shock or grief or stress) persists in literature, poetry and even a handful of medical journals.

But is there any truth to the rumor that we can actually scare our hair?

Yes and no, says dermatologist Dr. David Orentreich, associate director of the Orentreich Medical Group in New York and assistant clinical professor in the department of dermatology at Mount Sinai School of Medicine.

“It’s appealing on a literary or poetic level that a person’s experience could be so severe or terrifying that they age overnight,” he says. “But you can’t lose pigment in your hair. Once it leaves your scalp, it’s non-living; it’s dead.”

But, Orentreich says, while fear can’t suddenly cause your hair to turn white, there is a medical condition that could make people think it has.

New Line Cinema

The hair of Nancy Thompson, played by Heather Langenkamp, suddenly starts to turn white after Freddie Kruger torments her in her dreams in 1984's "Nightmare on Elm Street."

Alopecia areata is an autoimmune condition that attacks hair follicles, causing pigmented hair such as black, brown, red, or blonde to fall out, leaving the gray and white nonpigmented hairs behind. (Eventually most people lose all their hair entirely.)

“If someone has salt-and-pepper hair – a mixture of gray and black – and they develop alopecia areata, the dark hairs can fall out quickly,” he says. “So it appears that they’ve gone gray overnight.”

Stress, as it turns out, may be a trigger for some autoimmune disorders.

“It’s conceivable for a person who has a tendency for alopecia areata to go through a stressful experience which makes it flair up and the first thing that happens is their dark hair falls out,” he says. “And that can happen quickly – in days or weeks – leaving just the gray hair.”

Although autoimmune diseases have been around forever, Orentreich says it’s only been in recent years that doctors have come to understand their impact.

“These phenomena would occur but they were completely mysterious,” he says. “No one had any inkling that the immune system could cause hair to fall out. There was only a primitive understanding – if any understanding – of the immune system.”

Fear, shock or grief, on the other hand, were something people could wrap their brains around, which probably explains why emotions play a huge part in most of the stories about hair turning white overnight.

According to a 2008 paper in the Journal of the Royal Society of Medicine, the first documented case of sudden hair whitening was in the Talmud in 83 A.D. The victim was a 17-year-old boy who was appointed chief of the main Israeli Talmudic academy. His sudden white hair was said to have been a “consequence of strenuous studying.”

In later years, the phenomenon was attributed to Marie Antoinette, whose auburn locks supposedly turned ghostly white the night before she lost her head to the guillotine and to Shah Jahan of India after his favorite wife died (he went on to build the Taj Mahal in her honor). Even sharpshooter Annie Oakley reportedly fell victim at age 41 after she was involved in a horrific train accident (an alternate story claims her white hair was the result of an overly hot bath).

In the '80s "Nightmare on Elm Street" horror movie franchise, a shock of the heroine's hair turns white after she is terrorized in her dreams.

There have been reports of sudden blanching as a result of bear attacks, ill-advised bets, shipwrecks, adultery and the death – or serious injury – of a loved one. A 1902 British Medical Journal even described the case of a 22-year-old woman who witnessed a woman’s throat being cut and got up the next morning to find half her pubic hair had turned white.

According to Orentreich, though, even white pubic hairs could be explained by the autoimmune disease.

“When it attacks hair, sometimes the hair will keep growing with no pigment,” he says.
Alopecia areata may not be the only explanation for this hair-razing condition, though. Researchers who have studied historical references to the phenomenon also believe a “sudden” change in hair color could also be traced to hair dye simply washing out.

“If you get your hair colored today and then stop getting it colored, it takes a number of weeks or months for the gray to grow out,” says Orentreich. “But years ago, the dyes weren’t permanent. It could be something like that.”

Congratulations! That stomach cramp is a full-term baby

fitlist — Wed, 30 Sep 2009 22:52:00 GMT

By Diane Mapes, contributing writer

We all get busy at times, so overwhelmed with work, family, friends and obligations that we neglect our bodies. But how is it possible to be so out of touch with your body that you don’t know you’re about to give birth?

