The Body Odd : Melissa Dahl

Steroid abuse scars a young muscle man for life

fitlist — Tue, 26 Aug 2008 22:13:00 GMT

By Melissa Dahl

For one 21-year-old muscle man, the quest to build a perfect body ended in grotesque, lifelong scars.

Doctors were shocked when the young man came into their Dusseldorf clinic with one of the worst cases of acne conglobata any of them had ever seen: His chest and upper back were canvassed in craterlike ulcers and abscesses oozing with pus.

A 21-year-old amateur bodybuilder's steroid abuse left him with permanent scars. Courtesy of The Lancet

“He had these deep, ulcerating lesions with bloody crusts,” says Dr. Peter Arne Gerber, a dermatologist who treated the young man at Heinrich Heine University in Dusseldorf, Germany. Adding insult to injury, the poor young man’s sperm count had plummeted and his testicles were in a sad little shrunken state.

“For me, personally, it was the worst case that I had ever observed,” says Gerber, who wrote an article about the case study that appeared in a recent issue of the medical journal The Lancet.

He and his colleagues immediately suspected the young amateur body builder was abusing steroids, because acne is a typical reaction to rampant roid usage.

“Steroids increase the amount of sebum, or oil, production from the sebaceous gland, and acne is a bacteria that thrives on the sebum,” says Dr. Bruce Robinson, a Manhattan dermatologist who represents the American Academy of Dermatology.

Robinson describes the sebaceous gland’s normal oil offering as a light lunch for a few bacteria, but steroid users’ glands produce enough sebum to provide the bacteria with a lavish oily feast to which they invite all of their friends. “That results in this explosive steroid acne,” he explains.

It took a persistent amount of badgering, but the amateur bodybuilder finally admitted his doping habits: He’d been using two types of anabolic steroids twice a week for several months, and the high dosage and long-term usage kicked his bloody brand of acne up a notch.

Happily, his manhood issues – the tiny testicles and paltry sperm count – returned to normal after he quit using the steroids. But Gerber says the lesions, ulcers and abscesses that covered his unfortunate upper torso crept deep into the skin’s basal membrane, the cell layer that separates the outer skin from the deeper dermis. And when that happens, from acne or any kind of damage to the skin, scarring is inevitable.

Just one more reason to stay off the juice, kids.

Allergic to exercise?

fitlist — Wed, 16 Jul 2008 19:32:00 GMT

By Melissa Dahl

Does all that exertion on the elliptical machine make you nauseous? Have you ever been convinced that if you spend even one more minute on the treadmill, you will actually die? Maybe it’s not all in your head.

A few people are actually allergic to exercise, and in very rare cases, a sweaty workout could be enough to kill them.

Exercise-induced anaphylaxis is a fairly rare condition which can cause hives, fainting, vomiting and difficulty breathing during a workout, and the symptoms can last up to four hours after it. In some cases, it can be triggered by certain foods eaten before exercise, like peanuts, shellfish, eggs or even, in two reported cases, celery. But this isn't just your average food allergy, an expert explains.

"These are people who will not have this reaction unless they exercise right after eating this food," says Dr. Jacqueline Eghrari-Sabet, an allergist in private practice in Montgomery Village, Md., and a spokeswoman for the American Academy of Allergy, Asthma and Immunology. "Eating shellfish and sitting there? Nothing. But eating shellfish and exercising? For these people, it's bad news."

As you exercise and your heart rate speeds up, your blood starts whizzing through organs much faster, and therefore more frequently, than it normally does. With every trip your blood takes to your stomach, it's picking up more, say, celery bits. For those with exercise-induced anaphylaxis, the normal amount of celery antigens picked up by the blood isn't enough to bother them. But while exercising, the extra celery bits their blood is picking up causes an allergic reaction.

Running and jogging are the most likely to trigger an attack, but other strenuous activities like dancing, volleyball, skiing and even yard work can also cause a reaction.

Since the 1970s, only 1,000 cases of exercise-induced anaphylaxis have been documented – and among those cases, one death. Experts believe that’s because many people with this condition are able to recognize the symptoms quickly and keep it under control by waiting a couple hours after they eat to work out and bookending their workouts with a slow warm-up and cool-down.

"It'll usually happen when you're really exercising," says Eghrari-Sabet. "I don't think you're going to get it when you're bowling. But if you're doing cardio or a hip hop class, then, yes."

Others suffer from the less serious exercise allergy cholinergic urticaria, a common type of heat rash, which differs from anaphylaxis in that it starts and ends with the skin reaction – no nausea or difficulty breathing for these folks. Ten to 20 percent of the population will experience some form of it during their lives. Besides exercise, sun exposure, spicy foods or even getting too emotionally worked up can cause an itch attack.

The condition can strike spontaneously, so even if you’ve been exercising all your life with nary a rash, you can unexpectedly break out in hives. Even some marathon runners have suddenly come down with a bad case of the itches after jogging, explains Eghrari-Sabet. Women are most susceptible to the condition, and the average age for its first appearance is 16. (A handy way to get out of gym class?)

