This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


On episode 15 of season 1, called Mob Rules, a mobster named Joey arrives at the hospital with a coma, from which he comes in and out to repeatedly. It turns out Joey has ornithine transcarbamylase deficiency, a disease causing him to not being able to digest red meat. On a side note the team also discover he has hepatitis C (an infection transferred either by needle sharing or homosexual activity) and that he has a high estrogen level in his blood, caused from a drug used to suppress libido. The last two facts lead house to the conclusion that he is also gay.

Danger level: High

What is it?

Ornithine transcarbamylase deficiency (OTD) is a rare genetic disorder causing a problem with eating protein.

Who gets it?

OTD is a rare condition – it affects about 1 in every 80,000 people. The condition is genetic, meaning it is passed on in families. It also usually happens to males, due to the mode it is inherited.

Usually the condition becomes apparent in the first few days of life. Sometimes, though (like in the House episode), the condition can manifest later in life.

What causes it?

We live and function thanks to millions of reactions that happen in our body each day. One of those reactions happen inside a cycle of reactions called the urea cycle.

The urea cycle. Drawing by Yikrazuul

The urea cycle is a sequence of reactions that happen in our liver cells. It processes excess nitrogen, which is generated when our body uses protein. In order to get rid of the excess nitrogen, the cycle turns it into urea, which the kidneys can get rid of in our urine.

Each of the steps in the cycle happens through the action of a special machine, called an enzyme. In OTD, one of those enzymes is damaged or missing. Since the body can’t get rid of the excess nitrogen, it is accumulated in the body, turning into a dangerous substance called ammonia.

Ammonia is dangerous for our nervous system and so the condition causes neurological problems. The excess can also damage the liver.

How does it feel?

The condition, as we mentioned above, usually becomes evident in the first days of life. The baby will be lacking energy, vomit, or refuse to eat. Its breathing rate and body temperature will be poorly controlled. Sometimes seizures can occur, and even a coma is possible.

In adults the symptoms aren’t very different. They can include loss of appetite, irritability, heavy or rapid breathing, weakness, vomiting, disorientation, sleepiness, and also coma and death. (Remember that the guy on the House episode had recurrent comas).

How is it discovered?

A blood test is done which shows that the person has too much ammonia in their blood. There’s also a test done on a urine sample that can give a clue to the condition.

Also, a genetic test can find out if the person has the defective gene (although it doesn’t work all the time).

How is it treated?

Since the body can’t handle large amounts of nitrogen (it can’t turn it into urea like it normally should), the treatment includes measures that lower the amount of nitrogen in the body.

This includes not eating lots of nitrogen (protein is very nitrogen-rich. That is why a low-protein diet is subscribed. Remember the mobster in the House episode couldn’t eat steaks?).

Treatment includes saying goodbye to steaks. Photo by FotoosVanRobin

Treatment also includes lots of food and water when a person is ill (since otherwise the body tends to break down its own protein at these times) and some medications that can lower the nitrogen in the body.

What happens after treatment?

The baby’s brain can be damaged from the disease (by the ammonia) if not treated on time. It’s important to catch the disease on time, and then to keep with the strict diet throughout life.

The bottom line – How do I avoid it?

As with other inherited diseases, you can’t really prevent it once the person is born with a defective gene. Parents that know they carry the defective gene and can transfer it to their children can use genetic testing to test if the developing embryo has the defective gene (a process called preimplantation genetic diagnosis).

Related posts:

1. Allergies: All You Wanted to Know (As Seen on House MD)
2. Echoviruses (As Seen on House MD)
3. Wilson Disease – The Return (As Seen on House MD)

Ask every pediatrician and they will tell you that vaccines do no harm. At least nothing but side effects, like every drug can. Ask Dr. Andrew Wakefield, and he will tell you otherwise. In 1998 Dr. Wakefield published a study which linked the vaccine for measles, mumps and rubella to autism. That study influenced millions of parents to refuse the shot for their children, in spite of doctors’ recommendations.

Now, according to MSNBC, Dr. Wakefield was banned from practicing medicine in his own country, Britain.