Easy, say the people involved with “I Didn’t Know I Was Pregnant,” a 10-episode reality TV show that tells the story of 10 women who conceive and carry babies full term without realizing they’re pregnant.

“I think at first glance you think, how could a woman not know,” says Wendy Douglas, director of production for the TLC network. “Clearly she’s not paying attention or not smart or something. But that’s really not the case.”

Timothy Bullard / The Daily Courier

Bonita Ewen with 1-week-old Chance, who arrived seemingly out of the blue.

A host of circumstances can contribute to a stealth pregnancy, say doctors, starting with the fact that not all women experience the familiar nausea, weight gain, swollen ankles, food aversions and emotional ups and downs we’ve come to associate with pregnancy.

Pregnancy symptoms can really vary,” says Dr. Michelle Evans, a reproductive endocrinologist from Pasadena, Calif., who’s featured on the show. “Some women have very minimal or no symptoms. Other women will be throwing up every day.”

Expectations can also come into play, say the experts. Some women will take a pregnancy test and receive a false negative. Or be told by their doctor they’re unable to conceive. Moms who’ve just delivered a baby often (mistakenly) believe it’s too soon to be pregnant; other women will be using birth control but for whatever reason – an expired condom, a missed pill, a course of antibiotics – the system will fail. Thinking there’s no way they could possibly be pregnant, these women will attribute their symptoms to something else – morning sickness becomes a bad bout with food poisoning, swollen ankles are due to all the time they spend on their feet. They’ll blame their weight gain on outside circumstances – stress from the job, the fact they recently quit smoking – or they simply won’t gain that much weight in the first place.

“Some women only gain 5 to 10 pounds in their pregnancy,” says Evans. “One woman on the show was taking all of these extra Pilates classes and working very hard at exercising because she was gaining weight and didn’t know why.”

Other women’s weight will go up and down so much on a normal basis that the extra pounds don’t seem all that strange.

But wouldn’t these moms feel their babies kick?

“Everyone should have some fetal movement during the latter half of their pregnancies but there’s absolutely a range,” says Dr. Karen Wells, an ob/gyn at the Center for Women’s Health at Evergreen Hospital in Kirkland, Wash. “If a woman is heavy she doesn’t feel things quite as much and if the placenta is in the front, right under the belly, and the baby is below that, that’s going to insulate it, too.”

But if a woman doesn’t believe she’s pregnant, the movement of a baby will often be attributed to something else, says Evans.

“They may think they have indigestion or that there’s something else going on that causes them to feel movement,” she says.

Even old standbys like a woman’s period – or lack thereof – can often prove to be unreliable indicators, say the experts.

“One of the things I saw in many of these cases was that the women had very irregular menstrual cycles,” says Evans, who studied the case histories of the women featured in the show. “Many were so irregular that their doctors told them ‘When you want to get pregnant, we’re going to have to help you because you’re not ovulating.’ So when they had symptoms during pregnancy, they attributed it to some other condition.”

Spotting – which often occurs during a woman’s pregnancy – was another factor that led to confusion. Women with irregular periods assumed an episode of spotting was simply their haphazard period showing up.

Psychological factors like fear and denial can also play a role in a “surprise” pregnancy.

“Our minds are our most powerful organs and there are people who really don’t want to be pregnant and convince themselves that they’re not,” says Wells. “This happened twice during my residency. One time, a woman was in labor and was sure she wasn’t pregnant even when the baby was crowning. Some people are in complete and total denial.”

Although doctors say going full-term without knowing you’re about to give birth is rare, TLC’s Douglas says she’s been inundated with stories of surprise pregnancies.

“Each time a show airs, we get a flood of letters from people saying ‘This happened to me!’ or “I know someone this happened to,’” she says. “I think right now we have well over 150 stories that we could tell.”

