Get diagnosed…at the airport By Dr. Dave Hepburn

Dr. Dave Hepburn:

Being a Wisequack means making wisecracks at every opportunity where doing so fulfills some innate need in my soul to prevent me from ever truly maturing. I remain in the chrysalis phase of life and doubt I will ever really metamorphosize into the butterfly or a Sear sucker munching moth that I should be. Fellow Wisequack Rob Sealey is frankly, well…larval.

And so it was that traveling back from Phoenix, I couldn’t resist myself while standing in a full body scanner at airport security with my arms in the air looking like I got my shoulder joints stuck halfway though performing the crowd “wave” at my son’s hockey game.

I turned to the TSA security gal and winked “I feel like I need a smoke. Was it good for you?” But my wife thought that this was pretty lame repartee for me. “What you should have said dear” she suggested “is “Ummm listen, I was just swimming….”” “Babe, that’s a great line!! That’s absolutely hilari…wait a second!”  “…in the Arctic Ocean.”

Gone thru the full body scanner yet? The technique usually involves FM radio waves which, if tuned properly should be playing Barrys White and Manilow, given the intimate experience that awaits. For those who prefer not to go through these scanners, you can opt, as Sealey does, for a pat down. In fact, I heard him once ask for a cavity search believing he could get a cheap dental check up. Should have seen the size of his pupils after his check up, as “they checked up everything except my friggin’ teeth.”

But taking a good look inside our bodies is a huge part of everyday medicine and as technology reveals new technological technologies, diagnostic imaging has improved dramatically. One of the brightest new lights is the PET scan, more commonly known as  positron emission tomography.

Positron Emission Tomography - Dr. David Hepburn
Positron Emission Tomography – Dr. David Hepburn

Getting all the details from the pet shop boys, I am told that PET scans are extremely sensitive scans that allows doctors to see how organs function rather than simply looking at a fuzzy still image of them. It’s like the difference between snapping a still photo of, say a parliamentary debate or actually watching a 3D video of assorted vegetables, clothing accessories, pagers, pages being hurled across those esteemed seats of government. PET scans like to look at the metabolically active areas of our body that use a lot of energy ie. sugar that comes from our diet, our tissues and of course our lovely Snickers Bar organ.

Currently, PET scans are most commonly dealing with detecting and assessing treatment of cancer. When a cancer occurs in our body, the nasty cancer cells are very metabolically active as they multiply like an Osmond family in the spring.  Because those cells are so active, they suck up a lot of sugar, virtually stealing it from the rest of the body and literally starving out our pleasant normal cells.

This starvation is why the symptom of “unexplained weight loss” may be an indication that there is an active cancer. PET scans actually show us where there is this increased metabolic activity in our body. If it locates an area of high metabolic activity then there could well be a cancer present. If during cancer treatment, a PET scan shows no decrease in that metabolic activity, then that particular treatment regime may not be working so well.

Besides the cancer world, PET scans are also very useful in detecting heart problems (such as coronary artery disease and damage to the heart following a heart attack), brain disorders (including brain tumors, memory disorders, seizures) and other central nervous system disorders.

But a Pet peeve that many of us have is that while there is a Pet scanner in every hospital, clinic and Burger King in the US, it is rare to spot a stray pet anywhere in Canada. The only Pet scans in my city are when Tinkymuffin, the family Shih-tsu scans the kitchen table when you take a bathroom break. But should, one day, you decide to get a PET scan, or a body scan of any type… don’t go swimming first.


Ten ways to give yourself cancer – Dr. David Hepburn

A recent article I wrote recommending the top ten things you could do to acquire a heart attack generated a plethora of mail, and I do enjoy an occasional plethora. For example:

An interesting article, as in the Chinese curse “may your life be interesting.”” Wing Chow

Shing hoa chou bein mein wong shang sweet and sour.”  Sean McElgunn

We are upset that you have given the heart attack prime time as we think people would really prefer to know the best ways to get cancer.” Canadian Cancer Society

You are an idiot!” Rosemary Hepburn   “But you’re still my only son.”

Dr. David Hepburn
Dr. David Hepburn

And so, in order to give cancer equal time, here are my top ten recommended ways to get cancer. I include modifiable risks only as, though genetics plays a significant role in many cancers, it is a little awkward to go to the stork station and request a new set of parents because they usually say “Sorry Dave but this is the 62nd time you’ve asked us this month.” But as more than 30% of all cancers are self-induced, there is plenty you can do by yourself. Cancer is a growth industry, with 8 million deaths each year globally, projected to increase to 12 million by 2030.  If you don’t want miss out on the trend here’s what you can do.