Abandonment of the vaccine has led, according to the article, to a resurgence of the disease in Western countries where it had been mostly stamped out. Even US celebrities such as Jim Carrey and Jenny McCarthy have endorsed Dr. Wakefield’s approach.

Photo by alvi2047

We have already covered a possible consequence of measles here on A Disease A Day (called subacute sclerosing panencephalitis).

Now, as mentioned above, the UK have decided to deal with the problem, starting with Wakefield himself, as “Britain’s General Medical Council, which licenses and oversees doctors, found Wakefield guilty of serious professional misconduct and stripped him of the right to practice medicine in the U.K.”.

On our end, all we can do is try and convince you, if you’re a parent, to give the vaccine to your child. We hope that the following links will help:

• MSNBC’s article – “Britain bans doctor who linked autism to vaccine”
• Study dispels link between autism and measles vaccine – The Washington Post
• Anti-measles campaign saves seven million lives – The Independent

Having read that – are you convinced of the benefit of the vaccine? Or have you never had any doubt? Let us know in the comments below.

Related posts:

1. China to Provide First Swine Flu Vaccines
2. Soda Fountain Machines Contain Fecal Bacteria
3. Subacute Sclerosing Panencephalitis (As Seen on House MD)

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


On episode 4 of season 1, called Maternity, Newborn babies in the hospital are becoming ill due to an epidemic. After an investigation, which includes giving them different antibiotics (used against bacteria), it turns out all babies were actually infected with a virus called echovirus 11. They got it through teddy bears in the hospital. The teddy bears were covered with the virus since the lady delivering them was carrying the virus herself.

Dr. House checking babies around the hospital to see if they’re sick. Photo by Fox Broadcasting Company. Credit: Darren Michaels/FOX.

Danger level: High

What is it?

Echoviruses are viruses that belong to a family of viruses called enteroviruses. There are 32 types of echoviruses, each having a number. The House episode dealt with type 11. Infection with it in the first 2 weeks of life can cause a severe disease which can lead to death.

Who gets it?

Several studies have shown that the enterovirus family of viruses accounts for more than 50% of visits to the ER by infants and young children during the spring and fall time.

Infections are more common among people from lower socioeconomic status, since overcrowded living conditions and poor hygiene can contribute to transfer of the virus.

These viruses are known to cause widespread outbreaks.

The infections are more common as age decreases – meaning they are more common in babies than in older children and adults.

What causes it?

People get infected with echoviruses by contact with other people. Usually they’re transferred by feces – meaning someone who was in touch with infected stools didn’t wash their hands very well and contacted another person. Sometimes it can be transferred from mouth secretions (as happened in the House episode, where the old lady’s secretions covered the teddy bears).

The virus can also be transmitted through contaminated water or food, and also through contaminated swimming pools.

These viruses can replicate in our mouth and nose. Most of them, though, are swallowed and reach out intestines, where they multiply. From there, they reach the blood, using it to get to organs in our body, such as the brain, liver, spleen, bone marrow, heart and lungs. In these organs they continue to multiply.

After about 4-6 days from the time the baby (or adult) was exposed, they reach the blood again. At this time symptoms start to show.

Echovirus 11. This is how the bugger looks like under a microscope.

How does it feel?

Echoviruses can cause a few things:

1. Fever – This is the most common symptom in young infants and children. The fever usually starts suddenly, and is often accompanied by irritability of the child.

2. Rash

3. Meningitis – This is an inflammation of the brain’s coverings. You can read about it in our article here.

4. Encephalitis – This is an even more serious condition than meningitis, since instead of the brain’s coverings being infected, the brain itself is inflamed.

5. Muscle and joint infections – It can cause muscle aches, which usually resolve after the infection.

6. Pleurodynia – This is a condition which causes attacks of pain in the lower chest. It’s also called Bornholm disease.

7. Myopericarditis – This is an inflammation of the heart’s muscle and its coverings. This is what killed the babies in the House episode.

How is it discovered?

The virus can be found in the blood or other infected organs in the body.

How is it treated?

In spite of what was shown on the House episode, there isn’t any specific treatment for the virus. There are studies being conducted on some new drugs, but none has been shown to work so far.

Many of the babies getting encephalitis die, although children and adults have a better outcome. Most of the people getting myopericarditis actually live and go on with their lives without any leftovers, in contrast to the House episode.

