Seriously?!

While doing a stint as an annual physical examination doctor at a local call center, I came across several conversations that amused me and not just because they were coming from educated people who answered my questions in fluent English, but that they all said it with straight faces.

Me: Any other medical concerns these days?

A: Sometimes, doc, I get these throbbing pains in my low back area. Maybe it's just "panuhot" because I sleep with the fan and the air conditioning on, and for most of the night, my back is exposed to it. So maybe that's it, siguro.

First, I really don't know what "panuhot" is anymore. I used to think they were muscle trigger points in myofascial pain syndromes. I used to think of it as twisted muscle fibers and micro-tears healing in really funny ways causing knots and felt as such in the broad sheets of back muscle. Now, people use it for anything they feel -- stomach pains, chest tightness, difficulty urinating, and a host of other bodily aches.

Second, I really don't know how an electrical appliance can cause anything. They get blamed for so many things -- fires, lost files, not working properly -- that they really shouldn't get an even worse rap for causing back pains. Except for maybe some bloatedness, I'd hate for appliances to be agents of disease because these past few days of summer have been really really hot, and most people are going to be in front of those fans and AC's for the most part of their days.

Most often those bodily aches and pains are probably muscle spasms or knots of muscle healing from microtears which heat, stretching, and proper body mechanics can't cure.A pain reliever or two won't hurt either.

Me: Do you have asthma?

A: No, doc. Well, I did when I was small, but my mother just had me play basketball and I was cured.

If basketball was a cure for asthma, I'd prescribe it 3x a day to cure asthmatics everywhere! But seriously, if I had to write down the pathophysiology of asthma and how modern medicine helps its exacerbations, this just wouldn't be a fun blog anymore. Exercise can trigger asthma. That's precisely why asthmatic athletes take their inhalers with them.

But I do know that people who exercise develop a certain, for the lack of a better word, tolerance to asthma attacks. It does this by increasing oxygen, thereby, decreasing the body's absolute need for it in times of exacerbations and what other theorists have put out there, but this does not address the airway hyperresponsiveness and inflammation that are the fundamental abnormalities in asthma.

The basic problem is, people labeling an assortment of things as hubak or asthma. Coughing = asthma. Difficulty of breathing = asthma. If you go up a flight of stairs and you are still trying to catch your breath, bouts of coughing and simply because your diaphragm is getting pushed by your full stomach after a good hearty meal is not asthma.

Me: Do you have asthma?

A: Well, I was admitted a year ago doc for pneumonia.

It doesn't really answer my question.

Asthma is not pneumonia. The former is a condition characterized by inflammation and airway hyperresponsiveness while the latter is an infection of the lung parenchyma.

Yes, it's my job to educate people so I did, and I do.

Me: Sir, after three blood pressure measurements, by definition you are hypertensive. You should cut down on your salt intake, modify your diet and change your lifestyle.

A: So I can't eat pork anymore doc?

What I usually say is that I'm a very lenient doctor and you can still eat pork, but not with too much salt or seasoning. For those of us who eat pork on a near daily basis, we pretty much know it's delicious. So I say, everything in moderation.

First, hypertension and cardiovascular disease have so much more going on than Kim Kardashian and Kanye West combined. There is salt, salt-retention, sympathetic overactivity, renal considerations, heart considerations, allowances for end-organ damage, and whatnot, that to worry about it all would be a sin to life. But let's take one small step by reducing the salt intake since it has a big role in elevated BP.

People say that eating red meat increases mortality. I say "to live is to incur the risk."

Cut down the salt, get exercise, cut down on fat, and if it doesn't help, take your medications without fail.

Me: Any other medical problems?

A: I used to have these skin allergies and wounds doc, on my hands when I was young, but it went away because, (in a hushed tone) I don't know if you believe in it doc, but my mother used the urine of a lizard with wings (tiki nga naay pako) and it just went away.

Me: ???

I just sat there with my puzzled face on.

The work, we new-generation doctors have to do is a long, long road.