  1. Tobacco: be it ingested by smoking, snorting, the attractive chewing or in an enema, be it 1st, 2nd or even 3rd hand, be it mild, moderate or severe, be it in a pipe, a puff, a paper or a pinch, tobacco is far and away your single best bet for getting a tumour or two or twenty.
  2. Alcohol: Fire back two drinks of alcohol or more per day. Alcohol not only boosts your serum boorish levels, but it can boost your chances for melanoma, stomach, breast, colorectal, liver, mouth and throat and oddly even lung cancer.
  3. HPV: This contagious virus is not only responsible for those sweet genital warts but HPV, particularly when combined with smoking really enhances your cancer chances. The combination of the two not only increases your likelihood of developing cervical cancer by a whopping 15 times, but also causes fatal squamous cell cancers of the head and neck. And if you don’t have a cervix and are currently lacking a head or neck, you can enhance your risk of getting liver and lymphoma cancers by getting the Hepatitis C or even B virus.
  4. Obesity: Yes, that is a lot of a lot of us. So crank that spare tire up to say a spare walrus and increase your chances of getting: breast, colon, kidney, uterine, esophageal and prostate cancers.
  5. Sedentariness: Couch potato-itis not only helps your walrus develop, but if you’re skinny and just can’t get fat, then being a happy slug might help you snag pancreatic, breast, colon or uterine cancers. Exercising not only scares away tumours but it gets your clothes sweaty.
  6. PAHs and HCAs: Do not ignore the effects of burnt barbequed beef giving us those crunchy carcinogenic PAH’s and HCAs. And while you’re sweating over the barbie, light up a cigar. Bulls Eye.
  7. Ditch the D: Indications are that colorectal and breast cancer may be associated with low Vitamin D levels. No more Vitamin Dave.
  8. Diabetes (primarily type 2): is associated with an increased risk of some cancers (liver, pancreas, endometrium, colon/rectum, breast, and bladder). Oddly diabetes is associated with a reduced risk of prostate cancer. Sweet!
  9. Quit vegetables:  Stop eating your vegetables and fruit and dig right into those saturated fats. Wrap your hotdog up with salami and bacon. Barbeque them until extra crispy for added potential.
  10. Expose yourself: Get a job that exposes you to difficult to spell chemicals or even radiation. Inhale copious amounts of asbestos, benzene, pesticides or solvents. This can be done alone or with the rest of the band.

And should all of that fail then try these: avoid your pap smears, load up on the sun, practice unsafe sex, demand X-rays and CT scans for every sniffle. And if you need more ideas, heck, I have a plethora.

Fourth Leading Cause of Death – Dr. David Hepburn.

I am fascinated by World War 2 history. I read the books, watch the documentaries and I have little green and grey soldiers set up all over my house and office, ready for battle whenever I am. The green sniper on my bedpost is aiming at the grey bazooka guy on my lingerie chest. A platoon of flame throwers and grenade launchers are having it out on the back of the toilet, sent there by the Sarge after $1.49 day at the burrito barn. My wife is not impressed.

January 1945

The Hague, Netherlands

Hunger Winter of ‘44-’45

William was a starving 10 year old boy in the Hague, in 1945. Canadian tanks were advancing on the Germans who blew up the bridge leading into the Hague stalling the Canadian advance. William and a pal were wandering down a gully when they came across this halted tank group and, seeing their predicament, lead them to an alternate route into the city. The grateful Canadians befriended this kid who was barely surviving on beets and tulip bulbs and gave him Wrigley’s gum, Sweet Caporal and MacDonald cigarettes. To this starving kid this was a welcome delicacy that soon would become a necessity and then a disaster.

Cigarettes-Dr. David Hepburn
Cigarettes-Dr. David Hepburn

“You Canadians got me hooked on those.” he rasped, taking several breaths just to finish that one sentence. “I was starving and I got Sweet Caps, and I loved them.” A half a century later William is sitting in my office. He doesn’t go to doctors. Don’t blame him. Seldom will doctors have good things for him like Snickers bars, Wrigley’s or tulips. He knows what doctors will want him to stop doing.

He struggles to finish a sentence. His lips purse and walking, talking, breathing and life are all now an effort. He has COPD,chronic obstructive pulmonary disease and his lungs have deteriorated to the point that he needs oxygen to survive. Problem is you can’t really have O2 if you smoke. Small side effect of tending to blow yourself up, and everyone around you. So he has the option. Quit smoking or you can’t have the oxygen. William chose to stick to his beloved Sweet Caps and forego the oxygen. He died soon after, a casualty of WW2, 60 years later.