Indeed, the news is full of stories of stealth pregnancies. Last December, a British mother of two gave birth to a 5 pound, 8 ounce baby boy, who she claimed never kicked during the entire pregnancy. And in March of last year, 38-year-old Bonita Ewen of Oregon thought she was having stomach cramps, but instead gave birth to a 6 pound, 3 ounce baby boy out of the blue, telling reporters she had gained 10 pounds but experienced none of the “signs and symptoms of a pregnancy … no nausea, no cravings, none of that stuff.”

As in life, the unexpectant mothers featured in the show – which premiered September 30 –are from all walks of life. Some are in their late teens and early 20s, others are in their 40s (one woman was about to undergo a hysterectomy when doctors discovered she was on the verge of giving birth). Some have had children previously; others are new to the parenting game. One woman – who experienced no pregnancy symptoms whatsoever – tells the story of her two surprise deliveries, one at age 18 and another, three years later.

“Stealth moms” are found through e-0mails and letters sent to the show’s producers following each episode and via the show’s Web site.

Albeit unexpected, the babies are all healthy although considering the lack of prenatal care – and in some cases, the use of birth control pills or other medications – there are potential health concerns. The mothers, while unprepared, are extremely excited about their surprise packages.

Since none of them knew they had a baby on the way, stories are told in flashback form, via interviews with the women and her friends and family (many of whom vouch for the mother’s incognizance or lack of symptoms) and a series of dramatic reenactments.

And it can be dramatic, says Evans, who’s seen a surprise birth in action.

“When I was a resident, I once saw a patient like this in the ER,” she says. “A woman came in and and the family thought she had appendicitis or something horrible. They thought she needed surgery. I evaluated her and did a pelvic and I could feel a head. I said, ‘Oh my gosh, we need to get her to labor and delivery right away’ and everyone’s jaw just dropped.”

New clue in gender-bending mystery

fitlist — Fri, 11 Sep 2009 17:48:00 GMT

By Brian Alexander, contributing writer

After South African runner Caster Semenya came out of nowhere to zip past a track of world-class athletes in the women’s world 800-meter race in Berlin last month, spectators starting speculating that the muscle-bound 18-year-old was no lady. Her low voice and broad shoulders raised eyebrows and suspicions.

Now, newspaper reports from Australia say testing has determined that the running star has both male and female sexual organs – in other words, that she’s a hermaphrodite, and likely didn’t even realize it.

The International Association of Athletics Federations, which ordered the testing, refused to confirm or deny the reports and said it won’t issue a final decision until the next meeting in November.

In the meantime, there is worry about how the 18-year-old from a poor village in South Africa will handle the scrutiny, and widespread curiosity about what “hermaphrodite” means, exactly.

The popular notion of hermaphrodite comes from the Greek myth of Hermaphroditus, the offspring of Aphrodite and Hermes. Hermaphroditus, the Zac Efron of his day, was so pretty that a nymph named Salmacis fell madly (literally) in love. In her desperation, she jumped into a pool of water, grabbing Hermaphroditus on the way in and pleading with the gods to unite them forever. The gods did exactly that, which is why statues of Hermaphroditus depict a figure with a woman’s breasts and a man’s penis.

But such pure she-males are more myth, or the result of partial transsexual surgery, than reality.

That’s why, these days, the proper word is “intersex,” a recognition that there are a range of conditions between rigidly “male” and “female” and that gender is as much a product of society and self-perception as it is a matter of what gear you have or chromosomes you possess.

An intersexed condition can arise in a variety of ways, from a number of syndromes, but so called “true” hermaphrodites are often chimeric. In other words, instead of having cells with 46 chromosomes that include either an XX pair in women or an XY pair in men, they possess both 46XX and 46XY cells. Some may have one testicle and one ovary, or what are called ovo-testes, combo gonads comprised of both ovarian and testicular tissues. True hermaphrodism is thought to be rare, but according to the World Health Organization, no prevalence data is available.

In Semenya’s case, the Australian report says she has no ovaries and instead has internal testes, which produce large amounts of testosterone, explaining her muscular physique. It’s likely she and her family may have been unaware of the condition because the male organs are on the inside. In many cases of the intersexed condition, the external genitalia appear to be female.