The best thing you can do is practice basic hygiene, such as hand washing, especially when in contact with sick people. Also disinfection of contaminated surfaces can help to stop the spread.

If you’re a pregnant woman close to giving birth you should avoid contact with people who are infected with an echovirus. If you are pregnant and get infected, delivery shouldn’t be hasted. On the contrary – waiting gives the fetus more time to get protection through your blood.

Related posts:

1. Subacute Sclerosing Panencephalitis (As Seen on House MD)
2. Rabies – All You Need To Know (As Seen on House MD)
3. Neurocysticercosis – The Worm That Attacks Your Brain (As Seen on House MD)

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


On episode 2 of season 1, also known as Paternity, Dan, a 16 year old gets hit in the head during a lacrosse game. He also has night terrors and double vision. After a few mis-diagnoses (including sexual abuse and multiple sclerosis) the team (or, rather, Dr. House) arrive at the correct diagnosis of subacute sclerosing panencephalitis.

Dr. House asking his team to run unethical DNA tests on episode 2 of season 1. Photo by Fox Broadcasting Company. Credit: Danny Feld/FOX.

Danger level: High

What is it?

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological disorder characterized by inflammation of the brain (encephalitis = brain inflammation). It’s associated with infection of the brain with the measles virus.

Who gets it?

SSPE is rare. Before the measles vaccine was used, in the 1960’s, it was more common (and even then pretty rare – 0.61 cases per million people). In the early 1990’s only 2-3 cases per year were discovered in the US.

SSPE usually happens when people are infected by the measles virus at an early age, before the age of 4, and mostly before age 2. It then affects the infected person 7-13 years after the infection.

SSPE is twice as common in males as it is in females. It also tends to happen less in people living in cities, and more in rural areas. It’s also more common in children of Hispanic origin.

What causes it?

Usually, an infection by the measles virus tends to subside and the virus goes away. In SSPE, there appears to be a persistent infection with a virus that had somehow changed. That virus stays inside the cells in the brain for several years. After 7-10 years it starts attacking the cells in the brain that previously protected it.

This causes an inflammation in the cells which eventually leads to their death.

The measles virus. In SSPE it destroys brain cells.

How does it feel?

The disease can appear anywhere between age 1 and 30, but is more common in children and adolescents, as it usually begins 7-13 years after the infection with the measles virus occurred.

The disease has 4 stages:

In stage 1 subtle changes in behavior or school performance appear – including irritability, reduced attention span, or temper outbursts. This stage may be missed since the symptoms are mild.

In stage 2, a phenomenon called myoclonus is observed (which was also seen in the House episode). This is a brief, involuntary twitch of a muscle or a group of muscles.

In stage 3 there are no more involuntary movements. Instead, other, more severe types of movement problems appear, including something called choreathetosis (dancing movements), immobility, rigidity of muscles. These result from the destruction of areas in the brain responsible for movement.

In this stage, the infected person’s consciousness also deteriorates and can lead to a coma.

In Stage 4 brain areas that control our breathing, heart rate and blood pressure are destroyed, leading to death.

How is it discovered?

If the clinical stages above are seen by a doctor this might give a clue to SSPE. Also, at least one of these findings has to exist in order to diagnose SSPE -

1. Detection of antibodies – Antibodies are molecules the body produces to fight infections. Once we are infected, they may be found in the blood. Here, we actually look for antibodies not in the blood but in the spinal fluid, which runs throughout our brain and spinal cord. This is done by taking a sample from the spine, usually by inserting a needle to the lower back.
2. Findings on EEG – EEG is a tracing of our brain’s electrical activity, much like an ECG can show the electrical activity in our heart. In SSPE, the EEG has a certain pattern that can be seen in stage 2 of the disease.
3. Brain biopsy – This used to be more common. A part of the brain was taken to examine it under the microscope and see if the virus is there. Today it’s no longer done routinely.

Example of an EEG. Photo by Der Lange.

How is it treated?

Usually no specific treatment can be offered to people with SSPE, in contrast to what was seen on the House episode. On that episode, treatment with a drug called interferon was given to the kid, which cured him. Studies made on such treatment showed that only about 30% of people treated with it improved.

