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The Power of Itch

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In the most recent issue of The New Yorker, Dr. Atul Gawande delves into the mystery of itch, that most curious of sensations that rides the boundary between pain and nuisance. Following the story of an anonymous chronic itch sufferer (referred to as "M."), Gawande explains how bad itch can get -- and a word of warning, it gets very bad! Gawande proceeds to examine itch throughout history -- a fascinating read. Here's a taste:

The internist prescribed a medicated cream, but it didn't help. The urge to scratch was unceasing and irresistible. "I would try to control it during the day, when I was aware of the itch, but it was really hard," M. said. "At night, it was the worst. I guess I would scratch when I was asleep, because in the morning there would be blood on my pillowcase." ...nothing the internist tried worked, and she began to suspect that the itch had nothing to do with M.'s skin.

... [M's] itching was so torturous, and the area so numb, that her scratching began to go through the skin. At a later office visit, her doctor found a silver-dollar-size patch of scalp where skin had been replaced by scab. M. tried bandaging her head, wearing caps to bed. But her fingernails would always find a way to her flesh, especially while she slept.

One morning, after she was awakened by her bedside alarm, she sat up and, she recalled, "this fluid came down my face, this greenish liquid." She pressed a square of gauze to her head and went to see her doctor again. M. showed the doctor the fluid on the dressing. The doctor looked closely at the wound. She shined a light on it and in M.'s eyes. Then she walked out of the room and called an ambulance. ...

Although M's story is grim, the article is a very thorough look at the phenomenon of itching, include a brief survey of itch in literature and philosophy, alongside scientific explorations of itching and scratching. Gawande's writing will certainly have you itching, imagining some stray annoyance on your scalp. Read the rest for a fascinating exploration of a sensation we all experience -- but which, for some people, is a terrible ordeal.

See also: NPR's All Things Considered piece with Gawande.

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Big Questions
What Is the Difference Between Generic and Name Brand Ibuprofen?
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What is the difference between generic ibuprofen vs. name brands?

Yali Friedman:

I just published a paper that answers this question: Are Generic Drugs Less Safe than their Branded Equivalents?

Here’s the tl;dr version:

Generic drugs are versions of drugs made by companies other than the company which originally developed the drug.

To gain FDA approval, a generic drug must:

  • Contain the same active ingredients as the innovator drug (inactive ingredients may vary)
  • Be identical in strength, dosage form, and route of administration
  • Have the same use indications
  • Be bioequivalent
  • Meet the same batch requirements for identity, strength, purity, and quality
  • Be manufactured under the same strict standards of FDA's good manufacturing practice regulations required for innovator products

I hope you found this answer useful. Feel free to reach out at www.thinkbiotech.com. For more on generic drugs, you can see our resources and whitepapers at Pharmaceutical strategic guidance and whitepapers

This post originally appeared on Quora. Click here to view.

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Health
8 Potential Signs of a Panic Attack
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It's not just fear or worry. In fact, many panic attacks don’t look like panic at all. Panic attacks come on rapidly, and often at times that don't seem to make sense. The symptoms of panic disorder vary from person to person and even from attack to attack for the same person. The problems listed below are not unique to panic attacks, but if you're experiencing more than one, it's a good idea to talk to your doctor either way.

1. YOU'RE DIZZY.

Doctors sometimes call the autonomic nervous system (ANS) the "automatic nervous system" because it regulates many vital bodily functions like pumping blood all on its own, without our having to think about it. Panic attacks often manifest through the ANS, leading to increased heart rate or decreased blood pressure, which can in turn lead to feeling lightheaded or faint.

2. YOU'RE LOSING YOURSELF.

Feeling detached from yourself is called depersonalization. Feeling detached from the world, or like it's fake or somehow unreal, is called derealization. Both forms of dissociation are unsettling but common signs that a panic attack has begun.

3. YOU'RE QUEASY.

Our digestive system is often the first body part to realize that something is wrong. Panic sends stress hormones and tension to the gut and disrupts digestion, causing nausea, upset stomach, or heartburn.

4. YOU FEEL NUMB OR TINGLY.

Panic attacks can manifest in truly surprising ways, including pins and needles or numbness in a person's hands or face.

5. YOU'RE SWEATY OR SHIVERING.

The symptoms of a panic attack can look a lot like the flu. But if you don't have a fever and no one else has chattering teeth, it might be your ANS in distress.

6. YOU KNOW THE WORST IS COMING.

While it may sound prophetic or at least bizarre, a sense of impending doom is a very common symptom of panic attacks (and several other conditions). 

7. BREATHING IS DIFFICULT.

The ANS strikes again. In addition to the well-known problems of hyperventilation or shortness of breath, panic attacks can also cause dyspnea, in which a person feels like they can't fill their lungs, and feelings of choking or being smothered.

8. YOU'RE AFRAID OF HAVING A PANIC ATTACK. 

Oddly enough, anxiety about anxiety is itself a symptom of anxiety and panic attacks. Fear of losing control or getting upset can cause people to avoid situations that could be triggering, which can in turn limit their lives. 

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