In the past, it was common for doctors delivering babies with ambiguous genitalia to simply assign a gender and order up a surgery to make the child match that gender. But as intersex conditions have come out of the shadows, there is much more discussion about appropriate options. These can include hormone replacements, counseling, surgery, or doing nothing at all, a path favored by many intersex advocates.

Intersex athletes have been an issue before. Stella Walsh, the 100- meter champion in the 1932 Summer Olympics in Los Angeles, turned out to be intersexed, a discovery made after she was murdered in 1980 in a Cleveland parking lot during a robbery.

The 1966 world women’s downhill ski champion, Erika Schinegger of Austria, was discovered to have a version of a penis and testicles inside her abdomen. She later became a he, changing his name to Eric and becoming a father. Other famous “hermaphrodites” may include the Pardoner in Chaucer’s Canterbury Tales, and Queen Christina of Sweden in the 1600s.

Are some women superbreeders?

fitlist — Thu, 10 Sep 2009 00:26:00 GMT

By Diane Mapes, contributing writer

When Arkansas mom and reality TV star Michelle Duggar announced on the Today show Sept. 1 that she was pregnant with her 19th child, millions of Americans expressed joy and amazement.

But others – undoubtedly the queasiest of the bunch – were a bit uneasy. How could one woman – or rather, one uterus – bear so many children? Isn’t that, well, stretching things a bit?

Not necessarily, experts say.

“The uterus is a remarkably flexible organ,” says Dr. Florence P. Haseltine, ob/gyn and founder of the Society for Women’s Health Research in Alexandria, Va. “It can grow rather rapidly and it can recede rather rapidly. It’s able to reconstruct itself and reconfigure itself quickly.”

Beth Hall / AP

Michelle Duggar is surrounded by her children and husband Jim Bob, third from right, while she holds her newborn daughter, Jennifer Danielle, the couple's 17th child, on Aug. 2, 2007, in Rogers, Ark.

Haseltine says she understands how people would be amazed that one uterus could carry and deliver so many children – especially in a day and age when the average number of births per female is 2.12 – but it’s a misconception to think that giving birth to 18 or 19 children is overtaxing the organ’s ability.

“The sense is ‘My goodness, I get physically tired just thinking about it, so therefore the uterus would be tired,’ but that’s not necessarily true,” she says. “I don’t believe a uterus gets tired. If it had damage as a result of a specific pregnancy, it might cause trouble. But it doesn’t make any physiological sense why one should worry about the uterus.”

Thanks to the wonders of reality TV – the family has their own show entitled “18 Kids & Counting!” on TLC – keeping track of Michelle Duggars’ uterus has become sort of a national pastime. According to the family Web site, the couple married in 1984 and had their first child four years later. Since then, Michelle Duggar has given birth to an additional 17 children, including two sets of twins. Three of the births have been via Caesarean section; the others have been vaginal. She and her husband, Jim Bob, are currently expecting their 19th child (as well as their first grandchild).

While experts say good health plays a major role in any woman’s ability to conceive, carry and deliver children, particularly multiple children, good genes are crucial, too.

“Everyone is different in their health, and with some women it takes more of a toll,” says Dr. Karen V. Wells, an ob/gyn at the Center for Women’s Health at Evergreen Hospital in Kirkland, Wash. “And women have different muscle tone in their uterus. Some people get saggier and baggier earlier on and some people have good tone to their tissue. It has to do with our individual makeup, our collagen, our elastic fibers, our genetics. I know someone who after just two children had to have her bladder resupported. Other people seem to do fine. Obviously Mrs. Duggar is a very healthy woman and her body is handling it well.”

Not that there aren’t concerns and complications when it comes to multiple pregnancies or “grand multips,” as they’re known. After delivering five or six children, women are more prone to post-partum bleeding or hemorrhaging. The risk for toxemia and preeclampsia also increases. Anemia can also be a concern.