What happens after treatment?

Most people, unless rarely cured by the treatment, die within 1-3 years.

SSPE can be prevented if the initial infection by the measles virus is prevented. This is done by taking the measles vaccine.

Related posts:

1. Echoviruses (As Seen on House MD)
2. Rabies – All You Need To Know (As Seen on House MD)
3. AIDS (acquired immunodeficiency syndrome) – All You Need To Know

Yesterday Grey’s Anatomy came back for another season, and so does this column, where we teach you about a disease featured on each episode. This time – tethered spinal cord syndrome.

Danger level: High

Health forums category: Children’s Diseases

What is it?

Tethered cord syndrome (TCS)  is a condition which limits the movement of the spinal cord within the spinal column.

Who gets it?

TCS is a rare disease – it happens in about 0.05-0.25 of 1000 births.

There is, however, a more common condition called spina bifida, which happens to 1-2 people out of 1000. About 20-50% of children born with spina bifida have TCS. Spina bifida, in case you’re wondering, is a condition in which the bones of the spine (the vertebrae) do not form properly during pregnancy.

What causes it?

To understand TCS, you have to know how our spine is built.

In our back there is a row of bones (vertebrae), which together form our spine. Inside these bones travels a cord, called the spinal cord. The spinal cord is responsible for sending messages from our brain (where it starts) to the rest of our body, and by this it controls movement and sensation in the body.

The lower tip of the spinal cord is called the conus medullaris. During development in the womb, the spinal cord moves up in the spine. In TCS, it stops in the middle of the way, so that the conus medullaris is lower in the spinal cord than it should be. In this case, it is tethered, and doesn’t float freely.

When a child that has tethering of his lower spinal cord starts growing, the spinal cord, which is still tethered, starts stretching. This can cause damage to the spine and interfere with the blood supply to it.

How does it feel?

There are several things which TCS can cause:

1. Back pain – It’s usually worsened by activity and relieved by rest.
2. Leg pain – Especially in the back of the legs.
3. Leg numbness or tingling
4. Changes in the strength of the legs
5. Difficulty riding a bicycle, playing sports and falling while running.
6. Muscle contractions
7. Tenderness along the spine
8. Scoliosis – This is a condition in which the spine grows crooked.
9. Problems with urinating

And others…

How is it discovered?

MRI – This is a technique in which an x-ray image of the spine is taken. This is the best way to detect TCS.

How is it treated?

TCS is usually treated with surgery, in which the cord is released so that it is no longer tethered.

This video shows the part in the surgery where the cord is released:

What happens after treatment?

With treatment, the problems should disappear.

Without surgery, though, the condition can get worse. As the child keeps growing and the spine keeps stretching, the blood vessels supplying it get damaged, and less blood is transferred to the cord. This can lead to further damage to the cord and deterioration of the condition.

As mentioned above, TCS often coexist with a condition called spina bifida. There are certain things you can do to lower your baby’s risk for having spina bifida, and by this lowering its risks for TCS:

1. Take folic acid during pregnancy. Foods rich in folic acid contain avocados, black beans, and asparagus. The best way to obtain it, though, is by taking a pill supplement. Consult your doctor for the recommended dosage.
2. If you take drugs to treat seizures or acne, you should consult your doctor before getting pregnant, as those can cause birth defects.
3. Avoid getting too hot in the first weeks of pregnancy (such as in a sauna, a very hot bath, or when you have high fever) – The heat may raise the risk for spina bifida.

Related posts:

1. Superior Canal Dehiscence Syndrome – Hearing Sounds Inside Your Own Body (As Seen on Grey’s Anatomy)
2. As Seen on Grey’s Anatomy – Normal Pressure Hydrocephalus (NPH)
3. The Most Popular Posts in September

Last week, 18-year-old South African athlete Caster Semenya won a gold medal in the 800 meters race at the 2009 World Championships in Athletics. Now she may be forced to return the medal if she fails a gender-verification test imposed by the International Association of Athletics Federations (IAAF). the IAAF are testing to see whether Semenya has a rare genetic disorder that means she has female genitalia but male chromosomes. This disorder is called hermaphroditism.