The big three causes of death; stroke, cancer and heart attack are now the big four as COPD moves rapidly up this deadly list and, by 2020, is projected to surpass strokes as the third leading cause of death worldwide.

90% of those who suffer COPD are smokers. Throughout the years, COPD has been typically considered to be a “man’s” disease, primarily because it involved a lot of whining and sniveling. In the late 1960s, however, the Virginia Slims gang successfully targeted women with the “You’ve come a long way, baby,” campaigns resulting in a striking rise in smoking in adolescent girls that continues today. Because of the 30 year lag between smoking initiation and becoming a pulmonary cripple, women have now indeed come a long way and, in fact, have caught up. Every year since 2000, more women than men have died from COPD, baby!!

Lungs with COPD - David Hepburn
Lungs with COPD – Dr. David Hepburn

In addition to affecting a significant number of women, nearly one-half of the patients with COPD are under the age of 65 years. COPD is now a disease of old, young, men and women which includes just about everyone except perhaps Boy George.

So next time you go to light up your Sweet Cap, Marlboro or Death Styx remember my war story, speaking of which I see that my German flamethrower has just lit up the cat in the bathroom and Sarge is none too pleased.

Venom for medicine – Dr. David Frederick Hepburn

While New Mexicoing it recently in New Mexico I narrowly missed running over and squashing a monster sunning itself on the road, a Gila monster. Had I hit this loathsome leathery lizard and created this monster mash I could have once again destroyed one of the secrets that could save mankind. “Gila” pronounced “heela” as in healing, is a less than sexy reptile that, like the less than sexy Olson twins, eats only three meals a year.

Gila Monster - Dr. Hepburn
Gila Monster – Dr. Hepburn

I have some patients that eat three meals before breakfast. Most are now diabetic, a disease that is the product of how and how much we eat in this country. Yet Gila monsters not only don’t get diabetes but they don’t even get hungry. They have a chemical in their saliva, no doubt discovered by a lonely southwest lad with way too much time in the desert, called exenatide. Like insulin this chemical stimulates cells to take sugar out of the bloodstream but stops working when the sugar is normal! Thus it only works when it is actually needed, an advantage it gives diabetics who don’t want to have their blood sugar drop too low at the wrong time such as in the middle of the night or when dancing with Marie Osmond or her teeth.

As a result an exciting class of drugs called incretins have been spawned thanks to the lovely lizard of Laredo. It is known as exenatide, a much more palatable name than monster mucous, and is amongst the fastest expanding medications in waist expanding North America, diabetic capital of the expanding universe, which apparently, is expanding as it should. It is also an appetite suppressant and induces weight loss.

For those gumbooters who believe that only “natural” stuff can cure your lazy blood yeasts blahblahyawn, you can take rasta hair huggin’ joy in knowing that this medication is tantamount to swapping spit with a lizard. But hold your Gilas, lizard lovers. You are not to have all the glucose glory. Turns out that the skin of a South American frog secretes a compound that stimulates insulin release from the human pancreas with no side effects, unless warts bother you.

Now IT is about to be made into a medication, (Fernando flakes?). Soon it may benefit diabetics to camp out at the reptile and amphibian exhibit at the local zoo just to keep their sugars in check. Snuggle down at night with a monster and a frog (gotta kiss a few to find the guy formerly known as a prince anyway) and you could have normal blood sugars, a dream that only diabetics could appreciate.

Not to be outdone by his disgusting cousins, a scorpion named Sid decided to get in on the action. Finding that the diabetic field was getting crowded with do-gooder lizards and Amazonian frogs, Sid focused on brain tumours. He is no ordinary run of the mill, sleep in your slippers scorpion, he is the African Death Stalker (emit low evil cackle). What a cool friggin’ nickname. “Hey look out guys! Here comes Dave the African Death Stalker!” But Sid comes by his moniker honestly as his venom can kill a human or even Kim Il Jong.

His venom is remarkable as it has an affinity for the very nasty death stalking brain tumour known as a glioma. Injected directly into the brain the venom bypasses normal brain tissue and heads right to the tumour and with the help of a little radioactive package that the doctor has attached to it, kills the deadly glioma cells! Incredible! The cure for cancer possibly lies in the tail of a scorpion? Who knows? But wait there are even more venom cures.

Scorpion - Dr. Dave Hepburn
Scorpion – Dr. Dave Hepburn

There are fish loaded with pain killers, cone shells with anesthetics, ant juice that may lower blood pressure, tick stuff that may stuff heart disease and awkward looking toads that simply tickle our funny bone. Venom, designed by nature to kill us may in fact keep us alive. So scorpio/spidey/snake lovers, fill your boots. Just take a glance in them before you put them on.