“There’s a continuous leeching of calcium and iron, the supplemental building blocks that babies need,” says Dr. Peter Wall of Eastside Maternal Fetal Medicine in Kirkland, Wash. “After having many children, chronic anemia or osteopenia – weak bones – could be a chronic risk. Also carrying children does increase the risk of incontinence, but even women who haven’t had children have incontinence.”

And having lots of kids has health benefits, too, Wall is quick to point out.

“We know that having many kids protects from breast cancer and ovarian cancer,” he says.

Labor, also, becomes shorter the more deliveries a woman has, although it doesn’t necessarily become easier.

“The duration of labor is shortened, but that doesn’t automatically translate into easier,” he says. “You’ve been down that road before. The ability to cope with labor is probably better when you’re naïve and 18.”

According to the National Center for Health Statistics, the average number of births per female has gone up and down over the years, from 3.33 in 1917 to 2.17 in 1937 to 3.68 in 1957 to 1.77 in 1975. National averages aside, though, there have always been “supermoms,” from Queen Victoria and Rose Kennedy who both had nine children to Mrs. Feodor Vassilyev, a Russian peasant who made the Guinness Book of World Records by giving birth to a total of 69 children, including 16 pairs of twins, seven sets of triplets and four sets of quadruplets.

Today, the average woman has about 2.12 children, although if desired, any woman could try for supermom status. The trick is to avoid contraception, be exceptionally fertile and be up for the challenge, says Wells.

“Having that many children isn’t an oddity,” she says. “I look back at my own family history and my great-grandmother had 10 children and five survived. The fact is most people don’t want that many children today.”

Those who do want lots of babies are encouraged to space their pregnancies out by at least 18 months, says Wall. And to keep in mind that some women are simply more adept at baby-making than others.

“This woman has some remarkable capabilities,” he says. “I think this is her special talent.”

Skinny thighs could spell your doom

fitlist — Thu, 03 Sep 2009 23:05:00 GMT

By JoNel Aleccia

At last, good news for anyone who ever despaired of fitting into skinny jeans: Thin thighs might actually kill you. Or at least put a strain on your heart.

That’s the word from Danish researchers who studied more than 2,800 middle-aged people for up to a dozen years, only to find that those with the slimmest thighs had the highest chance of heart disease and premature death.

“There was up to a double risk for the people with the smallest thighs,” said Dr. Berit L. Heitmann, a director of research at Copenhagen University Hospital in Denmark. “It’s quite substantial.”

People whose thighs measured less than 60 centimeters, or about 23.6 inches in circumference, were in trouble. And those with stick-thin gams (less than 18 inches around) were at the greatest risk, according to new study in the online version of the British Medical Journal.

Stefan Gosatti / Getty Images file

By that measure, supermodels everywhere would be in grave danger, while those who one fitness expert described as “normal-sized people,” would be in the pink.

“Typically a 23.6-inch thigh on a female would be a size 6 to 8,” said Greg Benson, president of the International Sports and Fitness Trainers Association.

A woman with thighs that size might be 5-foot-1 and weigh about 135 pounds, a few inches shorter and a bit heavier than the reported measurements for singer Beyonce Knowles, who is known for her curves. A man with thighs like that might be 5-foot-7 and weigh 160, about the reported size of actor Tom Cruise.

Although the reasons for the increased risk of small thighs isn’t clear, it’s likely that those with smaller limbs lacked the muscle mass and lower body bulk necessary to ensure proper glucose and lipid metabolism, key factors for more serious disease, Heitmann said.

“It would seem that having too little muscle or fat in that region would be a problem,” she added.

Typically, of course, it’s the other end of the tape measure that signals trouble: People with too much junk in the trunk – and everywhere else – are usually obese and at risk for host of fat-related ailments.

But Heitmann’s study, which was started in 1987 and followed patients through 2002, found that people with thinner thighs had a 50 percent to 100 percent higher chance of developing heart disease within a decade or dying by year 12 than their chunkier companions.

The results were similar for both sexes, and, surprisingly, the thigh measurement stayed the same, too, noted Heitmann.