Caster Semenya.

Danger level: Low

What is it?

Our gender is determined, among other things, by our internal and external sex organs (Such as a penis or vagina on the outside, and a uterus on the inside). In some people, this distinction doesn’t fully exist – they may have both female and male sex organs.

Who gets it?

The numbers change from one study to another, but it is believed that between 0.1% and 0.2% of the population may be born with this condition.

What causes it?

We have 23 pairs of chromosomes in our DNA. These are molecules which hold our genetic material and tell our body how to develop and who we are going to become.

One of these pairs are the sex chromosomes. They are different between males and females. In males this pair is composed of an X chromosome and a Y chromosome. Females, on the other hand, have two X chromosomes.

When we develop in the uterus, our internal organs have the potential to become both male and female. Only at weeks 9-13 of pregnancy do we start developing into either males or females.

We usually develop into females by default unless we have the Y chromosome. This happens since there are certain genes on the Y chromosome which tell our body to develop testicles. Once testicles develop, they secrete a substance called testosterone (among other things), which helps us further develop into males, including a penis.

If we lack the Y chromosome, that gene is absent. In this case, instead of testicles, ovaries develop. Since there are no testicles to secrete testosterone, a female develops, including a uterus, fallopian tubes and vagina.

Some children are born differently, forming a group of disorders in which the above doesn’t necessarily happen:

• Female pseudohermaphroditism – In this case the sex chromosomes are XX and the female has ovaries, but also external male sex organs (penis).
• Male pseudohermaphroditism – They have XY as sex chromosomes, but their external organs are not fully developed or they are completely female on the outside.
• True hermaphroditism – While the above were “pseudohermaphroditism”, meaning they are mostly male or mostly female, in this case there are both testicles and ovaries. These people can appear anywhere from females with a large clitoris to those with male external organs.

We won’t go into details as to why this can happen, since it’s beyond the scope of this article. The reasons generally include problems with the development of testicles, problems with the creation of testosterone and other problems.

How is it discovered?

As you may understand, the condition is visible to the eye in most cases. The diagnosis contains checking the baby’s DNA to understand whether they are females or males by genetics and so understand what they were “supposed” to be.

Other measures include an ultrasound and other imaging techniques which will show which organs exist on the inside.

How is it treated?

Treating the condition involves surgical restoration and psychological support of the whole family. The direction the surgery will take (male or female) isn’t always an easy choice and can affect the child later on in life, as can be seen in this video from the show “without prejudice” (please note that we do not endorse the idea of a $25,000 prize given for people’s misfortunes, and the video is only given here as an example):

There is currently no known way to prevent the condition.

Related posts:

1. Turner Syndrome – The Missing X
2. Cystic Fibrosis – A Dangerous Inherited Disease Causing Thick Secretions
3. In the News – Hodgkin’s Disease

Danger level: Medium

What is it?

Asthma is a disease which affects the airways, causing attacks in which breathing is difficult.

Who gets it?

In the Unites States, about 5-10% of the population (or 22 million people) are affected by asthma (6 million of them are children).

Around the world, asthma is more common in industrialized countries, such as Canada, England, Australia, Germany, and New Zealand. 2-10% (300 million) of people worldwide have asthma.

Until puberty, asthma is more common in boys than girls (twice as much). From then on there is no difference. About 2/3 of all asthma cases are discovered before age 18.

The following are considered risk factors, meaning they increase your risk of having asthma:

1. A family history of asthma – Asthma is partly genetic, meaning that if someone in your family has it, your chances of getting it are higher.

2. Frequent infections in your airways as a child

3. Living in an urban area, especially one that contains a lot of air pollution

What causes it?

Asthma causes an inflammation in our airways – these are the “tubes” that lead from our mouth to our lungs. This causes 3 things:

1. Airway obstruction – Our airways are surrounded by muscle. Normally, this muscle is relaxed, so air can move freely to our lungs and back out. In asthma, these muscles tighten and also produce a liquid called mucus. Those things cause the airways to get obstructed, so air can’t move freely.

2. Inflammation – Besides the attacks which cause momentary blocks in the airways, there is also an ongoing inflammation, which can cause long term damage to the airways if not treated.