Unfortunately for people seeking an excuse not to break a sweat, most dermatologists and allergists send their patients with exercise-related allergies right back to the locker room.

“If they come to me, I’m not going to tell them not to exercise,” says Dr. Bruce Robinson, a Manhattan dermatologist. Instead he advises patients to pick a less strenuous regimen or a cooler place to work out.

Because the itchy sensation happens when body temperature suddenly rises, it can be eased by warming up and cooling down slowly, before and after every workout. Or try swimming for your normal cardio routine, which will keep the body temperature cool. If a food allergy is the culprit, don’t eat for a couple of hours before your workout.

Although serious side effects are rare, some experts believe, that exercise-induced anaphylaxis often goes undiagnosed. So if you start to feel itchy while working out, watch out. It’s probably best to avoid death by treadmill at all costs.

For more on exercise allergies and other workout quandries, read our Smart Fitness column.

Flipping their lids

fitlist — Thu, 07 Feb 2008 13:00:00 GMT

By Melissa Dahl, health writer

It’s a gross-out skill little brothers seem to be born with – a knack for turning their eyelids inside out, effectively freaking out all the ladies in their lives.

A fun, freaky trick, sure. But what if you couldn’t help flipping your lids? Some eyelids among us have minds of their own, flipping and flopping inside out whenever they please.

Those with a condition called floppy eyelid syndrome have lids that lack a normal amount of elastin, making the thin skin super stretchy. Grossing out their peers is totally out of their control – their eyelids can turn inside out spontaneously. In some cases, the upper lid can stretch all the way to the eyebrow, and both the upper and lower lids can be pulled forward as much as two centimeters. (Doesn’t seem like very much? Try seeing how far yours will go.)

And although it sounds weird enough to make a really freaky YouTube video, experts say the condition isn’t as rare as you might think.

“It’s actually very common – you probably have met somebody with it,” says Dr. Sean Blaydon, the president of the Austin Ophthalmological Society. Blaydon is also a plastic surgeon at Texas Oculoplastic Consultants in Austin, Texas, who says he regularly repairs wayward eyelids.

But many people don’t realize they have floppy eyelids. It’s most common in obese, middle-aged men, especially those who have obstructive sleep apnea. One clue you might have flippy lids is chronic pink eye, which your lids may pick up by flopping open on your pillow as you sleep. (Another clue is if your eyelid is touching your eyebrow as you read this.)

So, score one for Mom? Can your face really freeze that way? Not so much, says Blaydon. No amount of eyelid flipping can cause floppy eyelid syndrome.

As you were, lid flippers.

Can you flip your eyelids? Tell us!

Why Sean Paul’s tunes made one woman sick

BodyOdd — Tue, 22 Jan 2008 15:50:00 GMT

By Melissa Dahl, health writer

Does the very sound of a Fergie tune make you feel a bit ill? Maybe it’s not all in your head.

For Stacey Gayle, it was hip-hop artist Sean Paul who was making her sick – specifically his 2005 hit “Temperature.” Before the Jamaican rapper could promise to keep her warm, to shelter her from the storm, Paul had sent Gayle into a seizure.

When Gayle collapsed at a barbecue immediately after a Sean Paul song started playing, the 25-year-old started to put the pieces together. She brought her iPod to a medical center and played a Sean Paul song for her doctors – and suffered through three seizures shortly after.

Gayle was diagnosed with musicogenic epilepsy, a rare condition that sends its victims into seizures at the sound of certain musical cues. Surgeons removed a chunk of the right side of her brain, allowing Gayle to keep spinning Sean Paul on her iPod.

Paul appears to have been blessed with a particularly offending voice. Some singers are more likely than others to cause epileptic episodes, researchers have found. Those with a throaty voice and a lower range are most likely to send their listeners into epileptic fits. It’s not a particular note, pitch or rhythm that triggers the seizures – it’s in the way the singers’ larynx is incorrectly positioned while they warble.

Although the phenomenon isn’t common, Gayle’s not alone. One man couldn’t listen to romantic music, particularly tunes from Frank Sinatra, without having a seizure. And a 6-month-old girl’s seizures were sparked by loud rock music – especially songs by the Beatles.

Neurologist Macdonald Critchley published a lengthy report in 1937 about musicogenic epilepsy – or musicolepsia, as he preferred to call it. Based on his findings, Critchley wondered if the condition was actually more common than thought.

Critchley found that many people reported getting a creepy, even frightening, feeling once they heard certain songs – but the feeling was so disturbing that they would quickly cover their ears and switch the music off, neurologist Oliver Sacks writes in his book "Musicophilia." Critchley believed most people try to get away from the upsetting tunes before the strange feeling turns into something more serious, such as a seizure.

In other words – your instinct to shut the radio off before Fergie-Fergs can finish her first thought may be for your own good.