She was quick to add, however, that the study should not be interpreted as a free pass for people who want to skip the gym.

In this case, much bigger was not better. The protective benefits of heftier thighs didn't rise when thighs grew larger than 60 centimeters.

“There’s no further advantage there,” Heitmann said.

Cure for curious claw-hand condition?

fitlist — Wed, 02 Sep 2009 18:00:00 GMT

By JoNel Aleccia

A disabling disease that can turn human hands into virtual claws may be eased or even cured by a new injectable drug, a study suggests.

The drug, called Xiaflex, could be an alternative to surgery for Dupuytren’s contracture, a benign but often crippling disorder in which collagen cords form in the hand, curling the fingers immovably into the palm, according to a report in today's New England Journal of Medicine. A Food and Drug Administration advisory committee has unanimously recommended approval of the drug for treatment of the condition. The FDA usually follows the advice of its advisory panels.

Dupuytren’s is named for Baron Guillaume Dupuytren, the 19th-century French surgeon who described the disease now believed to affect some 13.5 million to 27 million people in the United States and Europe.

New England Journal of Medicine

This patient's hand was involuntarily clenched like hook (left), until injections with an experimental drug.

Ronald Reagan had the condition. Britain’s Margaret Thatcher has it, too. And J.M. Barrie, author of “Peter Pan,” may have used his own experience with Dupuytren’s as a model for the character of Captain Hook.

“It’s claw-like, if you will,” said Rod Van Sickle, 63, a retired Trabuco Canyon, Calif., firefighter who had to take a desk job after Dupuytren’s ravaged his hands. He had three surgeries on his right hand to correct the recurring condition before it shifted to his left. (A common pattern for the mysterious condition.)

Then Van Sickle joined a trial of 308 patients to receive injections of collagenase clostridium histolyticum, an enzyme that dissolves the thick cords that researchers say are stronger than steel.

“If I could show you my hands right now, my left hand is perfectly straight after three injections in three months’ time,” Van Sickle said.

Results of the trial, funded by Auxilium Pharmaceuticals of Malvern, Penn., the drug’s maker, report that the injections allowed nearly full or full extension in 64 percent of injected joints, compared to about 7 percent of joints injected with placebo.

Twenty-four hours after the injections, doctors manipulated the softened cords, which broke free with “an audible and palpable snap and a little burst of pain,” according to Dr. Roy A. Meals, the study’s chief investigator and a clinical professor of orthopedic surgery at the University of California, Los Angeles.

And that really hurts. Nearly 97 of patients in the trial reported pain, swelling, bruising or other problems.

The puzzling disease seems to be inherited and is related to hand trauma, smoking, alcohol and diabetes.

As it stands now, Meals said, only the people with the most severe cases, fingers bent to 30 degrees or more, are treated, and then usually with surgery, as was the case with Reagan and Thatcher. The others? “We advise those people to live with it,” Meals said.

Critics of the drug, which could cost as much as $1,500 per injection, say it will be as expensive as surgery and not necessarily covered by insurance.

In other pending trials, the drug is being tested for use to treat collagen build-up in other diseases, ranging from so-called “Frozen shoulder syndrome,” in which scar tissue limits shoulder motion, to Peyronie’s disease, in which plaques form along the penis, causing it to curve sharply to one side.

Ah-ah- achoo! Does that sneeze mean swine flu?

fitlist — Wed, 19 Aug 2009 18:35:00 GMT

By Diane Mapes

We do it when we’re sick, when we’re cleaning out our closets and, according to a recent YouTube chat with astronaut David Wolf, we do it in space. Even pandas do it.

Yet few really understand what’s happening when our noses explode in a sneeze. As we head into cold season and the dreaded return of swine flu, even the most innocent sneeze (Do you have a cat?!) can spread paranoia. Let go with a noisy honk and watch the uncomfortable reaction, or downright hostile stares, of nearby strangers. But are those powerful sneezes — called sternutations — proof that we’re carrying some kind of virus? Why do we sneeze anyway?