3. Airway irritability – The airways in asthma patients are very sensitive to things healthy people usually don’t react to, such as pollen or dust. These things can bring about asthma attacks, which involve obstruction of the airways.

This video gives a graphic illustration of the process:

The following things are known to trigger asthma attacks in people with the disease (they change among different people):

a. Airborne materials, such as pollen, animal dander, mold, cockroaches and dust mites

b. Respiratory infections – Such as the common cold

c. Exercise

d. Cold air

e. Smoke

f. Certain medications – Such as aspirin, beta blockers and others.

g. Strong emotions and stress

How does it feel?

Asthma attacks include the following things:

1. Shortness of breath

2. Coughing

3. Wheezing – This is a whistling sound characteristic of asthma patients. It’s heard when you take the air out.

4. Chest tightness or pain

The severity of the disease is different for different people. In some people attacks may appear only after exercise, while in others they may come a few times a day, making their lives miserable.

This video shows someone with an attack who unfortunately ran out of medications and was waiting for an ambulance. Notice the coughing and the whistling sounds when he takes out air. (And please don’t try this at home…)

How is it discovered?

If someone comes to the doctor when they are having an attack, it can be pretty simple (as you can see in the video above) to know that they have asthma.

Unfortunately, by the time someone arrives at the doctor’s, the attacks are often gone. Besides, other diseases can have similar symptoms. Therefore these tests were invented which can discover asthma:

1. Pulmonary function tests – These are special tests done to test the patient’s breathing pattern when they breath into a machine. The pattern in asthma patients is pretty characteristic.

2. Challenge tests – Certain substances, when inhaled by people with asthma, can trigger an attack. Using these substances (such as one called metacholine) helps in diagnosing asthma.

3. Chest X-ray – Can be used to rule out other conditions (such as pneumonia).

How is it treated?

There are a few things which can be done to treat asthma:

1. Avoiding triggers

2. Medications – There are short-term drugs and long-term drugs. The short-term ones are used to control attacks. The long-term drugs are used to control the inflammation in the airways, which prevents long-term damage to them.

We won’t go into much detail about the types of drugs available, but some examples of long-term drugs include corticosteroids, beta agonists, and others.
Short-term drugs are drugs that are usually inhaled, and that cause dilatation of the constricted airways, thereby making it easier to breath. These drugs are taken through special inhalers, such as the one in the picture:

An asthma inhaler. Photo by net_efekt.

What happens after treatment?

Except in very difficult cases, these drugs help to live a normal life with asthma.

Also, about 50% of children diagnosed with asthma are asthma-free after 10 years (in adults the disease doesn’t tend to go away as much).

The bottom line – How do I avoid it?

You can’t avoid asthma altogether, since, as mentioned above, the disease is probably genetic.

What you can do is decrease your risk of having attacks, by following these rules:

1. Stick to your medications

2. Identify your triggers and avoid them – One way of doing this is to keep a diary in which you write down factors you encountered before attacks (such as cold air, a virus, cigarette smoke, etc.). Then take measures to minimize your exposure to these things.

3. Treat allergies – Asthma attacks can also be triggered by any allergies you may have. You should avoid or minimize contact with the substance you are allergic to.
Also consider allergy shots (consult your doctor about those).

4. Get a flu vaccine – Every year. The flu almost always makes asthma much worse.

On a final note, we try to give you a personal angle about diseases we cover here. This time, you can get it by visiting The Angry Asthma Mama blog and The Asthma Mom.

Related posts:

1. Understanding Heart Attacks – Part 2 – Angina Pectoris
2. Cluster Headaches – Excruciating Attacks of Headaches
3. Understanding Heart Attacks – Part 3 – Myocardial Infarction

Danger level: Medium

What is it?

Labyrinthitis is an inflammation inside your ear, which can cause loss of balance and problems hearing.

Who gets it?

Labyrinthitis can be caused by a virus or bacteria. Usually, when it’s caused by a virus, it appears at ages 30-60 and is more rare in children. If bacteria are the cause, it usually appears in children younger than 2 years.

What causes it?

As explained in the article about vertigo, there are 3 systems responsible for giving us balance: The eyes, the joints and muscles, and the ears.

