PM Pediatrics
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Dr. Christina Johns
Senior Medical Advisor, PM Pediatrics

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A Few Medical Surprises: Volume II

I know I’ve said this before, but the human body does some unusual things. It’s all cool science and yet some of it is super weird and isn’t for the faint of heart. Every now and then I like to list out some of the more interesting elements because I just can’t bear to keep them to myself. So, with that, you’re welcome, and here we go:

Mosquito bites in weird places.

This really comes down to the physics of swelling in confined spaces, but mosquito bites in certain body parts can cause so much swelling that it can look like there’s a critical medical problem when in fact there is none.

For example, when you get a bite on the eyelid it can get so swollen that the eye area looks like it has either endured significant blunt force trauma or is suffering from a deep skin layer infection called periorbital cellulitis. People bring their kids often with concern that something may be seriously wrong with their child’s eye and it ends up being a just a reaction to a bite. I absolutely understand their worry and support the decision to get checked out.

illustration of a mosquito

How do I tell the difference between a bite reaction and something more serious?

A few key features. First, sometimes the bite is obvious- a red bump with a center pinpoint hole, called a punctum. In addition, if there’s no history of trauma or fever or extreme pain and the eyeball moves freely, then I’m feeling better that more sinister issues can be ruled out. But these can be extremely dramatic looking. And scary.

Another crazy bite reaction body part is the ear. The ear can get so red and swollen that it can look like what we call “cauliflower ear” , an emergency condition which is typically the result of trauma where the pinna of the ear (the external, outside part) fills with fluid and so the folds of the ear start to look like a cauliflower. Gross term. But accurate. The concerning component is that if the ear gets so swollen, it’s an enclosed space and the pressure can compromise blood flow and thus oxygen delivery to the ear itself, resulting in permanent damage to the ear cartilage. Drainage is then required to release the pressure so that blood flow can resume. Bites don’t usually cause this extreme condition, but they can get uncomfortably close.

Did you think I was going to add insect bites in the underwear region?

Notably, bug bites on the genitalia can be extremely uncomfortable, but interestingly they don’t often cause out of proportion strange reactions.

Bleeding like a crime scene, and from a minor cut.

There are certain places that have such a large blood supply network to the skin that if a cut happens there then it seems to bleed FOREVER. These places include (of course), the face and scalp, and fingertips most commonly. They require pressure for what seems like centuries in order for the bleeding to stop. Seems a bit like a design flaw, right— I mean probably 2 of the most inconvenient places for there to be incessant bleeding from a minor injury are your FACE, where your eyes are located so you can SEE, and your fingers, which you use to GET STUFF.

But there’s a reason for all that blood flow: important body tissues need lots of oxygen to work at peak capacity, hence the need for the increased blood flow to transport it. Mostly it means that longer periods of pressure are required to get the bleeding to stop, but it can really test your patience.

illustration of a band aid

You can’t breathe and swallow at the same time.

The airway is an awesome place, obviously vital for life, and as such its protective reflexes are pretty incredible. The esophagus (swallowing tube) and airway (larynx) are located in close proximity, which can be (and sometimes is) a setup for a choking disaster. But our airways are better than that, friends. The body is set up such that you don’t inhale while you swallow, because if you did that then half of your mouthful would go into your lungs, which is not good.

Foreign bodies of any sort in the lungs can cause respiratory distress, pneumonia, and even death. In my opinion it’s pretty swell that the body pretty much avoids this situation completely by maneuvers such as no simultaneous breathing and swallowing. Of course the system isn’t perfect because people do in fact choke and inhale things into their lungs, but considering all the breathing that’s going on it doesn’t happen often, thankfully.

illustration of throat anatomy

Stomach growls are called borborygmus.

That is all. I just like that word.

 

If you’re wondering how the spirit moved me to write about this, well- it’s the start of summer and in acute care medicine we always see an uptick (get it) of insect bites and stings, and more cuts and injuries too, so it got me thinking about the aspects that surprise my patients when one of these situations happens to them. I figure if I share them with you now, maybe you’ll be a little less alarmed should something similar happen to you or your child. On the other hand, you could also not be concluding that I think about some very weird stuff. I guess I’ll have to take my chances.

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