According to Dr. Anne Maitland, assistant professor of clinical immunology at Mount Sinai School of Medicine in New York City, sneezing is an involuntary response to anything the body identifies as a nasal irritant, including dust, hair spray, cigarette smoke, perfume, cleaning chemicals, pollen and/or viral inflammation.

“There are nerve fibers as well as hairs in your nasal passages that send a signal when they’re irritated,” she says. “They’ll signal: ‘We’re seeing something we don’t like. Mobilize forces quickly.’”

The body then goes into reflex mode, taking in air (“Aaaah, aaaah, aaaah”), closing your eyes and shutting the glottis, the membrane that covers the tube that leads to your stomach. Once all that’s done, air will rush up from your lungs and go through your mouth and nose at what Maitland calls “tremendous speed.”

“It’s a really forceful ejection, like taking a power washer to blow out your nose,” she says. “It’s trying to expel anything that’s not supposed to be there.”

Unfortunately, sneezes can sometimes expel that thing onto others.

“If you’ve seen somebody cough, the propellants from that will travel far,” says Maitland. “But sneeze propellants will go further. They’ve been clocked anywhere from 80 to 800 miles per hour. They travel almost 75 percent the speed of sound.”

Talk about a clear-out.

While getting sprayed with a sneeze is no picnic, it’s not cause for concern if the person is simply suffering from allergies — which aren’t contagious — or sneezing in response to dust, pepper or other nasal irritants.

If the person has cold or flu symptoms, however, such as fever or muscle aches, then those in the line of fire could be in danger of picking up more than just a gentle misting. When do you know it’s a cold and not allergies?

“It’s always the presence of other symptoms,” says Maitland. So if the person is also shivering or seems to have a fever or complains of being achy, run away. “Also, with allergies, you can predict it. It happens at a certain time of year or whenever you go visit Aunt Tillie and her five cats,” says Maitland.

Rhinoviruses are fairly hearty and can last for hours on surfaces, Maitland warns, so it’s important to wash your hands, especially during cold and flu season.

However, not all sneezes are caused by common culprits like allergies, irritants and cold or flu viruses.

Sneezing can also be triggered by environmental factors such as cold and dry air, by hormones, by certain kinds of drugs and by stimulation of the cranial trigeminal nerve, which often happens when you tweeze your eyebrows, according to a recent study. “If you tug on your eyebrows you’re irritating the hard wiring that’s responsible for causing the sneeze in the first place,” says Maitland. “You’ve inadvertently accessed that pathway.”

There’s also the “photic sneeze reflex” which causes anywhere from 18 percent to 35 percent of the world’s population to sneeze whenever they look at the sun or any bright light.

“We do not know exactly why this happens, but it might reflect a ‘crossing’ of pathways in the brain between the papillary light reflex arc and the sneezing reflex arc,” writes Murat Songu in the journal. “The reflex can be triggered only after the first exposure to light, never on repetitive stimulation.”

As with hiccups, some individuals have been overwhelmed with uncontrollable or “intractable sneezing,” such as the 13-year-old girl who, in 1957, sneezed steadily for over two months. Then there’s the teenage boy, written about in a 1994 case study, who sneezed continually for over a year. According to one study, most cases of intractable sneezing involve adolescents and are psychological in origin.

“It’s like people who have a tic with coughing,” says Maitland. “Some people have psychological disorders that are associated with intractable sneezing.”

Considering how satisfying a good sneeze can feel, it’s not too surprising the reflex has also been associated with sex. In 1972, researchers wrote about a 69-year-old man who complained of severe sneezing immediately following orgasm and a 2008 case study involved a middle-aged man with uncontrollable fits of sneezing that occurred along with sexual thoughts. Curious about the frequency with which this happened, researchers tapped into several online chat rooms and found “17 people of both sexes reporting sneezing immediately upon sexual ideation and three people after orgasm.”

“There are also some people who orgasm when they sneeze,” says Maitland. “These people feel really good” after a sneeze, says Maitland. “That’s just how they’re wired.”

Gesundheit, baby.