Our ears have 3 parts: The outer ear – which is what you see hanging one the side of people’s heads until our eardrum; the middle ear – is the part behind our eardrum, responsible for transmitting the sound; and the inner ear, which is responsible both for processing sound and for our balance.

The labyrinth is the part in our inner ear responsible for sound processing and balance.

The labyrinth – this structure is in charge of our balance.

In labyrinthitis, the labyrinth gets swollen and inflamed. Usually it’s caused by a viral infection, but bacteria can cause it as well. Often it comes after an upper respiratory infection (such as a cold or flu).

For a more detailed explanation (including a nice animation) you can watch this video:

How does it feel?

There are some things which appear in labyrinthitis:

1. Vertigo – In vertigo, you feel like the world is spinning around you. The vertigo starts suddenly, without a warning. Usually people with vertigo prefer to not move, and keep their eyes closed. Otherwise, they might feel nauseated and want to vomit.
2. Hearing loss – That loss usually goes away after the inflammation has passed.
3. Tinnitus – Tinnitus is the sound of ringing in your ears. It can be annoying, but it, too, passes after the inflammation subsides.

These symptoms tend to go away after a few days or weeks.

How is it discovered?

Usually, labyrinthitis is diagnosed by hearing your story and by a physical exam. The exam can include hearing tests, and an eye test to see if you have an uncontrollable flickering of the eyes, called nystagmus, which is common during labyrinthitis.

If the doctor suspects another cause for your vertigo, they may perform an MRI or CT scan to rule them out.

How is it treated?

In most cases, no treatment is needed, as labyrinthitis goes away on its own. If bacteria caused it, you may need to take antibiotics, but if the cause is viral, antibiotics will not help (since they don’t treat viruses, only bacteria).

While recovering, your doctor may give you drugs to help with the nausea and vomiting.

What happens after treatment?

In a few days to a few weeks, the symptoms are usually completely gone. Hearing loss may take more time to heal, though. If the cause is a virus, the hearing loss tends to go away, but with bacteria, some level of hearing loss may stay for good.

If you have an infection your airways (such as a cold) or an ear infection, treating them on time might prevent labyrinthitis from developing.

Related posts:

1. Meniere’s Disease – From Head Spinning To Hearing Loss
2. Head Spinning (Vertigo) – What Causes It?
3. Otitis Externa (Swimmer’s Ear) – Why You Should Never Use Q-Tips

Danger level: Medium

What is it?

Iron deficiency anemia is a type of anemia caused by a lack of iron in the body.

Who gets it?

Iron deficiency anemia is common. In the United States it affects about 1-2% of people.

There are groups of people more likely to have iron deficiency anemia:

1. Women – Women of childbearing age lose blood monthly in their period. This puts them at risk for iron deficiency anemia. Pregnancy also causes a higher demand for iron, which may bring about iron deficiency anemia.
2. Infants and children – Newborn infants have stores of iron which should last for their first months of life, after which a supplementation is recommended if they are breast fed, or iron-fortified formulas are recommended if they are formula fed. Children need extra iron during growth spurts (it’s important for muscle development).
3. Vegetarians – Our main source of iron is meat. Since vegetarians don’t eat meat, they are at greater risk of iron deficiency anemia. (The iron in grains and vegetables isn’t absorbed as well as the iron in meat).
4. People with decreased absorption of iron in the intestines – Such as people with celiac disease.

Unless you’re a hamster, eating only vegetables can bring about iron deficiency anemia. Photo by shhexycorin.

If you have iron deficiency anemia and you are not included in one of those groups, the cause may be a hidden source of bleeding within your body, such as a peptic ulcer, hemorrhoids, cancer or other causes.

What causes it?

Iron is needed by the body to make hemoglobin. As you can read in our anemia article, hemoglobin carries oxygen in our red blood cells to reach all parts of the body. When there’s not enough iron, hemoglobin cannot be formed, which leads to iron deficiency anemia.

How does it feel?

As with all cases of anemia, iron deficiency anemia causes you to feel weak and tired easily. You may look pale. If it is severe, you may feel short of breath. Other things which can appear are headaches and irritability.

Other, less common things which can occur in iron deficiency anemia include:

1. Pica – This is a phenomenon in which people eat things that aren’t considered food, such as clay, coal, soil, ice.
2. Spoon-shaped nails
3. Angular Chelitis – These are wounds in the corners of the mouth.
4. Glossitis – This is an inflammation of the tongue, which causes it to swell and change color.

And others…

How is it discovered?

There are blood tests which can discover if you have iron deficiency anemia:

1. Complete blood count (CBC) – It checks, among other things, the level of hemoglobin. It also allows the doctor to see the blood under a microscope, which gives clues to the cause of the anemia.
2. Blood tests to check your levels of iron

If the doctor suspects you have a bleeding somewhere in your body which causes the anemia, they may check your stool for blood or examine your digestive tracts to look for a cause.

How is it treated?

The treatment is simple: iron. It may be taken as a pill or given as an injection (in people who can’t absorb the iron properly due to a problem in their intestines, or those who have side effects when taking the pill).

What happens after treatment?

Most people begin to feel better after a few days of treatment. The treatment is needed for several months, though, to build up the iron in the body.

The bottom line – How do I avoid it?

You can avoid it by eating foods rich in iron, such as red meat, pork, seafood, poultry, eggs, iron fortified cereals/bread/pasta, beans, peas, dark green leafy vegetables (such as spinach), nuts and seeds, and dried fruit (like raisins and apricots). Iron coming from meat is absorbed better than the other types.

It’s also known that drinking citrus juice while eating iron containing foods helps with its absorption.

Related posts:

1. Anemia – All About It
2. Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency – When Certain Conditions Can Destroy Blood Cells
3. Ornithine Transcarbamylase Deficiency– What If You Couldn’t Eat Steaks? (As Seen on House MD)

Danger level: High

What is it?

Also called congenital analgia, congenital analgesia and congenital pain insensitivity, it is a rare condition in which a person can’t feel pain.

Who gets it?

This condition runs in families. Since the number of people with this is so small, no one knows for sure how it is inherited, so no one knows the chance of having a sick baby if you have the disease yourself.

Since the cause for the condition is in the genes, and since it is so rare, it is seen more in groups who marry amongst themselves (if someone carries a defective gene for a disease and has children with another carrier, the combination will give a new person with the defective genes from both parents). Examples for this are Gällivare, which is a Swedish village where about 40 people have the condition. It is also more common in Ashkenazi Jews.

What causes it?

Our body has receptors all over the body. They are nerves, which can feel all sorts of things. For example, they can sense the temperature and let us know if we are touching something cold or hot. They can sense where our body is in space. They can also sense pain.

When these receptors sense pain, they send a message to our brain so that it “knows” we are in pain. We will then stop the action which caused us pain and try to avoid it in the future.

The brain. This is the area that perceives pain. Photo by Washington Irving.

For reasons unknown, in congenital insensitivity to pain the connection between the nerves that sense pain and the brain’s recognition of pain is missing.

How does it feel?

While at first the inability to feel pain may sound like a gift, the opposite is true. When babies grow, they experiment with their surroundings. When they feel pain, they learn that something is bad for them and stop doing it.

Not these children. Examples for what these babies/kids do to themselves include biting themselves deeply, breaking bones without feeling they did, poking their eyes with their fingers, biting their own tongues.

In some cases, this condition also contains anhidrosis, which is the lack of sweating.

You can view a clip from the documentary “A Life Without Pain: A Documentary” about 3 children with the condition.

You can also read about one of the girls in the film in this article.

How is it discovered?

Usually the story is enough to understand that a child has insensitivity to pain.

How is it treated?

There is no cure. The emphasis in treatment is on the prevention of injuries to the child. It can be difficult in young children.

These children should avoid jumping from heights, and also avoid certain sports such as those involving kicking. It’s also important to take care of their skin and monitor it for injuries they may not notice.

The bottom line – How do I avoid it?

Since the condition is genetic, and the method of heredity for it isn’t known yet, there isn’t a way you can prevent it.

Related posts:

1. Congenital Insensitivity To Pain – From the Comments
2. Fibromyalgia – Chronic Pain and Fatigue
3. Chest Pain – Is It a Heart Attack?